Home, Sweet Home

More and more older Main Liners are choosing to age in place.

Rosemont’s Sara Pilling will never forget the helplessness she felt while watching her father’s life slip away in a Main Line nursing home. “My dad had dementia, and I spent 12 years dealing with the nursing home,” Pilling recalls. “I could not do to my children what my father inadvertently did to me.”

For Pilling, the issue wasn’t just the high fees. It was about accountability. “If you don’t have a personal advocate pushing for you every day—asking, “Why is Dad in bed all day? Why haven’t his clothes been changed?”—nothing gets done. They simply don’t pay nursing home employees enough to do more than the minimum,” she says.

In 2006, when Pilling turned 68, she needed a knee replacement. That’s when she decided to ensure her own long-term independence.

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“I became a member of Friends Life Care at Home. I think it’s a terrific deal,” says Pilling, who investigated other long-term care insurance options before committing to the Blue Bell-based Quaker home healthcare service. “I’d like to leave some money for my children, and I also want to take responsibility for myself. I don’t want to depend on someone else to take care of me without having an advocate.”

Pilling’s choice to age in place is part of a growing national trend. AARP studies show that 85 percent of retirees want to remain in their own homes as long as possible. “In retirement communities, the residents are the same age, and there’s only one way to go—down!” quips Pilling. “I’m convinced that for someone who wants to stay in their own home and be in control, Friends Life Care at Home is the answer. ”

Pilling is a realist. She knows that someday she may not be able to remain in her home, even with round-the-clock aides. “When that time comes, my advocate at Friends Life Care at Home will help me make the best decision,” says Pilling. “I’ll be able to choose the nursing facility I want, anywhere in the country. Then she’ll discuss the matter with my children. They won’t be the decision makers; I will.”

Carol Barbour, president of Friends Life Care at Home, views the Quaker agency as a retirement village without walls. “The dramatic difference between us and long-term care insurance is that we are the people you actually turn to to provide the care. If you don’t like the home health workers we send, we’ll send someone else. Our goal is to maintain your health and prevent a need for higher-level services.”

Barbour is excited about the new VIP (Vitality Improvement Pathways) program launching this fall. “We are focusing on helping people make healthy, long-term changes, including stress management, exercise, sleep patterns and nutrition. Individuals participating in the program will have a personal coach to keep them on track.”

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According to studies, less than 8 percent of people over 50 can kick an unhealthy habit without help. “A lot of major diseases can be avoided through educational sessions, personal coaching and ongoing support,” says Barbour.

Friends Life Care at Home has almost 1,800 members in the Philadelphia area. It’s a nondenominational organization, so you don’t have to be Quaker to join. The minimum age for enrollment is 40; the maximum is 81. “Fifty percent of new members are between 40 and 65,” says Barbour. “People need to be in good health at the time of enrollment.”

The desire to maintain control of one’s healthcare and money is a given in our society. And yet, how many times do we hear of octogenarian millionaires who are financially and emotionally abused by greedy heirs? More importantly, when Grandpop is diagnosed with dementia, how often is his hard-earned money spent down without his consent by adult children who seem all too eager to move him into a nursing home?

That’s just what happened to a former Main Line resident we’ll call Ruth. “I loved my daughter, but I knew she’d throw me into a nursing home the first chance she got,” Ruth admits. “So after my husband died, when I moved into assisted living, I put my younger brother in charge of my finances. I gave him complete control.”

Ruth’s devoted sibling promised her she’d never go to a nursing home, even if she outlived her estate. Then he died unexpectedly. “My daughter called me up one day and said, ‘Uncle Teddy is dead.’ When I asked if he’d provided for me in his will, she said, ‘No. You’ll have to move into a nursing home.’ I was in shock. But what could I do?”

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Six months later, at 88, Ruth reluctantly moved out of the lovely 60-resident assisted living facility where she’d had her own apartment, and into a 320-bed nursing home in Northeast Philadelphia with all the warmth of a warehouse. Accustomed to getting a wash and blow-dry every week at Jean Madeline Salon in Wynnewood, she didn’t know what to make of the dazed, unkempt nursing home residents.

“There’s no medical reason for me to be here; I don’t need clinical care, only some help with bathing and dressing. I have degenerative osteoarthritis,” Ruth explains.

In Pennsylvania, Medicaid doesn’t pay for assisted living, only nursing care. The sooner adult children spend down their aged parent’s estate, the more money they stand to inherit—and the less the state takes—a fact not lost on Ruth’s daughter. The system is fine and dandy only if you have compassionate, loving children and an eldercare lawyer ready to quash any tampering with your assets.

Ruth’s decision to choose a family member over an eldercare professional is a common mistake, especially among members of her generation. But baby boomers are less likely to put their entire future—and fortune—in the hands of a sibling, spouse or child. “We recently surveyed Montgomery County residents, and the No. 1 issue is remaining independent in their own homes, where they can maintain a sense of control and independence,” says Joanne Kline, executive director of Montgomery County Aging & Adult Services (MCAAS).

MCAAS provides emergency response systems, meals and safety checks, along with a program that matches volunteers to seniors who want to receive daily phone calls. “Montgomery County has the oldest median age in the six-county region, and it’s increasing,” Kline says. “Our plan is to help people remain at home with the right support, with dignity, choice and independence.”

Jewish Family and Children’s Service of Greater Philadelphia (JFCS) offers geriatric care management from its City Avenue office. Programs include respite services for caregivers, transportation for shopping, emergency alarm systems, Meals on Wheels, and home visits.

“Our Senior Horizons Program helps arrange for evaluation, assessment and ongoing geriatric care management,” says JFCS assistant director of senior services Kathleen Lavanchy. “No one has to fumble with these tough decisions on their own. We want our seniors to age in place and to stay in their own community as long as possible.”

ElderNet of Lower Merion and Narberth provides free services for older adults, including friendly visitors, yard work, telephone reassurance, emergency financial aid, help with aging issues, and transportation to doctors, banks and markets. For any resident of Lower Merion Township or Narberth who is 55 and older, and lives alone or has major health issues, ElderNet’s free Lock for Life program will arrange for township police to install a lockbox that stores house keys near the entrance to the home. The access code is available to police, fire and EMS personnel, and used only if responders can’t gain entry without using force.

For more information on a variety of related topics, ElderNet’s free publication, A Guide to Personal Care Homes and Assisted Living Facilities, is an invaluable guide to some of life’s toughest decisions.

“We are the community’s one-stop referral service for seniors,” says ElderNet executive director Ruth Sperber.

Support Services for Seniors

The CARE Program at Lankenau Hospital provides “Caring Assistance and Referral for the Elderly,” including assessments, care plans, educational modules on healthcare insurance and end-of-life planning, and services in the home. Fees are based on income for adults 60 and older. (610) 645-8554.

ElderNet of Lower Merion and Narberth provides free practical services for older and disadvantaged neighbors in the community. (610) 525-0706, eldernetonline.org.

Friends Life Care at Home is a nondenominational, nonprofit Quaker long-term home health plan for individuals who wish to remain in their homes as long as possible. (215) 628-8964.

Jewish Family and Children’s Service is a nondenominational, nonprofit social service agency specializing in services to assist seniors in their homes. Its private-fee Senior Horizons Program provides home health aides and other services to help seniors maintain their independence. (267) 256-2023, jfcsphil.org.

ElderNet’s Lock for Life is a free emergency lockbox service provided to seniors in Lower Merion Township and Narberth who live alone or have major health issues. (610) 525-0706, eldernetonline.org.

Montgomery County Aging and Adult Services provides a wide array of services to help seniors remain in their own homes, including Meals on Wheels, emergency response systems, caregiver support, adult daycare, transportation, ombudsmen and advocacy programs. (610) 278-3601, mcaas.montcopa.org.

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