How to Have Conversations about Aging in Place.
If you have a parent who wants to stay in their home but you have concerns about their safety, what do you? What are the warning signs and how do you have these conversations?
In this interview sponsored by Harmar, Kim Barnes of Parenting Aging Parents is joined by Alison Starkey, Physical Therapist and CEO of Gaitway of Charlotte. They discuss strategies for ensuring the safety and comfort of aging parents who wish to remain at home. Alison highlights the importance of early planning for home modifications, identifying warning signs that necessitate safety measures, and offers practical suggestions such as grab bars, stair lifts, and home elevators.
They also talk about proactive renovations that balance functionality with aesthetics, compare the costs and benefits of home modifications versus nursing home care, and provide insights on how to approach these sensitive conversations with your aging loved ones.
00:00 Introduction to Home Safety for Aging Parents
00:31 Identifying Warning Signs and Early Planning
01:22 Physical Therapy and Balance Issues
03:12 Home Modifications and Safety Measures
05:24 Discussing Major Home Renovations
06:23 Modern Stairlifts: Space-Saving Solutions
06:39 Elevators: A Long-Term Investment
07:53 Cost Comparison: Home Modifications vs. Nursing Homes
08:59 Proactive Planning for Aging in Place
10:13 Aesthetic and Functional Bathroom Renovations
11:38 Final Thoughts
Read the full transcript
Transcript of Interview: “Getting Aging Parents to Make Home Safer”
Kim Barnes: If you have a parent who wants to stay at home and you’re wondering, how do you have conversations and how do you make sure that they’re safe? Today, we’re bringing in Alison Starkey, who is a physical therapist and the CEO of Gateway of Charlotte to have this conversation with us. Thanks so much for being with us, Alison.
Alison Starkey, PT: Kim, thanks so much for the invitation. It’s a real pleasure to be here.
Kim Barnes: For many of us, we have parents that want to stay at home. They’re adamant about wanting to stay at home, but we might not feel that they’re Maybe 100 percent safe. What are the things that we should be looking for as warning signs of things that maybe we need to make adjustments to the home to make them safer?
Alison Starkey, PT: So my message today is really that you want to start planning for any home renovations. Way before you see any signs for the need. What we like to do at Gateway is really educate adult children of older adults. Um, and if you have a parent that is really committed to [00:01:00] staying at home in the cold light of day, it’s much easier to have a conversation with them about, you know, you were thinking about renovating your bathroom.
Maybe we should look at doing that now and maybe incorporate some things that would make it safer for you if you end up having difficulty walking around. I think that’s a much easier conversation, um, starting when you don’t need it. If you’re looking for signs of, you know, when you have a parent that, you know, really might be starting to be a fall risk, there’s a couple of things you can do.
Number one, you can request from the patient or your parents doctor. Um, to get a physical therapist involved and you can go see any physical therapist as an outpatient and they’ll do routine testing that will really determine if your Parent a is at risk of falling and b what they can do about it But the other things that you can see is like sometimes getting up from a lower chair or a couch that it takes them a little Longer that they have to kind of lean forward Far to stand up [00:02:00] and then also just You Watching them move.
Sometimes you’ll see a senior, they’re kind of holding on to the wall as they go past, like in a hallway, you and I would just, you know, we wouldn’t be holding on to anything we would just walk, but a senior tends to kind of hold on to the back of the sofa, transfer the other hand to holding the back of a chair.
Same in the kitchen, they kind of follow the counter around, but they always have a hand on something. And that’s a very good sign that it’s time to take action.
Kim Barnes: And that would be along with potentially looking for some of those things that we know are the obvious fall risk, right? Like if you have a lot of rugs or if the lighting is not very good.
So those are, would I guess be things that you can just be kind of observing that are potential problems, but also what you’re talking about is more, how are they moving around and what could that lead to?
Alison Starkey, PT: Yes. So if someone is holding on what we describe as cruising furniture, um, just holding off from one part to the other, then, you know, we know that they’re not confident in their balance.
And that’s a, that’s absolutely consistently going to be a balance issue. And, but, you know, a physical therapist will be able to diagnose that for you. And the good news is physical therapy really helps you balance. So,
Kim Barnes: so when we’re thinking about home modifications, it could be, how do you determine what sort of modifications we might need?
You know, we think of the obvious sort of grab bars, maybe in the shower or in the bathroom. What are some other modifications that could be really useful?
Alison Starkey, PT: So what’s really important is to kind of look at the situation and look at both parents. See if there’s any like comorbidities, like does someone have Parkinson’s?
Does someone, someone at risk for a stroke? Does someone have poor circulation? And then, you know, we need to sit down with them and have a conversation with them and say, listen, you know, I want you to be able to do what you want to do, which is to age in place. But in order for us to do that, we’re going to have to make some changes.
Um, I always [00:04:00] try to have adult children approach the situation with their parents. encouraging their parents to think about the impact on yourself. So for instance, if I was talking to my mother, I’d say, I’m really concerned because if you have a fall with all that’s going on with the kids and the rest of the family, I don’t know how I’m going to be able to stay working and be able to help you out.
So I want us to come up with a plan that’s going to keep you safe at home.
Kim Barnes: Well, and certainly the fact of that, we know. A fall often leads to just a decline in health. And so we, you know, if we’re trying to also, I guess, come from the perspective of that, I want you to be safe because I don’t want anything to happen to you and I don’t want you to be in the hospital or break a hip or, or that kind of thing.
Alison Starkey, PT: Well, you know, a third of all people that fall over don’t survive the fall. Falls are deadly. You know, you can either bang your head and have a head injury. If you crack your pelvis, you can lay on the floor and die, you [00:05:00] know, and die from bleeding out. So falls are really, really important things that we try to avoid.
And every PT in the business is, that’s our biggest focus when it comes to seniors.
Kim Barnes: So I could see where even in our family that if I try to, if I suggest things like a grab bar or some of the obvious, pretty simple, uh, modifications that, that probably would be, you know, fine. I think if I started talking about, you know, a stair lift would really be helpful because that way you could get, you know, from the, you can use all of your house.
You don’t have to try to figure out, How to either add a bedroom downstairs, because maybe there’s not a bedroom downstairs, you know, how do you, you know, a, a, a stair lift could be a great option to be able to help you do that. That or a bathroom remodel, maybe that they weren’t already planning. How do you have those conversations when it’s something that is a little bit of a bigger project?
Alison Starkey, PT: So again, I think you, you put it back on them. And so you, you’ve told us that you really [00:06:00] want to stay at home, but with your master bedroom and bathroom upside down, We need to have a conversation about that because what if there comes a time where you really can’t go up and down the stairs safely and you know the last thing we want you to do is fall down the stairs.
Um, there are many solutions you know you mentioned a stair lift. Stairlifts are great. You know, they’ve come an awful long way in the last 10 years. It used to be that stairless would take up, you know, half of the staircase itself. So if you had an able body person in the, in the house, they’d have to kind of creep around the stairlift to get upstairs, but now they snug up to the wall and they’re out of the way.
So it leaves the staircase open. You know, we’re seeing, um, in our particular practice, we also recommend a lot of elevators and people. You know, kind of look at me quizzically and say, well, gosh, I can’t afford an elevator. Um, but the thing about an elevator is if you are in a wheelchair and you want to go upstairs, it’s quite challenging to, to continue to use a, [00:07:00] um, stair lift, especially if you don’t, if you’re not able to sit securely, you have to be able to sit securely to use a stair lift.
And the great thing about an elevator, it not only adds value to your house, but you can use it as long as you need. You know, to be able to go upstairs because you can use a wheelchair in there. Um, so for someone that’s really committed and we’re looking at a longer timeline and no way that they’re ever gonna, you know, entertain being placed.
Sometimes an elevator is a great solution.
Kim Barnes: Hmm. Okay. Yeah, that not something that people I think something that is becoming more accessible where it’s not as it’s still a big project, but it’s not as big of a project as maybe it might have been maybe even five or 10 years ago.
Alison Starkey, PT: Absolutely.
Kim Barnes: Yeah.
Alison Starkey, PT: And there, there are now elevators that you can get that don’t require a shaft that are very user friendly.
And not out of control expensive. Um, and I think the cost of these renovations is a little scary to some people, but you also have to compare it to [00:08:00] if your parent does have a fall, and they end up in a nursing home, you know, the cost of a nursing home as opposed to being able to stay at home and enjoy that time at home.
Even with the cost of care at home, there’s that intangible that most adults have, which is, I just want to stay in my own house.
Kim Barnes: Right. So playing off the comparison of, you know, bathroom renovation or a stair lift or other modifications or an elevator, you know, what is the cost of that compared to the potentially really high cost of having to be in a nursing home or something like that, where you’re going to need a lot of care.
Alison Starkey, PT: Yeah, I think it’s important to compare those numbers because everyone, you know, I mean, I think those numbers are shocking to the average Joe, um, but you really do need to compare them to, um, you know, the cost of nursing homes in your area.
Kim Barnes: The cost of those can be quite shocking as well, right?
Absolutely. Adding those up. So I [00:09:00] think the message here is really trying to be more proactive than reactive because I think a lot of times people, there is a fall or there is. something that happens that makes you think, Oh, there’s a problem. And maybe we already, mom already has a broken hip. And now we’re looking at renovations or, or updates versus trying to do it to prevent the fall.
Yes.
Alison Starkey, PT: Yeah, that’s absolutely the case. So, you know, being proactive on the front end is really the way that you want to go. Now, if you find yourself in a situation where you feel like you’ve been talking about this for five years and your parents have just kind of declined the conversation, and then somebody does have an injury, a big injury with a fall, you know, it means that you just have to kind of get things going as soon as possible so they can come home.
Mm
Kim Barnes: hmm. And any last words of wisdom just as far as I guess part of what I’ve learned so much leading this community is, is you have to figure out [00:10:00] what’s going to appeal to your parents, whether it’s It would be a gift to me. I want to protect you. It’s going to be better for dad. You know, I think it’s, it’s really just figuring out what that, what might appeal to them.
Yeah.
Alison Starkey, PT: Yes. And I think that one of the, one of the fears when people hear about bathroom renovations, that they’re worried that their new bathroom is going to look like a hospital, that it’s going to be sort of stainless steel bars and, you know, and it just kind of look ugly. Um, the fact of the matter is, is that there are beautiful fittings available and, um, You know, you can incorporate fittings that are beautiful, but also functional to the point where if you walked into a bathroom with the right kinds of fittings, um, you would have no idea that something was functioning as a grab bar.
You would just assume it was a fancy shower. So I think also making the renovations very aesthetically pleasing and kind of fitting in Um, yeah, I mean, if I was doing my bathroom, I’d want it to look nice. [00:11:00] I’d want everything matchy matchy and not to look like a hospital. So that’s the other thing that we really try to educate the public about.
If you go to the big box stores, that there are plenty of options, um, that, You know, they might be special order, but certainly you can look on the website. Um, and it’s amazing the selection that they have these days.
Kim Barnes: And when you look at some of those, it might make the idea of doing some of these modifications not feel so scary or institutional like, as you mentioned.
Alison Starkey, PT: Yes, exactly. So, and you know, and then get them interested in color and tile and all of that. And you may have a success on your hands.
Kim Barnes: All right. Well, thanks so much for sharing your words of wisdom today.
Alison Starkey, PT: You’re so welcome, Kim. Thanks again for the opportunity. We really appreciate it.
Kim Barnes: And if you have other ideas that you’d like us to tackle on parenting aging parents, just let us know.
*This transcript is auto-generated. Please excuse any typos or mistakes.