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50+: Live Better, Longer

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Choosing to Live at Home

You don't need to stay in a nursing home to get good care.

Simple Touches Make a Difference

Once a geriatric care manager puts a basic plan in place, other support organizations can offer additional help. Sometimes a few home modifications are all it takes to allow older people to stay where they are. Improvements such as ramps, grab bars, improved lighting, and special, easy-to-use door and faucet handles are among the easiest changes, but widening hallways and doors or lowering kitchen counters can also help. The AARP publishes a room-by-room checklist with tips for making a home safer; other publications are available from the National Resource Center on Supportive Housing and Home Modification.

For the challenges of daily living, such as housekeeping, errand-running, cooking, and even companionship, companies such as Home Instead have appeared in many cities and towns. For medical care, nurses and aides from a variety of agencies make house calls or stay around the clock if needed.

Loneliness is another problem. A visit to the local senior center, an outing with a companion to a movie, or a chat with a visitor or neighbor may be all that's needed to solve the problem, but an elderly person living alone may need encouragement and help in making these plans. When seniors can no longer drive, trips to the grocery store, doctor's appointments, or visits with friends can become a challenge. Caretakers or transport services can fill the gap.

A Word About Finances

Fees for private care managers vary, from about $50 to $150 an hour, with prices typically higher in urban areas. Some long-term care insurance policies reimburse for care managers, and depending on a senior's eligibility, Medicare or Medicaid plans may offer some help. Help with finances is, in fact, usually part of the caregiving plan.

A good care manager can usually put together a plan that fits within a family budget. And some part-time care at home is usually far less expensive than a move to a nursing facility. Most important, a good aging-in-place plan allows older people the familiar comforts of home -- for as long as possible.

Jeanie Puleston Fleming has written for The New York Times and other publications. She is based in Santa Fe, N.M.

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