Aging-in-Place Villages: Incontinence and the Caregiver

Nancy Muller Health Pro
  • In early February, Howard Gleckman authored an enlightening article for The Washington Post (February 9, 2010) on new concepts in community support for aging-in-place villages. While variations were cited as examples, all depict ingenious ways for neighbors to help neighbors stay at home as they age. They revolve around three basic designs. The first functions much as a social "club" to which dues-paying members, organized in "houses" like fraternity or sorority networks, assist each other in providing services, such as rides to the doctor or store. The second, modeled after Boston's Beacon Hill Village and Washington's Capitol Hill Village, require income-dependent dues for covering services. The third model, promoted by a not for profit group called Partners in Care, is based on the idea of service exchanges that operate much like bartering. 

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    Success of all three depends both on the infusion of volunteerism and engagement of individuals. No doubt, the healthiest models are those whose neighborhoods enjoy a balance of young and old residents, each bringing different skills sets and resources including both time and mobility to perform services for others.


    Survey data reveals the fact that bladder and bowel control problems restrict people from social engagement and physical activities.  This makes it more difficult to shop and run errands.   Living in a village under any one of these models can remove embarrassing obstacles. 


    But what is done when incontinence overwhelms the family caregiver? This happens across our nation in instances of the elderly, particularly in instances where one spouse has advanced dementia or Alzheimer's disease. An impaired spouse can't be left alone while the well spouse is shopping for incontinent supplies and other necessities.  Studies have demonstrated a direct connection between incontinence and falls and fractures in the elderly, just one problem to worry about with self-toileting. Consequently research documents that incontinence is among the top three reasons that a loved one is placed in a residential nursing facility. And placement itself can lead to an even higher incidence of incontinence following admission. To learn more about incontinence and the impact of the aging process as a risk factor, NAFC can help you.


    Although the average, annual cost of nursing home care is more than $50,000 a year and climbing, the AARP reports it can vary widely depending on where you live. Employee health insurance does not pay for nursing home care. About a third of nursing home residents pay all of their nursing home costs from their own savings, and many people exhaust their finances after just six months. Only a small fraction of the population-about 5 percent-holds long-term care insurance, which covers the cost of a nursing home or other extended care.  Medicare, the federal health insurance program for older persons and some younger ones with disabilities, pays only for short-term nursing home stays immediately after hospitalization.  Clearly, more alternatives are needed to a residential nursing facility. Aging-in-place communities could be a real answer and certainly help to postpone at least the need to leave one's private home.


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    Be a leader in your community. Research what models may already exist elsewhere that might fit your neighborhood. Call a neighborhood meeting.  Survey the interest in such a concept, the skill sets for bartering, and the unmet needs for services among neighbors. Find out what services are already available through the local government and not for profit organizations...and those that are threatened without more public-private partnerships. Look after your village to promote safe and loving aging-in-place for everyone.


    Nancy Muller, Executive Director

    National Association For Continence

Published On: April 15, 2010