Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 108

Longino and Bradley described the migration patterns of older people in terms of three moves.²⁵ The first generally occurs at retirement and involves moving for improved amenities (such as weather, lower cost of living, or proximity to friends and family). The second move is precipitated by moderate functional disabilities, complicated by the loss of a spouse, and is often toward the community in which an adult child resides. The third move is due primarily to severe disabilities and is local and toward an institution such as a congregate living or custodial facility.

Older adults generally prefer to age in place. However, they may face a number of challenges with regard to housing. Structural problems with the dwelling may be difficult to remedy for adults on a fixed income and/or with physical or cognitive limitations. In developed countries, provisional government grants may be available to help older adults offset the costs of needed structural repairs. Community volunteer organizations may be available to help with minor repairs or decorating. For adults having trouble affording property taxes or utility services, local governments and utility companies may have loan services, payment plans, or reduced payment options for residents with limited income. Providers should familiarize themselves with locally available services for at‐risk seniors.

For seniors with functional limitations, efforts should be made to optimize the home setting rather than pursuing institutionalization. Physical and occupational therapists can perform in‐home assessments to reduce falls risk and recommend appropriate adaptive equipment. Smart‐home technology is an evolving area of interest. Devices such as voice‐activated electronics, fall sensors, and surveillance cameras may enable older adults to remain safely in their homes.