Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 110

A doctor's opinion about housing decisions is often as highly respected as their opinion about health decisions, particularly on that difficult decision – ‘Should I move?’ Although each case is unique, it is possible to list guidelines for decision‐making. Figure 4.4 provides optimal and suboptimal reasons for moving. In general, every attempt should be made to solve housing problems if doing so will eliminate the need for a move. Mobilization of community resources, adaptations based on physical and occupational therapy recommendations, and integration of technology can also allow older adults to age in place. However, due to cognitive changes, health decline, or the need for additional emotional support, the time may come when older adults can no longer safely live alone. The decision of whether an older adult should move into a relative's home or to an institutional environment represents one of the hardest decisions associated with ageing for both the older person and the potential caregiver.

Figure 4.4 A summary of suboptimal and ideal reasons for older adults to consider moving. Older adults and their care team should attempt to address suboptimal reasons with the listed strategies before initiating a move.

Sheltered or congregate housing in the UK and senior apartment buildings or assisted living facilities in the US are the types of housing that most people think of when new housing for elderly people is mentioned, although many innovative and non‐traditional housing options are being developed and explored. For instance, senior‐friendly communities with shared communal resources that emphasize ‘neighbour helping neighbour’, cooperative housing developments, and even co‐housing programmes providing inexpensive housing for college students in exchange for housekeeping services for seniors are all being trialled. Older adults should work with their families and providers to understand what needs are not being met and their anticipated healthcare trajectory to make the best decision about future housing.