Stroke happens fast, leaving no time to prepare for its life-changing consequences. It happens to approximately 795,000 people each year. Stroke risk increases with age, but strokes can—and do—occur at any age. Stroke is the leading cause of serious, long-term disability in the United States. Mobility is reduced in more than half of stroke survivors age 65 and over. High blood pressure, high cholesterol, smoking, obesity, and diabetes are leading causes of stroke. 1 in 3 U.S. adults has at least one of these conditions or habits.
The Physical, Cognitive and Emotional Toll of Stroke
According to the National Institute of Neurological Disorders and Stroke, “Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis.
Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Stroke survivors often have problems understanding or forming speech. A stroke can lead to emotional problems.
Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions. Many stroke patients experience depression. Stroke survivors may also have numbness or strange sensations. The pain is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures.”
Stroke Survivor Needs Upon Hospital or Rehabilitation Facility Discharge
With paralysis, reduced mobility and neuropathy you’ll likely be using a wheelchair or walker and need physical support for transferring. You may also need caregiver assistance with daily activities (showering, dressing, toileting, meal preparation, medications, transportation, errands, etc.). Health care provided in the home, as well as occupational and/or physical therapy may be needed, too. Stroke survivors benefit from Senior Living Design, which addresses physical, psychological and emotional needs.
Mobility devices, caregiver support and home health care service each have requirements that 99% of homes simply aren’t ready to accommodate, according to a 2017 Harvard Housing study. And, hospitals and rehab facilities can’t release stroke patients to an “unsafe” environment.
So, unless you’ve already had your house or at minimum the master bathroom designed and remodeled for Aging in Place and wheelchair accessibility, you wouldn’t be able to go back home.
Following Are Four Housing Options After Stroke. Which Would You Choose?
1. Permanently move to an assisted living community, care home or skilled nursing facility.
Advantages: Readily available, often with immediate occupancy. Many assisted living communities offer activities and outings, provide nutritious meals, include housekeeping service for your apartment, offer different levels of care, and have nice amenities. Most have been designed by professional senior living designers, which provides psychological, emotional and physical benefits throughout the common areas. Other benefits of assisted living are that there are caregivers and staff to assist if you fall or have medical events, and it’s maintenance-free living.
Disadvantages: Community living and shared walls. Requires downsizing. Assisted living community apartments are typically 400 to 1,200 SF. It’s a bedroom or shared bedroom in care homes, which are typically licensed for 5 to 10 beds. Ownership, management, caregivers, and staff can change. Rent and care fees can increase.
Cost: $4,000 to $8,000 per month for Assisted Living and $8,000 to $12,000 per month for Skilled Nursing. Long-Term Care Insurance will pay for it, if you have a policy. Most assisted living homes and communities are private pay and do not accept Medicaid, so you must have funds available to pay out-of-pocket. If you need to sell your home first to access those funds, that may take time.
There are a limited number of assisted living communities and care homes that accept Medicaid, but you must first apply and then meet the stringent qualifications (for example – have less than $2,000 in assets and meet specific health needs criteria).
2. Have your home designed and remodeled for Aging in Place by credentialed professionals while you temporarily stay in assisted living.
Advantages: Done right, your home will be wheelchair accessible, functional, safe and beautiful to accommodate you through and beyond active adult years. Because it’s a life-safety matter, be sure to hire an Aging in Place or Senior Living Designer and a qualified Licensed Contractor to accurately design, obtain permits, meet codes and construct/install.
Caution: There are a lot of designers and contractors that say they can do Aging in Place design and remodeling but have no formal training or certification. It’s technical and tricky and that’s where mistakes are made, which could result in injury or death.
Disadvantages: It generally takes 2 to 3 months for design and construction. It may require a temporary stay in assisted living or with a family member while the work is being done.
Cost: Design and remodel cost (less than a year’s rent in assisted living). Plus, 2 to 3 months at $4,000 to $8,000 per month for temporary assisted living housing during the remodel design and construction process. Long-Term Care insurance coverage often includes home modification costs, so check with your provider to see what their policy is. Reverse mortgages or home equity lines of credit can be a good way to pay for Aging in Place design and remodeling.
3. Permanently move in with a family member whose home will meet your safety and care needs. (The home should first be assessed by a Certified Aging in Place Specialist or a Home Care Agency professional to ensure that it will be safe and accessible.)
Advantages: The opportunity to live with family and not be isolated or lonely.
Disadvantages: You’ll lose some privacy and/or independence. You may have to give up your furniture, artwork and home furnishings because your family doesn’t have space for it, it’s not their style and won’t integrate well, or the cost to move the furniture would be too high. It may require moving to another city or state where your family resides.
Cost: Rent, home health care, and possibly moving expenses
4. Sell your house and buy a new one.
Advantages: You retain the privilege of owning and living in your own home. It’s tough to find aging in place ready homes for sale, but you can hire an Aging in Place designer and contractor to remodel the house to accommodate your needs. Once you find a house, you’re serious about buying, have it evaluated by a Certified Aging in Place Specialist or Senior Living Designer before purchasing it to ensure it’s a good remodel candidate. Otherwise, you could invest a lot of money only to learn that it is not suitable to meet safety and accessibility needs and a remodel won’t cure it.
Plan on 2 to 3 months for the aging in place design and remodel to be executed. That means you’ll need to live in assisted living or with a family member until that process is completed.
Disadvantages: It could be too physically, emotionally or cognitively challenging to be house hunting. It may take time to sell your current home.
Cost: New house purchase, Aging in Place design and remodel (less than a year’s rent in assisted living), plus $4,000 to $8,000 per month for temporary assisted living housing during the house hunting, remodel design and construction process. Long-Term Care insurance often includes home modification costs. Check with your provider to see what they’ll cover. A reverse purchase mortgage may be a good finance tool for you.
Design Matters for Adults 55+ and Stroke Survivors
Because I’m trained, seasoned and award-winning in both commercial senior living design (including Memory Care) and residential Aging in Place design, I’m uniquely skilled to infuse senior living design techniques into the design of my residential clients’ homes. As a result, they benefit from evidenced-based senior living/healthcare design in a home setting, normally only available in senior living communities. I design for the unique physical, psychological and emotional needs of adults 55+, and address specific conditions or limitations. Well beyond what Aging in Place design alone provides.
For stoke survivors, that translates to a living environment that is designed for mobility device accessibility; helps prevent falls and accidents that can result in injury or death; supports independence; preserves dignity; makes daily activities easier; helps combat depression; and accommodates caregiver assistance and home health care.