title: Advanced life events (ALEs) that impede aging-in-place among seniors.
abstract: Despite the wishes of many seniors to age-in-place in their own homes, critical events occur that impede their ability to do so. A gap exists as to what these advanced life events (ALEs) entail and the planning that older adults perceive is necessary. The purpose of this study was to identify seniors' perceptions and planning toward ALEs that may impact their ability to remain in their own home. We conducted focus groups with 68 seniors, age ≥65 years (mean age 73.8 years), living in the community (rural, urban, and suburban), using open-ended questions about perceptions of future heath events, needs, and planning. Three investigators coded transcriptions using constant comparative analysis to identify emerging themes, with disagreements resolved via consensus. Subjects identified five ALEs that impacted their ability to remain at home: (1) Hospitalizations, (2) Falls, (3) Dementia, (4) Spousal Loss, and (5) Home Upkeep Issues. While recognizing that ALEs frequently occur, many subjects reported a lack of planning for ALEs and perceived that these ALEs would not happen to them. Themes for the rationale behind the lack of planning emerged as: uncertainty in future, being too healthy/too sick, offspring influences, denial/procrastination, pride, feeling overwhelmed, and financial concerns. Subjects expressed reliance on offspring for navigating future ALEs, although many had not communicated their needs with their offspring. Overcoming the reasons for not planning for ALEs is crucial, as being prepared for future home needs provides seniors a voice in their care while engaging key supporters (e.g., offspring).
authors.affiliation: Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address: LAL425@northwestern.edu.
authors.forename: Lee A
authors.initials: LA
authors.lastname: Lindquist
authors.affiliation: Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Ramirez-Zohfeld
authors.affiliation: Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Priya
authors.initials: P
authors.lastname: Sunkara
authors.affiliation: Aging and In-Home Services of Northeast Indiana, Fort Wayne, IN, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Forcucci
authors.affiliation: Lincoln Park Village, Chicago, IL, USA.
authors.forename: Dianne
authors.initials: D
authors.lastname: Campbell
authors.affiliation: Skyline Village, Chicago, IL, USA.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Mitzen
authors.affiliation: Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Kenzie A
authors.initials: KA
authors.lastname: Cameron
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000503:physiopathology; D004644:Emotions; D005190:Family; D005260:Female; D017144:Focus Groups; D006760:Hospitalization; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D008297:Male; D010465:Perception; D036301:Qualitative Research; D012424:Rural Population; D013383:Suburban Population; D014505:Urban Population
keywords: Aging in place; Home care; Older adults; Qualitative