On March 16, 2020, a shelter-in-place warning was issued in San Francisco and the surrounding Bay Area to slow the spread of the COVID-19 pandemic in California.
How does the COVID-19 Sheltering in-place contrast with Aging in-place, long-term care and LTC Insurance?
Shelter-in-place is to seek safety within the building one already occupies rather than evacuate the area or seek community emergency shelter. The American Red Cross says the warning is issued when chemical biological or radiological contaminants may be released accidentally or intentionally into the environment and residents should select the small room with no or few windows taking refuge there.
The phrase shelter-in-place is also been erroneously used instead of the more accurate “lockdown” to describe precautions to be taken by the public when violence has occurred or might occur (particularly in shootings) in the area and the perpetrator may still be in the area but not yet apprehended.
People in the area are advised to carry out all the same tasks as a typical shelter in-place, but with the additional step of sealing the shelter to prevent outside air from circulating indoors. In the scenario, people are simply urge to lockdown – stay indoors and close, lock and stay away from external doors and windows.
During epidemic or pandemic with an infectious agent posing significant risk of death or illness, authorities may recommend shelter-in-place for the general population or for segments of the population at high risk. Unlike other shelter-in-place incidents, recommendations may only be for specific at-risk populations, such as the elderly and immuno-compromised, and the recommended duration for an extended period of days, weeks or months.
Shelter-in-place may be implemented as a strategy for suppressing or mitigating an epidemic, for reducing numbers of critically ill patients presenting at the same time and to reducing the impact of critical illness health care systems and reducing the likelihood that a surge in illness will overwhelmed critical care resources.
Shelter-in-place may apply specifically to individuals or groups judged to be at risk for death or serious complications if infected and contrasts with self-isolation (voluntary seclusion at home to prevent infecting others) and quarantine (voluntary or involuntary seclusion to avoid exposure to infection for a period of time to determine infection status).
Shelter-in-place over extended periods in epidemics may involve significant logistical considerations, including measures to safely provide food, medications and other supplies over time as well as arrangements for social and psychological support.
The US Centers for Disease Control and Prevention defines aging-in-place as the ability to live in one’s own home and community safely independently and comfortably, regardless of income, age or ability. Research in environmental gerontology indicates the importance of the physical and social environment of housing and the neighborhood, as well as its implications for aging in place.
Most adults would prefer to age in place – that is to remain in their homes of choice as long as possible. In fact, 90% of adults over the age 65 report that they would prefer to stay in their current residence as they age. One third of American households are home to one or more residents 60 years of age or older.
According to the US Census, 46 million people age 65 + lived in the US in 2014, and the same segment of that population will grow to 74 million by 2030 – in just 10 years. There are four categories of technology that act as enablers for aging-in-place:
- Communication and Engagement
- Health and Wellness
- Learning and Contribution
- Safety and Security
Remember, today LTC insurance has evolved to become nothing more than a pool, bag or pot of money – designed to help your client stay at home for as long as possible!
There are many risks for injury to older adults in the common household, thereby impacting their ability to successfully age-in-place.
Among the greatest risk to our ability to age-in-place is falling. According to CDC, falls are the leading cause of injuries and deaths among older adults. Therefore, engagement and fall prevention is crucial to one’s ability to age-in-place.
Common features in an everyday household, such as lack of support in the shower or bathroom, inadequate railings on the stairs, loose throw rugs and obstructed pathways are all possible dangers to an older person. However, simple and low-cost modifications to an older person’s home can greatly decrease the risk of falling as well as decreasing the risk of other forms of injury, increasing the likelihood that one may age-in-place.
Some examples of home modification include:
- walk in bathtubs
- increase lighting
- non-skid flooring
- additional grab bars
- a handheld flexible shower head
- accessible switches at both ends of the stairs
- the removal of throw rugs and clutter in most areas
Home modification can be simple and cost-effective while simultaneously offering substantial benefits to the individual.
Remember, when it comes to discussing LTC Insurance features of any policy, always remember to highlight the BENEFITS of that feature, such as home modification.
Don’t forget – Why do people buy LTC Insurance? Freedom | Choice | Independence | Control | Dignity
Why the need for Home Modifications?
Many elders have difficulties with everyday functioning that requires modifications to their homes they live in. There are several reasons why these changes happen.
- Motor Functioning: In a 2002 study by Minsoo Kang, it was reported that the elder population in America, 18% will have a disability. This calculates to 51 million Americans who have difficulties in functioning every day. 32% over 65 will have difficulty walking, which may require use of walkers, wheelchairs and canes. To make life easier for the elderly, some modifications that can aid them are wider entrances, grab rails and elevators on stairs.
- Fine motor functioning: Elders may have difficulty using their fingers, which can be problematic. As a result, modifications to handles, door knobs and bathroom fixtures can aid with his problem.
- Cognitive functioning: It was reported in Kochera (2002) that one out of five people over the age of 55 will have a mental health disorder. Due to the deterioration, the five senses in cognitive capability decrease and cause slower responses. As a result, fire hazards may not be noticed, which makes it very important to set up fire alarms.
Aging-in-place can be further defined by:
- Aging in place without urgent needs: this group includes individuals who want to stay in their current home, are not experiencing immediate health mobility issues and prefer aging-in-place.
- Aging-in-place with progressive condition-based needs: this group is made up of those with chronic or progressive conditions that will require special modifications for aging-in-place. These individuals are usually aware of their needs but meeting them is not necessarily urgent. Many have chronic conditions such as diabetes and lung/heart disease that challenge them.
- Aging-in-place with traumatic change needs: this group includes those who experienced an abrupt or immediate change that demands adjustments in the living environment for aging-in-place such as home modifications or universal design.
Aging-in-place well mean that you plan out your future years before it becomes urgent and life changing. It requires one to prepare for and make choices and preferences clear to family and friends.
Aging-in-place does not mean that you need to do everything yourself. Resources and technology such as medical alert systems allow seniors to live at home safely for much longer period of time.
Take a moment and think about it the past few months. All of us have experienced aging-in-place for the last 60-90 days. However, most of us were still able to function “independently” in our homes and community. The key to understanding long-term care is “functioning” and doing so independently. It’s when you can no longer function independently is when you or a loved one and/or your client that you will need assistance, most often beginning in your home.
This is just the tip of a longer exercise that we will be conducting on part of our ongoing LTC Insurance educational process in our Webinars.
Many of you have taken our LTC or a Partnership live Webinars and heard about our upcoming 4 hour Partnership Webinar regarding rate increases and how to advise a client on their options and choices, including the class action settlement agreement and options regarding Genworth and their traditional and Partnership policies from 2003-2013.
We will be discussing in great detail the issues regarding your client’s options and protecting your book of business and renewals. We will also provide you with checklists, questions to ask and what they should consider, backed by facts and statistics.
Check out our new “Tuesdays with Tom” Webinars (non-CE) as well as our new LTC Gold Club (for seasoned agents) and LTC Silver Clubs (for junior agents).