Living independently is one of life’s greatest freedoms.

If asked their preference, most older people will say they want to stay living in their homes for as long as possible.

Alongside driving, independent living is one of the most difficult things for an elderly person to give up. Many people remain active and healthy living in their own homes well beyond 65. Others aren’t so fortunate. For those who are unable to continue living by themselves at home – whether it be for physical, mental or other reasons – Sequim and its surrounding areas offer a variety of housing and care options for seniors.

To live at home, a person must, at the very least, have access to transportation, be able to go shopping, cook and be able to do household chores, according to the Administration on Aging. Being able to respond in an emergency and complete "activities of daily living," such as bathing, dressing, grooming, going to the bathroom, taking medication and communicating, also are important.

If such activities prove difficult for an individual, hiring in-home help, relocating to a retirement community or moving into an assisted-living facility or nursing home might be necessary.

Hiring somebody to help at home

If activities of daily living are challenging for an individual, one option is to hire in-home help. For a fee, people will maintain lawns, wash windows, cook meals, go shopping, do laundry, assist with exercise, provide transportation and even administer personal and skilled nursing care at home.

Debbie Stoltenberg, home care supervisor of the Caregivers Home Care Team Sequim branch, describes in-home care as ideal for seniors who are starting to feel overwhelmed and unable to keep up with everyday household chores or perhaps for people who don’t have any close friends or nearby relatives to help out with housework.

In-home care is a way for seniors to remain in their own homes, which from her experience, a majority of older persons are adamant about, Stoltenberg said, referring specifically to her father who died two years ago and refused to be "put in a home."

"They tend to heal faster and feel better in their own surroundings," she said.

"In-home care is not about losing your independence," she continued, "it’s about staying independent."

Caregivers can make home visits as often as every day or as infrequently as once a month.

Enjoying a retirement community

For people willing to relocate, more options exist.

Retirement and life-care communities are for individuals who are self-sufficient and want the freedom and privacy of their own separate, easy-to-maintain apartment or house, along with security, comfort and social activities of a senior community.

According to Bill Littlejohn, owner of The Lodge at Sherwood Village, the Fifth Avenue Retirement Center and Sherwood Assisted Living, many seniors choose to move into a retirement center for social reasons. "Most people come here because they are lonely, especially if they are single," he said. "And they are tired of cooking and cleaning and don’t want to ask (people) for help anymore."

"With my parents," he continued from experience, "the house was getting old and needed a lot of maintenance, live-in help was too expensive and they knew it was probably better to have somebody around to help."

Moving into an

assisted-living facility

For seniors who don’t have severe medical problems but who need help with personal care such as bathing, dressing, grooming or meal preparation, an assisted-living facility might be appropriate.

Rena Keith, assistant living coordinator at Sherwood Assisted Living, said that more often than not, residents who move into the facility blossom.

"Oftentimes if a person starts forgetting to take their medication or not taking it on time, losing weight and not cooking because it’s too much work to cook a meal for one person, or not showering because they are afraid of a fall, they might be a good candidate for assisted living," Keith advised. "There are lots of activities going on and people who look in on them, they get food, with choices, that they don’t have to prepare on their own, and somebody remembers for them to take their medicine."

Keith dispels negative connotations about assisted-living facilities. "It’s the best of both worlds. They can come and go as they want but at the same time it’s safe and secure and they have assistance with the things they have trouble doing," she said. "They have their own room with a kitchenette, can bring their own furniture and pictures, and go out to lunch, sing in the choir or participate in the actor’s guild … there are lots and lots of activities."

24-hour care from

a registered nurse

Skilled nursing homes are the most comprehensive level of residential care and offer 24-hour help for complex medical needs.

Some residents check in for short-term rehabilitation after a surgery or injury, perhaps a stroke, said Mary Perry, admissions coordinator of Olympic Care & Rehabilitation. Others are admitted for long-term care when their needs pass the level of care given at an assisted-living facility.

"They are unable to care for themselves at all; they might be wheelchair bound and need help being lifted in and out of bed," Perry explained.

"And most skilled nursing homes offer respite care so that if a family member is caring for a loved one at home, they can bring them in for a week or two while they go on vacation," she added.

For more information about senior care and housing options, contact the Olympic Area Agency on Aging by calling 452-3221 or go online to www.o3a.org.

When determining what type of senior housing arrangement is best for an individual, some key issues to consider

• Temporary versus long-term care: An older person might go to a nursing home for rehabilitation following a surgery or stroke, then return home. In other circumstances, a senior’s needs might be better served by planning a move that is likely to remain the same for many years to come, such as a retirement community or assisted-living facility.

• Independence: Can the senior live alone, and more importantly, does he or she want to? Or would living in a more service-oriented environment be more nurturing?

• Privacy: Independence and assistance generally form a continuum: privacy decreases as the need for assistance increases. If the senior’s desire for privacy is paramount, independent living or assisted living might be preferable to a nursing home.

• Need for personal care: How much and what kinds of personal care are needed or desired? Does the individual want help completing "activities of daily living," such as bathing, dressing, grooming, going to the bathroom and taking medication or does he or she need 24-hour professional medical attention? A free needs assessment questionnaire is available online at www.carepathways.com/needs.cfm.

• Need for medical care: If the senior has a chronic illness that requires special medical care or ongoing services of medical professionals, independent living and even assisted living might not be suitable. More appropriate options might be in-home care or a skilled nursing home.

• Costs: Learn about the financial aspects of senior housing to determine what options are affordable.

• Walk through and evaluate facilities that seem suitable: Reviewing facility comparison checklists can help a person determine which type of environment fits the senior resident’s requirements and preferences.

• Seek guidance from professionals who are experts in senior housing issues: Medical social workers, case managers and geriatric care managers can help with identifying goals and values, assessing needs, determining what is affordable and suggesting appropriate

facilities. – Helpguide.org