Given the choice, most people want to stay in their homes as they age. In one AARP survey, 89% of those 50 and older said they preferred to remain in their own residence, and the older the respondents, the stronger their feelings on the subject.gt;gt; "The people for whom it is hardest to stay in their house want to stay the most," says Elinor Ginzler, coauthor of gt;Caring for Your Parentsgt; and the director of livable communities at AARP, the Washington, D.C.–based lobbying group for older Americans. The good news: It may very well be possible. By carefully thinking through your options before you're in poor health, your home environment can meet your needs for the rest of your life. Here are some suggestions.gt;gt;gt;Modify your housegt;gt;Narrow hallways, slippery floors, steps—homes are filled with hazards for an aging person. Research suggests that making modifications and repairs can prevent about a third of home accidents. "Falls are the leading cause of death and disability among older people," says Ginzler. Increase safety with these simple, quick methods.gt;gt;gt;gt;Remove throw rugs to prevent trippinggt;gt;gt;gt;Install motion-sensor lighting to make nighttime trips to the bathroom less perilousgt;gt;gt;gt;Use a no-skid spray on slippery floor surfaces like tiles and linoleumgt;gt;gt;gt;Install grab bars in tubs and on stairsgt;gt;gt;gt;Remove knobs on cupboards and replace them with lever handles, which are easier to graspgt;gt;Of course, you may want to make more extensive renovations to your home, such as installing ramps or redesigning kitchens and baths. Think about working with a gt;certified aging-in-place specialistgt; (CAPS), a builder who has been trained by the National Association of Homebuilders to assess the improvements you may need.gt;gt; gt;Enlist your familygt;gt;Make sure your family knows you wish to remain in your home as long as possible. You can do that in an advanced care directive, which lays out the type of care you want toward the end of your life. Better to have forthright discussions up front so that you can discuss how your desire to stay at home can be achieved. Adult children may not realize that parents can be safe at home if the right modifications are made. gt;gt;gt;gt;Consider long-term-care insurancegt;gt;Paying someone to care for you in your home can be enormously pricey. At an average of $19 an hour, the services of a home health aide can add up to more than $3,000 a month for 9-to-5 care, Monday through Friday. Medicare, the government insurance program for the elderly, and private health insurance usually don't cover long-term care. To get this kind of help in your home, you must either pay for it out-of-pocket or use long-term-care insurance. Policies differ, but long-term-care coverage often kicks in if you are unable to perform at least two activities of daily living—like bathing, dressing, going to the toilet, or feeding yourself—for 90 days. It tends to be most affordable when purchased in middle age, long before most people develop health-related disabilities.gt;gt; meet your needs for the rest of your life. Here are some suggestions.gt;gt; "It's really a product that works best for people who think it through early," says Ginzler. "It's rarely appropriate for someone in his 70s, and less appropriate for people who have acute, chronic conditions."gt;gt;gt;Find the money in your housegt;gt;If you own your home, a reverse mortgage lets you convert the equity in your home into cash. "Quite often the house is the largest asset people have and it can be a good source of money," says Katana Abbott, a certified financial planner in Commerce, Mich., and the founder of gt;Designated Daughtergt;, a support network for caregivers. Those funds can then be used to hire a home help aide or make renovations.gt;gt;The more equity you have in your home, the more cash you can borrow. "A reverse mortgage is a good way to pay off what remains of your first or second mortgage, and free up cash to pay for medical expenses," says Barbara L. Steinberg, a certified financial planner and gt;registered financial gerontologistgt; in Lincoln Park, N.J. The loan only comes due if you sell your home, move out, or pass away. In the last case, your heirs can either sell the home or pay off the loan balance themselves—if you owe more than the home is worth, the lender takes the loss.gt;gt;You must be over the age of 62 to qualify for most reverse mortgages. In general, the older you are and the more your home is worth, the more equity you can access. (The AARP has an easy-to-use gt;reverse mortgage calculatorgt; on its website.) For reverse mortgages insured by the Federal Housing Administration, you may borrow up to $362,790 (depending where you live), as long as your home is appraised for more than that amount. You can receive the money in several ways: a lump sum payment, a line of credit, monthly payments, or some combination of all three. Closing costs are subtracted from your remaining equity, so there are few out-of-pocket expenses.gt;gt;There are a few drawbacks: Fees on a reverse mortgage are higher than on a regular mortgage, so it makes most sense if you intend to stay in your home for several more years. You also will not be able to leave the house unencumbered by debt to your children, which can be a factor if they have an emotional attachment to it.

If your parents become unable to make decisions about their end-of-life care, a living will is one of the documents that can help ensure they receive the treatment they want. But it has benefits for you, too—namely, the peace of mind that comes from knowing you are following their wishes. Indeed, living wills aren’t just for seniors. Sanford J. Mall, a nationally certified elder-law attorney with Mall Malisow & Cooney, in Farmington Hills, Mich., explains why everyone needs one.gt;gt;
gt;Q:gt;
gt;What is a living will?gt;
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gt;A:gt;
gt;A living will, sometimes called an advanced health directive or a medical power of attorney, is a legally enforceable document that identifies a patient's end-of-life wishes. It can specify that you want the cessation of treatment under a specific set of conditions—when you want to "pull the plug," in other words. Most people draw the line in one of three ways.gt;gt;

gt;gt;If they're in a coma or a persistent vegetative state and there's no hope for recovery.gt;gt;gt;gt;If they're not in a coma, but have lost so much cognitive function that the doctor feels there's no hope for recovery.gt;gt;gt;gt;If there's a terminal illness with no hope for recovery.gt;gt;

A living will does not authorize someone else to act on your behalf for medical decisions. You need a health-care proxy for that.gt;
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gt;Q:gt;
gt;Who should have a living will?gt;
gt;gt;
gt;A:gt;
gt;Anybody who is older than 18 and competent. If you are sure you don’t want to be put on artificial support, and don’t want to have extraordinary measures used to sustain your life, then you should sign a living will. Remember the case of Terri Schiavo: Her husband and her parents fought a seven-year legal battle over removing her feeding tube, with some 20 judges ruling on whether there was sufficient evidence that she would want to stop treatment. If it had been in writing, would you need 20 judges, or all the heartache and family strife? No.gt;
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Next Page: gt;What to include in your living willgt;
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gt;Q:gt;
gt;How do you get a living will?gt;
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gt;A:gt;
gt;In many cases, gt;state bar associationsgt; have forms available online. They may not be exactly what you want, but at least they're a starting point. If you work with a lawyer, you won't have to worry about whether the form is good or bad. Plus, you may want something very specific in your document that the form doesn't cover; a lawyer can help you with that. Each state has its own requirements for what you need to do to make the document legally enforceable, such as the number of witnesses and who can sign as a witness. These guidelines, which can affect whether the document is legal or not, should be spelled out on your state's bar association site. You may also be able to find living will resources at local hospice groups. Some hospitals offer the forms for patients or visitors.gt;
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gt;Q:gt;
gt;What should a living will say?gt;
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gt;A:gt;
gt;I recommend that a living will respond broadly to what a person wants—it’s hard to anticipate every possible specific scenario. However, there might be individualized specifics. Take my grandmother, for instance. On the one hand, she believed that "where there's life, there's hope," but on the other, she never wanted to be intubated because she had it done once and found it to be the most excruciating experience. Also, she didn't want a doctor to perform any chest compressions on her, even if she could die without them, because she was weak and her ribs could be easily cracked. So the document we drew up for her had to take all that into account.gt;
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gt;Q:gt;
gt;How do you talk to your parents about getting a living will?gt;
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gt;A:gt;
gt;The best way to have that conversation is proactively. Have it in advance of anyone needing a living will. Even if your parents put off your initial approach, at least you've planted the seed. And even in states where next of kin can legally make an end-of-life decision for someone, a living will can at least let you know what your parents want. I recently had a situation where a man who had a terminal illness came to see me to do his end-of-life planning, including a living will. At his funeral, his daughter came up to me said, "When we got the call from the hospital that a decision needed to be made about Dad, we pulled out all the documents and read what he wanted. It was such a comfort knowing that he thought about these things and was specific about what he wanted."gt;
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