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The push to have seniors age in their homes, not hospitals

ARI SHAPIRO, HOST:

Turning 65 is a pretty big milestone. Here in the U.S., it's when you officially gain status as a senior, and it's estimated more than 10,000 people achieve that rank daily. Lately, there's been a growing push for programs to help older people live at home and out of nursing homes and hospitals. Natalie Krebs with Side Effects Public Media has this report.

NATALIE KREBS, BYLINE: Sixty-eight-year-old Celita Flowers sits on her red, leather couch in the living room in her home in Waterloo, Iowa, while one of her dogs nestles beside her.

(SOUNDBITE OF DOG BARKING)

CELITA FLOWERS: This one here is Princeton. He's a little toy poodle, and Princeton barks all the time.

KREBS: Flowers has eye and knee issues. And back in January, Flowers got sick. She ended up in the hospital for six days. When she got home from the hospital, Flowers relied entirely on her husband for support.

FLOWERS: He had to help me to the bed. I couldn't get in the bed by myself. I was really too weak to walk.

KREBS: But that was a lot for her husband, who works full-time, so a friend connected Flowers with Hannah Thomas. She's a specialist with the Northeast Iowa Area Agency on Aging. That group helps run Iowa's Return to Community program, which pairs social workers like Thomas with vulnerable seniors who have had recent hospitalizations for at least a 90-day period.

HANNAH THOMAS: We asked a whole bunch of questions about what she can do, what she needs help with.

KREBS: The goal is to provide support that Flowers and any other older adult would need to keep them at home and out of the hospital. There are a number of programs throughout the country that try to offer similar services to help older adults. Studies show that when seniors are hospitalized for an injury or illness, they're more likely to continue to struggle with daily activities, especially if they don't get sufficient support at home. There's a name for this. It's called hospital-acquired disability.

CARA FERCH: The mental health goes down. The physical health goes down. You just start to kind of spiral and snowball.

KREBS: Cara Ferch is the regional director of one of the agencies that works with the state to run Return to Community. She says the program's goal is to break that downward spiral before it begins. That could also save a lot of money. A 2023 University of Iowa report estimated seniors who are part of the program could significantly reduce their use of health care services and save them an average of around $15,000 over a 10-year period. Ferch says it could also save the state money if Medicaid is not needed to pay for expensive nursing home care.

FERCH: If we can pay $600 a month for them to stay in their home, versus 5- to $6,000 a month for them to stay in the facility, again, it's just a win-win for everybody.

KREBS: It's made all the difference for Celita Flowers. Keeping a meticulously clean home is very important, but she can no longer deep clean with her health issues. So together, Flowers and Hannah Thomas decided she would best benefit from housekeeping services. Flowers says it's made her feel much more comfortable in her home.

FLOWERS: She get down there with a rag and clean the floors. See how clean the floor is? She gets down there, and she cleans. She don't use a mop. She does wonderful.

KREBS: Iowa's Return to Community is a pilot program with no permanent funding yet. Officials hope to convince state lawmakers, insurance companies and others that these types of programs are the best way to help older adults stay out of the hospital and nursing homes as they age. For NPR News, I'm Natalie Krebs in Des Moines.

(SOUNDBITE OF ADRIAN YOUNGE, ALI SHAHEED MUHAMMAD AND MARCOS VALLE SONG, "GOTTA LOVE AGAIN") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Natalie Krebs
Natalie Krebs is the health reporter for Iowa Public Radio in Des Moines. She previously worked as an independent producer in west Texas where she covered issues related to the environment, immigration and health care. She has a master’s degree in journalism from the University of Texas at Austin.