For many older adults, remaining at home is the preferred choice. But staying home safely often depends on how much help a person needs and whether that help can realistically be provided there.

Shalom Plotkin, owner of Right at Home Cleveland East, said in-home care can allow older adults to stay in their own homes while continuing to live independently.

“It means staying in their familiar surroundings,” Plotkin said. It also means keeping family, friends, pets and community close by, he said.

For seniors who are still largely independent, relatively modest support may be enough. Caregivers can help with activities of daily living, cooking, cleaning, driving and household tasks. Home modifications can also make a difference. Plotkin mentioned ramps, stair lifts, grab bars, detachable shower heads and easier-to-use fixtures as examples of changes that can improve safety.

The goal, he added, is not to take over everything.

If a senior can put on his or her own shoes, for example, a caregiver may help only with a more difficult task such as putting on tight support stockings. Maintaining independence remains part of the care.

The need for assistance often begins after a specific event. Plotkin said a fall, a significant change in health, the death of a spouse or another major life change can prompt families to discuss whether an older adult needs more help.

Social isolation can also become a concern, especially after the loss of a spouse. Plotkin said families can create routines that include regular calls and visits. Technology may also help some seniors remain connected.

Transportation is another important part of remaining at home. Plotkin said Right at Home caregivers take clients to medical appointments, stores and personal appointments such as hair or nail salons. Those trips can also provide an opportunity to get out of the house.

Cost can also be a consideration. Plotkin said in-home assistance is typically less expensive than moving into a care facility when a senior needs only a limited number of hours of help each week. But if someone needs care around the clock, staying at home can become much more expensive and a facility may be the more practical option.

There are limits, however, to what in-home assistance can provide.

Plotkin said safety becomes the central question when an older adult’s needs increase. Someone who requires significant nursing care at all hours may be better served in an assisted living facility.

He also said many clients seeking in-home assistance are no longer fully suited to independent living. Their needs may fall somewhere between independent living and assisted living, and some may eventually require assisted living, memory care or another setting offering greater supervision.

That decision can depend on how much monitoring and engagement the person needs. Memory care, for example, may provide more continuous supervision and structured activity than a person can receive while living alone at home.

Plotkin described one client approaching 80 who had stopped getting out of bed regularly. She was not eating properly, taking her medications consistently or keeping up with personal hygiene.

With a caregiver providing regular assistance and companionship, her condition improved. She began eating better, taking her medication, reconnecting with a family member and returning to activities she enjoyed.

“They have lunch together,” Plotkin said. “They have conversations. They have a relationship.”

Ellen Braunstein is a freelance journalist.