Dr. Anthony Zizza, chief medical officer at Element Care, a Program of All-Inclusive Care for the Elderly (PACE) provider, emphasizes that families often overlook crucial healthcare and coordination needs when planning for older adults to age in place. He advises proactive planning rather than waiting for a crisis like a fall or hospitalization, which can lead to rushed decisions about assisted living or nursing homes.
Zizza suggests homeowners and families assess their homes for safety before an emergency arises. Key considerations include safe access to bathrooms, mobility within the home, and the feasibility of navigating stairs. Modifications like grab bars, secure handrails, nonslip surfaces, and removing loose rugs can enhance safety. He also stresses the importance of addressing the individual's physical condition, such as strength and balance, and managing medications, as well as ensuring adequate cooling during heat waves.
Element Care's occupational therapists conduct in-home assessments to identify potential hazards and coordinate necessary support, including physical therapy, transportation to appointments, and home modifications. Nurses and medical providers monitor participants for changes in health status. The PACE model integrates medical care, rehabilitation, transportation, meals, and other services to support participants' independence.
Zizza shared an example of a participant with COPD whose frequent hospitalizations due to heat exposure in his home were resolved by providing an air conditioner. He also cited a federal analysis from March 2026, which indicated lower hospital and emergency department utilization among PACE participants compared to those in non-integrated Medicare Advantage plans, suggesting the value of integrated care.
When evaluating financial and practical trade-offs between aging in place, senior living communities, and nursing facilities, Zizza advises families to consider the full monthly costs, including home maintenance, modifications, and paid assistance for aging in place. For senior living communities, it's important to clarify what services are included in the monthly fee and the costs of additional care. Nursing facilities offer a higher level of care but come with considerations of cost, privacy, and routine changes.
