Friday, May 16, 2014

The Active Process of Aging in Place

by Jen Molinsky
Research Associate
America’s older population is poised for unprecedented growth. The youngest members of the baby boom population, born 1946-1964, have turned 50, while the oldest boomers have crossed the 65 threshold. Growth among 65-74 year olds is set to soar, climbing from 22 million in 2010 to an estimated 39 million by 2030, a 78 percent jump. By 2040, there will be an estimated 30 million 75-84 year olds, and another 14 million people 85 or over.

The vast majority of older adults currently live independently. This is true even among the oldest group: of those aged 85 and above, 72 percent live by themselves or with a spouse/partner in their own homes, according to the 2012 American Community Survey. With evidence that Americans of all ages are moving less, and given health care improvements that have delayed moves to institutional care, the trend toward independent living in older age is very likely to continue.

Indeed, surveys show that most people want to live independently in their current homes and communities as they age—a preference popularly called “aging in place.” In a 2010 survey of 1,600 people over aged 45, AARP found that 86 percent somewhat or strongly agreed with the statement “What I’d really like to do is stay in my current residence for as long as possible,” while 85 percent somewhat or strongly agreed “What I’d really like to do is remain in my local community for as long as possible.” A 2014 online poll by the American Planning Association found that 69 percent of 50-65 year old respondents with at least two years of college reported that staying in their homes as they got older was somewhat, very, or extremely important.

The Center for Disease Control defines aging in place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.” The CDC’s focus on aging in place as an “ability” is on point: because abilities may change over time, the definition hints at the dynamic nature of aging in place, rather than the absence of action and change regarding one’s living environment. The reality is that, for many, aging in place is a deliberate and dynamic process, one best undertaken with preparation including adaptations of physical space, modes of transportation, or other facets of life in advance of physical or cognitive need to do so. For some, it may even involve moving in order to set the stage to live independently for as long as possible, relocating to a new home that is more comfortable, safe, affordable, and/or convenient. Moves may be within the current community – preserving existing social connections – or outside to locations where changing needs can be better accommodated either because of more community resources or proximity to family.

And even with preparation, aging in place is an ongoing process (as literature from the field of gerontology recognizes) in which older residents renegotiate how, and indeed if, they continue to stay in their current home as their preferences and circumstances (health, finances, relationships and family and social supports) shift over time.

The CDC mentions the ability to remain in one’s community as well, and indeed a critical part of aging in place is the setting in which it occurs. Many researchers, advocates, and commentators point to the same list of elements needed to make communities more livable for all ages, including older adults: affordable, secure, and physically accessible housing; and affordable, safe, and reliable transportation alternatives for those who are unable or choose not to drive (such as mass transit, paratransit, and safe and desirable walking routes to services and amenities). Opportunities for older residents to engage with their communities in recreational, learning, cultural, volunteering, and/or social experiences, and options for in-home health care and/or assistance with activities of daily life as circumstances change are also critical.

Yet there are tremendous challenges in ensuring that our houses and communities are ready to support a high quality of life for older adults aging in place now, and the growing numbers of those who will do so in the future. Needs include more accessible housing units for those with ambulatory difficulties; a larger range of housing options for those seeking smaller, more affordable units; improved infrastructure to promote pedestrian safety; transportation alternatives to private cars;  and local services to assist older adults with home maintenance, care, and meals. The federal government has a role too, in providing financing options to help homeowners and renters modify their homes to improve safety and accessibility, supporting the growing number of low-income senior renters, and in improving collaboration between health and housing programs to ensure they are mutually supportive of aging in place.

There is much to be done to provide the needed supports for today’s older population and the coming waves of older adults engaged in the dynamic process of aging in place. A first step is for individuals to recognize the value of planning in anticipation of future needs, and for government at all levels to recognize the magnitude and importance of the challenges and opportunities associated with an aging population seeking to age in their communities. The next step is to take stock of what we already know about the best way to support aging in place and to consider how the public, nonprofit, and private sectors can innovate and bring solutions to scale. 

To help spur and inform this important discussion, the Joint Center for Housing Studies and the AARP Foundation will release a comprehensive report on this topic this fall. Housing America's Older Adults: Meeting the Needs of an Aging Population will be released at an event in Washington, DC on September 2, 2014.  Join our mailing list to receive more information this summer.

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