The Three Main Challenges to Aging in Place
It’s undeniable that baby boomers have reshaped society during the past two decades, and as they take their journey through retirement, experts see them continuing to break with the ways of the past and forge their own trail through life’s golden years. For baby boomers, retreating to an institutional setting to spend the later years of their life, the way their parents did, is unappealing. Surveys consistently show that the vast majority of baby boomers intend to age in the comfort of their homes while remaining active in their communities with family and friends.
While aging in place is the goal for 70 percent of seniors, financial, home and community challenges will make aging in place a steep road for many to travel. As we close 2017, IKOR is taking a special look at aging in place. Last month, we took an in-depth look at the different reasons seniors prefer to age in the comfort of the family home. This month we examine the obstacles many seniors will encounter as they attempt to age in place.
Conversations about aging in place typically begin with safety as the focus. Old age brings a loss of agility and balance, diminished mobility and increased frailty. A trip or fall, which wouldn’t have received a second thought earlier in life, can be life-threatening for a senior. Falls are the leading cause of both fatal and non-fatal injuries for older adults. As important as safety is, it is only part of the equation for successfully aging in place when thinking about the home environment.
To age in place comfortably, a senior needs to be able to go about their daily routine without much push-back from their home environment. Experts use the term “environmental press” when discussing the relationship between the senior and their living environment. During adulthood, the challenges a physical environment can present can be easily overcome by physical ability. So much so, that for able-bodied adults that we rarely recognize the push-back we receive from our physical surroundings. However, anyone with arthritis in their hands can speak to the pain of turning a faucet. A loss of flexibility can make bending to reach clothes out of the washer a challenge. Diminished mobility can turn a flight of stairs into a venerable mountain. To address the challenges of environmental press, a concept called “universal design” is increasing in popularity.
Universal design is a design concept which aims to “make homes accessible for young and old, healthy and infirm, without making the home look sterile and cold” according to AARP. Incorporating universal design into a home as one ages can be an effective way to continue living comfortably as physical abilities decline. Implementing universal design can range from a weekend DIY project to expensive remodels of bedrooms, bathrooms and kitchens.
However, the ability to pay for home modifications or in-home assistance presents another challenge for many seniors.
Aging in place is often championed as the cheaper alternative to growing old in an instructional setting. Whether motivations for aging in place are living on one’s own terms or avoiding the expense of living in an independent or assisted living facility, there are “soft costs” of aging in place that must be taken into consideration. Home modifications to mitigate safety risks brought on by old age and design changes to accommodate changes in ability come at a cost.
Earlier this year, The New York Times offered advice to those wishing to grow old in the family home: find a contractor now as the ability to move safely and comfortably around one’s home is essential to aging in place. The Harvard Joint Center for Housing Studies found that homes with single-floor living entrances without steps and wide enough hallways and doorways to accommodate wheelchairs and walkers are critical features that facilitate aging in place. It is estimated that only four percent of homes in the US have all three elements. Replacing knobs with levers, adding lighting, changing traditional light switches to accessible ones and moving up electrical outlets on walls so they can be easily reached are home modification costs that can add up quickly. While some modifications can be cheaply and quickly completed, as mentioned earlier, nationwide, the average price for a fully accessible “universal design” bathroom can cost upwards of $25,000.
Home modifications aside, most seniors will need some form of in-home assistance to maintain their independence and live safely. Genworth Financial estimates the cost for a homemaker to help with tasks, such as transportation, meal preparation or managing housework can cost nearly $48,000 per year. Should the senior need help with personal care, the cost of a home health aide can approach $50,000 annually. The costs of care, compounded with the costs of home modifications, can make moving to an independent or assisted living community the financially sound option. The same Genworth survey found the national average for assisted living communities to be just $45,000 per year.
Health and well-being are influenced by factors beyond the home environment, and any conversation about aging in place must look beyond the home and consider the community as well. Age-friendly communities provide activities to keep their older residents engaged and connected. Age-friendly communities have engaged in city planning and zoning in ways that will help seniors live safely and feel secure. From walkable neighborhoods to accessible transportation, affordable housing and necessary healthcare and social services, these forward-thinking communities are proactively changing to address the needs of an aging society.
Since 2006, the World Health Organization has led the global effort to create age-friendly communities in response to the world’s rapidly aging population. Today, there are 13 affiliate programs in 37 countries covering more than 158 million people.
Planning Can Make the Difference
While there are many challenges to aging in place, proper planning can often help ensure the ability to age while living the lifestyle older adults desire. In next month’s Life Navigator, we will look at steps for successfully aging in place. If you are not receiving our monthly newsletter, you can sign up here.