America might be a youth-obsessed culture, but the reality is that people 65 and older are the fastest growing population segment in the country. What are the implications?
A new book, Independent for Life: Homes and Neighborhoods for an Aging America (UT Press, 2012), co-edited by Henry Cisneros, Margaret Dyer-Chamberlain ’80, and Jane Hickie, envisions what communities, neighborhoods, services, and housing will need to look like to support an aging population.
The good news: Dyer-Chamberlain and her co-editors are optimistic that valid strategies are emerging, and the book includes various case studies and workable solutions. The key for individuals, families, communities, and the larger society, she says, is planning—being proactive rather than waiting to react after a crisis occurs. The book covers a range of housing solutions, services, and ideas for healthy communities and positive changes.
As senior research scholar and managing director at the Stanford Center on Longevity, Dyer-Chamberlain quotes the founding director of the center, Stanford Professor Laura Carstensen, who believes that, “To the extent that people can approach old age mentally sharp, physically fit, and financially secure, many of the problems of aging fall away.” When we look at aging holistically, Dyer-Chamberlain says, “We begin to have a conversation about long life as opposed to old age.” Here she offers some insights on the topic of the aging of America.
Aging in place
In our book we’ve defined the term “aging in place” as a senior living in the residence of her choice, utilizing a range of housing and service options that support people as they age and change.
In the United States, the number of people 65 and older will double in the next 30 years from 40 million to 80 million, so this is a sea change in terms of population. Globally, the share of older people in a given population is increasing everywhere, despite wide variation across countries.
What about retirement, continuing-care, and assisted-living communities?
Those communities can be good options for people, but they tend to be too expensive for many Americans. Quality can be quite varied, and they often are not very integrated into the fabric of a community. Many studies point to the importance of people being engaged with their communities.
There’s a huge variety on the aging continuum. Housing and health problems intensify as people become older (85 and up), or if they have a disability or chronic health issue. Although most people express the desire to stay in their homes, not all homes are accessible or affordable. And not all services, like health care or the ability to get to a market without driving a car, are available to people in their homes, especially in suburban and rural areas.
There are many global best practices. Scandinavian countries jump to mind, for example, where there’s much more opportunity for intergenerational communal living, with people sharing resources and working together. In the United States, we’ve tended to approach older populations as needing to be separate from the rest of the community. Still, there are wonderful, heroic, innovative programs happening across the country, and the book showcases a number of diverse examples. The challenge is to create services that are replicable, affordable, and can work in any number of different communities.
It takes a village
One interesting concept started in Boston, where a group of older people who knew each other came together to assist one another and pool resources. They called it the Beacon Hill Village*, and it has inspired a village movement that has spread across the country and is organized under an umbrella organization called the Village-to-Village Network. We see it as a promising model because it’s a “let’s-take-charge-of-our future” model. It has funding challenges, though, that need creative solutions.
The time is now
As a society, we don’t tend to be good at planning ahead. Although the numbers are staggering, this still feels like a looming problem. As researchers, we see and understand the urgency. We’re swimming upstream in this country, because there isn’t much that’s holistic. For example, healthcare strategies don’t always interrelate with housing policies.
It’s a hard thing for Americans to consider the issues of aging because people don’t like to think about getting old. Start by thinking about your current home and whether it will support you as you age. Look at factors such as location (are you near family?), community, and remodeling. Consider your plans for retirement. There’s a section of the book that provides case studies and looks at a person’s home from the perspective of a contractor. We have a chapter on interior design and multifamily housing.
Families need to look at how they will support older relatives and how relatives can feel like they’re participating in family life. There is a lot of good care-giving literature material. Also, families need to think outside of the box. For example, intergenerational housing happens a lot in other cultures—it may be counter to our culture, but why can’t we change that paradigm? Zoning laws across the country are changing related to accessory dwelling units that enable people to have a small house, cottage, or renovated garage on their property.
Neighborhoods that are age-friendly are better communities for people of all ages. Many of the things we can put in place are so obviously beneficial to everyone that they should be no-brainers: sidewalks, lighting, benches, providing enough time for people to cross the street—these kinds of things can make a major impact.
One thing we think should happen is combining funding streams and planning for housing and health care. The Program for All-Inclusive Care for the Elderly (PACE), for example, has shown that putting together Medicaid and Medicare dollars, and letting older people stay in their homes, can save money and offer better results.
*Susan McWhinney-Morse ’55 was one of the influential people behind the founding of Boston’s Beacon Hill Village (BHV). She used her marketing and fundraising skills to help launch the nonprofit organization and further the concept that seniors can successfully stay in their own homes by having access to a network of support services in their communities. Her social innovation has won McWhinney-Morse recognition and awards, including the Smith Medal in 2011. She continues to contribute her entrepreneurial and leadership expertise to the BHV, which has since spurred a nationwide movement that now includes more than 70 villages.
Jane Falla is assistant editor