For me context is the key; from that comes the understanding of everything.

-Kenneth Noland

Context Matters:

The dictionary defines Context as; the set of circumstances or facts that surround a particular event or situation.

A man was driving up a steep and narrow mountain road. A woman was driving down the same road. As they passed each other, the woman leaned out the window and yelled, “PIG!” The man immediately leaned out his window and replied, “BITCH!” They continue on their way and as the man rounded the next corner, he crashes into a pig in the middle of the road.

The unfortunate encounter with the pig could have been avoided—provided he knew the context of the woman’s warning…

I’ve employed this old story to make a point about the importance of context in human affairs. And the concept is easily applied to aging in place.

 

Aging in Place is Contextual

Much of the aging-in-place talk focuses on the physical or built environment, and for good reason. Obstacles to staying home are often environment-caused and it’s the obvious point of entry.

Put a handrail on the stairs, get a raised toilet, and remodel a bathroom to accommodate a wheelchair…These are physical changes that can be marked off a check list and seen as making tangible progress. Important as these accommodations are to the changing physical needs of the aging home owner, if not done in a larger context of support, aging in place is unlikely to be successful.

I’m reminded by Meda Ling  about the economic and social aspects of true “sustainability” (and the humane quality of life factor) when designing for an aging population.

She notes:

…And of even greater importance to this line of thought: no matter how well an individual home may accommodate and adapt to the changing physical needs of a homeowner over time, if it does not encourage social interaction or a sense of ‘belonging’ to a supportive community- whether intentional or serendipitous – ‘aging in place’ is unlikely to be an option. One must ALWAYS consider the context of a home within the greater environs of a neighborhood or community. Are the homes sited in such a way that people are encouraged to interact and know their neighbors? How does location of a home or development relate to the greater community and access to transit options, shopping, health care, entertainment and passive and active recreation such that it encourages a healthy lifestyle? How does the home and the neighborhood relate to the environment – does it make sense in terms of land use, water and air quality objectives of sustainability?I have strong reservations about the concept of ‘aging in place’ as a sustainable model for a humane quality of life. From the perspective of a site architect, I consistently find myself reminding my professional colleagues to step back and see the forest for the ‘kitchen cabinet’ selection — and ask that we consider the quality of LIFE as the guiding principle of how we design, how we use the land, how we build. Rather than designing/building for ‘aging in place’, please consider designing/building for ‘LIVING in COMMUNITY.’

 

Her request is a systems thinking approach. When planning for Aging in place the key understanding must be that it happens within a larger system of community and the goal is an increased quality of life for everyone; now and in the future.

Failure to consider the contextual elements of aging in place and narrowly focusing on remodeling as the solution is flirting with disaster. Building with beautiful Universal Design in isolation is lipstick-on-a-pig…Look out ahead!

Successful Aging in Place: Contextual Considerations

1) Physical Health Status: Is your body/mind available to you? Do physical or mental limitations affect your ability to manage at home?

 2) Informal Care: Do you have a close circle of family, friends, church members, or neighbors who can provide care for you? If you have a spouse are they able to provide the care giving? And can you get your health needs met at home?

 3) Finances: Do you have the resources to pay for in-home help if needed? Home care services are not often covered by insurance; Medicare provides limited short term home health care under specific guidelines, and long term care insurance might not meet home care requirements. Do financial institutions provide easy access to information on Reverse Mortgages in your area?

 4) Community Services: What services are available in your community? Is your city an age-friendly community? Do you have a local Area Agency on Aging? Is your City Planning for “New Urbanism” or revitalizing old neighborhoods? How about public transportation? Are there community building opportunities available for older adults?  

5) Cultural Construction of Aging: Does your culture view aging from a “peak and decline” perspective or see aging as an opportunity no less than any other phase of life? Is aging in place a societal value? Does your neighborhood value multi-generational living? Or want its elderly age-segregated?

6) Physical Home Environment: Is the home age-friendly? Are you able to get around in the living space? Are stairs becoming a problem? Do you use a walker or wheelchair? Can visitors with physical limitations enter/exit (“vistability”) your home? Is home maintenance becoming burdensome and beyond your physical level? Are repairs too costly or even unsafe for you to take on?

For help with aging in place contextual considerations consult a Geriatric Case Manager. These are professionals working in public and private settings trained to help manage the care you or a loved might need to remain home by choice.

For help with aging-in-place remodeling consult the National Association of Home Builders /CAPS directory  

For help with Contextual (systems) thinking consult Fritjof Capra: The Systems of Life

 

See

What is a Professional Geriatric Case Manager? 

WingSong CoHouisng

(Photo windsong.bc.ca)

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