Aging in Place in a Nutshell
Problems are why you have running water and insulation in your home. Plumbing was created because of a problem. Toothbrushes were invented because of a problem.
~ Bill Burnett, Designing Your Life
Aging in Place
I wrote a book review 9 years ago on Independence for Life: Homes and Neighborhoods for an Aging America: University Press/Austin 2012. I revisited the issues recently and they remain much the same and largely unresolved. The COVID-19 global pandemic has brought the aging-in-place versus institutional care settings debate to the collective consciousness of a nation in crisis. Below are the key points in the book which are now even more urgent.
Henry Cisneros understands the issues of our changing demographics and aging society. As a public servant who made it from Mayor of San Antonio to the BIG Dance as Secretary of HUD, he has long been interested in housing and communities. Henry has now focused his formidable energies on the area of aging in place. I’ve often heard it said that proper diagnosis is 80% of the cure; Mr. Cisneros has identified the issues surrounding aging in place and is now focusing on treatment (policy) leading to eventual improved outcomes for an aging society.
The issues:
- Fast-arriving changes in age, race, and ethnic composition
- The need to create Liveable Communities
- Large segments are at risk for health, social, and economic hardships
- Suburbs where most elderly now live are auto-dependent distant from social, cultural, services, basic needs
- Rural elders struggle to get service delivery needs to be met
- Choices of housing must be wider range; retro-fitting current stock, new-age-appropriate housing built, existing neighborhoods reconnected, co-housing, new communities planned
- Financial strategies like reverse mortgages need to be adapted to changing needs
- Public opinion needs to be better aligned with changing values of accessibility, affordability, connectivity, and diversity
- The government needs bold solutions to address aging population requirements
- How to meet the social isolation of seniors with emerging technologies
- Safety and security of aging in place boomers and seniors
- Diminishing social service gaps need filling
- Living independently with multiple chronic conditions and health/wellness management and emphasis on ALE or Active Life Expectancy and the Compression of Morbidity
Longevity Dividend and Environment as HeathProtectant
The late Robert Butler, former president and CEO of the International Longevity Center in New York City, introduced the idea of living longer and in health (functional) as a worthy goal. Henry Cisneroshas included this concept into his approach to successful aging in place. He knows that as we age our bodies need to be available to us in order to enjoy “Independence”–and continued contribution to our communities.
Compression of Morbidity is a key component along with an environment that supports and facilities wellness. A place to live that is physically manageable and emotionally uplifting is connected with independence, peace of mind, and self-improvement (*p.10).
Cisneros contends that many homes will need significant modifications to support healthy living, and older Americans may ignore necessary changes until there is a crisis. A proactive approach is his goal, for the individual, the community, and our government; a call to action is required to make successful aging in place possible for those Americans like his own mother who remains home by choice.
In Summary
As a society, we need to be producing more housing that is of a smaller scale, affordably priced, suitable for multiple-family use, located in walkable communities, and close to amenities, commercial districts, health facilities, and public transit. And we need to compress morbidity so we are not just prolonging life, but also functional health.
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*Independence for Life: Homes and Neighborhoods for an Aging America: University Press/Austin 2012
(note: Mr. Cisneros’s mother has since passed)