Aging in Place: The Obstacle is the Way

The impediment to action advances action. What stands in the way becomes the way.

~ Marcus Aurelius

Aging in Place

The quote above from Roman Emperor, Marcus Aurelius was penned in his private diary approximately 2,000 years ago and was the impetus for a book The Obstacle is the Way, by international best-selling author Ryan Holiday. The idea/concept that infuses both Aurelius’s quote and Holiday’s book is that successful people in life turn negatives into positives. A more colloquial way to perhaps express the same idea is the old saying “turn lemons into lemonade.” Modern life is filled with daily obstacles as it clearly was in ancient times–the evidence for this was found in the emperor’s personal notes to himself. So, to live successfully one must learn to not just overcome obstacles, but to employ them in the service of individual goals.

Obstacle as the Way

Turning the obstacle into the way is easily applied to aging in place at home for many elders that I have watched navigating cluttered environments. Let me explain, I was reading an informative post from Steve Hoffacker, CAPS titled: Are Open Floor Plans Beneficial Aging in Place Features? Steve is an expert on aging in place environments and his content is always rich, in-depth, actionable, and worth reading. The article confronts the popular trend of open floor plans where the kitchen, dining or eating area, living room, and family room, if not more, into one open space without any connecting or dividing walls. Often, the space opens onto a patio area. Steve brings up a thought-provoking point that walls often help determine wayfinding for older adults. Removing the wall structures to accommodate aging in place design elements such as walkers or wheelchairs, at first glance seems intuitively correct. However, he argues this can be disorienting to older adults with perceptual or visual challenges:

Steve reports:

Many people feel that the open concept is consistent with modern design strategy that facilitates aging in place. However, look at what aging in place means – that people can remain safe in their living space and find it comfortable, convenient to use, and accessible. Often, the very factors that define an open concept weigh against these effective aging in place considerations. People suffering from a low vision that is compounded by a visual distraction from too many colors and shapes being present in a large area without the benefit of wall space or other confining shapes to isolate them, those affected by color overload from too many shapes, patterns, and colors in an undefined area, and those easily distracted by the shapes and sizes of furnishings without finding them anchored to a wall area are going to find an open concept less to their liking and less safe to be in and navigate than one that provides the security, safety, and structure of rooms defined by physical walls.

His points are well taken and should be considered prior to convert to open floor plans to accommodate an older adult. This type of openness was popular in the 1950’s ironically for this very generation when they were young and growing families. The concept was known as “Ranch Style Homes” which housed the baby boom generation in the suburbs of America. Affordable, one-story, open floor plans, pitched roofs, smaller footprints (downsizing), incorporation of outdoors into indoor spaces, all desirable for a once young post-WWII generation and in many cases today for that now-aging cohort as well.

This type of architecture seems very conducive to aging in place, in fact, I have written about it in the past. But, as singer/songwriter Tom Waits once noted in the song Please Call Me, Baby; “If I exorcise my devils, will my angels may leave too…” translated, if designed for an open floor plan will the unintended consequences of ridding the home of perceived obstacles, be creating more problems for the end-users?

Selective Optimization with Compensation

Steve’s query into the potential side-effects of open floor plans got me thinking about seniors I have been around both personally (family/friends) as well as professionally (patients) and experiencing how they negotiated home environments. What can first appear as clutter in the home generally–and what’s termed “goat paths” specifically, where the pathways through the home are seemingly obstacle courses of tables, chairs, lamps, dressers, or an array of items littering travel paths actually act as stabilizing anchors by which the aging in place seniors uses to move about. This recalls primates who swing from limb to limb using various vines or imagine a trapeze artist moving from place to place by way of swings. It appears dangerous, but the animal/human knows exactly what they are doing from years of practice and it works.

I will be the first to say that removing clutter and obstacles is the best practice concerning accessible homes, but I will also admit witnessing older adults using these “obstacles” quite effectively! This brings us full circle to the obstacle is the way…Older adults living in environments that they have created over decades employ strategies that help them optimize person-environment fit, even to seemingly less than optimal environments. This is known as Selective Optimization with Compensation (SOC).

Baltes Theory of Successful Aging is called Selective Optimization with Compensation and is defined as:

A strategy for improving health and wellbeing in older adults and a model for successful aging. It is recommended that seniors select and optimize their best abilities and most intact functions while compensating for declines and losses. For example, an elderly person with fading eyesight who loves to sing could focus more time and attention on singing, perhaps by joining a new choir, while cutting back on time spent reading. Overall, this model suggests that seniors take an active approach in their aging process and set goals that are attainable and meaningful (source: alleydog.com)

Winston Churchill was once credited with saying, We shape our dwellings and later our dwellings shape us. I have seen this enough to agree that this is certainly true. The bottom line is older people get creative in less than optimal living situations to compensate for aging bodies and losses. The goal is always to improve safety first and quality of life will hopefully be an outcome of aging in place design. What is key is to never forget the end-user in the design process because what might appear to be an obstacle may in fact, be the way…

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stevehoffacker.com

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