Most people want to stay put as they age. And just as there is a wave of disruption in senior housing, there is disruption in the ways to help people stay out of senior housing and keep them in their homes.
The first step in thinking about aging in place is retrofitting the house, with features like elevated ovens and flexible faucets, at least one no-step entryway, and D-shaped knobs on cabinets to help arthritic hands.
When renovating a home, experts on aging recommend leaving a closet open for a future elevator, widening doorways to accommodate wheelchairs, and installing full baths on the first floor. Also helpful: hiring an occupational therapist who can assess a home and help make tweaks based on need. Some of these modifications may be covered by long-term care insurance, so it’s a good idea to check.
That’s the relatively easy part. A bigger challenge is battling loneliness, shown to be as damaging as obesity and smoking to one’s health, which can become more burdensome once someone has a harder time getting around.
Grass-roots initiatives have emerged, most famously with communities like the Beacon Hill Village in Boston, that try to make aging in place more feasible. Now more than 200-strong, the village movement applies to seniors the African proverb “It takes a village to raise a child.”
Each village is different, though most charge an annual fee, often a couple hundred dollars, for services. These can include a vetted list of service providers like handymen and care managers, access to cultural events, discussions, and other gatherings.
The average village has 145 members and 92 volunteers, with only 14% of members on average in fair or poor health, according to the Village to Village Network, which acts as a hub for these informal communities. The challenge will be when their residents become older and less healthy, requiring more assistance, including with the shower and toilet. The group is already trying to help villages segue into that care role, either by using its own resources and volunteers to offer rides, run errands, and even outsource additional care to prevent or delay the need for assisted or skilled nursing care, says Barbara Sullivan, executive director.
Some villages, like Capitol Hill Village in Washington, have two licensed social workers to work with its volunteers, while another, Tierrasanta Village in San Diego, has tried to divvy up a caregiver’s time among members who may need just a couple of hours each.
More businesses are also emerging to fill the gap. For example, some continuing-care retirement communities are starting services aimed at those aging in place, incorporating long-term care insurance, care management, and staffed caregivers for a fee. Other start-ups are trying to pool 25 people in proximity together to offer them care management, meals, help with medicine, and other services for a monthly fee that comes in at a fraction of what they would pay in assisted living.
New technologies, from wearable devices to telemedicine, are also aimed at delaying, if not preventing, the need for assisted living or skilled nursing care and allowing more people to have a shot at having their retirement plans play out.