Myth of Aging in Place

One of our projects is in Niagara Falls where Covenant Care Niagara is working to create a new kind of nursing home in Ontario where aging is not considered an illness suitable for a large institution, but a fact of life, where, in a small setting, life continues to be meaningful, relevant, and important.

The inspiration comes from the Green House homes that are becoming very popular in the U.S. They are a change away from our institutional, medicalized model where advanced age is an illness.

Bill Thomas is the driving force behind this movement and I was struck by a comment he made in the linked article.

"Aging is, and has always been, a team sport. The myth of "aging in place" harms people by defining the decision to share one's daily life with others as failure. But a big piece of the reluctance to seek out new ways of living with others is the dread of institutionalization. People cling to their homes in large part because they fear life in a nursing home more than they fear death. These are solvable problems, but we can't and won't make much progress until we come to a vastly deeper appreciation for the value of "life beyond adulthood."

I suspect he is right about "aging in place" as a reaction against the alternative. For 10 years it has been the buzz phrase for progressive thinking on elder care. It should mean having sufficient supports to remain in one's current home not as long as possible, but rather until a better, more meaningful alternative makes better sense. One view is clinging to the last hope of independence. The other is ensuring any place one lives is the right place.

Boomers - Act NOW Before it is to late

From TopRetirements
It seems like an oxymoron that, just when you were beginning to think about down-sizing, you could actually be near outgrowing either your existing home, or the one you build or buy for retirement.

The answer is that you probably won’t outgrow it, but if you are not careful, your needs will change to the point that your home no longer fits you. And then the choice is either to move, or put in expensive and inconvenient renovations. Building a home with universal design principles can add about 5% to the cost, but a big savings when compared to retrofitting a home at 30%.

Several important concepts apply to this issue. “Universal design”, which as the name implies means that one set of design principles should be applied when it comes to accessibility. In other words, whether you are a young child, healthy and athletic 40 something, a slowed-down senior, or confined to a wheelchair - your home ought to be able to accomodate you. Fitting along with this concept is the goal of “aging in place”, a goal that the AARP says is shared by 84% of Americans 50 and over.

So with these two concepts in mind, what can you do to promote your future aging in place - whether you are renovating your existing home, building a retirement home, or buying into an active adult community? First, you should read up on universal design as it applies to aging in place (see references below). If you are buying an existing home or one that is in the process of being built you might be able to negotiate some of these improvments into your purchase contract. Or you can choose to look elsewhere.

Some of the obvious steps are: 

- Wide doorways and hallways
- No changes in levels (unless they are ramped) between rooms- Ramped entry(ies) to your home
- Tall toilets and grab bars in bathrooms
- Non slip floors- No glare, contrasting lighting and paint
- Lever style handles instead of doorknobs
- First floor master bedroom (or the option for that)
- Provision for future elevator (if building or remodelling)
- Kitchens and major appliances on the main floor
- Kitchen counters at varying heights to fit a range of users

Building in universal design principles now will save you time and trouble, and allow you to age in place. Typically people tend to think they are 10 years younger than they are, but if we are fortunate enough, we will age and lose mobility. Better to be prepared now.The National Association of Home Builders has a Certified Aging-in-Place Specialist program to help builders and designers. Pima County, Arizona is just one town that has mandated universal design elements for all new housing.

NAHB Aging in Place Suggestions

NC State R.L. Mace Universal Design Institute

Blueprint for Boomers

VIP Service - Keeping Seniors in their Home

The Veteran’s Independence Program (VIP) has existed since 1915 and I’m amazed that it has not been expanded to the general population. This program concentrates on keeping a person in their home, including housekeeping and home maintenance, areas of concern that cause so many to give up and move to more expensive assisted living or even long term care. From a recent Toronto Star article …..

VIP focuses on what Ontario's Community Care Access system (explained on the front page of this newpaper today), does not.

"In Ontario, if you just need a little help with house cleaning, you won't be eligible for CCAC home care," says Margaret MacAdam, a Toronto gerontologist. "In Ontario, you have to need help bathing to get CCAC services. They're targeting a more needy population."

In fact, home care provided by the Ontario government's community care program is limited to providing medically necessary services to maintain seniors at home. That, says B.C. health policy analyst Marcus Hollander, means Ontario is ignoring the critically important role of non-medical services.

"If the VIP services keep people out of facilities," he says, "they are medically necessary."

Hollander led a research team that compared the costs and outcomes of VIP home care versus long-term care and supportive housing. The team interviewed veterans, widows and caregivers across the country.

One of the findings was that wait lists for nursing homes shrank when veterans joined VIP. Once they could manage at home, with support, they no longer wanted to get into a nursing home.

"We showed that clients – and taxpayers – get better value for money when you substitute home care for facility care," says Hollander.

But MacAdam notes that the bedrock of home support is still the family.

"None of the public programs replaces family contributions. If there's a breakdown, you call your daughter. She may not live in your city but you'll count on her to take action. If you're on your own, you're counting on the reliability of the service."

Why are we not doing this to a greater extent?

Retirement Housing in a Down Market

This from topretirements.com:

Many retirement communities (in the United States) are experiencing a sales slowdown for this specific reason. One of the problems with the issue is many retirees only want to sell if they can realize 2005 type prices - accepting anything less seems like some sort of defeat. Unfortunately that is the state of the current market - prices are off at least 20% in many parts of the country, and probably won’t be headed higher for some time to come.

This is something we will have to watch here. The fact its, our market is not the same, at least not yet. This is, of course, a matter of psychology - the self-defeating desire to sell low and buy high. If markets start to decline the cost of construction will also decline – in the short term. Waiting to buy, when the market has hit bottom will not be wise. The return to present equity levels may take a long time. If energy prices continue to increase as expected, property values may not return in a very long time.

U-Boomers

“We’re so special.” It makes one wonder how the other generations feel about us. The new term, among many, for a large segment of the boomer generation is “U-Boomer.” The “U”, as mentioned in Forbes, stands for uncompromising, so U-Boomers are those who intend on keeping a high flying lifestyle but likely do not have the finances to keep it going. This means those who market to boomers need to figure out how to give them what they want without a lot of cost.

For marketers of active adult communities, that will be a challenge. Part of the solution is in positioning communities so they deliver high value and prestige without pricing the product out of reach. Maybe that means inexpensive hiking and biking trails instead of ultra-expensive golf courses. Or intimate
clubhouses instead of monstrous edifices. A la carte services instead of the buffet approach. Environmentally sustainable communities that not only keep energy expenses down, but make U-Boomers feel like they are fashionable and responsible.

The last line is a bit cynical and was written by someone who does not understand how we change as we age. Research has shown that older adults are actually interested in being environmentally responsible. They do not want to "feel like" they are responsible. They have a desire for authenticity and in leaving a legacy for future generations.

Thorold Abbeyfield Public Meeting

A Thorold councillor wondered if this were a cult when it went before council for rezoning. Good grief! Abbeyfield homes are one of the great successes world wide in creating affordable congregate living for seniors. Volunteers, families, and seniors themselves create family like settings with a housekeeper and cook.
Grace Community Church, on St. David's Rd. is conducting a public information meeting on Wednesday, March 12th, 7:30 p.m. to discuss concerns raised at council. Hopefully more intelligent questions about the nature of this project can be answered. For more information about this Abbeyfield project call 905-680-4092.