© 2011 by Tom King
I'm a boomer and proud of it. Some 75 million of my generation are approaching what our parents called “The Golden Years”. Well, we've seen what our parents and grandparents have gone through during their own “Golden” years and, frankly, a lot of us don't think that winding up in a nursing home could be described as “golden”. Yet, for many of our seniors, that has been seen as an inevitable consequence of aging.
Over the past half century, a conventional long-term health care track has been to move from home to some form of senior housing to assisted-living to nursing home care. This model emphasizes a reactive approach to health care for seniors. As health breaks down, the senior moves to ever more restrictive and intrusive environments. Often this encourages feelings of helplessness and loss of control. These emotions have been shown to lead to depression and increased incidences of physical illness in senior patient.
My generation is looking at approaching retirement with a little less submissive attitude. Our parents kind of spoiled us. They wanted their babies lives to be better than their own and, as a result, we're used to getting what we want. And what we want from retirement is to live in our homes and do what we want to do. We read Dylan Thomas in high school. We have no intention of going “quietly into that good night.”
An AARP survey determined that 80% of seniors want to stay at home. This approach is called “aging in place” and, not only does it appeal to aging boomers, but it also makes good financial sense. A University of Missouri study found that the emotional benefits of remaining in a familiar community and receiving supportive health services at home prevented most people from having to eventually relocate to a nursing home.
The Missouri study analyzed total care costs for individuals following an aging in place strategy over four years. The costs for living and health care were far less than those for assisted-living and nursing home services. As an added bonus, subjects aging in place reported improved mental and physical health outcomes over their peers following a more traditional track.
The coming new crop of seniors tend to be more health-conscious, more physically active and socially engaged. They prefer to plan their own future rather than follow a course charted by someone else. They have no intention of waiting till their children have that inevitable meeting down at the I-HOP to decide “what to do about Dad”.
The aging in place (AIP) model emphasizes provision of services and care in the home to meet the increasing needs of seniors. This not only prevents the necessity of moving to higher levels of care, but also promotes mental, physical and social health. The AIP model also emphasizes preventative health care strategies like proper nutrition, exercise and socialization which have been shown to be effective at reducing illness and injury in seniors.
Leaving home has always been traumatic for aging Americans. Many work all their lives to build and pay for their dream home. They become comfortable with their surroundings and their neighbors. They have powerful memories, a sense of independence, dignity and security. Owning your own home supports a sense of control over your own life. Seniors, forced to move from their homes, often lose that sense of control. There are several solutions for successfully aging in place.
Individual Planning
With the help of home health services, Internet-based supports like on-line groceries and supplies, security monitoring, communication and companion services, senior can obtain a wide variety of supportive services that will enable them to live independently. This requires careful financial planning. You'll need money to make modifications to your home to meet your accessibility requirements, insurance to cover long term home health services and a human support system made up of family, friends, medical and attendant caregivers.
A naturally occurring retirement community is a neighborhood where residents have, over time, aged together as friends and neighbors. The community may be an apartment building or a street of single family home, an old development or houses bound by naturally occurring boundaries. As residents stay and age, they band together to seek help in maintaining a high quality of life in the old neighborhood. By developing an organized community council, the neighbors can obtain help, access to services and often city support to aid community members who need assistance to remain in their homes. An estimated 27% of all seniors live in such communities. Fair Housing laws allow for communities with 80% of residents over age 55, to adopt age-restriction zoning policies. Neighborhoods with 100% of residents over age 100 can also be formed, but these are more rare.
Planned Communities
Planned communities are developed by health care companies, nonprofit organizations or real estate developers. Many are apartment complexes or gated retirement communities and offer amenities and services in exchange for homeowner's or association fees. Such communities are often quite nice, but they are, after all, planned by the property developer. Often residents find themselves paying for amenities they never use, services they have no need for. It is important that you check the community thoroughly for things like accessibility. Residents have found, after spending their life savings for a condo, apartment, cottage or house in a gated community that developers didn't build streets wide enough for para-transit buses for residents who lose their ability to drive. Seniors have found themselves playing “Dodge-'em” in the parking lots because the designer left out sidewalks in the plan. Residents of one senior housing community I know of, has to call para-transit in order to get from their front door to the grocery store even though they can see the store from their porches. Nobody thought to put in a sidewalk and curb cuts when they built the place.
Deliberate Communities
Finally, a new concept in senior housing is the resident-designed community. The way it works is, a group of older individuals band together to create for themselves, not a dream home, but a dream community – a place they would like to live in with people with whom they enjoy associating. The group works together with a realtor, architect and AIP professionals to create a plan for a neighborhood that facilitates aging in place. The group buys a piece of property and builds their individual homes or cottages around a central commons like medieval villages used to. They work with an architect who understands principles of universal design and how to build to facilitate aging in place. The group decides what amenities they want to have and what features they don't want and these are built into the commons area. Homes are designed so that features or modifications that support health-care needs, provide accessibility or improve safety either already exist or can be inexpensively added.
The Deliberate Neighborhood, also called co-housing, is a unique type of housing driven, not by outside designers or developers, but by residents themselves. There are six characteristics of co-housing communities.
- The process of designing the community is driven by the residents themselves. Although the community may be initiated by a developer, the residents of a well-designed co-housing community will involve residents throughout the development process at all stages. If this doesn't happen, the community is not true co-housing.
- The site plan is designed to encourage a sense of community. Private cottages usually cluster around a central open common space. Front porches face the commons and pedestrian ways with automobiles parked along the outside of the neighborhood. The intention of the layout is to draw residents toward the shared spaces and encourage socialization among neighbors.
- The residences are designed with simplicity and efficiency of space usage, energy consumption and maintenance in mind. A central commons area usually includes a large kitchen and dining area, sitting areas, a laundry and whatever other facilities and amenities the community desires. This may include gardens, libraries, crafts rooms, playgrounds, a spa, pool or even guest rooms. Some resident groups leave large areas of undeveloped woodland around the edges of the property to encourage birds and wildlife.
- Homeowner's groups in co-housing communities have a loosely structured system of governance. Decision-making is non-hierarchical. Generally, those who have a burden to lead or contribute in some way tend to adopt roles in the community that fit their talents. Decisions are reached by general consensus. Some groups formalize voting and governance rules if that becomes necessary, but generally these kinds of communities operate more along the lines of a “good old boy” network.
- Management of the communities is performed by the residents themselves. They share work, participate in preparing common meals if the group decides to have regular communal meals and they meet together as needed to address problems or create rules and policies. People tend to take on jobs they are good at.
- All the members of the community manage their own finances. The community generally charges dues or homeowner's fees to maintain facilities and may even hire someone to do specific tasks like maintenance or tilling up the garden, mowing the grass or repainting the gazebo. Often the community will hire its own members for these sorts of things. More often, such jobs are considered a contribution to the shared responsibilities. Others take on flower beds or cleaning the kitchen. These communities really do share the care and upkeep of the neighborhood.
Co-housing communities lend themselves particularly well to urban or rural, suburban and semi-rural settings. Co-housing neighborhoods can be built close to shopping facilities, churches or recreational areas – virtually anywhere the neighbors want to build. Neighbors in the community watch out for each other, helping with neighborhood security, sharing transportation, food preparation or household problems.
The community is designed to facilitate access by health care providers and to provide universal accessibility to all parts of the community. Neighbors also take a more hands-on approach in some cases, helping to monitor the health of other neighbors, their medications and their physical activity. Like villages and extended families of the past, these communities encourage neighbors to depend on one another for things they would ordinarily pay professional health-care workers and caregivers to provide. For individuals and couples with a desire for an active and rewarding retirement, co-housing may be just the thing.
Resources:
Aging In Place
Aging in Place Initiative
National Aging In Place Council
Senior Resource: Aging In Place
Age In Place
Neighbor Works America: Aging in Place
Partners for Livable Communities: Aging In Place Initiative
Physorg: Aging in Place Preserves Seniors' Independence
Co-Housing.org
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