Wanted: Housing & Community for Aging Americans

Part One in an exploration of housing for an aging population

Photo by Kostiantyn Li on Unsplash

The current realities of the US housing market are depressing for anyone who rents, wants to purchase a home, or wants to sell their home. The problem is an affordable housing shortage, estimated at 4-7 million units, caused primarily by restrictive zoning in both urban and rural areas. Unregulated capitalism is based on supply and demand, contributing to the lack of affordable housing:

• Rent prices have risen 30% since 2017, and at least half of all renters spend 50% of their monthly income on housing. In the last two decades, the number of people over 60 who rent has dramatically increased.

• Mortgage rates have soared after record-level low rates, adding hundreds of dollars to monthly payments. In addition, financial regulations in the mortgage industry prevent many potential homebuyers from qualifying for a mortgage.

• People over the age of 55 are likely the fastest-growing group of people experiencing homelessness.

• Investment corporations are buying affordable housing like mobile home parks and apartments, and then raising rents, and evicting tenants.¹

• Most homes are too big for the shrinking size of US families and seniors.

• Builders are focused on building multi-level apartments and townhomes, which an aging population may not be able to live in.

• It’s estimated that over 1 million people, the majority over the age of 55, choose to live full-time in RVs, campervans, and their cars. This number is expected to increase.

I have shared my decision to leave what I believed would be my forever home in Revising a Dream and thought that if I had to, I could move into the small village 30 minutes down the mountain. But the real estate prices have more than doubled in the last 15 years and few houses even come on the market in my small town. I have spent the last two years looking at homes and communities that would serve my needs and interests as I age. What’s on the market is either beyond my price range, too big, needs major repairs or is in a 55-plus mobile home community that charges ridiculous rents for the lot your mobile home sits on and has more rules and regulations than my high school did, including “approval” of my pets. It’s been a frustrating experience, and after two years, I am now considering a broader range of possibilities.

I have been reading and researching what aging in America will look like over the next two decades, and I have already concluded that it will not be pretty, especially if you are not wealthy. 

• Lack of affordable and appropriate housing 

• Lack of healthcare providers, including doctors, nurses, home health assistants

• Outrageous (or, as my friend says, criminal) medical and pharmaceutical costs (w/o insurance, two epi-pens cost $475) 

• Older people increasingly living in isolation

• Significant increases in everyday costs of living 

• Absence of services for seniors in rural and small communities

• Lack of interest by politicians in addressing the current and future needs of an aging America

Creating an Aging Plan

Much to the frustration of my sister and me, my mom and stepfather’s only plan for aging was to die in their home. My mom was fortunate to do that with support from her spouse, her children, a family friend/caregiver, and hospice staff. My stepfather was not that fortunate and faced some difficult and unhappy decisions about his housing and need for caregiving, almost all of it out of his control. I learned much from their somewhat tragic experience. 

Many of us look forward to our retirement, planning travel, and taking up new activities. But few of us consider what our elderly years will look like and how we will live during those years. A plan for growing old begins with a long-term vision based on needs, goals, and a healthy dose of reality. Many variables come into play, and flexibility and regular analyses are key to supporting an aging plan.

Gardeners know that the right plant placed in the right place will flourish. Designing an aging plan is the same: placing ourselves in a healthy environment to age will allow us to flourish as elders. Each person has specific needs, desires, and wealth. One size does not fit all. Yet our culture’s thinking about aging and caregiving is an institutional model, which none of us want. This series of newsletters about aging, housing, and caregiving represents a starting point for discussion and for creating proactive and flexible plans.

Aging in Place 

In poll after poll, most older Americans indicate they want to stay in their homes as they age. Aging in place is more complicated than installing grab bars in the shower and widening doorways for wheelchair access. They may not have considered the often-real scenarios of aging:

• Becoming physically disabled

• Various levels of dementia

• Loss of control of bodily functions like urination and bowel movements

• Pain and medication management 

• Maintaining optimal nutrition and movement levels

• Financial limitations

• Availability of community resources like healthcare, social services, and transportation

• Availability and affordability of home healthcare

• Loss of social connections; loneliness, isolation

During the last stage of our lives, most of us need help. Caregiving is often done by a partner or adult children. Hiring private, full-time caretakers and nurses might be ideal, but it’s also expensive. In some areas, there are simply not enough healthcare providers available to fill the demand.

There has been a trend of older Americans moving into rural areas, building their dream homes, and perhaps thinking like I did, that this would be a great place to live out our lives. However, rural areas have limited healthcare, social services, and community resources. In my rural village, most specialized healthcare requires a 1-2 hour drive to a city.

Because of finances and the desire for autonomy, aging in place may be the only option for many older Americans. Creating an aging-accessible home allows residents to navigate the kitchen and bathroom more easily, allows for wheelchair use, and reduces the potential for falls (the leading cause of injury for people 65 and older). An aging accessible home includes the following:

• A step-free or ramped entryway 

• Bedroom and full bathroom on the first floor

• Door handles instead of knobs; handrails along stairs

• Bathroom accessibility: Built-in shower seats, elevated toilets, step-free shower access, handrails or grab bars in the shower and next to the toilet

• Wheelchair accessibility: no steps, extra-wide doorways and hallways, access to electrical switches and outlets, and access to kitchen cabinets and sinks

Shared Housing: Living with Family

For some elderly people, moving in with an adult child or family member is an affordable way to have both housing and caretaking. In the US, about 15% of American adults in shared housing are the parents of one family member. For many centuries and cultures, this was the traditional model for families: caring for our elders was the responsibility of the nuclear family and their surrounding communities. Nowadays, many families are separated by long-distance moves, so elders are isolated from their children.

Photo by Rod Long on Unsplash

Living with family can be a great solution for affordable housing and can offer social benefits to all family members. But as an older person’s needs demand daily caregiving, that responsibility can dramatically change the shared living experience. Modern medicine can extend people’s lives for several years which necessitates 24/7 caregiving. The risk of dementia increases as we age and the majority of elders with dementia are cared for by unpaid care - family members. Many adults in Western cultures are employed outside of the home. Research indicates that this option can be stressful for families and especially for women: the majority of family caretakers are women who are employed while also caring for an elder. 

AARP offers a list of questions and discussion points for families who are considering a multi-generational living arrangement.

People without children or other family members have options for shared housing. In Part Two, I will discuss co-housing, home sharing, and senior communities.

What’s your plan for aging and housing? Are you currently caring for an elder? I would love to hear about your experience, tips, and thoughts. You can share with other readers in the comments or hit reply to send them privately to me.

1. https://www.nytimes.com/2022/03/27/us/mobile-home-park-ownership-costs.html?searchResultPosition=7