Wanted: Housing & Community for Aging Americans
Part One in an exploration of housing for an aging population
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 renting has dramatically increased.
Mortgage rates have soared after record-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 needs of the shrinking size of US families and seniors.
Builders are focused on building multi-level apartments and townhomes, which an aging population may be unable to live in physically.
It’s estimated that over 1 million people, the majority over 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 in my small town even come on the market. 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 significant 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 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 = increasing poverty among seniors
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 stressful experience.
Many look forward to retirement, planning travel, and taking up new activities. However, 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: putting ourselves in a healthy environment to age will allow us to thrive 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 that no one wants. This series of newsletters about aging, housing, and caregiving represents a starting point for discussing and 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 stages 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
Most people need help during the last stage of their lives. A partner and/or adult children often provide caregiving. Hiring private, full-time caretakers and nurses might be ideal, but it’s also expensive. In some areas, not enough healthcare providers are 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 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 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.
Living with family can be an excellent solution for affordable housing and offer social benefits to all family members. However, as an older person’s needs gradually demand daily caregiving, that responsibility can dramatically change the shared living experience. Modern medicine can extend people’s lives for several years, often necessitating 24/7 caregiving. The risk of dementia increases as we age, and the majority of elders with dementia are cared for by unpaid caregivers - 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 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.
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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.
https://www.nytimes.com/2022/03/27/us/mobile-home-park-ownership-costs.html?searchResultPosition=7
Such a well done and important post, Sue! Though I think both Joe and Jill Biden are able to see the needs you speak to for our aging population, I have been flummoxed by our country's blind eye to all of the needs people encounter as they age. Aside from zealous marketers, that is! UGH!
I cared for my much-loved parents through most of my 60's. They were in their 80's - 90's and had lived quite healthy lives. I lived 2 hours away. I started visiting 2-3 days a week to help as needed. A year later I was spending at least one overnight visit. All of this was going on while I continued to run my much-loved business. About a year apart, both of my parents took falls that required hospital care and soon after new living arrangements had to be made. My mother rather quickly started to have signs of senior dementia and required a wheelchair. And I became aware that my father's driving habits were not at all good. Mostly he slowed down and tended to hug the curb. UGH! The good news is that one of my sisters made room for my mother to live with her. She and her husband had a house that was accommodating to mom's wheelchair and mom loved being there! My other siblings helped me find a modestly priced seniors-only complex for my father. I was totally prepared for my father to reject this alternative as he had been a carpenter and loved where he lived. To my surprise, he loved his new apartment with its little sun deck and a view of the parking lot and entry area. He was able to bring his much-loved cat and that was a big plus, too. On the downside, I had to figure out how to have dad give-up driving. And soon dad was experiencing senior dementia, too.
Turns out there is so much to learn about aging and caring for our parents. I was clueless. I knew nothing about dementia, and the other medical side of things, financial aspects, the change in family dynamics, and on and on. We were lucky in that there was just enough money to have occasional help and very good health insurance. We were not lucky in that my parents' home and vehicles was being destroyed by looters and kids on drugs. To the point that all utilities had to not only be turned off but also disconnected. And it was hard to find property insurance. The local police had their hands full with quote - 'real crime'. UGH!
I have tried to condense this while at the same time provide a sense of what aging in America is like.
thank you for including us on your journey in downsizing and making the tough decisions for realistic living accommodations for elder years. We had to make these decisions during the housing crisis of 2008 before retiring and were fortunate to find a community and home that will see us into our latter years. It doesn't offer everything we wanted, but we're making it work out. Encouraging our children to think about and make plans for these things while they're in their 40s is important to us.