Because obtaining a Reverse Mortgage is such an integral part of Aging in Place, we are publishing a series on what is means to “age in place”. From keeping your home safe, to knowing your neighbors and neighborhood, the services and products available to you, the health and recreation services, planning is a big part of staying in your own home. Not to mention the feelings of dignity and independence, staying in your beloved home with all it’s memories can be a healthy, enjoyable choice for you and the whole family. We would like to thank Senior Resources of Irvine, CA for making this compilation of information available to us on the east coast.
Gloria de Gaston Boone
Aging in Place
1. What is “Aging in Place”
The term “aging in place” is in reference to living where you have lived for many years, or to living in a non-healthcare environment, and using products, services and conveniences to allow or enable you to not have to move as circumstances change. More recently “Aging in place” is a term used in marketing by those in the rapidly evolving senior housing industry. CCRCs, (Continuing Care Retirement Communities), by definition offer the chance to age in place, but first you must move to their community to “start aging”. Multi-level campuses market “Independent Living, Assisted Living and perhaps Alzheimer’s care and Skilled Nursing in one location, and claim to offer the opportunity to “age in place”, but again you must move there first. In many cases you must also move from one wing of the campus to another to receive the increased services.
Here we address issues and needs related to “aging in place”, without first relocating.
2. What is a “NORC
NORC is a community or neighborhood where residents remain for years, and age as neighbors, a NORC or Naturally Occurring Retirement Community develops. NORC may refer to a specific apartment building, or a street of old single family homes. Residents would just have stayed in their home or apartment for many years, and evolved into a senior community.
It is possible to band together and develop, or seek help to develop, access to services to aid those needing assistance, to retain the highest quality of life as they age.
Some 27% of seniors live in a NORC.
Fair housing laws provide for a complex with 80% of its residents over 55, to become officially age restricted.
For many years the law required an age restricted community to offer significant amenities and services if it was age restricted. That is no longer the case, but to compete, and attract residents, we still see most age restricted communities offering amenities and services to serve their residents.
Significant amenities and services may include:
- Social and recreational programs
- Continuing education program
- Information and counseling
- Outside maintenance and referral services
- Emergency and preventive health care programs
- Meal Programs
- Transportation on a schedule
Aging in place” successfully requires planning. To accommodate physical, mental, and psychological changes that may accompany aging, physical changes should be made in your home.
3. Why Aging in Place
A significant concern as people grow older is that they may have to leave their home. This would mean leaving behind a comfortable setting and many memories. In addition a certain amount of control is lost when one leaves their home. This “control” provides the underpinning to our feelings of dignity, quality of life and independence. One’s home is a strong element in their sense of security.
Most American seniors desire to stay in their homes for the rest of their lives. In fact an AARP survey found this number to be greater than 80% of seniors. This “stay at home” approach is also know as “Aging in Place” Several reasons are cited for this strong Aging in Place preference. These include:
Comfortable Environs
Independent Feeling (helps retain dignity)
Convenient to Services
Familiarity (with neighborhood, services, transportation)
Safe and Secure
Closeness to Family (and friends)
“Aging in place” successfully requires planning. To accommodate physical, mental, and psychological changes that may accompany aging, physical changes should be made in your home.
4. Changes Related to Aging
Contrary to popular belief, most American seniors live independently while maintaining strong relationships with family and friends. Their personalities remain relatively stable throughout their lives. Depression occurs less in uninstitutionalized seniors than among young adults.
Normal age related changes do occur. These may include:
Hearing impairment
Weakening vision,
Osteoporosis.
Increased likelihood of arthritis, diabetes, heart disease, and hypertension,
Mental process changes
- speed at which information is processed
- speed of responding to changes in the environment
- long term memory declines
- word finding ability declines
Visual impairments
- decreased reading speed
- seeing in dim light
- reading fine print
- sensing changes in the environment
These changes may lead to difficulties in interacting with one’s living environment. These include:
Decreased mobility and dexterity
Decreased strength and stamina
Reduced sensory acuity: vision, hearing, thermal sensitivity, touch, smell
However some functions tend to remain the same with advancing age. While seniors tend to process new information slower, daily social and occupational functioning ability remains stable. Most language related skills also tend to remain stable with age. Most notably, creativity and wisdom continue at strong levels.
In addition to physical changes, seniors experience social changes that may be disruptive. These include: isolation from family and friends, loss of peers children living far away and hanging neighborhood
The majority of seniors learn to adapt to their changing situations and lead happy and productive lives.
5. Aging and Your Home
The aging process is blamed for many problems seniors may encounter with daily activities. However quite often it is the home itself that caused the difficulties. Most residential housing is geared to young healthy adults. Builders do not take into account age-related conditions such as reduced mobility or limited range of reach. Hence, most dwellings do not support the physical and sensory changes that older adults encounter as they age. What appear to be insignificant home features can have significant effect: for a person with even minor aging issues.
Many seniors avoid home modifications and helpful technology items that are designed for people with disabilities. This is caused by these products having an industrial appearance. No one wants to have their home look like a hospital. Consumer demand and computer technology have pushed institutional products to be redesigned to be more acceptable in the home. Some of these include:
Chairs designed for easier in and out
Enhanced high and low frequency tones for doorbells and telephones
Grab bars and hand rails with decorator colors
Hospital type beds with wooden headboards and footboards
Items that are easier for arthritic hands to handle,
Larger print for declining eyesight
On/off buttons with color contrasts
Walkers in bright hues
The National Center for Injury Prevention and Control states that falls are the number one cause of home injury, and studies suggest that a significant proportion of all falls are due to environmental factors
The three leading causes of home injuries, according to the National Center for Injury Prevention and Control, are: falls, burns and poisoning. Seniors are especially susceptible to these types of injuries. Most falls are caused by environmental factors such as a home not truly suited for a person with elderly issues. Burns are caused primarily from fires. Older adults are killed in home fires at twice the rate of society as a whole (National Association of Home Builders (NAHB), 1990 Poisoning is mostly caused by medicine non-compliance: older adults are six times more likely than other age groups to suffer adverse medical reactions (Alliance for Aging Research, 1998).
One of the bigger challenges is to identify safety issues that may be unique to an individual based on their particular aging status and conditions. While research via books and the internet can help focus on such issues the use of a good checklist in assessing the home environment is helpful.
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