“Aging in Place” – A Technical Assistance Guide

The term ‘aging in place’ deals with a variety of issues, one of which is having older Americans age in their own communities and homes. Almost 89 percent of the elderly in the United States wish to reside in their own homes, creating a powerful impetus for elderly-friendly (aka “aging-friendly”) communities. To allow older Americans to stay in their own homes, communities must supply elders with appropriate services. Affordable housing, transportation, social services and social opportunities allow elderly people to function independently or with some assistance and continue living their lives within the community.

The 2007 report, “Aging in Place: A Technical Assistance Guide”, published by Partners for Livable Communities.

The contents of this Guide are organized into five sections: SECTION 1 – Introduces the critical issues that older adults face as they age in place, seeking to remain independent in their own homes and communities; SECTION  2: Chronicles the evolution of the Aging in Place agenda as well as how some important national partnerships have shaped Partners’ approach; SECTION 3: Provides short descriptions of what was accomplished in some of the many places that Partners has worked over the years; SECTION 4: Provides help in determining your community’s Aging in Place readiness with the Community Report Card; and SECTION 5: Lists and describes comprehensive technical assistance offerings from Partners for Livable Communities.

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  1. “Aging in Place” versus “Aging in Community”

    The May 11 post focused on a technical guide for “aging in place.” It is important to note that “aging in community” is an important alternative perspective. In the Summer 2009 issue of Generations (a publication of the American Society on Aging), William Thomas and Janice Blanchard wrote the following in an article entitled, “Moving Beyond Place: Aging in Community” (see pages 16-17).

    “Because of its intense focus on independence, the concept of aging in place leads, rather directly, to an emphasis on the dollar; paid professional services are required to provide care that will allow individuals to remain in their own homes. The combination of an aging society with the enshrinement of the private home as the only acceptable locus for aging yields cost projections that boggle the mind. Consider the following. The post–World War II generation that is now approaching old age has about 70 million members. If we imagine making a trillion dollar investment in the care of that generation, simple arithmetic tells us that that provides a per capita amount of just under $15,000 dollars. That is not $15,000 a year but rather for the entire period that members of this generation will need care, barely enough to cover two years in-home supportive services in 2005.

    The cost of an independence-based public policy, centered on the concept of aging in place, lies far beyond what our society can afford. At the same time, the use of mass institutionalization to cope with the needs of frail older people is gradually being seen as morally unacceptable. It is in this context that a third way becomes increasingly attractive. We need a public policy that facilitates the blending of financial resources (such as personal savings, pensions, and money from government programs like Medicare and Social Security) with social capital (which is created and maintained by healthy families and communities). For this blend to occur, we will have to confront and overcome deeply held and highly negative preconceptions about age and aging.

    Conventional wisdom holds that the aging of America is, by necessity, a bad thing. The inventory of losses and unwelcome burdens is long and has been detailed in scholarly journals and the mainstream media. Omitted from these calculations, however, is an accounting of what age and aging contribute to everyone. The virtues of aging remain invisible.

    Occurring parallel to this phenomenon of a rapidly aging society are shifts in family patterns (particularly the trend toward smaller family size, childlessness, alternative families, and divorce); increased mobility of families; the growing number of women in the workforce; increased life expectancy past the age of 85; spiraling healthcare and long-term-care costs. Another factor is the increased social acceptance of age-segregated communities.

    Still, new opportunities and hopeful paradigms are emerging: an increased interest in civic engagement in older adults; a conscious aging movement that promotes a new vision of elderhood; and examples like Hope Meadows that show intergenerational community as a tool that can be used to address social challenges that young and old face.

    At its most fundamental level, human longevity creates the possibility of multigenerational families and communities that contain three and sometimes even four or more generations. Because it is the multigenerational transmission of culture, values, and wisdom that is most essential to our humanity, strategies that strengthen interaction and ties between generations contribute enormously to our stock of social capital.

    The concept of aging in community is presented here as a useful successor to the concept of aging in place because the former shifts the emphasis away from dwellings and toward relationships. As the models described above demonstrate, the aging-in-community idea will be replicable across the spectrum, from rural to urban. With a high value placed on economic sustainability, it is critical to explore ways to extend the opportunity to age-in-community to the broadest possible segments of the population.

    United by the intention to create innovative alternatives to current housing choices, the new movement for aging-in-community promises to inspire the entire national conversation about aging and to engage the skills, spirit, and imagination of architects, planners, builders, and community activists of all ages. “

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