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The hype of aging in place -- so bad for so many

The articles and tech industry focus on ‘aging in place’ and fear. And it’s not unlike the ‘I’ve Fallen and I can’t Get Up’ fear. AARP fuels it with survey results (77% of the 50+ want to age in place). Free-lance writers follow up with an Aging in Place story citing the survey. It capitalizes on the recent CES with a laundry list of tech offerings that could help with fears -- like sensors, medication management, motion sensors and smart watches to mitigate fear of falling. And AARP helps add brand recognition to the term ‘Age Tech’ with a collaborative of companies at the Nexus of Longevity and Technology to deal with health issues and mitigate fear.  But wait…

What if aging in place is media-fueled, but bad long-term for many (most) people? What could go wrong?  Perhaps aging will be solo – no spouse, partner, children or nearby siblings.  Perhaps it will be in a rural area, on a property with considerable land, but no nearby services. Perhaps it will be in a home that needs ‘age-proofing’ -- a large house with stairs, no nearby relatives and no first-floor bedroom. Perhaps that retrofit is not affordable. Perhaps the house is old and requires significant maintenance. Perhaps the grounds are too much to mow, plow or traverse up or down. 

Who should be worried – it’s not those aged 50-65. The odds are good these days that the 50-65 are still working and can afford where they live.  AARP’s 50+ segmentation misrepresents who is really worried about 'aging in place' – and that means 65+ and (way) beyond. They could worry about a too-big house they can’t sell. A house they can't maintain, but panic about leaving -- they too read the same hype. So they stick it out, reading the upbeat stories in Fortune and then not-so-upbeat articles in Time Magazine (with its insulting title). They have high hopes about AgeTech -- how it will help them stay in their homes. If they can afford it, they buy suites of sensors to help -- otherwise their families, ever-optimistic, spend the money. They are hopeful about the new technology designed to help them.

Finally, the struggle to stay independent, aging in place, gets to be too much. Home care agencies are contacted, transportation providers of rides to-from appointments arrive, food is delivered, and other services are brought in. The numbers of care recipients in home care, senior living, and adult day services has likely crossed 5 million by now. The number of home care providers is exploding due to demand, much of it from people who should be in senior living or nursing homes but they (or their families) are too stubborn or lack the cash to make the move. So the average move-in age to assisted living is 85 – and the majority of residents are women, now exhausted by living alone. They look forward to eating meals with others, served by others. Many will say they should have moved earlier. Contrast that with the home care recipient. She is also an aging woman – and the only person she meets during an average day is the worker. But she is 'aging in place.' 

Comments

Thank you for this important column.  Aging in Place could be, became very lonely for my mother, even though she was living in our downstairs apartment in the 1990s. Her life changed for the better after we moved her to the Windsor Elms, which provided mom with more activities, more scope to move about, and even new friends (wonderful volunteers and staff). They made her part of a more active social life, one that I could not have matched, as a househusband with a young child in school and a part-time professional product design career, living just upstairs.  None of the current tech-based solutions could have done what the people - residents and staff - provided. 

Thanks for sharing Laurie. As a caregiver to my stepmother for five years before her passing, it was a REAL learning experience! Multidimensional and certainly complex to navigate for all. Appreciate your continued insight and sharing.

Interesting perspective. Thanks for posting.

As an Aging/Living-in-Place Consultant, with degrees in #Gerontology and #OccupationalTherapy, I practice a person-centred approach.

There's no 'one size fits most' solution. Each person/family situation has assets & liabilities, personal preferences and, often, blind spots in their thoughts or actions.

I like to think I that help people make educated, informed decisions. This includes having them consider how they'll know it's time to change their care or living arrangements - for various reasons... medical, social, financial, emotional, etc. And then, helping to implement plans that will keep their options open

Again, the importance of our social connections.

I mean...what does Aging in Place really mean? I think of it as "aging where you want to be". If you want to live at home for as long as possible, and certain technologies and accommodations can help you to do so, then great! If you prefer to move into a condo on the beach and it works safely for you, that's excellent too. I think a lot of people may move from their original homes into smaller apartments and still think of themselves as "aging in place". Technology and accessibility can play a role in proactive, predictive care and hopefully enabling that person to be "more independent" and happier/healthier for longer.

Sara Zeff Geber, Ph.D. writes often about the solo agers and has recently discussed some co-housing options that are interesting. Ryan Frederick says it so well when he emphasizes the importance of place. This is esp important when the place you are currently in, does NOT help you thrive (back to your main point in your article)

“Engaged active living with purpose” can be practiced/ delivered in multiple settings. Technology helps. The core of the experience design starts with needs. We need to adopt a continuum approach of Senior Living as a Service enabled by technology- location evolves! I guess that was the thought process behind the CCRCs (just need to add home and golden girls apartments) before they became rigid and technology phobic.

I agree with Ravi Bala "We need to adopt a continuum-for-care approach of "Senior Living" as a Service model, enabled by technology. This can be an overlay service in any age friendly setting, including mobile-home parks, active-adult communities and even income restricted senior housing. So, yes in multiple settings. The core of the experience design starts with "WANT" not need. Autonomy and independence is far more important than a patronizing, outdated care industry. Technology can deliver most of this but the willingness to democratize and educate the seniors for this is another story.    

 

There is always a hype cycle. Healthcare preferences are a very personal matter greatly impacted by available support, network, beliefs, and resources.
The success of healthcare is tied to being able to adapt preferences to meet individual needs. Aging-in-Place has, in many ways, lost a clear definition, thanks to the range of options for living arrangements that are evolving. Isn't it more appropriate to think of community living, with a broad range of diverse communities?

Keep beating the drum Laurie Orlov. "Aging in Place" is an awful term and nearly 100% of the time a flawed strategy if strictly adhered to.

I've spent way too much time thinking about this (with a book that includes a chapter rant on the topic!) but I am more convinced than ever that -- no matter the age -- we are best to regularly evaluate our needs & preferences with the realities of our place (from four walls to neighborhood to metro, etc.) to make sure it is a good fit.

Where you live and how you choose to engage where you live is foundational for our health/healthy longevity. I think this will become more clear to more people over time. AARP would do society a great service by entering into this dialogue in a more nuanced way.

Well said, Laurie Orlov ! With all the hype about hashtag#aginginplace , we encourage older adults to think they do not need to plan for how they will achieve quality of life as they age, they can just plan to stay put and that is their plan. Unfortunately that may sell lots of hashtag#agetech products but it leaves many older adults, particularly women, totally invisible and unseen by the rest of society, except when the paid hashtag#caregiver or hashtag#mealsonwheels volunteer shows up. As Dr. Bill Thomas has said, "we mmay love our homes, but as we age, they often don't love us back

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