Acute shortages of home health aides and nursing assistants are cropping up across the country.
Boston, Portland, ME May 1-May 15, 2017
Washington, April 28-29, 2017
Washington, June 1-5, 2017
When aging in place is out-of-place. Aging in place may not be for everyone, as the University of Florida's Stephen Golant noted: 48% of seniors spend more than half their income on housing -- 14% of the 75+ still have mortgages. Separated by distance from adult children, perhaps they suffer from isolation and poor health and other downsides that Dr. Golant spells out in some detail. He recommends that moving out of one's own home need not be viewed as a tragedy, suggesting options like NORCs or village approaches for shared services, moving in with family members, or moving to a smaller home or condo.
How about much smaller? Place the downsides to aging in place within the context of downward mobility that an aging society like Japan represents. In the midst of diminishing expectations, housing expectations have also diminished, literally -- consider the description of microhousing: "matchbox-size homes stand on plots of land barely large enough to park a sport utility vehicle, yet have three stories of closet-size bedrooms, suitcase-size closets and a tiny kitchen that properly belongs on a submarine." These micro-houses (approximately 300 square feet) today are city dwellings for young people who want to live in the city with a micro budget for housing.
Back in the USA -- prefab microhouses are emerging. Modular microhousing may be another option beyond those envisioned by Dr. Golant to address the mismatch between housing costs of the seniors who may, as he noted, have to choose between home maintenance and eating or paying for medications. Kits for microhouses that can be placed on existing property are in the market now: for example, a 'sustainable' home starting at 381 square feet like FabCab, an 'Inspired In-laws' unit in which "all generations maintain privacy and families have peace of mind", or a modular medical home like the 288 square foot MedCottage which "can monitor vital signs, filter the air for contaminants, and communicate with the outside world via high-tech video". These are all variations of micro-housing that can be placed on the property of an adult child to enable an aging or ailing family member to be (very) nearby. Attractively designed, these microhouses can be had for under $100K, assuming the availability of land and appropriate zoning.
In the village, could microhouses be developed in volume? Our suburban sprawl of isolated house lots and transportation-starved streets might be the appropriate setting for a development of microhouses as part of the village-to-village network concept. Imagine that seniors who are becoming house-poor in areas that still have some available land could sell the houses that are starving them, and instead move into an attractive microhouse cluster that is grant-developed and placed on donated town land. Place the cluster within easy access to transportation, services, their previous neighbors and soon-to-be volunteers. Add in more MedCottage-like features: "Sensors alert caregivers to an occupant's fall, and medication reminders are provided via computers. Technology could also provide entertainment options including music, literature and movies." And perhaps the campus areas where these microhouses appear are in or near the very campuses of CCRCs, which already have services that could be expanded to include microhouse residents.