Question: I am 84 years old, a widow and live in my own two-story home.  I am healthy, walk 2 miles a day, garden, cook, have my grandchildren over for dinner, attend adult education classes, as well as go to movies and theater.  My children worry about me and are “helping me” by taking me for tours to assisted living facilities.  They are planning for a “what if” moment.  Am I being selfish by wanting to remain in my own home? 

Answer: What you are describing is the desire to “age in place, a formal concept that emerged about 20 years ago for older adults who want to remain in their own homes. The subject is a big one.  It was a major issue in the 2005 White House Conference on Aging and is part of evolving housing and aging policies.

In the recent article, “New Approaches to Housing and Aging in Place” in the Public Policy and Aging Report, Jon Pynoos, USC professor of gerontology, policy and planning and doctoral student Caroline Cicero wrote, “…policy responses to support aging in place have been piecemeal and fragmented, leaving many older people in homes that are unsupportive and in communities that offer them few housing options.”

They continue: What is worse is that “new homes are being built that lack features to help the next generation of older adults to age in place.” The decisions are not easy given the lack of support to age in place.

Here is one approach.  Consider remaining in your home and modify the existing environment, known as home modification.   It can involve very simple things such as grab bars and handrails or more costly additions such as walk-in showers, stair glides and ramps.

Research has documented that home modification is key to aging in place.  It reduces falls, supports independence, helps individuals remain active and just makes life and tasks easier — and even reduces mortality.

Unfortunately, Medicare and Medicaid pay for few home modifications even though there is documentation that such home changes promote health and prevent accidents.

For those who do not want to remain in their own homes, new models have created interest.  Beacon Hill Village, started by a group of Beacon Hill residents, is a Boston membership organization that coordinates services for those 50 and older to help them stay in their homes.  Members pay $600 for an individual or $850 for an annual household fee.  For that money, members have access to exercise classes, discounted membership to health clubs, geriatric care management, transportation for groceries and medical appointments, routine cleaning, financial organizing and social and cultural events.

Two Villages similar to Beacon Hill Village have been built in California:  The Avenidas Village in Palo Alto and the Tierrasanta Project in San Diego.

Another development is the Eden Alternative, a non-profit organization founded in 1991 by geriatrician William Thomas.  It is based on the belief that aging is a time of continued growth and development, rather than one of consistent decline. Its new initiative is Eden at Home,  designed to transform the home culture to embrace the core principles of the Eden Alternative.  Among them are to eliminate loneliness, helplessness and boredom among older adults; to have a community that is in continuous contact with plants, animals and children; to allow older adults to make decisions for themselves; and to offer care without it being the focus of an older adult’s existence.

Co-housing is another emerging model. This consists of residents participating in the design of their community to ensure it meets their needs. The housing encourages a sense of community, common facilities that are used daily and resident management of the community performing most of the necessary work.  In Davis, in Northern California, Glacier Circle Senior Cohousing is a good example.

If you are happy in your home and are managing well, consider aging in place.  At the same time, explore the need and possibilities of home modification.  And if you find that you need to move, think about where and how you would like to live. Remember what you love to do.Visits to assisted living sites might at some point become Option B, to be used only when needed.  This type of planning does not seem selfish.

May we all thrive as you are in our eighth decade of life.

© Helen Dennis 2010, all rights reserved.

Question: I am 84 years old, a widow and live in my own two-story home.  I am healthy, walk 2 miles a day, garden, cook, have my grandchildren over for dinner, attend adult education classes, as well as go to movies and theater.  My children worry about me and are “helping me” by taking me for tours to assisted living facilities.  They are planning for a “what if” moment.  Am I being selfish by wanting to remain in my own home? 

Answer: What you are describing is the desire to “age in place, a formal concept that emerged about 20 years ago for older adults who want to remain in their own homes. The subject is a big one.  It was a major issue in the 2005 White House Conference on Aging and is part of evolving housing and aging policies.

In the recent article, “New Approaches to Housing and Aging in Place” in the Public Policy and Aging Report, Jon Pynoos, USC professor of gerontology, policy and planning and doctoral student Caroline Cicero wrote, “…policy responses to support aging in place have been piecemeal and fragmented, leaving many older people in homes that are unsupportive and in communities that offer them few housing options.”

They continue: What is worse is that “new homes are being built that lack features to help the next generation of older adults to age in place.” The decisions are not easy given the lack of support to age in place.

Here is one approach.  Consider remaining in your home and modify the existing environment, known as home modification.   It can involve very simple things such as grab bars and handrails or more costly additions such as walk-in showers, stair glides and ramps.

Research has documented that home modification is key to aging in place.  It reduces falls, supports independence, helps individuals remain active and just makes life and tasks easier — and even reduces mortality.

Unfortunately, Medicare and Medicaid pay for few home modifications even though there is documentation that such home changes promote health and prevent accidents.

For those who do not want to remain in their own homes, new models have created interest.  Beacon Hill Village, started by a group of Beacon Hill residents, is a Boston membership organization that coordinates services for those 50 and older to help them stay in their homes.  Members pay $600 for an individual or $850 for an annual household fee.  For that money, members have access to exercise classes, discounted membership to health clubs, geriatric care management, transportation for groceries and medical appointments, routine cleaning, financial organizing and social and cultural events.

Two Villages similar to Beacon Hill Village have been built in California:  The Avenidas Village in Palo Alto and the Tierrasanta Project in San Diego.

Another development is the Eden Alternative, a non-profit organization founded in 1991 by geriatrician William Thomas.  It is based on the belief that aging is a time of continued growth and development, rather than one of consistent decline. Its new initiative is Eden at Home,  designed to transform the home culture to embrace the core principles of the Eden Alternative.  Among them are to eliminate loneliness, helplessness and boredom among older adults; to have a community that is in continuous contact with plants, animals and children; to allow older adults to make decisions for themselves; and to offer care without it being the focus of an older adult’s existence.

Co-housing is another emerging model. This consists of residents participating in the design of their community to ensure it meets their needs. The housing encourages a sense of community, common facilities that are used daily and resident management of the community performing most of the necessary work.  In Davis, in Northern California, Glacier Circle Senior Cohousing is a good example.

If you are happy in your home and are managing well, consider aging in place.  At the same time, explore the need and possibilities of home modification.  And if you find that you need to move, think about where and how you would like to live. Remember what you love to do.Visits to assisted living sites might at some point become Option B, to be used only when needed.  This type of planning does not seem selfish.

May we all thrive as you are in our eighth decade of life.

© Helen Dennis 2010, all rights reserved.