Sunday, January 15, 2006

residential choice and design for the elderly

The vast majority of older Americans prefer to live independently with their spouse, or alone, rather than to live with other people. Less than 10 percent of males and 20 percent of females over 65 who are not living with a spouse live with someone else. The General Social Survey, conducted annually by the National Opinion Research Center at the University of Chicago, shows that the majority of the older population is unenthusiastic about living with others, and that less than 25 percent even favors living with their own children.
Over 70 percent of the elderly own their own homes, and, whether they own or rent, 80 percent prefer to remain in their own familiar surroundings rather than to move. Forty percent of the adult U.S. population changes residence annually, but only 20 percent of the elderly do so. This latter group does not always seek out warm weather locations in the south, but instead often looks for other amenities, such as family and friends, church locations, low tax rates, and the like, in choosing a residence area.
The great majority of older Americans prefer to stay in place out of choice rather than out of inertia. Still, because residential options are numerous and an appropriate residence may be more critical in old age than at any other time in life, a number of studies have given considerable attention to the residential choices of the elderly. Typically older Americans address several major questions when they consider residential plans.
Does one's present residence-which may have been purchased to house a large family- suit one's present life circumstances, or is the home too large and difficult to maintain? Is a move to a warmer climate desirable, or does staying near children, family members, friends, neighbors, and in familiar surroundings seem preferable? If one does decide to move, what part of one's income can one afford to spend for housing (the usual standard is not more than 30 percent)?
Does the new location, or even one's present location, enable access to shopping areas, health facilities, transportation, recreation, entertainment, opportunities for socializing, and leisure activities (hobbies, sport, volunteer work, or a part-time job)? Suppose that sometime in the future it becomes necessary to restrict one's physical activities due to health problems, several factors in home design, remodeling, and location should be considered: whether all rooms are on the ground floor to avoid use of stairs; railings are on stairways; pull bars are in bathrooms; there's good lighting; friendly neighbors or family live nearby; safety and security services are within call; and access is available to restaurants and home meal delivery services.
No one answer to these questions can suit everyone because the tastes and needs of America's elderly vary widely. For instance, the 100,000 or more who live in single room occupancies (SROs) located in residential hotels and elsewhere in inner cities, obviously have very different attitudes and perceptions of life and their retirement needs than someone who lives in a retirement community in the south.
The residential options available to older Americans can satisfy a wide variety of tastes and requirements. Today over a million people live in retirement communities which range from the vast Sun City, Arizona, with over 45,000 residents, to the modestly sized Avery Heights life-care center in West Hartford, Connecticut, that houses a few hundred people. These elderly residential communities usually designate a minimum age for permanent tenancy, and they offer numerous appealing options for older people-buildings and grounds maintenance, room cleaning services, food services, nearby shopping malls, recreational facilities, and so forth.
Another alternative chosen by an estimated 300,000 older persons is the mobile home, or trailer home, often located in a trailer park. While this type of residential setting has sometimes been criticized for shabbiness and run-down conditions, a number of parks maintain high standards and offer quality environments. Other people live in "Granny flats," a name probably borrowed from England to describe an attached but separate apartment located in or on the same lot as the residence of an adult child, or situated in a trailer on a family member's property.
Recently home sharing has been advocated for older people. In this arrangement a pair, or group, of older individuals, jointly occupy a residence, dividing expenses for mortgage and taxes or rent, insurance, utilities, heat, and air conditioning. The advantage of such an arrangement for lowering living costs is obvious, but it also offers shared living, which many elderly find beneficial. One instance of home sharing in a 27- room mansion in Florida captured national attention because the dozen tenants who were sharing this home successfully sought relief in court from a local zoning rule against multiple tenancy. They won their case by gaining recognition as a "family," which entitled them to continue to occupy the mansion together and to employ people as their home managers.
As life advances housing needs may change because illness or disability may interfere with an individual's capacity to carry out the routine chores of daily living in a present residence. In such cases it may be possible to adapt an existing home to accommodate a disability, or to secure support services to help remain in an existing residence or even a resort type community.
For individuals who remain physically independent, however, moving into "congregate housing" is becoming increasingly popular. Private as well as public housing for the elderly often provides "congregate" living arrangements, so called because they include common facilities, such as a dining room for meal service, lounges, and recreation areas, shared by all residents. The residents live in one- or two-room apartments equipped with light cooking facilities, and they use the common facilities as occasion warrants, or according to some predetermined plan, such as taking a daily meal in the common dining room.
Yet another variant is the "life-care community," which combines condominium units or apartments for independent living; nearby hotel like units for those who need some assistance with daily tasks, such as help with bathing, or moderate nursing supervision; and, if needed, a nursing home facility. Many life-care communities are nonprofit and run by fraternal organizations (Masonic homes, for example) or church groups. They commonly charge a major one-time entry fee, similar to a payment for purchasing a condominium, with a monthly rental charge based on the level of service required-the rates increase depending on whether one is residing in the independent living apartments, the hotel-like facility, or the nursing home.
In the past special residential facilities for older people were considered undesirable because it was thought that residential separation of the older generation would deprive them of the stimulation of living with younger people. People spoke of separate housing for the elderly with contempt, calling it "age segregated." For many years the federal government accepted this negative view, and federal policy for public housing supported only age integrated facilities. In the early 1960s an age-segregated facility was constructed for the first time in San Antonio, Texas, and subjected to intensive study by psychologists, who were retained to determine the impact of such a specialized living environment on older people. The research showed beyond question that a specialized residence for older people not only provides better services, but that the residents thrive in the environment-socializing more than they would normally, engaging in stimulating activities, and eventually surviving beyond normal life expectancy.
Some experts have proposed that the "lifecare" residence, which has proven very successful in meeting the needs of older adults, might well serve as the normal pattern for future elderly living. Whether or not the older generation ever abandons its present preference for autonomous living in its own separate home or apartment, it is clear that the alternative of living in a retirement community or other special facility already has wide appeal and is satisfying the needs of a growing segment of the older population.
Gillies, J. A Guide to Caring for and Coping with Aging Parents. Nashville: Thomas Nelson Publishers, 1981.
Russell, C. M. Good News About Aging. New York: John Wiley and Sons, 1989.
U.S. Bureau of the Census, Statistical Abstract of the United States: 1989. 109th ed. Washington,
D.C.: U.S. Government Printing Office.
Ward, R. The Aging Experience, 2nd ed. New York: Harper and Row, Publishers, 1984.

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