If you’re going to write about new options for vulnerable older adults who want to age in place in your community, it behooves you to understand the relationship between housing and health.
I’m afraid I didn’t find that kind of knowledge evident in a poorly reported piece on “granny pods” by Craig Guillot published last week on money.msn.com.
“Granny pods” are prefabricated structures that accommodate older people who want to move close to caregivers but not live in the same house. Options include standalone cottages that can be set up in a backyard or structures that can be attached to existing homes with minimal effort.
Judith Graham (@judith_graham), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society.
If you have questions or suggestions for future resources on the topic, please send them to judith@healthjournalism.org.
The development of these alternatives – also known as “accessory dwelling units”(ADUs) – is an up-and-coming trend in senior housing, and it’s been getting a bit of press recently with write-ups on the New York Times New Old Age blog, Huffington Post, AARP’s website, as well as Guillot’s piece.
Some ADUs are for healthy, independent older people but others are being marketed as long-term care alternatives for seniors who have medical issues that require attention. It’s reporting about the second group that concerns me.
Take Guillot’s piece, which carries the misleading headline “‘Granny pods’ vs nursing homes” and the sub-head “Prefab backyard alternatives to assisted-living facilities let elderly relatives stay close to loved ones, and the units can be much less expensive.” Mixing up nursing homes and assisted living doesn’t occur just in the headers: the reporter repeats this mistake in his first two paragraphs.
“With millions of baby boomers expected to need assisted living in the near future, some homebuilders are bringing creative housing solutions to the market.”
“Small modular units, dubbed ‘granny pods,’ can serve as an alternative to a nursing home. Compact, specifically designed to meet medical needs and relatively inexpensive compared to living in a facility, they bring assisted living right into your backyard.”
It’s a significant error because assisted-living facilities and nursing homes are not equivalent. Assisted living facilities offer far fewer services to residents who are typically less disabled and operate with lower levels of staff. To say that “granny pods” can substitute for both betrays a troubling lack of understanding of how these facilities function.
Message to editors: When a business reporter writes something that touches on the health beat, make sure he knows what he’s talking about. Or, when a health reporter does a story that crosses into the business beat, make sure your reporter understands the basics of the business issue she’s writing about.
At the New York Times New Old Age blog, Susan Seliger also suggests that MEDCottage, a new medically-oriented ADU, can serve as a substitute for a nursing home under some circumstances. What’s the evidence? Seliger mentions rubberized floors, lighted walkways in units that can help prevent falls, a camera system that watches for problems, an “elaborate medical monitoring” system that monitors vital signs, and ceiling tracks that can accommodate an automated lift or a trapeze hook that helps older people move around.
“One of the primary reasons people have to go to nursing homes is that caregivers can’t lift them anymore and get them out of bed and keep them mobile,” explained Kenneth Dupin, founder of the Virginia company that makes MEDCottage.
Actually, the reason most people go to nursing homes is that they need more care and oversight than spouses, siblings, daughters, sons, friends or other caregivers can provide. And that’s the missing ingredient that isn’t discussed here – care.
Someone has to look at the results of that medical monitoring and take action if issues surface; someone has to get the older person up on the Hoyer lift and take them back down again; someone has to be around if an older person loses her balance and ends up on the floor; someone has to make sure grandma or grandpa is eating adequately, clean, staying hydrated, and all the rest.
Seliger recognizes the issue in a short paragraph about two-thirds of the way through her blog post.
“Of course, unlike nursing homes, granny pods don’t come equipped with 24-hour professional care and three meals a day. Hiring a health care aide (around $19 an hour) just during weekdays can easily add another $39,000 a year.”
Also, Seliger includes a quote from an expert at the University of Massachusetts noting that “the level of care needed by the older adult may exceed what the family is able to provide.” I couldn’t agree more. Whether this type of housing is a good idea or not depends on the fit between the older person’s needs and abilities and the family’s willingness and ability to help.
I’ll go out on a limb here and say that the biggest issue for most older adults who are candidates for nursing homes is getting adequate help, not securing adequate housing. If MEDCottage helps make this possible by putting people closer to their families and if families in turn commit to providing this kind of help or finding others to do so, that’s wonderful. But it shouldn’t be assumed that a new backyard housing option will solve the caregiving challenge that confronts so many time-pressed American families.
Here’s another question: Who are these units really appropriate for, in the end? Is it the severely compromised older adult who otherwise would end up in a nursing home? Is it an older adult who needs help with some activities of daily living but otherwise can function pretty well independently? Is it the independent but lonely older adult? Is it only families with considerable financial resources, once again leaving lower-income and poor families out of the picture?
I wish independent experts had been asked to assess this issue in greater depth in the pieces I looked at. If and when you write about this or related aging-in-place topics, it’s something I hope you’ll address.
