Tip Sheets

Aging in place — a guide for journalists

By Liz Seegert

Nearly every older adult wants to grow older at home surrounded by familiar friends, neighbors and possessions. A recent AARP Survey found that 77% of those over 50 and 90% of those over 65, prefer remaining in their own home despite potential challenges like steep stairs or doorways that are too narrow to accommodate a walker.

As people age, many will require help with activities of daily living such as bathing, dressing or toileting. Others may be able to accomplish self-care, but still require assistance with other tasks like grocery shopping, transportation or household chores. However, as we’ve previously reported, remaining at home can pose some serious risks, and it may not even be possible for those who need more skilled care. Fortunately, for many elders who want to age in place, there are available options and programs, like this one in East Tennessee.

Aging at home can also save money — and while not cheap, having in-home assistance is still less expensive than assisted living or continuing care retirement communities, according to Financials’ cost of care 2020 report.

The Center for Aging in Place describes aging in place (AIP) as “a national movement that enables people to stay in their own homes as they grow older by making available the social supports, wellness activities, and home maintenance services they require to live happy, productive lives in the community. AIP groups (also known as villages) are growing across the country as older people choose to live independently while benefiting from coordinated programs and services in their own community.”

Aging in place has spawned entire industries to help make homes easier to navigate for older people and give families more peace of mind.

  • Professionals like occupational therapists can be hired to do walk-throughs of a senior’s home and make recommendations for modifications.

  • Technology — wearables and motion sensors placed around the house can identify falls or lack of activity and alert loved ones. Smart devices like Alexa or Google Home can be set up to remind elders to take medications, close the refrigerator door or turn off the stove. (More on aging in place technology to come in a future tip sheet)

  • Community programs and services such as PACE or CAPABLE, which we’ve reported on previously, have teamed up with organizations like Habitat for Humanity to make minor repairs or modifications such as changing counter heights or installing bathroom grab bars.

  • The Village-to-Village Network is a growing movement of consumer-driven, grassroots community-based organizations. These “villages” are made up of groups of neighbors who help connect members to services that can help connect elders with everything from non-medical tasks like housekeeping or transportation to recreational, social, and cultural programs. Activities like these also help reduce social isolation and loneliness, which in turn can help boost mental and physical health.

  • For those who don’t own their own homes, safe and affordable senior housing remains a challenge, according to the AARP Foundation.

  • Naturally Occurring Retirement Communities (NORCs) are a low-cost alternative for aging in place.

  • Helping elders remain in their home often means addressing principles of universal design, which benefits everyone.

Age-friendly care and communities

Another critical way to support healthy aging at home are with age-friendly health systems. These health care institutions provide evidence-based elements of high-quality care, which aims to consistently provide older adults with the four “Ms” of care:

  • What matters — to align goals of care

  • Medication — avoid medication that may interfere with mobility, cognition, or goals of care

  • Mentation — prevent, identify and manage depression, dementia, and delirium

  • Mobility — ensure older adults move safely to maintain function and accomplish what matters

Age-Friendly Health Systems is an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association (AHA) and the Catholic Health Association of the United States (CHA), This list of age-friendly health systems may include one in your reporting area.

Geriatric Emergency Departments are another important element in age-friendly health systems. The expertise an emergency department staff brings to an encounter with a geriatric patient can meaningfully impact both the patient’s condition as well as expensive inpatient or less expensive out-patient treatments. It can also help guide more effective resource allocation for a patient population which uses significantly more resources per event than younger populations, according to the American College of Emergency Physicians. A geriatric emergency department might include:

  • Dedicated space with enhancements that are help older adults remain safer improve communication and reduce distractions or noise; a special observation unit may be set aside in the emergency room for patients requiring further evaluation from in-house geriatric specialists.

  • A dedicated team of including geriatric clinicians, nurse-practitioners, social workers, physical therapists, occupational therapists, palliative medicine consultants, and pharmacists.

  • Screening tools which help determine which older adult patients should be treated in a geriatric or regular emergency department unit.

Story ideas

Journalists can pursue a wealth of stories about aging in place — as did journalist Andrea King Collier on her journey to making her home more suitable as she ages. Other ideas include:

 

  • Community partnerships and programs which are locally available to help older people remain safely at home.

  • How the latest in-home design incorporates more universal, age-friendly elements.

  • Efforts by cities and counties to help suburban/rural elders remain safely at home — from transportation options to volunteer groups that assist with chores like grocery shopping.

  • The home care worker crisis — who will help care for elders at home.

  • Co-housing — elders who take in roommates to help with costs, home maintenance and care.

  • It takes a village — how the village-to-village movement is changing how we age in place.

Resources

  • The National Institute on Aging offers tips and guidelines for consumers who want to age in place.

  • This report from the Bipartisan Policy Center examines the connections between housing, architecture, health care, information technology, telecommunications, transportation, urban planning, and financial services to help meet the growing challenge of aging at home.

  • Aging in Place: Facilitating Choice and Independence, report from the U.S. Department of Housing and Urban Development; (much of the information in this 2013 report is just as relevant nearly a decade later)

  • Area Agencies on Aging are good resources to find out about local programs and services by zip code.

  • This paper by economist Jesse M. Abraham, Ph.D., research director of the Homes Renewed Resource Center, which focuses on the cost effectiveness of modifying housing as a means to reduce overall health care costs.

  • Housing America’s Older Adults is a 2019 report from the Joint Center for Housing Studies of Harvard University and Johns Hopkins looks at ways to ensure middle-income elders can live safely and affordably in their current homes while they continue to struggle with financial and retirement security.

  • Aging in Place in America — a research report commissioned by Fresenius Medical Care, looks at how people perceive their own odds of aging in place.

  • This article about NORCs — naturally occurring retirement communities.

  • Habitat for Humanity partners with states and counties on programs like this to help older adults remain safely at home.

Experts

Aging in place/Aging in community

  • Stephen Golant, Ph.D., Professor Emeritus, Geography, University of Florida, Gainesville, with a focus on housing, mobility, transportation, and long-term care needs of older adult populations, author of Aging in the Right Place

  • Max B. Rothman, J.D., L.L.M, president & CEO, Alliance for Aging — part of a network of 11 Area Agencies on Aging in the State of Florida. Which connects elders, family caregivers, and providers to services for meals, recreation, adult day care, personal care, legal help, transportation 305-670-6500

  • Jacqueline Mondros, D.S.W., dean and professor assistant vice president for social determinants of health, Stony Brook University (aging in suburbia)
jacqueline.mondros@stonybrook.edu

  • Robyn Stone, Ph.D., senior vice president, research and co-director, LeadingAge LTSS Center @UMass Boston, is a researcher and expert on aging and long-term policy,

Age-friendly health systems

  • Kedar Mate, M.D., president & CEO, Institute for Healthcare Improvement kmate@ihi.org 

  • Alice Bonner, Ph.D., R.N., advisor, Care of Older Adults: abonner@ihi.org 

  • Emily A. Greenfield, Ph.D., Institute for Health, Health Care Policy and Aging Research, Professor, School of Social Work, Rutgers University egreenf@ssw.rutgers.edu, (848) 932-5877

Geriatric emergency departments