Wednesday, March 18, 2020

Where Should Older People Live?


In my gerontology practice, the number one issue related to aging is whether to relocate.  For example, grown children want to build on a granny suite or granny addition to the home. Or older adults grapple with a decision to move near the grandkids.  Or newly-widowed older adults want to move near their children or friends.  Of course, numerous factors must be considered including financial, social, and health status.  I advise my clients to NOT make any major decisions for at least a year following the death of a spouse.
The moving quandary is weighty, as in most cases, the decision is usually irreversible due to health and financial constraints.  Moving to be closer to grandkids? If this decision is made with the assistance and approval of grown children, it is often successful. However, moving to be closer to them without coordinating it far in advance may result in them moving away, believing that parents are burdening them with unwanted caregiver roles and/or grown children want to keep their distance.  Don’t just assume that your grown children want you in their neighborhood, as that is a recipe for disaster.   
The January/February 2020 issue of Aging Today included an informative and captivating article related to relocation and aging in place.  The author, Stephen M. Golant, Ph.D., is a leading scholar and seminal authority on aging in place, long-term care, transportation, mobility, and housing.  A former Fulbright Senior Scholar, Dr. Golant is professor emeritus at the University of Florida, Gainesville.  He authored, Aging in the Right Place (2015), a publication I recommend for older adults, family members, students, policymakers, stakeholders, allied health workers, medical professionals, and gerontology professionals.  Here is a link to the Kindle book that provides a summary of content: https://www.amazon.com/Aging-Right-Place-Stephen-Golant/dp/1938870336
Golant (2020) cautions that older adults who believe they are “aging in place” may be “trapped in place.”  Aging in place, if not planned well, may lead to becoming stuck or hemmed in, living in a place that no longer meets active aging guidelines.  Older adults typically do not leave home to relocate, although younger cohorts assume that the lure of beaches and sunny climate lures them away.  However, studies show that only 2% of older homeowners and 10% of older renters relocate.  Although the majority of older renters and about a quarter of older homeowners spend 30% of their income on housing, not including upkeep and repairs, they still resist moving.  Homes age and residents age.  Mobility, crime, cognitive declines, transportation, and caregiving present unique challenges for the older population. Despite these barriers, the overwhelming majority never move because they are emotionally attached to their home, neighborhood, family and friends, and their possessions. They desire privacy and independence. Finding new friends in old age is daunting.  Finding new healthcare providers is unthinkable. Living among a lot of old people? The majority of older adults don’t want that. Although these opinions are not my personal views, we must understand how older adults think about relocating and understand why 98% of homeowners and 90% of renters prefer “aging in place.”  Lower-income older adults may want to move and are unable to find affordable housing, especially the oldest old [85+] needing assisted living.  
According to Golant (2020), four identified barriers may challenge future older adults from remaining in their own homes:
1.     Rejection of technology and privacy concerns.  An example is the perception of telehealth as impersonal.
2.     Fewer caregivers to meet the demand of the expanding older population.
3.     Escalating and prohibitively costly in-home care, modifications, technological devices, and assisted living facilities.
4.     Increase in the oldest-old population [85+] with high disability and numerous chronic conditions.

Reference:
Golant, S.M. (2020, January/February). Aging in place – or trapped in place? Aging Today, xli(1), pp. 7, 10.  

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