Aging in Place - The Preferred Method of Aging
December 2, 2009
Harvard University, Joint Center for Housing
Studies
A long-standing assumption has existed that as an
individual grew frailer, he or she required a continuum of senior living
facilities, physically moving from one residence to another, as health or
housing service needs changed. Increasingly over the last ten years there has
been growing acceptance of the idea that older persons do not necessarily need
to relocate as their needs change, but can modify their environment by adding
supportive services and reconfiguring their residence. This “revised view of the
housing continuum therefore stresses the elasticity of conventional housing in
terms of its ability to accommodate a wider spectrum of older persons.” It can
be achieved by “creating a wider variety of options for frail older persons that
facilitate aging in place in physically supportive residential settings linked
with service,"1 Aging in place requires the
coordination of health and assistance services to deliver a customized level of
care in an individual’s current environment.
In the last decade aging in place has not only become
the most desirable way of aging but also in most cases it is the more
cost-efficient way of aging. The AARP reported in May 2000 that “the desire to
remain in their current residence for as long as possible becomes more prevalent
as age increases. Seventy-five percent of those age 45 to 54, and 83 percent of
those age 55 to 64 strongly or somewhat agree that they wish
to remain in their homes as long as possible, while 92 percent of those age 65
to 74 and nearly all of those age 75 and over (95 percent) want to do so.”2
Aging in place has become a part of the public
rhetoric in the last ten years. Seniors and their children are starting to
envision, and demand, a range of options beyond the nursing home. Policy makers
generally agree that keeping elderly individuals out of nursing homes is the
primary objective of aging policy.3
Successful aging-in-place programs minimize the
provision of inappropriate care, and therefore the costs, by offering a range of
flexible services and calibrating those services to fit the needs of the
individual. Rather than a rigid service-delivery system, aging-in-place
strategies create both health-care and assistance options that provide support
at the margin of need as defined by an individual’s personal desire and efforts
to live independently. Aging in
place works best as part of a comprehensive and holistic approach to the support
needs of an aging individual and an aging community.
Consequences of Aging in
Place
Maintain social network. Aging in place promotes self-sufficiency, encourages
interdependence between friends and neighbors in the community, and offsets
social isolation. Rather than relocating individuals to a facility, allowing
them to age in place keeps valuable social networks. Relocating can entail the
loss of friendships, regular shopping and entertainment areas and familiar
support personnel, resulting in a significant loss in the quality of life,
personal control and dignity. Aging in place allows all of these powerful
networks to remain intact, providing both quantitative and qualitative benefits.
A recent study completed by the Department of Health
and Social Behavior at Harvard University concluded that “compared with persons
who had 5 or 6 social ties, those who had no social ties were at increased risk
for incident cognitive decline after adjusting for a variety of socio-economic
and physical factors.”4
Limit the negative effects of relocation and dramatic
transitions. The very act of moving
an individual can be expensive. Searching for the appropriate facility can be
time consuming and can often result in the expense of overcare. Any move can be
traumatic, but a move resulting in the loss of functional independence is
particularly difficult to recover from and can result in confusion and
diminished self-help capacity. When an individual is allowed to age in his or
her community with social support networks intact, costs are minimized and care
is delivered in response not to a rigid service-delivery model, but to actual
need. Communities save needed resources by reducing the amount of unnecessary
service to individuals who could and would prefer to be more
independent.
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