My name is Mary Wark and I have chosen Frederick, Maryland as my place for aging. I am in that later sixties age bracket and have just gone through a period of making personal decisions about where and how to spend my “golden years”. Ways to stay is an Informational blog and social network website by an actual boomer planning to age in place.
I have seen the same headline from four different sources. All scream out that the cause of the housing affordability crisis are boomers who are staying in their homes. I have been anticipating this. I am surprised it took this long to point the finger at the aging population’s recalcitrant need to stay in their own homes and communities.
Some relevant statistics, half of the the number of homes needed to satisfy younger homeowners are occupied by seniors. That is 1.6 million homes and they are not leaving. People are moving less in general. The average stay in a home is now up to 13 years. The same ‘traditional ‘ proportion of seniors are not relocating to warmer climates, signing into senior living communities and may I add are living longer. This is creating a bottleneck of millennial buyers ready to rehab that affordable older home with little to bid on.
It is disheartening to know that the approach is one of blame. If there is to be fault assigned here, what about the the fact that so few affordable downsizing options are open to seniors in their own communities. Why should seniors have to move out of state or out the county where they worked and made connections to find affordable housing?
If the only housing that is being built are inaccessible townhouses with multiple levels of narrow stairs or large 5 bedroom 4 bath mini mansions that anyone one would find cumbersome after the children leave, that logically means everyone will be leaving eventually. That is not an attractive or sustainable solution. It is amazing to me that few people look far enough ahead to understand the logic of this scenario.
Once upon a time you moved into a neighborhood and stayed maybe until you were the oldest folks on the block then figured it out as age and disability warranted it. Back then Long Term Care policies were affordable and covered more or you moved in with relatives.
Seniors are in a box that they did not create. Around them land values have changed to make staying in their own homes the only way to remain in their own communities. They have had fewer offspring. Senior housing as much as it is straining to cater to the tastes of younger seniors, has escalated in price pass assets and insurance polices.
Maybe, just maybe this impasse will bring better solutions. Think of it as a mass sit down strike against the status quo.
As we leave the first month of 2019 behind, I am reflecting on several different numbers and facts that indicate some positive developments for those who want to age in place and stay independent in their homes. First off, realize that the beginning of age wave started turning 73 years old this month. That means approximately 300,000 of the oldest boomers are answering the question again, “am I really old yet?”
I remember coming across an reference in the AARP articles on marketing materials calling those age 75 and up, to be the ‘true elderly’. Another article that started me on this path of blogging about aging and aging in place was by a physician who believed that by age 75 you should suspense any extraordinary medical treatment and let nature take its course. So, somehow the tipping point is supposed to be 75 years of age?
The bar for what is considered old has been moved along by our generation and others as they age. Yes, of course you can take the ‘age is an attitude’ approach at any age. You can be old at 60 in your mind if not in your body. Millennials reportedly now see old age starting at 59 but they no longer feel young by age 40. Yet the fastest growing segment of the population are those who are reaching age 85. There is a lot of room in there to define who is old and who is not.
But maybe we are finally moving away from tired old labels for older people and on to define age by wellness and independence. Yes, the maladies of an older body can drag you down in giving up on keeping up. I read an article the other day that noted retirees spend a lot of time preparing a financial plan, and that they need to also do a wellness retirement plan.
The numbers we should really care about are progress in more wellness and independence programs. Two to watch: Medicare Advantage is touting new plans that will help with in home adaptions and transportation etc etc. They exist in only 7 per cent of the existing Part C plans for 2019. That is 273 out of the 3700 plans nationwide. That must be expanded.
Other good news CAPABLE (Community Aging in Place for Advancing Better Living for Elders) has received a three million dollar grant to expand beyond 25 sites in 12 states to help low- income seniors stay in their homes safely. Habitat for Humanity also is now on board. The expertise to do just enough to help seniors stay at home is expanding and I do not mean a dozen variations on available grab bars. There is more than one way to age in place.
This is a delicate time and perhaps a transition from what do I do, to what do I have to do to stay at home. From my vantage point more flexible solutions are evolving and that is a good thing.
There is no shortage of articles and books about how to extend your health span. Health span means not just living longer but living better. The tips and hints at the secrets of how to achieve this line up in several categories.
AARP just published an exhausting (not exhaustive list) in their current Bulletin issue. It is a mix of solid tried and true medical advice regarding how increased physical activity can ward off diseases. Dietary dos and don’ts are always part of the live well longer part; eat fruits, eat fiber, eat nuts and seeds. Try and keep stress to a minimum, financial stress in particular. Watch out for immune stress, take in the natural world even if you can’t take a bath in the woods Japanese style. By item 100 I wanted to add item 101; beware of lists that stress you out by the enormity of their expectations for your control over your life. Yes, getting a library card is simple, and so is getting a flu shot. Other items not so much.
In Dean Ornish’s and his wife’s new book Undo It!, there is a lot of the new vocabulary about aging science regarding telomeres, oxidative stress. Their big revelation is:
The radical underlying theory is that for the vast majority of chronic diseases in our 40 years of research, we didn’t find that it was one set of lifestyle changes for reversing heart disease and a different diet and lifestyle program for diabetes or prostate cancer. It was the same lifestyle changes for all of them.
In order words, I think he is saying that everything that ages us comes from not doing enough to not age prematurely? Slowing down is equated to giving up. I take issue with this premise. Disease does happen. The accumulation of of toxins in our environmental adds cancers even as other are being cured. The stress of moving into the next decade with the massive political change that may be underway, is not a screen we can turn off.
The missing link as I see it is partly what the Ornishs bring up as the fourth leg of the longevity stool. They call it Love More. According to their research 20% of the adult population can be classified as lonely and therefore depressed and prone to more disease. It is their newer mantra than love conquers all: “The time we spend with loved ones is the single most important determinant in how long and how well we live.”
This makes sense in a certain way. People may find solace in overeating, drugs and other unhealthy behaviors. The loss of a partner, or long time friend can be as devastating as a life challenging medical diagnosis. Yes, social isolation can be a killer. But we can’t add friends and relationships like choosing the healthy stuff from the menu. The missing link to longer life may be the support and the love we get and give, but it is a complex order.
One of the major reasons seniors decide to age in place in their original neighborhoods is the pulse of living in the inter-generational “real” world. We all for the most part, grew up in a regular neighborhood where there were always new babies and the reality of the old and everyone in between. The prospect of going to a retirement community that is solely the new old, older and oldest is still off putting to many even as they grow older themselves.
No manner of amenities, sous chefs with interesting menus of healthy food, a gym you can walk to, or creative or stimulating activities balances out the aspect of being around others who are on the decline. It is our own sense of ageism Even within senior living communities, there is an ageism factor where people more dependent on mobility devices (walkers etc.) have to use a different entrance.
So what is the answer to the natural occurring neighborhood that filters in and out with the lives of young and old? I would like to introduce the next step in an attempt to become a better reality of senior living by seniors not corporations. As affordable housing becomes more of a widespread crisis and the real estate market is less fluid less rewarding to sell and move, people talk more and more about just having a tiny house. Not the one that has more space than you need or more maintenance then you can handle. But they do not just sprout up in the old neighborhood, sometimes you have to create a new one.
A year ago I introduced in a blog: https://waystostay.org/rebel-rebel/ a project headed by Dr Bill Thomas to build small Minka houses through MAGIC. First the house then the idea to place them in a community that would give enough added support but allow independence. When I first looked at the architects drawing of the community to be built in Clearfield PA, about 20 miles northeast of Penn State I felt like I was in fairy tree hugger tale land.
As I enlarged the graphic and read the titles of the lush green spaces around the 60 age and dementia friendly homes to be built, I was dazzled a bit by the ideal nature of the layout. Meditation woods, urban farming , community building and a healing forest. Then being from Pennsylvania I remembered that the location is both isolated and yet next to the resources of a major state university. Both single family and multi-generational homes will be available for residents of all ages.
This is an experiment worth doing, one that is well overdue. I am sure there are naysayers who would revolt at the idea of mixing students in with the housing for seniors. Animal House meets the Best Exotic Marigold Hotel population? They are hoping for just the right mix.
The idea seems to be affordable housing (low tax base) in a natural environment. Other states are already on board to launch similar projects. It is not a commune, not co-housing, nor are they Accessory Dwelling Units and definitively not a CCRC with a guarantee step down to more care. Will it be a place where somehow it all works out in the magic of the neighborhood bonds formed?
Care for seniors through Medicare has always been focused on a medical model of illness versus wellness. Tracking ER visits and re hospitalization rates have been a primary way at looking at the efficacy of care. CMS ( Center for Medicare and Medicaid Services) has made the decision to finally look beyond straight medical needs alone and acknowledge that the person’s (patient’s) home is part of the continuum of care.
What does that mean? A new reality is that some Medicare Advantage plans (Part C) can cover the costs for equipment to make the home safer and more accessible. It is premature to hail this as the ultimate answer to those seniors who want or need to age in their original homes. Kaiser Health News announced that 35% of the new enrollees for Medicare Advantage plans in Michigan have elected this coverage. It will be interesting to see what actually materializes in peoples’ homes to make homes safer and more comfortable.
Other good news, the CAPABLE program started through a pilot project for CMS in 2010 at John Hopkins in Baltimore has just received over 3 million dollars of private foundation money to expand the program beyond the 12 states where it now operates. CAPABLE stands for Community Aging in Place Advancing Better Living for Elders. The essence of it is specially trained Nurses and Occupational Therapists. They form a team to go out on multiple visits to low income seniors’ homes to listen and assess the strengths and needs. Together with the home owner they identify mobility and fall challenges along with recognizes how pain, mood and strength issue add up to a definable intervention. It also can mean suggested ways to become more social and active outside the home. A handyman (person) then comes in to make changes in the home, think grab bars, ramps and fixing hazardous stairs etc. There is followup to assess the homeowners satisfaction with the program.
Again the proactive aspect of these two different programs are major steps forward.
This post is a continuation of my Thanksgiving for a few weeks series. In my last blog, I offered a positive perspective that despite all the pressing issues upon boomers and older seniors who want to remain in their homes, many are staying healthier longer much to the surprise of the senior housing industry who were ready to welcome people into assisted living at age 65! Also I projected transportation services that are vital in preventing isolation and maintaining independence are expanding and improving.
This week I would like to point out that by the time many of us need more interaction with technology to stay at home it will be there. I am not just talking about monitoring systems or easier smart phones. The more interesting part of silver tech will be in the interactive systems. Some people are familiar now with Siri and the other talk back to me and/or answer questions devices. I was recently introduced to the simplicity of Goggle Hangouts much easier to use than Skype and a very practical way to keep in touch with family and friends.
A new device called Pillo had entered the market, and yes it has to do with taking medication. They have even coined a new phrase conversational treatment adherence device. Some people have complex care plans with multiple medications to be taken at different times of the day. That would be confusing for anyone. It is connected and can set up video calls between patients and their caregivers or doctors. It does not just shoot out pills at different times of the day. So many falls are attributed to the mis-management of medication, and that could make this type of device a worthwhile accessory to advanced age.
The essence is of course that somewhere, somehow you can also have some human contact to answer questions or reassure you. For now, many will feel this is still intrusive but the good news is that it will be there is you want or need it.
An old commercial for a communications company had a slogan – reach out and touch someone. The lesson for the future may be – do not be afraid to talk to small shining objects if they can keep you safe and at home- your home.
Real estate developers took a calculated leap when they poured millions into developing retirement communities to meet the emerging market of the baby boomers coming of age. The plan I guess was for the 10,000 boomers reaching retirement age a day to flock to sign up for the package deal. They projected that the newest group of seniors would be grateful for the lack of household duties, be enticed by multiple luxury amenities a stroll away as well as crave the peace and quiet of being segregated from the rest of the multi generational world.
Why are many of these new developments lagging behind in sign ups or as they are referred to move ins? It is not that 70 is the new 55, rather that many a 65 to 72 year old is still working part time or full time, or tending to family. The costs of moving out of home sweet home to these well appointed facilities is very foreboding as the financial security levels have gone down through lack of pensions and a fluctuating stock market.
But it is more than that on a very granular level. Even those who have the assets to do so are hesitating. Their reality is that many of these new seniors are not feeling the old part yet. What does that mean, denial or an unrealistic attitude? Over the next few weeks I intend to blog about several areas that are essential to staying independent in your home and what is already out there that we should be thankful for.
First, the issue of Transportation. One of the predictions was that the very nature of the suburbs being so car dependent would isolate seniors. Keeping doctor appointments and social contacts take on a whole new meaning without being able to drive. Enter the world of ride services with both expanded public and private transportation.
Today I saw on the highway a ‘kneeling van’ with a adjustable ramp attachments at the back. Uber is looking to add handicapped accessible vans. Transportation is actually one of the easier problems to solve for non driving seniors. There are volunteers non profit services and a sliding scale of other paying options to get from here to there.
The newer cars we buy have more safety features with back up cameras and lane assistance. Improved vision care is keeping more people on the road longer. There are driving safety courses for seniors through AARP that provide a discount off your rates and help tune up your skills. Your driving circle of life may become smaller but many seniors manage to stay active and safe. As for shopping, many supermarket chains offer different variations of online ordering pick up or delivery. Online shopping brings everything to your front door.
Giving up your keys does not have to mean giving up your home. This growing network of ride options is one of the developments we should all be thankful for.
As the marketing end of the longevity economy pushes on to make the most of business opportunities from the growing aging population, I still find myself reacting with a bit of unease. Those of you who have followed this blog since I started it three years ago may recognize that my original skepticism about the longevity marketplace has never toned down.
For example, I should be glad to hear about “innovations” such as combining a easier to use cell phone that automatically connects to Uber or Lyft for medical appointments.Great Call the people who bring you life alert buttons and in home monitoring systems is going to make it easier to arrange transportation for older adults. The fact that you can call yourself from your own app does not seem to be part of the equation. As we approach a huge challenge with many seniors out in the burbs in their original homes losing their driving moxie, it is addressing a need for those who can afford the whole system. Hopefully they will not drive yellow cab out of business.
I saw a notice recently about a Longevity Economy Summit to be held in DC next month. I was surprised to see the keynote speaker is the VP of AARP. The head of the conference says , “This two-day conference will bring you (companies seeking to engage with mature consumers) up to speed with innovation in the technology for older adults and highlight the thought leaders. As with all of our events, this is where deals get done and lessons are shared.” I would be curious to know about those lessons shared and what kind of deals are being done. All that marketing potential is somebody’s profit prize.
Also I cringed when I ran by a reference to living in a CCRC (Continuing Care Retirement Community) or Assisted Living as supporting aging in place! The luxury end of the market is adding ‘affinity’ buildings. That means within the residential setting you can be in the same building as the artsy folks or maybe the super health and wellness segment of the population. Maybe they serve more kale there. Now they are adding circadian lighting to help every one be in a better mood when they see their monthly tab. The question arises, who can afford all this upgrading?
All of the above may well appeal to the high asset ‘mature consumer’, but it ignores the fact that affordable housing is the number one issue for the more sizable part of senior population. Working that puzzle out is a lot trickier than inventing another monitoring device. I am trying to find stats about the overall financial health of most the senior population. The reality is that many are still reeling from lack of retirement finds, missing pensions and taking first hand care of generations ahead and behind them.
The government and non profit sector will always have limited resources to meet the needs of the real aging in place folks trying to maintain their properties or not get priced out of their rental situations. In my view, the longevity economy still means skimming off the most profit from those mature consumers (aka boomers and older seniors) for what the market will bear.
Once upon a time when I worked in the mental health field, I heard a lecture about how trying to get grant money for proactive efforts to prevent mental illness was usually futile. You could always find the stark evidence of untreated illness, but it was difficult to define/prove what preventive measures could have mattered.
What has this got to do with aging, aging in place? We are facing a concrete demographic shift in the age of our citizens. When you learn the over 85 year old age bracket is growing at the highest rate (even though the smallest segment) it should make you step back and ask what will that mean. Many cities, towns are starting to face this fact more head on. They are looking into transportation needs, providing more social engagement to keep seniors from being isolated. Policies on building ADUs (accessory dwelling units) and funding for affordable housing units as well as rent control for seniors must be pushed to the forefront and dealt with. Grassroots are always the strongest springboard for action.
Change is coming. Now that can be a good thing, a well informed change or negative consequences of not facing reality. No one would argue against the idea of age friendly communities or livable communities (a dual AARP mantra). The truth is that policy changes are always slow and government can and will only do so much. Yes, there are volunteer opportunities to help on a local basis, but also think of the big picture.
If too many seniors especially of the I will live forever fit and fine boomer generation, deny that they need to get involved, much will be lost. Personal responsibility plays heavily in this. Many affluent senior live in their own bubble of I can afford to weather this storm. The majority of us who either choose or have to age in place face another reality. So stay informed and do not think putting that grab bar in your bathroom makes you prematurely old. Proactive is a word our generation grew older with. Ageism is a word we will deal with more than any other generation. Think about it.
I was going to rant this week about the rising costs of assisted living or expose the lengths to which developers will go to design the latest greatest amenity filled retirement communities. The price tags of both of these ‘must have’ items are so far beyond the reach of most seniors it is ludicrous. So I will choose to ignore that for now and do a little fantasy project.
This week I read about a new product coming out by late this year called Focus smart glasses. They are well beyond the original but now much maligned Google glass in practicality and appearance. For a thousand dollars (I hear the cost of the newest best iPhone you can buy), you can have a pair of these: https://www.cnbc.com/2018/10/23/norths-focals-smart-glasses-first-look.html
The current benefit besides correcting your vision are:(they) connect to your phone via Bluetooth and have a small projector that beams data into the wearer’s eyes. They can tell the wearer the weather or time, read text messages and even order an Uber. The glasses are also connected to Alexa, so if you can ask them for directions or information, a small speaker will tell you the answers.
They are relatively unobtrusive and are not designed for any particular age group. When I reviewed in my mind all the tech that has been created and prompted for seniors in the past year, I tried to think of a few add ons. Besides correcting your vision needs what else would I want them to do. It could eliminate the need for a push button device hanging around your neck, or a lumpy watch on the wrist. What else could they add to this product to make aging/aging in place more secure for seniors. Any ideas?
Well here we go, if there is an Alexa connection (which I have not experienced yet, but know more people who speak positively of her abilities) then appointments would not be missed. Searching for that word or remembering the name of a book or a movie might be easier. Could a GPS that knows all of your regular driving or walking routes keep you safer. Could they add on some of the medical monitoring that some people may need to go out with less anxiety, or help those with early memory problems function independently longer?
Walking around talking to yourself used to be a sign of mental illness or senility. Maybe having a pair of these super glasses would help you realize how much smarter and more capable you are than the device. Tech will come to have more of a place in the lives of future seniors, but you always have to remember to administer the Hippocratic oath, first rule- do not harm.