Hanging On at Home

We're right in the middle of a massive shift in how our society answers the single most fundamental question about retirement: Where will people live as they grow old?

If you're like most Americans, you would like to stay right where you are: 89 percent of 50-and-overs told an AARP survey in 2005 that they wanted to remain in their homes as they age. But many are not fully prepared to do so; most seniors have not taken even basic steps to increase the safety of their own homes. Living in your own home, which social scientists call "aging in place," is a fairly new trend, and one not supported by the way many municipalities and local businesses operate.

Of course, before the New Deal and World War II, there wasn't much question about where seniors would live, first because there were far fewer of them, and second because families tended to care directly for their elders. In 1930, with life expectancy around 60 in the U.S., persons 65 and older made up just 5.4 percent of the nation's population, compared with about 13 percent today. And just 3 percent lived in places such as almshouses or mental hospitals, according to data compiled by ElderWeb.

After the war, this traditionalist way of senior life yielded to a more institutional model. Older Americans were living longer and had their fortunes boosted by Social Security, then Medicare. But at the same time, migration to the suburbs and the Sun Belt fractured millions of families, and the rise of two-income households meant that even if children stayed geographically close to their parents, fewer could provide full-time care.
The inevitable, if unhappy, result: Millions of seniors moved to nursing homes and similar facilities.

Now the wheel is turning again. Baby boomers are not only far less trusting toward impersonal institutions than their parents, but they are also more likely to view their living environment as an embodiment of their self-expression. Plus, they are healthier than earlier generations of seniors. And they have invested more in their homes -- many of which have fallen in value so steeply over the past year that it won't make much financial sense to sell for a long time. For all these reasons, the generation of Americans now entering retirement is hanging on to, and hanging out in, their homes as they age. From 1987 to 2003, the proportion of Americans over 85 living in single-family, detached homes rose from 45.7 percent to 62.6 percent, according to the federal Consumer Expenditure Survey. In a field where statistics don't usually change all that quickly, that's a staggering increase. The number is now probably near 70 percent, experts say.

Today there are aging-in-place books, Web sites and videos, organizations, consultants, and initiatives, all dedicated to giving you advice about how to stay in your own home, many looking to charge you money for the privilege. I have five suggestions for cutting through the clutter.

First, do a full evaluation of the changes your home would require to become an elder-friendly place. And not piecemeal quick fixes; it's easy enough to tape down a rug or make your towel racks more secure, but only thorough preparation will avert problems. To get a sense of everything involved in a proper retrofit, whether it's easy-to-grip faucet levers, bright lighting or rounded countertops, you can take the free, easy and extensive online home assessment at the Web site of In Your Home, an aging-in-place consultancy based in Portland, Ore. (www.iyhusa.com).

Second, embrace the concept of universal design, which means making various parts of your home easier for everyone to use. You don't need to modify your home so it screams, "Old people live here!" You just need to boost its safety and convenience. Installing a bench near entrances to put packages or placing chairs in bathrooms to allow grooming while seated can help any visitor, not just senior residents. For other universal-design tips to make your home safer, check out "Home Modification: Your Key to Comfort, Safety and Independent Living," a free booklet from AARP. To discuss the mechanics and costs of making changes to your home, make sure you consult a builder or remodeler certified as an aging-in-place specialist (CAPS) by the National Association of Home Builders. (To find one in your area, search for CAPS at
www.nahb.org.)

Third, place special emphasis on preventing falls, particularly in the bathroom. I am well aware that today, as 65-year-olds attend Rolling Stones concerts (or, for that matter, perform in them) and 75-year-olds are waterskiing, it can sound quaint to warn about slipping in the shower. The stark truth, however, is that such accidents are a nasty, underappreciated threat to your financial future. Every year, one in three people over the age of 65 slips and falls, says Claire Berman, author of Caring for Yourself While Caring for Your Aging Parents. And not only do falls send seniors to the hospital five times more frequently than any other injury, but 20 percent to 30 percent of those who fall suffer injuries that make it harder to live independently and increase their odds of early death.

Fourth, once you have evaluated your home and comparison-shopped among remodelers, don't be afraid to reject the whole project. Really! If your home needs just a few nips and tucks to accommodate the way you think you'll be living at age 90, great. But if it requires massive rebuilding -- and in particular, if there are entire floors that you have stopped or will stop using, with no real way to reclaim them -- your best move may be to a home that is already more accessible to seniors. Sometimes it's hard to admit that our homes are better-suited to younger families. But aging in place doesn't necessarily mean aging in the place you're in right now, just someplace that will let you stay free, not trap you like a prisoner.

Finally, stay aware of the public trends. Communities will need to adapt zoning laws to let seniors divide or rent part of their houses to other tenants. Transportation systems will have to become more personalized.

Businesses, particularly health care providers, will have to figure out how to deliver more services to consumers in their homes. To keep abreast of these and other developments (or get involved), contact the National Aging in Place Council (www.naipc.org) or the Aging in Place Initiative (www.aginginplaceinitiative.org). Because lifelong independence is going to take some work.