Aging in Place: How to Continue Living at Home

The quest for independence is a constant motivator in life. From the time we learn to walk, to driving our first car, to buying our first home, we strive to become and remain independent—a characteristic that does not change with age. According to research by the American Association of Retired Persons (AARP), 9 out of every 10 older adults want to stay in their own homes as they age. However, “aging in place” is often made more difficult because of health care needs. Despite a need for day-to-day assistance, however, most (82 percent) would prefer to stay in their homes. Only a few express a preference for moving to a facility where care is provided (9 percent) or for moving to a relative’s home (4 percent). A recent survey MetLife Mature Marketing Institute showed that 91 percent of pre-retirees, age 50 to 65, responded that they want to live in their own homes in retirement. Of that group, 49 percent want to stay in their current homes.

This unplanned phenomenon, of individuals aging in place, is having a radical effect on the composition of some neighborhoods, especially in San Diego County. A recent study undertaken at SDSU by Maurizio Antoninetti, looking at Naturally Occurring Retirement Communities (NORCs)--which is a clustering of households with aging residents--shows that although we have a number of communities that are rapidly aging, only a few of these NORCs have any supportive services that will enable aging in place.

Living in a house which is not designed for frail older persons is the primary cause of falls among older adults. Falls are the leading cause of injury-related visits to the emergency room in the U.S. and the primary cause of accidental deaths (75 percent) in older people over 65. Each year, more than 12,000 older adults in San Diego County arrive at the hospital after a fall. You are more likely to fall if you take four or more medications, have foot problems, get dizzy, have problems seeing, or have trouble walking and getting around.

Despite this statistic, living by one’s own rules is a key reason for staying in one’s own home, with 42 percent of seniors choosing it as one of their top three considerations. But how realistic is this? A recent survey by The SCAN Foundation in California reported that “. . . should they need long-term care, many working Californians are only a month away from economic crisis.” While most pre-retirees expect they will be able to live independently during retirement; relatively few (14 percent) expect they will need day-to-day assistance. Although the idea of getting older is on the minds of most, adult children are more likely to think their parents will become dependent and need their help then their aging parents themselves.

Aging in place is possible only with planning, and even with the best laid plans, older adults need to entertain the idea that aging in place is but another life stage and that we still need to discuss all the options for all eventualities. Discuss with your loved ones how you would like to live if you become dependent. Who has access to your money, your personal items? Who should be in charge of your hygiene? Talk with alternatives for end-of-life, explain what you want. These are tough issues to bring up. Growing old is not for sissies.

Mario Garrett PhD is a professor of gerontology at San Diego State University. He can be reached at mariusgarrett@yahoo.com © Mario Garrett 2010