If necessity is the mother of invention, then the aging-in-place movement is a natural. For years, consumer surveys have reported that most people want to live right where they already are as they get older. Sure, millions may move to locales that, figuratively and literally, provide sunnier climes. But 10 times as many prefer to stay put.
In recent years, they've had little choice. Home values are still some $7 trillion below their peak. As many as 20 percent of homeowners have outstanding mortgage balances that exceed the current market value of their homes. U.S. Census figures show interstate migration has just about ground to a halt.
Why accept a depressing reality when it can be turned into a positive marketing and lifestyle mantra? So it is with aging in place. Seniors are told that they can save money by staying in their homes, while also retaining priceless relationships with nearby family and friends. They can age in familiar surroundings, and thus may be able to avoid moving to a nursing home or assisted living facility. If finances are challenging, there is always a reverse mortgage that can provide needed funds and permit seniors to stay in their homes.
As attractive as the idea of aging in place may be, progress in creating a nationwide movement in this direction has been slow and uneven. Towns and cities that have been built for automobiles and interstate highways are not very friendly to older residents, especially those who can no longer drive.
Downtowns are not very accessible. Public transit is spotty or nonexistent in many cities. Homes themselves are often hostile to residents who need wheelchairs, walkers, or other help getting around. Bathrooms and bedrooms, in particular, can be lethal danger zones for older occupants.
Addressing these needs will require lots of ingenuity and huge amounts of money. And it will take decades. Late last year, AARP commissioned the National Conference of State Legislators to survey state-level, aging-in-place efforts throughout the country. The report identified programs broken into three major areas: land use, transportation, and housing. Here are some of the best ideas being pursued around the country, according to the report and additional materials provided by one of its authors, Jana Lynott, with AARP's Public Policy Institute.
Land Use. Utah supports partnerships between public transit programs and private land developers. The state can donate land along transit lines for private development that will stimulate retail and housing developments and encourage use of public transportation.
Through its Georgia for a Lifetime program, the state and the Atlanta region stand out for efforts to roll back urban sprawl and coordinate aging-in-place policies.
Pennsylvania's Fresh Food Financing Initiative helps develop retail food stores in areas designated as so-called "food deserts" because they lack stores that provide fresh and nutritious foods. Between 2004 and 2009, it helped set up more than 80 stores in nearly three dozen rural and inner-city communities.
Transportation. Washington has expanded the state's intercity bus network for rural residents at a time when bus service in many parts of the country has been reduced. Bus service is connected to rail, air, and ferries to help people age in place but have the mobility they need.
New Jersey requires drivers to stop, rather than yield, to pedestrians in marked crosswalks. It also provides grants to local police departments for undercover enforcement efforts.
Volunteer driver programs are essential to help older residents who don't have access to cars. Only two states, Georgia and Oregon, explicitly protect volunteer drivers from civil liability stemming from accidents during their volunteer activities. "Of Americans over age 65, 21 percent do not drive," the report said. "This reduced mobility has a direct and often debilitating effect on older Americans' independence. More than 50 percent of nondrivers over age 65 normally do not leave home most days, partly because of a lack of transportation options.
Housing. Pennsylvania law permits $2,500 tax credits for any new or redeveloped housing unit that provides easy access, wider doorways, and entry-level restrooms.
In Texas, new affordable housing units cannot receive state or federal funds unless they have certain accessibility features, including wider doorway entrances, bathrooms with grab bars, and light switches and wall plugs that are raised to permit easier access.
Naturally occurring retirement communities (NORCs) identify concentrations of older residents and, through private and government efforts, develop aging-in-place support services. New York offers public grants to support NORCs that can efficiently provide a range of government health and social services.
Florida's Communities for a Lifetime program provides seed funding for communities that want to develop or expand age-friendly initiatives. Seniors must be involved in planning and development efforts and the towns also must engage multiple age generations in building awareness of shared needs and opportunities that involve older residents.