Aging in Place Requires a Plan

According to AARP, more than ¾ of people aged 50 and older prefer to age in place. However, far fewer people have thought through what this approach may involve, often at their peril.

"Aging in place" refers to the concept of staying in one’s home, often for decades, and living independently as long as possible. For many, aging in place seems ideal, providing psychological comfort, financial stability, and social connection.

But life rarely unfolds as expected.

Necessity for a Plan

The feasibility of aging in place can vary depending on one’s specific place and circumstances. For example, living alone in a three-story house in a rural area presents challenges different from living with a partner in a one-floor apartment in a walkable urban area. The desire to age in place may be the same in both instances, but what it takes to implement that strategy is different, as are the associated risks.

In the first case, overseeing a large house for one person can be time-consuming and expensive. Living alone, particularly in an environment without neighbors and friends close by, is physically isolating at best and creates loneliness at worst. Outfitting a multi-storied house for aging in place can be quite involved, particularly if there is difficulty navigating stairs.

In the second case, living in a flat with a roommate is more conducive to successfully aging in place. However, it may come with its complexities. Urban environments may be walkable but are they safe? Older adults can be a target for thieves. If you rent an apartment, making modifications to facilitate aging in place, such as adding grab bars, raising toilets, widening doorways, implementing slip resistant tiles, etc., may not be authorized by the landlord.

Assessing Risks at Each Stage

To optimize the odds of aging in place working, assessing the risks of your current stage and what may be in store in the future is critical. For example, consider whether the physical design of your home meets your current needs and what might be needed in the future. Evaluate whether your home can support your health needs, whether that is access to health care, ability to exercise and/or availability of foods you desire. A key area is to appreciate whether your home offers the social support and sense of community you need today and in the future. And, obviously, it is important to appreciate your ability to pay for your home under various scenarios.

Your home doesn’t need to score well under every possible scenario in the future (in fact, that’s nearly impossible). However, if there are fatal flaws with your current place under key scenarios, your existing home may not be the best spot to age in place in the future.

An area that can get overlooked is how places change over time. If you plan to age in place over the next decade or so, there is a risk that elements of your place, such as your block, neighborhood, metropolitan area, state, etc., may become less appealing due to various factors, such as politics, tax policy, cost of living, climate change, and more.

Example of When Things Go Awry

Aging in place works until it doesn’t and, when it doesn’t, it can often be catastrophic. The story typically unfolds something like this: an older adult seemingly is getting by aging in place in his house until there is a fall, commonly in the bathroom. The fall leads to an emergency room visit where it is determined a hip has been fractured. Surgery is near-immediate and rehab is necessary to regain strength and motion. In this event, it becomes clear to everyone – but especially friends and family – that the current home may not be the best place – or, in some cases, even a viable option – for the older adult. A crisis arises to find a new home on an urgent timeline.

This story happens countless times every day. According to the CDC, over 14 million older adults in the United States fall each year, which is roughly one in four adults 65 and older. Said differently, in the U.S., an older adult falls every other second on average.

None of us should be surprised about this risk, and without proper planning, aging in place can ultimately lead to a disastrous situation.

Implications for Older Adults, but Also Their Adult Children

Poor planning wreaks havoc on the health and well-being of older adults and their families. Often, adult children are preoccupied with their responsibilities between their jobs and parenting their kids. More than likely, adult children don’t live within a close drive of their parents, making the complicated task of sorting out what is best for their parents even more difficult.

Of course, a lack of planning may be even more problematic for solo agers, people who don’t have a partner or adult children to rely upon.

In other words, saying you plan to age in place is very different than truly planning for it.