Aging adults face a number of challenges within their homes and communities.
One challenge is the accessibility of homes, most of which are not built to accommodate unique physical needs of older adults who may face mobility, cognitive, or perceptual limitations and challenges. Consider, for example, how traditional doorknobs can be difficult for people with arthritis to open, or how entryways with one or more steps can contribute to tripping and falling. Other common housing features that pose accessibility challenges for aging adults include: ill-placed electrical outlets and light switches; narrow doorways and hallways that prevent or restrict movement of persons with mobility devices; and slippery surfaces.
Fortunately, there is greater recognition of the need for Universal Design that incorporates accessible features designed for all users, regardless of age or ability level. Universal Design is different from federal Americans with Disability Act (ADA) that sets forth building and facility standards for accessible design to accommodate persons with disabilities. The Center for Universal Design has identified seven Principles of Universal Design to accommodate people with a range of abilities such as a no-step entrance that enables access by a person using a wheelchair, pushing a stroller, or rolling luggage.
Transportation and Community Mobility
According to an AARP report on Livable Communities Livable Communities, “transportation that connects individuals to the goods, services, and social opportunities of the community contributes to successful aging.” Transportation and mobility options are needed to accommodate older adults with disabilities, who do not drive, who live in areas where public transportation is unavailable or lacks routes that connect to desired destinations, and/or live in communities where the build environment is unsafe for walking.
Transportation is often difficult to come by for those who are aging-in-place in suburban communities that are automobile dependent, or who move to remotely located “active adult” and “independent living” residential communities. Two studies, Aging Americans: Stranded without Options and Aging in Place: Stuck without Options, document the crisis that America’s largest generation will face in terms of isolation, reduced quality of life, and possible economic hardship when they live in areas that require travel by car and where affordable travel options are lacking.
An additional challenge specific to “active adult, 55+, or retirement lifestyle” communities is social isolation. As Amy Levner of AARP reports, “…age-segregated retirement communities are not attractive to a majority today.” Rather than live in communities composed entirely of aging adults, seniors prefer to stay engaged in their communities and maintain their existing social ties. An AARP Public Policy Institute fact sheet on supportive housing describes options that allow older adults to live in a non-institutionalized settings. Supportive housing can provide a variety of on-site support services for older adults via affordable housing units, adult foster care homes, continuing care retirement communities (CCRCs), congregate housing in apartment complexes, and multigenerational and intergenerational communities that foster interaction and social connectivity. Services within these settings can range from light housekeeping, to group meals, to wellness monitoring.
Local governments can develop livable communities policies that address issues such as land use, housing and transportation, which are vital to developing communities that facilitate aging in place.
Health and Social Service Needs
According to an IPA health policy poster, about 40 percent of Delaware’s adults ages 65 and older have a disability. The need for caregiving for older adults by formal, professional caregivers or by family members— and the need for long-term care, health, social services and supports—will increase sharply during the next several decades, given the effects of chronic diseases on an aging population. According to a 2012 Delaware State Plan on Aging, Delaware’s long-term care expenditure patterns are indicative of an over-reliance on facility-based services. Currently in Delaware, about 87% of long-term care dollars are spent on facility-based services, as opposed to 66% for the nation as a whole. Several recent studies have pointed to the need for Delaware to strengthen and improve access to its system of home- and community-based, long-term care services and supports.