Helping Boomers Age in Place

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As the Baby Boom generation ages, the number of older adults living in America will double by 2050, with nearly 19 million of those adults age 85 or older. While the needs of this older adult population continue to grow and change, the current paradigm of care—institutional settings like nursing homes and assisted living facilities—is an inflexible and expensive way of caring for older adults with physical limitations or chronic health conditions. According to a new report,Aging in Every Place: Supportive Service Programs for High and Low Density Communities, home- and community-based services are a cost-effective strategy that can solve this challenge by helping older adults maintain their quality of life as they age in their homes, whether those homes are in cities, suburbs, or rural America.

Aging in Every Place, released today by the Center for Housing Policy, the research division of the National Housing Conference,profiles several programs in communities across the U.S. that serve older adults. The report finds three elements that are essential to success: program development is guided by the preferences of older adults, programs evolve to serve a wide range of needs, and programs are built on partnerships with service providers and community stakeholders. The research finds that programs that support “aging in place,” as opposed to aging in institutional settings, can succeed in rural, suburban, and urban communities by tailoring program elements to address the unique needs of older adults in various communities.

Home- and community-based supportive service programs offer many types of assistance, often including case management, medical services, social activities and personal care assistance, which address difficulty completing essential tasks like eating, bathing, dressing and walking. Some programs also include home safety evaluations, help with minor home repairs, and other services to increase the suitability of older adults’ homes.

“Caring for older adults in their homes, instead of in institutional settings, is far less expensive and satisfies the desire of most older adults to remain in their homes as they age,” explained Research Associate and report co-author Janet Viveiros. “Many older adults move into nursing homes if they begin to have difficulty completing basic tasks on their own, like bathing or eating. Home-and community-based supportive services can help frail older adults care for themselves in their own homes and achieve better health outcomes than if they moved to a nursing home or assisted living facility.”

The characteristics of the community an individual lives in influences the kinds of barriers older adults with physical limitations face when aging in place. Effective home- and community-based supportive service programs offer a wide array of services that specifically deal with these community features. For example, multifamily buildings in dense, urban neighborhoods can serve as a hub for onsite supportive service programs, provided in cooperation with building owners or managers, to reduce the need for individuals to travel to receive services. In smaller multifamily homes or single-family homes clustered in less dense neighborhoods, it can be more difficult to serve individuals in their homes. Therefore transportation to medical appointments, errands, or social activities becomes a critical program component. For individuals living in single-family homes dispersed across a county or region, distance from medical and service centers and limited public transit can inhibit their ability to access supportive services. Successful supportive service programs in low-density communities often offer transportation, utilize existing community centers, or bring services to the homes of individuals who are unable to travel. 

Supportive services facilitate housing stability and overall wellbeing for aging renters and homeowners. Effective models need to be brought to scale to ensure that older adults can remain in their homes even if they experience frailty. According to Senior Research Associate Maya Brennan, “The rising number of older adults will bring increasing demands for on-site supportive services at affordable housing developments as well as integrated in the community, and this report shows that models exist to accommodate these needs in every type of community.”