Supporting Aging in Place: A Policymaking Blueprint for Addressing U.S. Older Adults’ Unmet Home Modification Needs

Abstract

Older adults wish to remain in their homes as long as they are able, but little research has evaluated what role housing plays in the decision to age in place. Qualitative interviews of aging services providers and focus groups with older adults provide insight into needs for home improvement while aging in place and the effects those needs may have on deciding to relocate. In light of the recent CHRONIC Care Act and resultant new access to potential home improvement assistance for some older adults, findings from this study highlight the importance of maintaining independence while increasing older adults’ awareness of and access to home improvements to support aging in place.

Keywords:

• Aging in place
• policy
• housing
• home modification
• older adult

Notes

Acknowledgements

This work was part of a larger dissertation effort. I acknowledge Brandeis University’s Heller School for Social Policy and Management and the faculty therein for assisting in the required dissertation and degree confirmation processes.

Disclosure Statement

The author has no financial interest nor has any benefit arisen from data collection, analyses, or application of this research.

Notes

1 This study uses the U.S. Centers for Disease Control definition of aging in place: “The ability to live in one’s home and community safely, independently, and comfortably, regardless of age, income, or ability level” (CDC, 2011). Though numerous phrases have been used interchangeably (Pynoos & Nishita, 2006; Vasunilashorn, Steinman, Liebig, & Pynoos, 2012), including aging in community, healthy aging, successful aging, and aging well, aging in place is the most widely recognized term. This CDC definition also is used most commonly in the existing aging literature, including in many recent scholarly studies conducted in the United States and internationally (Rogerson, Poetker, & Rutherford, 2013). Most importantly, the term aging in place best addresses the core goals of this research, as the chosen definition characterizes place as both a finite location, such a home, and as a broader neighborhood or community. For this study, aging in place excludes seniors living in facility settings, group homes, or other eldercare settings.

2 An estimated 1 in 5 U.S. seniors will be age 65 or older by 2030 (U.S. Census Bureau, 2010a).

3 Medicare is the U.S. public health insurance program that provides coverage for Americans age 65 and older through a variety of different insurance plans, including Medicare Advantage. Medicaid is the U.S. public health insurance program that supports low-income Americans. Some older adults may qualify for both programs (i.e., dual beneficiaries), meaning they are both age 65 or older and low-income.

4 All data collection efforts received approval from the Brandeis University Institutional Review Board.

5 Because interviewees were public employees with limitations on ability accept gifts, no monetary compensation or honoraria were provided.

6 All focus group participants across all focus groups received a small honorarium ($20/person).