The challenges and opportunities of an aging population already are beginning to transform our homes and neighborhoods.

Today, we do not have enough affordable, appropriate housing and services to meet the needs of a population that includes significant numbers of very old Americans. Challenges will be particularly pressing for the vulnerable “oldest old,” those who can no longer work, whose savings are depleted, who are in poor health, and who need services that are unavailable. Among the oldest old, the percentage of the population residing in skilled nursing facilities is declining. The desire to age in the home of one’s choice actually increases with age.

Action is needed through research and culture change in four priority areas:

• housing
• neighborhoods
• amenities
• support services

Important questions include:

• What factors are important in the decision to stay in one’s current home, remodel, and/or to move elsewhere?
• What are the community indicators that measure the well being of older people?
• Which incentives would encourage builders and remodelers to construct smaller, age-appropriate, lifelong homes?
• Which affordable, replicable technologies and systems can effectively deliver services to old people?
• How can individuals working in a wide array of fields be linked to share information and priorities for action?