Chapter Summary

(Chapters by authors Cisneros and Carstensen) The evidence is abundant from studies of history and science that Americans can live for many more years without the painful, costly, dispiriting effects of debilitating diseases. “Aging in place,” as we discuss it in this book, refers to a range of housing and services, a continuum of options, that together support older people as they age and change. A central purpose of our society should be to change our culture to support both old and young people so that very long lives are lived well.

(Chapters by Authors Hayutin and Downs) The demographic shifts facing the United States are known, predictable and quantifiable. Demographic realities demand new solutions to meet the needs of an aging white and younger minority population. There are serious consequences if issues of aging in homes and communities are ignored and the nation stays on its current path.

(Chapters by authors Ginzler and Scharlach) Even though older people want to age at home, the delivery of health and social services in home based settings can be a challenge personally and financially, and may not be appropriate for everyone.

(Chapters by authors Greenhouse, Dishman, Miedema, Black, Roldan, Collins) A place to live that is physically manageable and emotionally uplifting is connected with independence, peace of mind and self-improvement. The goal should be to support communities in which older persons can choose from a variety of types of homes: single-family and multi-family units, rentals and owner-occupied homes.

Trained professionals, such as remodeling contractors, interior designers and architects can help families plan and construct needed improvements. With professional advice, a home that is suitable for aging in place can be beautiful as well as affordable.

(Chapters by authors Frank, McNulty and Littlefield, Dunham-Jones and Williamson, Ball and Plater-Zyberk, and Leinberger and Glynn) Most people in the United States live in the suburbs and will continue to live in the suburbs. Retrofitting existing neighborhoods can be accomplished through adaptive reuse, redevelopment or by removing structures to bring back green space.

Planners, designers and developers believe that there may be a growing market among baby boomers for the walkable urban form of neighborhood. There are hurdles, however, in the lack of flexibility in traditional zoning, absence of adequate financing and need for additional management.

(Chapters by authors Torres-Gil, Green and Painter, Franklin and Hickie) Each of us must take personal responsibility for how we will age, and we must also think about our responsibility as citizens. The recent recession has underscored the importance of Social Security and Medicare for all but the wealthiest Americans. Medicaid long-term care has been essential as a safety net, however disagreeable, for the very poor elderly. These entitlement programs are under tremendous budget pressure, just as the numbers of older people dramatically increases. We must implement new financial strategies for aging in place, quickly, particularly for the oldest old. There are proven and promising initiatives but accomplishing a cohesive system of private and public support based on home and community services requires research, advocacy, media attention, legal and electoral action.

(Henry Cisneros) Americans need to be increasingly aware of the growing proportion of the population that is aging. This reality will become apparent in fiscal pressures, workplace challenges, market adjustments and demographic-related conflicts that emerge in our society. The economic and personal dividends derived from enabling elderly Americans to live in their own homes for as long as they can are so great that they require intentional aging in place strategies.