I’m sorry, but “aging in place” is a piece of *@!%

Last updated on: April 27, 2014 at 2:13 pm by Jane the Actuary

I’m sorry, but “aging in place” is a piece of *@!% 2014-04-27T14:13:00-06:00 Jane the Actuary

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So we spent Easter weekend with my parents.

Dad’s in the hospital. He fell, once again, and (rather than breaking a hip as we’d feared) he hit his head. He’s now getting physical therapy (walking with a walker) as well as occupational and speech therapy — mom says he just doesn’t seem to be able to focus on tasks and is periodically confused about what’s going on, and she (and the doctors, too, maybe?) doesn’t know to what degree this’ll fade or be a lasting effect of the head injury.

We’ve had The Talk with them. You know, the one that goes, “Mom, Dad, you should look into moving into a condo.” Dad’s always said, “I’ll leave this house when they carry me out on a stretcher,” — and, although he always meant, “. . . straight to the funeral home,” it is literally true that they carried him away in the ambulance (though my husband pointed out that, strictly speaking, he was already outside, on the driveway, when he fell).

But we have this whole mythology around “aging in place.” We provide “senior freeze” reductions in property taxes — sometimes quite substantial benefits which you’re only eligible for if you stay in your own home. Move from a single-family home to a condo and lose that benefit, even if the condo has roughly the same property value and paying the taxes are just as burdensome. Local governments and charities organize volunteer yard-work help for seniors, and there are transporation services for those who have had to give up driving, meals-on-wheels, friendly visitors, etc. And seniors themselves spend large sums of money in pursuit of the “age in place” goal, whether it’s the lawn and snow-plow services, housecleaning services, and the like.
Does it “work”? Are the elderly who stay in the home in which they raised their family happier than those who have left for greener pastures, whether it be a condo in an elevator building, a smaller single-level home close to transit, or a dedicated 55+ residence of some kind? I have a hard time believing this. Yes, moving away means leaving a place filled with memories, and means making hard choices about what personal belongings to give away or store (maybe you don’t really need the everyday dishes, the good china, the Christmas plates, and the Thanksgiving dishes), and if “staying in your own home” is your own metric of whether you’re remaining physically and mentally sharp and capable, then you’d have to give up that notion and, until you do, feel as if you’ve failed. But the family pictures can be re-hung, and the old recliner can come along to the new home. And if “aging in place” means a home you can’t keep clean because of its size, stairs that harm your quality of life (because Dad can still go up and down stairs, but it is quite difficult and both Mom and Dad try to avoid it), and loneliness and isolation if you’re in a typical suburban home without nearby mass transit options once driving isn’t an option, then I fail to see how the short-term negative of adjustment to a new home really outweighs the long-term benefits — especially for those seniors who make the move to a more senior-friendly home (no steps, no maintenance, close to services) when they’re young enough to mentally adapt easily.

Which means that the whole plethora of services to help seniors “age in place” are not just expending resources (tax money, charitable donation dollars) that we don’t have, but they’re doing more harm than good. And all due to a reverence for the “family home” — which, come to think of it, is much like the reverence for home ownership which did such harm in prodding people to buy homes who really shouldn’t have.

(Of course, the issue of nursing home vs. home care is a separate issue. My husband and I were discussing this yesterday and stumbled over a rare vocabulary issue: “Altenheim” in German is literally an “old folk’s home” but is a residence that provides both assisted living services and nursing care like an American nursing home. Our nursing homes are pretty lousy — though you’d think that fixing nursing homes to be more humane and habitable ought to be more cost efficient, for those who need round-the-clock care, than 24-hour home health care.)

And, yes, in 25 years, if I stick with blogging and you stick with me with reading, you are more than welcome to ask me how my move is coming along!

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