In this lecture, we'll discuss the concept of aging in place. Aging is one of the most significant social transformations of the 21st century. The number of Americans aged 65 and older is projected to more than double, from 40 million today do over 98 million by 2060. By then, nearly one in four Americans will be over the age of 65. The implications of this unprecedented demographic shift are among the United States' most pressing socioeconomic and health policy issues. Most attention focuses on economic forecasts, healthcare demands, and a shrinking workforce. The everyday experiences, context and needs, of individuals to grow old well within their social and physical environments can be critically overlooked. Where does our aging population live? Over 95% live in private homes. The majority and single-family houses designed for the physically mobile and cognitively able. Bedrooms are often on the second floor, narrow door frames may not fit a walker or a wheelchair, and grocery stores and doctor's offices are frequently located miles away. Many neighborhoods are unsuitable for aging residents, but a growing number either choose not to or can't afford to move the limited supply of affordable and accessible supportive housing. These numbers will increase as many baby boomers age in place. The Centers for Disease Control or CDC defines aging in place as the ability to live in one's own home and community, safely, independently, and comfortably, regardless of age, income, or ability level. This popular slogan is applied at local, national, and global scales by private corporations, municipalities, the American Association of Retired Persons or AARP, and the World Health Organization. We frequently hear that up to 90% of seniors want to stay in their homes as they age. They cite reasons of convenience, independence, comfort, and familiarity. There's also a financial incentive that home based care is considered cheaper than institutional living. The aging in place market has come to represent a huge portion of the home improvement industry. And so aging in place is attractive to individuals, private industry, service providers, and policy makers alike. But despite its widespread popularity, it remains an ambiguous and problematic concept. What about cultural minorities with differing residential expectations, long time renters, those in unsafe housing? What about the homeless? How does aging in place address their situations? In my research, I talked to older adults and policymakers regarding experiences, expectations, and abilities or lack thereof to age in place. What makes a good place to grow old? Views on this can vary widely, but they tend to center around four overarching concepts. First is having a safe and comfortable home and neighborhood environment. Second is access to services, facilities, and recreational amenities. Third is social connection, which can include everyday interactions, social support, and sense of community. And fourth is stimulation, and by that I mean an environment with opportunities for fulfilling and meaningful activity. In order to support healthy aging in place particularly for low-income and marginalized seniors, there are at least four domains to address moving forward. The first is enhancing access to affordable and accessible housing. Second is boosting accessible and safe transit by foot, bus, ride share, and car. Third is having nearby and appropriate services and amenities. And forth is choice and support for health and care. Understanding optimal environments for aging in place requires an interdisciplinary and collaborative approach. And the conceptual breath to tackle issues of inequality, poverty, urban, decline, and gentrification. We need a stronger and more coherent link between research and policies on aging in place. Participatory methods can invent efforts to engage older adults as leaders and visionaries in targeted neighborhood improvements and the development of policy measures to support aging in place. Coproduction of knowledge between researchers, policymakers, and diverse community stakeholders creates a forum for rich and meaningful engagement, inclusion, respect, and mutual learning. This will events opportunities for more just and inclusive approaches to aging in place and generate greater health and equality in the aging experience.
