Nearly all of us want to age in place. We want to grow old in a safe, comfortable, secure, affordable, and interesting community. But what the heck does that mean?
As the U.S. (and the rest of the world) ages, governments, non-profits, think tanks, advocacy groups, and universities are trying to figure it out. It turns out to be not so easy. And instead of cooperating with one another, many of these initiatives seem to be going their own ways.
There is nothing wrong with experimenting. It is, in fact, a very good idea. But an unfortunate consequence is a befuddling collection of initiatives that are wasting scarce resources and confusing families and local grassroots groups.
In 2006, the World Health Organization began a formal program called the WHO Global Network of Age-friendly Cities and Communities. It started with about 33 cities. At last count there were 137 member communities in 22 countries. In the U.S., they range from New York City, Chicago, and Washington, D.C. to Roseville, CA. In 2012, AARP became an affiliate for the WHO program and now offers program support for some U.S. communities.
But there are far more age-friendly initiatives than appear on the formal WHO roster. By one estimate, there are 560 such communities in Canada alone, including 316 in Quebec.
In one way or another, they seem to have the same broad goals: affordable, accessible housing; community health programs; strong public transportation and walkable neighborhoods; parks and other outdoor recreation; and available social services such as meals programs and caregiver supports.
Trouble is, in an era of severe budget constraints, meeting all those ambitious goals is unrealistic. Besides, elders (like the rest of us) differ widely in their own priorities.
In a series of new reports, AARP’s Public Policy Institute is examining how seniors define livable communities. Using focus groups and a major public opinion survey, AARP found a broad range of personal preferences that sometimes vary significantly by gender, race, income, and level of disability.
Elders were asked to rank steps that local governments can take to make their communities more livable. All rated increasing police presence #1 or #2. But, after that, there was little consensus.
For example, and not surprisingly, seniors with disabilities or with family caregivers wanted better transportation for people with limitations. They were less interested in improved parks, pedestrian friendly streets, or better buses or subways than those without disabilities. Similarly, people with lower incomes were more interested in affordable housing than those with higher incomes.
The gerontologist and geographer Stephen Golant argues that the age friendly movement needs to set specific priorities given these competing demands and inevitable resource limitations. It is, he says, “unrealistic” to try to be all things to all seniors.
In a recent article for IRPP Insight, a journal published by the Canadian Institute for Research on Public Policy, Golant suggests two controversial ways these groups could focus their efforts. First, they should target their support to relatively healthy elders who are most likely to remain active and productive in their communities rather than rather than those who are extremely frail. And, he says, initiatives should target moderate income seniors rather than the very rich or very poor. Low-income elders, he says, already have access to social services.
His suggested triage will be enormously controversial and in many ways conflicts with the current focus of much of the aging in place movement in the U.S. For instance, while senior villages are an important initiative, they tend to attract relatively wealthy, highly educated seniors rather than blue collar or poor elders. Similarly, many government- or non-profit-sponsored programs are aimed at the very poor or the very frail—exactly the groups Golant would put at the bottom of his priority list.
The great benefit of grassroots initiatives is that they can focus on ideas most appropriate to their own communities. There will still be conflicts as groups battle over their own priorities but that may be a necessary step as the aging in place movement begins to mature.