Challenges to Aging in Place: Understanding Home Maintenance Difficulties

Age-related declines in capabilities may compromise older adults' ability to maintain their homes thus threatening successful aging in place. Structured interviews were conducted with forty-four independently living older adults (M(age) = 76.1, SD = 4.7) to discuss difficult home maintenance tasks and how they managed those tasks. Solutions to managing difficulties were categorized as person-related or environment-related. The majority (85%) of responses were person-related solutions. An understanding of the specific challenges that older adults face in maintaining their homes can guide redesign efforts and interventions to effectively support older adults' desire to age in place.     

Meaning of Home in Later Life as a Concept to Understand Older Adults’ Housing Needs: Results from the 7 Age-Friendly Cities Pilot Project in Québec

To support older adults’ desire to age in place, their housing needs must be well understood. However, little research has explored housing needs from older adults’ point of view. This article, based on the results of 49 focus groups (n = 392) and one case study from the Age-Friendly Cities Project in Québec, Canada, uses the concept of meaning of home in later life to explore older adults’ housing needs. An overview presents how older adults express meaning of home and what their needs are regarding housing and relocation. Finally, the implications for decision makers and stakeholders are discussed.     

Quality of life of older people in Israel: a comparison between older people living at home who are members of a ‘supportive community’ and nursing home residents

The supportive community is a program that was developed in Israel for older people who live at home. The program provides its members with a service package that includes medical and social services, emergency call-button, cultural activities, and a ‘community parent’ who is responsible for the members. Using quantitative method, this study compared the level of quality of life between 55 older people living in their homes who are members of a supportive community (average age = 74.7) and 60 elderly people living in nursing homes (average age = 75.8). As expected, results indicate that quality of life among the older people living at their homes who are members of a supportive community was higher than among the older people living in a nursing home. In addition, the quality of life of married, educated, functionally independent older people in good health and with a good economic situation was higher. Predictor variables of quality of life were: the place of residence, health status, and age. In light of increased life expectancy and the growing need to care for the older population, the practical application of the study focused on a recommendation for the social services to continue the support community development program.     

Vulnerable African American Seniors: The Challenges of Aging in Place

American Community Survey data are used to develop typologies of the generational dynamics and living arrangements of the estimated 1.6 million African American older adult households who will likely encounter the most difficulty aging in place. Policy recommendations and strategies are offered to address the specific barriers and challenges that must be overcome in order for these older adults to successfully live out their lives in their homes and community.     

Age Similarities in Interpersonal Perception and Conversation Ability

Older adults tend to perform worse on emotion perception tasks compared to younger adults. How this age difference relates to other interpersonal perception tasks and conversation ability remains an open question. In the present study, we assessed 32 younger and 30 older adults’ accuracy when perceiving (1) static facial expressions, (2) emotions, attitudes, and intentions from videos, (3) and interpersonal constructs (e.g., kinship). Participants’ conversation ability was rated by coders from a videotaped, dyadic problem-solving task. Younger adults were more accurate than older adults perceiving some but not all emotions. No age differences in accuracy were found on any perception task or in conversation ability. Some but not all of the interpersonal perception tasks were related. None of the perception tasks predicted conversation ability. Thus, although the literature suggests a robust age difference in emotion perception accuracy, this difference does not seem to transfer to other interpersonal perception tasks or interpersonal outcomes.     

The Role of the Environment in Sedentary Behavior in Community-Dwelling Older Adults

To compare amounts of sedentary behavior and physical activity in adults residing in planned group residential settings to those residing in private homes, this study recruited 31 older adults who resided in planned group residential settings (n = 13) and in private homes (n = 18). Daily activities were measured using the SenseWear Armband for 7 days. Estimates of the duration of daily activities performed across sedentary, light, and moderate-to-vigorous intensities were captured. It was found that participants in planned group residential settings were older (age 85.9 ± 3.5 vs. 78.3 ± 7.2; p = 0.001) and spent more time in sedentary behaviors (12.7 ± 1.5 vs. 11.3 ± 1.6; p = 0.02) than participants in private homes. The difference was attenuated slightly after controlling for age and wear time (adjusted difference 1.2 ± 0.6 hours, p = 0.06). Thus, adults residing in planned group residential settings, which provide supportive services, were more sedentary than adults residing in private homes. The environment in which older adults live may contribute to sedentary behavior.     

Sustainability Processes among Naturally Occurring Retirement Community Supportive Service Programs

ABSTRACT

Sustainability remains a concern for community models to better support older adults’ aging in place in their own homes and communities. Based on qualitative data from leaders of 53 Naturally Occurring Retirement Community (NORC) Supportive Service Programs, which is among the most prominent community practice models in aging, we aimed to develop an empirically-grounded framework on sustainability processes. Results indicated that programs use funding, staff members, interorganizational partnerships, and volunteers to offer services to attract older adults, and that older adults’ participation, in turn, is perceived as influencing the accrual of additional resources. Across themes, respondents discussed the importance of being responsive to the community and facilitating consumer participation.     

Environmental Evaluations and Modifications to Support Aging at Home With a Developmental Disability

ABSTRACT

Increasing numbers of people with developmental disabilities are living into old age and are now residing in community-based housing, largely due to the deinstitutionalization movement. The overlay of age-related impairments onto pre-existing, lifelong disabilities puts this population at a magnified risk for premature behavioral limitations and loss of independence. This article describes a demonstration project designed to enable people with developmental disabilities to age in place. Interviews and observational assessments with 45 older adults with developmental disabilities were conducted in their community-based homes to identify potential barriers to aging in place. An Individualized Environmental Intervention Plan was developed for each study participant, recommending ways to solve problems and eliminate potential barriers. Individualized Environmental Intervention Plans were implemented to the extent possible through home modifications and assistive technology. Pre- and post-modification task performance and self-report revealed the positive impact that home modifications and assistive technology can have. The study demonstrates the need for ongoing evaluation and assessment sensitive to the needs of people with developmental disabilities and the unique characteristics of supported living settings.     

The Use of Humor With Older Adults Aging in Place

As more older adults seek ways to remain in their homes during their “golden years,” humor has proven to be a worthwhile intervention that reduces stress and provides a hopeful, playful, and optimistic environment. Development of creative and supportive housing situations for older adults combined with the use of modern technology (e.g., the Internet and computer devices used in the home), aid in bringing humor to the older adult. This article addresses some of the challenges that older adults face and the way that the use of humor can assist them to meet these challenges.     

Characteristics of LGBT caregivers of older adults: Results from the national Caregiving in the U.S. 2015 survey

Using data from the Caregiving in the U.S. 2015 national survey, we compared characteristics of lesbian, gay, bisexual, and transgender (LGBT) and non-LGBT caregivers of older adults and explored predictors of caregiver strain. LGBT caregivers were younger, more racially/ethnically diverse, and less frequently a spouse/partner compared with their heterosexual counterparts. LGBT caregivers more frequently reported helping with medical nursing tasks and reported higher levels of financial strain. While LGBT identity was not an independent predictor of greater strain, characteristics more frequently reported by LGBT caregivers were, for instance, helping with medical nursing tasks. In addition, LGBT individuals who were children of the older adult were more likely to report higher levels of emotional strain than other relationship types.     

’Til Divorce Do Us Part: Marriage Dissolution in Later Life

Late-life divorce—commonly referred to as gray divorce—is a rising trend that parallels the growth of the older adult population. We sought to gain an in-depth understanding of the experience of marriage dissolution, the divorce process, and life following divorce in a sample of older adults who divorced after more than 20 years of marriage. Qualitative data were collected from 10 divorcees (7 women and 3 men; M age = 63.5) and analyzed to understand the gray divorce experience; that is, factors that determined or delayed the decision to divorce and divorcees’ coping during and after divorce. Participants’ stories demonstrate that marriages endure despite problems because relationships are complex, and good experiences mix with bad ones. Outcomes of late-life divorce have significant health and financial implications for both individuals and society.     

Women Caring for Our Aging in Place Seniors Will Lose Out because of U.S. Immigration Policies

Most older people experiencing chronic health problems, physical disabilities, and memory losses are still able to age in place in their own homes. However, they often need help from others to enjoy healthy, active, and independent lives. They turn mostly to family members, mainly women and usually their daughters, daughters-in-law or wives. But caring for frail elders has become more demanding and complex, and these family members often feel physically and emotionally overwhelmed and burnt out. They concede that they cannot do it alone. Others find it more difficult to hold full-or even part-time jobs. Hiring home (direct) care workers to assist their loved ones can be an effective solution to ease their caregiving responsibilities. However, these personal care aides, home health aides, and nursing assistants are already in short supply. Moreover, going forward the aging of the baby boomer population will result in an even greater demand for their services even as these jobs are often unattractive to American-born workers and turnover is high. This country’s immigration policies will make it even more difficult for women caring for older persons to hire these workers. Over 25 percent of home care workers are low-skilled immigrants or foreign-born. However, the Trump administration’s policies reduce the number of immigrants entering the U.S. and specifically choke off the various pathways that enable low-skilled persons to be hirable in the home care sector. Female caregivers seeking relief from their caregiving responsibilities will lose out unless we remove these immigration barriers.     

The Power of Older Women and Men in Egyptian and Tunisian Families

We adapt resource theory to compare involvement in family decisions by older women and men in the more patriarchal setting of Egypt and the more egalitarian setting of Tunisia. Data from the World Health Organization Collaborative Study on Social and Health Aspects of Aging are analyzed. In Egypt, women participate less often than men in most decisions, whereas participation is more gender equitable in Tunisia. Increasing age and declining health are negatively associated with participation in daily and life course decisions, particularly for Egyptian women. Although women participate less often than men in life course decisions in Egypt, involvement is more frequent among widows and those owning their homes. Future research should examine the relationship of resources, support, and the family power of older adults across normative contexts.     

Staff responses to age‐related health changes in people with an intellectual disability in group homes

The purpose of this study was to explore how supervisors in group homes caring for people with intellectual disability responded to the development of age‐related health changes in their residents. Ten group home supervisors working in the disability sector were interviewed once. Data were analysed using Dimensional Analysis. The study identified several factors related to whether a resident could stay ‘at home’ or would need to be moved to residential aged care (nursing home) including: nature and extent of group home resources, group home staff comfort with residents’ health changes, staff skill at navigating the intersection between the disability and ageing sectors, and the supervisor’s philosophy of care. The ability of older people with an intellectual disability to ‘age in place’ is affected by staff knowledge about and comfort with age‐related illnesses, staff skills at navigating formal services, staffing flexibility, and the philosophy of group home supervisors. Despite the growing international concern for the rights of people with disability, particularly in relation to decision making, questions about the older person’s choice of residence and participation in decision making about what was best for them, were almost nonexistent. Rather, decisions were made based on what was considered to be in ‘the best interest’.     

Healthy mind in healthy body? A review of sensorimotor–cognitive interdependencies in old age

We review four broad lines of research on couplings between sensorimotor and cognitive aging, with an emphasis on methodological concerns. First, correlational cross-sectional and longitudinal data indicate increasing associations between sensorimotor and cognitive aspects of behavior with advancing age. Second, older adults show greater performance decrements than young adults when sensorimotor and cognitive tasks or task components need to be performed concurrently rather than in isolation. Third, aerobic fitness interventions produce positive transfer effects on cognition that are particularly pronounced for tasks with high demands on attention and executive control. Fourth, neuroscience findings from animal models and humans have identified aging-sensitive structural and functional circuitries that support cognitive functions and are enhanced by higher levels of sensorimotor functioning. We conclude that sensorimotor and cognitive aging are causally related and functionally interdependent and that age-associated increments in cognitive resource demands of sensorimotor functioning are malleable by experience.     

A city within a city: A “snapshot” of aging in a HUD 202 in Detroit, Michigan

Because of a recent surge of aging in place literature, we know a considerable amount about how older adults wish to remain in long lived-in homes and communities. However, there are still gaps in our knowledge. What happens when older adults live in a community that does not support their everyday needs? This paper represents an initial attempt to explore how one group of poor, non-white, central city residents in Detroit, Michigan make sense of and organize a new age-segregated home. Findings presented in this article are based on 30 in depth and photographic elicitation interviews with African American, low-income, older adults living in one Housing and Urban Development 202 (HUD 202). Findings suggest that participants in this sample cultivated a new urban space within the facility to compensate for the deficiencies of a deteriorated inner-city neighborhood. I use these findings to encourage broader conceptualizations and consideration for the aging in place model to be more inclusive to the lived experiences of older adults who occupy oppressed places.     

Family Members' Reports of Abuse in Michigan Nursing Homes

The objective of this article is to describe abuse and neglect of adults age 65 and older in Michigan nursing homes, as reported by members of their families. Using list-assisted random-digit dialing, data on abuse and neglect for a 12-month period were collected from individuals who had a relative age 65 or older in a Michigan nursing home. Of the nursing home residents represented in this analysis, the majority were female, Caucasian, and widowed. Neglect and caretaking mistreatment were the most frequent types of abuse reported. Comparison of these data with data from the National Ombudsman Reporting System suggests that family members constitute a sensitive source of data on abuse in nursing homes.     

“No Home,No Place”: Addressing the Complexity of Homelessness in Old Age Through Community Dialogue

The aging-in-place agenda supports the right of seniors to live in their preferred environment, as the place where they can retain a sense of independence and control in old age. This right is compromised for vulnerable seniors who are homeless or at risk of becoming homeless. Causes of homelessness in old age are complex, and pathways into and out of homelessness are multifaceted, including financial insecurity, relationship breakdown, and addiction, compounded by barriers to accessing services, shrinking social support networks, and complex health challenges. Addressing the multidimensional nature of homelessness in old age requires holistic solutions that bring together the knowledge and expertise of multiple stakeholders, not least seniors themselves. With this aim, this paper reports on findings from multistakeholder community dialogue sessions conducted across Metro Vancouver with seniors’ organizations, service providers, and local government to prioritize the challenges of senior homelessness in Metro Vancouver and propose strategies and solutions for addressing the issue. The paper highlights some of the ways in which services and housing supports can be designed to support older adults who are homeless or at risk of becoming homeless.     

Life-Stage and Mobility: An Exploratory GPS Study of Mobility in Multigenerational Families,Ahmedabad, India

As the population of older adults in India grows, research is needed to plan a sustainable future for India’s older adults. This article reports results from a Global Positioning System (GPS)–based pilot study that examined the mobility of middle-class, older adults living in Ahmedabad, Gujarat, India. Using mobility as a lens through which to examine the lives of older adults, we map potential research and identify policy areas of interest considering older adults in urban India. The study explores the role of life stage in mobility as well as the effects of gender and urban environment on mobility. Using this distinctive perspective on day-to-day life, we propose themes through which, using policy and planning tools, the living environments of older adults in Indian cities can be improved. These policy measures include focusing on walkability and pedestrian safety in residential areas and building on existing mixed land use to create high accessibility to goods and services in urban environments.