AGING IN PLACE

When staying at home is an option.

Most seniors prefer to live in their own homes and communities for as long as they are able. It makes sense. Where it’s possible, the outcomes for their health are far better than for those who are forced into long-term care facilities, and living at home is a lot less expensive than going to one of those places.   But, as they say, aging is not for beginners. Successful aging in place has several requirements. These involve housing, transportation, health, social engagement, opportunities for volunteering, support for care givers, and advocates for the concerns of the elderly. 

Successful aging in place requires planning. What do you want your future to look like? Not only financially but also personally. Do you want to live with or near your children? Do you want to continue to live in your broad community or would you rather live in a smaller ‘senior’ or mixed community? Maybe you want to remain in your community but live in a smaller house.  And so on. Talk this out with your family now so that you can plan for the future that you want.

Some of the most important adjustments you will make to enable you to age in place will involve where you live, your physical environment. Your house. Is it close to shopping? A medical center? Public transportation? Your children and/or friends?  You really should plan for level entries and make modifications to enable you to live on a single floor within the house.  We did all that when we built our house in 2011, but we should have put hand railings in our shower because my balance has deteriorated in the past couple of years. Many web sites (AARP is an example) discuss all this. The National Aging in Place Council offers many suggestions for making your house senior friendly.

Around here some of our fellow residents are living in houses that they grew up in in the forties or fifties or earlier. Your venerable old New England homestead might have gotten much too big after the kids left. In 2016 a New Hampshire law, soon to be codified as RSA 674:71 to 73, will permit you to build an Accessory Dwelling Unit attached to your house. It doesn’t have to be an ‘in-law’ or ‘granny’ flat; you don’t have to be related to whoever lives in it, but it must be self-contained with a kitchen and sanitation.  You might want to adopt this smaller space for yourself and rent out the old place to a young family. There is a shortage of rental accommodation in our state and this could provide you with some needed income. Some towns already permit these additions, but the new law supersedes zoning ordinances in the towns that prohibit such development.   

Another possibility is house sharing. If you don’t use the computer, get somebody to search on ‘elder house sharing’ and you will come up with lots of sites that describe ways of sharing your house with a roommate, sometimes in return for some level of care or maintenance. Of course you must exercise care in going this route, in accepting a roommate, and you must be sure to consider your own need for privacy, but getting a roommate can be a good way to stay in the old house.

Modifying your house to enable you to live independently can be expensive. Some low-cost loans are available, mainly from government sources. The US Department of Housing and Human Development (www.hud.gov) outlines many options to aid you.  Medicaid and Medicare can help with some things, and there are programs to help veterans. It might helpful for you to engage a professional occupational therapist to help modify your house. Sometimes they are paid for by Medicare. Do think in the long-term as you plan your modifications because the trend is for us to live a lot longer (the obesity epidemic not withstanding). 

The Granite State ties with Vermont as the 2^nd oldest state in the Union, behind Maine. Currently folks aged 65 and up are in a minority, but this segment is growing rapidly. Nationally, the US Census Bureau projects that the life expectancy of a child born in 2060 will be about 85 years, up about 5 years from 2015. The average life remaining to men who reach 65 is projected to rise from 17.5 years in 2010 to 22.2 years in 2050; for females, these numbers will rise from 19.9 years in 2010 to 24.1 years in 2050. In The Granite State, Baby Boomers are choosing to stay. What this adds up to is that the population of us old folks will nearly double between 2010 and 2025 and, because younger people are leaving, the elderly population will amount to about a quarter of the state’s population.

How is New Hampshire to prepare for this shift?

Aging place requires more than your own personal planning. It requires significant political and financial contribution from your community and from the state. Policies for affordable housing, transportation, and land use (which can help older adults live closer to or within walking distance of the services they need) are the three major components AARP lists as ways states can enable aging in place.  The New Hampshire Dept. of Health and Human Services (www.dhhs.nh.gov) provides many links for family caregiver support services. Monadnock at Home (www.monadnockathome.org), a 501 (C) (3) membership organization that serves towns in the  Eastern Monadnock region, is an example of an organization that has the vision of building community and systems to meet the needs of seniors as they age in place

Communities first need to recognize a need. Your Select Board members, for example, should be made to understand that a large part of their electorate comprises senior citizens.  Seniors need to be involved in planning. Land-use policies and local regulations can segregate senior citizens into age-restricted housing, contrary to the wishes of those who wish to age in place. It takes a community to decide to provide and recruit amenities (a senior center, a library, a grocery store) that are easily accessible to seniors and where seniors can come together along with other community members and engage in physical and mental activities that are so important to a successful old age. Communities should foster local health facilities. Shuttered stores in malls can be transformed into medical centers (for physical therapy, easy access to doctors and pharmacies). The county or state should invest in public transportation so that the independent senior can be truly independent.  So much of our state has no public transport and seniors must rely on the good will of volunteers. There is a limit to what volunteer groups such as Greater Hillsborough Senior Services can provide.

How does New Hampshire pay for needed senior amenities? I did not hear any of the current batch of candidates for governor or congress discuss our aging population.  We hear emphasis on the need to bring young families to the Granite State so that they can buy houses and pay real estate taxes. How attractive is New Hampshire to young families? Why is in-state tuition to UNH the highest in the nation? This only drives kids seeking higher education to leave the state. Immigrants, despite dire warnings from some politicians, contribute to the state and community in many ways, not least of which is financial. True, the first crop of immigrants costs money, but they and their children develop businesses that generate tax revenues … and cultural diversity. Their children remain in New Hampshire. Data show that the second generation of immigrants actually contributes more to the state and local economy than residents who have been here for a long time.

Seniors themselves are great entrepreneurs and potential tax payers.  How can we facilitate them in following new career paths? New Hampshire may have to reconsider its antipathy to income taxes. The burden for funding communities lies squarely with real estate taxes and as our population ages, our ability to pay those taxes diminishes. This is not sustainable.

Election Day is very close at hand, and our local elections take place in March. As you weigh the merits of the candidates, ask them where they stand on planning for our state’s ‘Silver Lining.’