Health

How to Promote Aging in Place (Hint: It’s More Than Wheelchair Accessibility)

March 06, 2019

by Martha Fedorowicz

Type the phrase “aging in place” into a Google search, and you’ll likely see pictures of wheelchairs fitting comfortably through home doorways, bathtubs and showers with zero-step entrances, and open floorplans to facilitate seamless movement from room to room.

But what is often missed in discussions promoting aging in place is that increasing livability doesn’t just mean adapting a home’s physical characteristics, it also means ensuring a range of cost options and housing types in a single community.

In 2015, the AARP Public Policy Institute released the Livability Index, a scoring system for communities across the United States based on 60 indicators that align with seven categories: housing, neighborhood, transportation, environment, health, engagement, and opportunity. A policy update in 2017, followed by a comprehensive update (PDF) of the online tool in 2018 added three years of data, and allows communities to assess their progress in becoming more livable for all ages over multiple years.

The Livability Index’s select indicators highlight that increasing a community’s livability through housing requires policies that promote not just housing accessibility but also housing options and affordability. “As far as livability, we want to see communities that have housing options that allow people to remain in their homes and communities as they age. What we like to see is an expansion of housing options for people who choose a home in their early 30s and can age into it. And if they can no longer live in their home, for health circumstances or a job change, that they have other accessible and low-cost options in their community,” says Shannon Guzman, a senior strategic policy advisor at the AARP Public Policy Institute.

So how can communities tackle these three housing goals—accessibility, affordability, and options—to increase livability? Here are some examples of policies and programs from around the country.

Housing Accessibility

Enact visitability legislation. In 2002, Pima County, Arizona (PDF), enacted the first mandatory visitability ordinance for all new publicly and privately funded homes in the unincorporated areas of the county around Tucson. The ordinance requires no-step entry, doorways at least 30 inches wide, lever door handles, reinforced walls in ground-floor bathrooms for future installation of grab bars, and electric controls reachable by people in wheelchairs.
Implement an adaptive modifications program. Philadelphia’s Division of Housing and Community Development facilitates an Adaptive Modifications Program, which funds and performs home modifications for people with low incomes and permanent physical disabilities. A recent study of the Center for Medicare and Medicaid Innovation’s Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program, which sends an occupational therapist, a registered nurse, and a handyman to participants’ homes to assess the home’s physical barriers, found that 75 percent of participants reported improvements in their basic activities of daily living, as well as improving symptoms of depression.

Housing Affordability

Rewrite zoning ordinances for senior housing. The New York City Planning Department’s 10-year plan, Housing New York (PDF), proposes eliminating parking requirements for new, affordable senior housing units and allowing existing affordable senior housing developments to reduce or eliminate their parking requirements.
Fund and prioritize housing trust funds. In 2016, the city council of Austin, Texas, voted to put 100 percent of tax revenues from properties previously owned by the city into an affordable housing trust fund. This move is expected to generate $68.2 million over a decade.

Housing Options

Allow for accessory dwelling units. California’s accessory dwelling unit laws were recently updated to allow for accessory dwelling units statewide. The law does not require a municipality to have an accessory dwelling unit law, however, it does prohibit municipalities from outlawing them.
Offer a home-sharing program. A nonprofit called HIP Housing in San Mateo, California, hosts a unique program in which homeowners or renters with one or more bedrooms are matched with people in need of housing. Home seekers can either pay full rent to the homeowner or pay a reduced rent and perform some household duties. The program is intended to support those who may not want to live alone. Since 1979, 65,000 people have been served through this program.

Before implementing any of these policies or programs, it is essential to have strong mechanisms in place to understand your community’s needs and wishes. “There’s no one strategy that will work in housing. It’s really about assessing your needs based on what data you know about your community’s needs on the ground, your community design, and figuring out the tools that will work for your community,” says Guzman. “No one entity can do this alone. We can look to local government to provide the regulatory framework and help with funding, but it has to be in tandem with checking in with the community and understanding their needs and talking to businesses and the private sector and anchor institutions.”

For more information on increasing livability and promoting aging in place, visit the Livable Communities page at the AARP Public Policy Institute.

Thanks to Shannon Guzman and Jana Lynott at the AARP Public Policy Institute, who provided quotes and context for this article. All opinions or errors should be attributed to How Housing Matters alone.

Photo by riopatuca