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Health, Science, Environment

Home sweet home: Most seniors want to age in place, but economy and aging can make that tough

Provided by Anna Jackson

This article first appeared in the St. Louis Beacon, May 21, 2012 - Anna Jackson's cottage sits atop a hill near Old St. Charles. It faces east, and some mornings, the 64-year-old is greeted by sunrises that fill the sky with colors of molten lava. Every day, she walks quietly around the back of her home toward the front. When she reaches her mailbox, the robins that live just above freeze, but she coos to them quietly as she gets her mail, and soon they get back to their family.

Jackson's house is small, and it needs some work, but it's just right for her and Sammy D., the cat she adopted from the flood of '93.

She's lived here for more than 30 years. And she hopes to spend the rest of her life in this home, in this neighborhood, with the people and the places she knows. 

Most people do. 

“I think older adults often want to age in place,” says Tom Meuser, a clinical psychologist and director of the gerontology graduate program at the University of Missouri-St. Louis. “I think the desire for home is very strong.”

Anna Jackson
Credit Kristen Hare | St. Louis Beacon
Anna Jackson

“Ninety percent of people 65 and older want to stay at home,” agrees Diane Meatheany, chief operating officer for St. Andrews Resources for Seniors

And the majority do, according to a report from the Administration on Aging using data from the 2010 Census. 

According to the report:

  • Over half of older, noninstitutionalized people live with a spouse.
  • About 29 percent live alone, but that number increases with age. For women 75 and older, for instance, that number is more like 47 percent.
  • In 2009, only 4.1 percent of people 65 and older lived in an institutional setting, such as a nursing home, but again, that number grew with age. Among 75 to 84 year olds, it was a bit over 13 percent. 

Both the desire for and reality of people living independently might be strong, but many things make it hard for seniors to stay in their homes, including their ability to take care of that home, to be safe in it and to get around when they need to. And with the recent recession, affording that home is also an increasing challenge. 
It adds up

Right now, Juanita Carl is waiting to hear back from a real estate agent. It’s time to sell her home of more than 40 years.

“I’m going to have to do an as-is sale,” she says.

In 1971, Carl and her husband bought their University City home for $26,000. It needed a lot of work.

“We had always planned that when we both retired we would work on our home for two or three years and then enjoy it,” says Carl, who worked at Washington University as a biochemist and will be 75 later this month.

But then her husband died shortly after retiring. Carl retired in 2005. She owns the home mortgage-free, is still able to maintain her lawn and do her own gardening. Her utilities are fairly low since she dresses warm and keeps her home around 66 degrees. She’s careful to turn off the lights and has switched to high-efficiency bulbs and appliances. But the cost of property taxes and insurance are steep, she says. In 1971, her property taxes were about $500. Now they’re $2,500. 

And the house still needs more work. 

Carl’s plan is to move to Maine this summer. There, she can help her daughter and son-in-law with their two children and live in an apartment they’ve built into a barn on their property. 

“It seems like it will probably be a very good solution for me,” she says.

Other than helping her daughter out with costs, Carl won’t have to pay insurance or property taxes or utilities anymore. And for many Americans, those little things add up quickly. 

In a 2011 paper, the AARP Public Policy Institute examines “Housing for older adults: The impacts of the recession.”

One central finding was that the costs of housing are becoming greater for older adults, especially those who still have a mortgage and those who rent. And home owners in the lowest income quartile who have paid off their mortgages are still at a high risk of what the paper calls financial peril. (The U.S. Census Bureau defines housing cost-burden as “30 percent or more of income spent on housing costs.” That includes things such as utilities.) 

“Although many older people desire to age in place, rising property taxes, utilities and maintenance costs or falling incomes may make that goal more difficult,” the report states. “These problems can be compounded by a decline in health status or other factors.”

In Missouri, according to AARP’s state housing profiles, the percentage of householders 50 and up who owned a home with a mortgage was 36.5 percent in 2000. In 2009 it was 41.6 percent.

Some other findings: 

  • For people 50 and older, housing costs have increased at all income levels between 2000 and 2009. 
  • For renters 50 and older, more than half are burdened by what it takes to maintain their homes. In 2009, 28 percent of them used at least half of their income to pay for housing. 
  • For lower-income adults, or those making under $23,128, more than three-quarters, or 78 percent, of renters are burdened by housing costs, and 96 percent of homeowners with mortgages were also burdened. 
  • The number of people 50 and older who owned their homes outright dropped from 44.2 percent in 2000 to 38.9 percent in 2009.
  • Median monthly housing costs rose from $813, or 19 percent of income, to $1,158, or 22 percent of income.
  • Statewide, people 50 and up made up 13.1 percent of total foreclosures and at-risk, compared with 12.2 percent nationwide.
  • And people 50 and up made up 25 percent of privately subsidized rental housing, and 36 percent of people using low income taxing house credit properties.
  • Missouri had 60 HUD-endorsed reverse mortgages in 2000 and 1,607 in 2009.

“The problems for all of us in the economic downturn in 2008 and 2009 are even more dramatic for the elderly when they potentially lost 37 to 40 percent of their asset base in 2009,” says Meatheany, “and they’re still trying to recoup it because they have needed to have very conservative investments.”
Staying put

When Mary Roth was just 61, she and her husband sold their Shrewsbury home and moved into a HUD senior housing apartment complex nearby. She didn’t think about the future then or what life would be like if she’d stayed in her home. But when her husband died 10 years ago, Roth began using the transportation services of Shepherd's Center, which serves people in Webster Groves and Kirkwood with a number of programs, small home repairs and yard work. They also offer programs on site for seniors aimed at keeping them engaged and active. 

Roth, 86, doesn’t live in the home where she raised her children anymore, but she does live independently and is glad to be among friends in her building.

“If he’d have died and I’d lived in our home ... I would have been up a creek, I guess,” Roth says.

Gayle McHenry, executive director, says Shepherd’s Center has between 500 and 600 people through the doors each year for classes, another 250 to 300 using the transportation service regularly, and a steady pool of 200 volunteers. She hasn’t seen any increase in people using their services because of the economy, and there also hasn’t been a drop off in volunteers. But helping seniors with things like mowing their lawns does mean a lot, she says.

“Those little things can mean so much in helping them feel like they’re not isolated,” she says. 

While it’s not available yet, Meatheany thinks technology may be another solution to helping people remain in their homes. The No. 1 reason that seniors deteriorate is depression, she says, and if there was a system in place to check on people in their homes digitally, to see when they last had a visit from family or a neighbor, if they’re eating well and keeping up with their medications, that could be prevented. 

Chandelle Martel, a geriatric care manager with Independent Solutions, recommends that people who remain in their homes get involved early on with their neighborhoods and communities. Get to know people. Build relationships. 

“If they will invest in people early, then when they need help, people will come and help them,” she says.

Communities could work harder to keep seniors in their homes, too, says Mary Schaefer, executive director with the Mid-East Area Agency on Aging.

“Aging in Place,” a 2011 study by AARP, cited several factors that make communities more livable for seniors, including integrating land use and transportation policy, developing housing around transit, the construction of “complete streets,” which work to serve the needs of everyone, “regardless of age or ability,” affordable housing, standards that promote accessible living and models that provide services at home. 

With new construction, the doors and hallways should be built larger, with handicapped accessibility in mind, she says. Walkable communities are also the best option for seniors, and many communities in Florida have done a great job of creating livable places, Schaefer says.

“If it’s good for seniors,” she says, “it’s good for everybody.”

What's the plan?

For many seniors, understanding their options -- from remaining at home with some assistance to finding assisted living facilities -- can seem confusing, says Meuser. Now add the desire to age in place with a generally conservative approach to finances, he says, “and I think you get a lot of people that don’t want to pull the trigger on this.”

But resources are available both to help people stay at home or to find the right place when home isn’t a good option anymore. The trick may be not waiting to find those resources until you actually need them.

"Many older adults are one fall or other challenging, traumatic event from having a change in housing levels,” Meuser says.

But if you start planning early, Martel says, then you get to call the shots.

She recommends having what she calls the 60/40 conversation when people are in their 60s and their children are in their 40s. Lay out what you want, where you want to be and who will be your support system. 

If you need to move to a one-level apartment or to be closer to your support system, then do so. If you want to remain in the home where you raised your children, that's fine, too, Martel says, but convert the dining room to a bedroom, expand the half-bath and bring the laundry to the main level. 

And just like you would go to a financial planner for help mapping out your finances, consider a geriatric care manager for help planning out retirement.

"There's a lot of information out there and some of it's good and some of it's bad and some of it's hard to comb through and some of it's just a whole new language."

Martel recommends finding professionals who are certified through the National Association of Geriatric Care Managers

There are other resources in St. Louis, too, including a local adult services resource guide and a resource center at Shepherd's Center that helps people learn what’s out there to help them, regardless of their situation. 

And for people who can no longer remain at home, there is a broad continuum of care, Meuser says, from independent living to full care, including levels of assistance ranging from meal assistance to on-site nursing and administering medicine. 

“Understanding your options is a big issue,” he says.

Most older adults know what they want for the future but don’t plan for the unforeseen, such as illnesses and accidents, says Meuser. 

"Most people want to stay at home," Martel says. "And most people do stay at home. Whether they do it successfully depends on what kind of planning they've done to make it successful."

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