A wake-up call regarding the rising tide of older Americans on course to swamp the nation’s housing resources has been issued by Harvard’s Joint Center for Housing Studies and AARP. Their new report shows that the number of Americans 50 and over is expected to grow to 132 million in the next 17 years—a rise of more than 70 percent since 2000. The over-65 population is due to double in this period to one in five Americans. Meantime, the number of people older than 85 will more than triple—to 20 million. And most of the latter will face cognitive, hearing, mobility, or mobility problems.
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The report, Housing America’s Older Adults—Meeting the Needs of an Aging Population, cites a number of uncomfortable facts:
- High housing costs currently force a third of adults 50 and older to pay more than 30 percent of their income toward shelter that may or may not fit their needs, forcing them to cut back substantially on food, health care, or retirement savings.
- Much of the nation’s housing inventory lacks basic accessibility features (such as no-step entries, extra-wide doorways, and lever-style door and faucet handles), preventing older persons with disabilities from living safely and comfortably in their homes.
- In our car-dependent culture, transportation and pedestrian infrastructure is generally ill-suited to those unable to drive, which can isolate them from friends and family.
- Disconnections between housing programs and the health care system put many older adults with disabilities or long-term care needs at risk of premature institutionalization.
- The generation approaching old age will have fewer family caregivers to rely on. Today, there are seven potential family caregivers for each person over 80. But families have fallen in size, and by 2030 there will be only four.
Younger baby boomers, now in their 50s, illustrate these predicaments, the report notes. They have lower incomes, less wealth, lower homeownership rates, and more debt than previous generations, so they may be unable to afford appropriate housing or long-term care after they retire. While most people over 45 want to stay in their current homes as long as possible, estimates are that 70 percent of those who reach age 65 will eventually need some form of long-term care. Renters are the worst off. The typical homeowner 65 or over has enough assets to pay for in-home assistance for nearly nine years or assisted living for 6.5 years. The typical older renter, however, can afford only two months of such support.
“The Joint Center is often referred to as the joint center for gloom and doom,” quipped Chris Herbert, its acting managing director.
However, Henry Cisneros, former secretary of the U.S. Department of Health and Human Services, who keynoted a webinar introducing the report, says the tragic consequences suggested by aging trend lines are not inevitable.
“We are just at the beginning of the baby boom surge . . . ,” Cisneros notes. “The critical mass is when those who just turned 65 reach their 80s, which is 12, 17, 20 years from now. We have some time. “
The report calls on government at all levels to expand housing options for older adults. One idea: offer tax incentives and low-cost loans to help owners modify their homes to accommodate household members with disabilities.
The Joint Center advises municipalities to adapt their building codes and zoning regulations to:
- encourage production of more diverse housing, including mixed-use developments with residences within walking distance of services and amenities;
- allow construction of smaller units, such as accessory dwellings, for those wishing to downsize, reduce their housing costs, or house a live-in caregiver;
- develop housing suitable for intergenerational housing or flexible enough to accommodate changing household needs;
- promote construction of more rental housing in the suburbs to give older adults who want to remain in their communities more options; and
- require that all new residential construction include certain accessibility features.
The Joint Center is also keen on the need to coordinate housing and supportive services. It urges government housing and service providers to support older adults of low and moderate income who require help managing their health and other needs as well as affordable housing. The authors observe that “while models of supportive housing already exist, need far outruns availability.”
However, Michelle Winters, a visiting senior fellow at ULI’s Terwilliger Center for Housing, notes that there has been a recent movement to co-locate health care in housing as part of enriched services for seniors. This, she says, is going on in both high-end (assisted living) and affordable housing.
“The money is spent in one area [housing and services],” Winters explains, “and benefits are achieved in another area (health).” Combining them, she adds, “offers a lot of cost savings.”
The report itself points to one such initiative: the 140-bed Mission Creek Senior Community in San Francisco, which serves very low-income adults 62 and over, many referred from skilled nursing facilities, hospitals, and shelters. Funded by the city and California’s Medi-Cal program, the project provides skilled nursing services, occupational and physical therapy, meals, and coordinated care. The project also produces significant cost savings for Medicare and Medicaid.
The report cites new models of residential care that have emerged to meet the growing need for long-term care and health services now found in assisted living and nursing homes. These include continuing-care retirement communities with different levels of care and Green House homes, an alternative to traditional nursing homes. But, the report says, even more innovation will be needed to meet the diverse housing needs of the booming older population.
At the federal level, the report recommends expanding a number of efforts, especially rental assistance, which currently reaches only a fraction of older renters with low incomes and high housing costs. The authors also advocate additional funding for housing with supportive services.
For his part, Cisneros called for altering retirement communities to accommodate in-home care, nutrition assistance, and better transportation as part of a webinar with the Joint Center.
The report is not just a recital of deficiencies. It points to a number of entrepreneurial approaches that have already been tried to address the aging issue through housing, transportation, and walkability initiatives as well as ordinances promoting accessibility in private homes.
