We often talk and write about the fact that a majority of today’s older adults say they want to remain in their home as they grow older. But what are the motives behind this preference? A recent study conducted by The Associated Press (AP)-NORC Center for Public Affairs Research highlights some of the top explanations of why people say that aging at home is their preference, but there may be larger issues at the heart of this matter.
Research on long-term care preferences
The data used by AP-NORC researchers was collected through a monthly survey of a NORC panel designed to be representative of the U.S. household population of adults age 18 and older. This recent research, Long-Term Care in America: Americans Want to Age At Home (PDF), released in May 2021, was based on this panel’s responses to long-term care-related questions in March-April, 2018 (1,945 respondents), August-September, 2020 (1,893 respondents), and March, 2021 (1,113 respondents).
The responses of these panel participants highlight Americans’ preferences on how and where they will receive any necessary care as they age.
Key findings about care and aging at home
Receiving care at home
Overall, 88% of Americans would rather receive any necessary and ongoing assistance or care in their own home or in the home of a loved one. Only 12% of respondents would choose to receive care in a senior living community, such as an assisted living community or nursing home.
One might deduce that this high number is a repercussion of the COVID-19 pandemic, but this figure has remained fairly consistent for the past 8 years. For instance, in the 2020 AP-NORC long-term care survey, 89% said they would prefer to receive care at home or in a loved one’s home. In the 2016 survey, 81% said the same thing.
Support for government action on long-term care costs
Americans largely believe that funding for ongoing long-term care should come from institutions rather than individuals. Respondents believe that the costs of long-term care should fall in large part to health insurance companies (52%), Medicare (51%), and Medicaid (41%). In contrast, only 35% think individuals should bear this financial responsibility, and just 15% believe a long-term care recipient’s family should foot the bill.
According to the AP-NORC research, a significant majority of Americans support government initiatives to assist with long-term care costs. Specifically, 60% favor a government-administered long-term care insurance program, similar to how Medicare works. Additionally, 63% support government funding for programs like Medicaid that would enable individuals with low incomes to receive the care they need at home.
Among the concerning results of this poll, nearly half of respondents — 49% — say that they expect to rely on Medicare to pay for any long-term care services they need as they age. The reality, however, is that Medicare only pays for such care in certain circumstances and for a finite amount of time. Learn more about what long-term care services Medicare does and does not cover.
Few discussions or preparation for aging at home and long-term care
It’s important to make your preferences around care and aging at home known to others. Yet the AP-NORC researchers found that few people have discussed their long-term care preferences with their doctor (11%) or with family and friends (31%). Even among those aged 60 and older, these discussion rates are relatively low — 14% with doctors and 46% with family and friends.
Many Americans also feel unprepared for their future care needs. A significant 69% have done little or no planning to make their preference for aging at home more feasible. What’s more, only 16% said they are confident they will have sufficient financial resources for long-term care, whether delivered at home or in a senior living community.
>> Related: New Statistics Could Reshape the Meaning of Aging in Place
A variety of concerns about aging and care settings
Image credit: AP-NORC
Of note, respondents’ fears surrounding a variety of aging-related issues was a common theme of the AP-NORC research.
For instance, 60% of those polled were worried about becoming isolated from family or friends as they grow older. Almost as many (57%) were concerned about their social needs being unmet as they age. And over half — 53% — said they had worries about having to move into a nursing home.
But maybe most notably, the top worry about aging was a fear of losing independence. More than 2 out of 3 (67%) of those who responded to the 2021 poll said they were moderately to greatly concerned about this issue. Relatedly, over half (53%) also said they were worried about having to leave their home to move to a nursing home.
>> Related: What’s the True Cost of Staying in the Home?
Addressing the top concerns about senior living and care
We believe these AP-NORC findings, particularly around people’s aging and care-related worries, should be a call to action. We must take a two-pronged approach that involves both the senior living industry, as well as government policies.
Systemic solutions
This is an important topic that goes beyond the scope of this post, but generally speaking, our nation must devise better ways to allow people who prefer aging at home to remain as independent as possible for as long as possible. Just as it takes a village to raise children, so too it requires the support of a community to help care for our elders.
And our policymakers need to step up to the plate as well. This should include support for necessary transportation, socialization opportunities, and care needs, which can draw on a combination of technology as well as human resources. Advancements in virtual healthcare visits, artificial intelligence, and other tech show great promise in this arena.
Solutions from the senior living industry
It is also imperative that the senior living industry acknowledge and respond to the common concerns about aging that this poll reveals.
What can retirement communities of all types do to convey that in many cases, their residents are actually able to remain more independent for longer as a result of living there? The communal buildings’ and residences’ aging-friendly design and the built-in supports and amenities that come with living in a 55-plus community should be emphasized.
Secondly, how can senior living communities give their residents as much autonomy as possible, while still ensuring their safety and happiness? Technology likely has a role to play here, but the value of in-person, human interaction should never be discounted.
Additionally, how can the senior living industry address the common concern about the ability to pay for care? We know that worries about affordability is a top barrier to entry that many retirement communities prospects must overcome. Education is key here. Senior living communities should include consumer education and financial affordability tools in their sales and marketing. Learn more about solutions available from myLifeSite to help in this area.
Of course, not everyone wants to live in a retirement community, and not everyone will be able to afford one. But in some cases, working through the numbers in a quantifiable way puts prospective residents’ minds at ease about their ability to afford to live there.
There are opportunities for senior living communities to continue to address many of the other concerns noted by the AP-NORC poll as well. Creating messaging around the countless positives of living in a retirement community — the fact that there are often more options for socialization, less of a chance of becoming isolated, fewer concerns about becoming a burden to loved ones, and more built-in provisions to ensure residents’ safety … just to name a few of the benefits.
>> Related: “…but I love my home”: Is Staying in Your House the Right Move?
Empowering older adults to live, receive care where they prefer
Making a decision about where you will live as you grow older is highly personal and involves many factors. For some people, regardless of cost or potential logistical challenges, aging at home is their preference. Others may feel that aging at home is their only option for various reasons — among them cost, a partner’s preferences, or feeling overwhelmed by the idea of downsizing and moving.
While this AP-NORC study does underscore a clear preference among Americans for aging in place, it also highlights the need for local and federal policymakers to find innovative ways to better support senior living choice. This includes facilitating more home-based care options that meet the health, safety, and social needs of older adults.
As our aging population increases in number in the coming years, senior living communities also must seize upon the opportunity to tailor their communications to their target audience. The industry needs to create messaging that more effectively highlights their many benefits while speaking to prospects’ apprehensions about a move to a retirement community, particularly fears about losing independence and affordability.
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