New Statistics Could Reshape the Meaning of Aging in Place

As we have shared many times, the majority of Americans — 77% of people age 50+ — say they want to remain in their home for as long as possible — sometimes referred to as “aging in place.” For many people, at the heart of this decision is a desire to remain in control of one’s own life. In order to safely and successfully achieve this objective, there is often much planning that must be done. However, research shows that there is frequently a disconnect between older adult’s desire to remain in their home and the preparation — and potential costs — that this decision may necessitate.

The definition of aging in place vs. the realities of it

Most humans have an innate desire for independence. It begins from an early age — think of the child trying to put on their own shoes exclaiming, “I can do it myself!” That same sentiment continues throughout life as we leave the comfort and security of our parents’ home in young adulthood and make countless decisions from then on to exert our free will. We all want to control the course of our lives as much as possible.

This same independent mindset is closely tied to many older adults’ desire to remain in their own home as they age. Indeed, there can be many benefits to remaining in one’s home: a comfortable environment, a familiar neighborhood and community, existing social connections, to name a few.

Forbes recently published an interesting compilation of information and statistics on aging in place that offers some helpful insights if this is your or your loved one’s senior living goal. Much of the article’s information was pulled from the University of Michigan’s report entitled “Older Adults’ Preparedness to Age in Place,” based on data from the 2022 National Poll on Healthy Aging.

This poll of 2,277 Americans age 50 to 80 found that 88% believe it is “important” to remain in their home for as long as possible. But while there are certain advantages associated with aging in place, the poll also found a number of factors that can make the realities of this decision challenging for some people. For instance…

Home layout and features

The University of Michigan pollsters asked about certain home features that make it easier and safer for a person to remain there as they grow older and perhaps begin to have mobility issues. The poll found that, among respondents:

88% reported they had a main-floor bathroom.
- Some had safety-related features in their bathroom such as shower chairs or benches (36%), raised-height toilet seats (36%), grab bars (32%), or barrier-free showers (7%).
78% had a bedroom on their home’s main floor.
54% said their home’s door frames were wide enough for a wheelchair to pass through.
32% had lever-style door handles.
19% said the entrance to their home had a ramp or no stairs.

Overall, just 34% of poll respondents said their home “definitely” has the features needed in order to allow them to live there as they age, while one in five respondents (19%) said their home does not. This appears to show a substantial discrepancy between people’s desire to remain in their home and the day-to-day challenges that this decision could create, particularly if a person’s health or mobility declines.

This also suggests that in order to safely remain living in their current home, many people would potentially need to make sometimes-costly home modifications, or alternately, they would need to consider relocating to a home that has any necessary safety and accessibility features.

Health considerations and in-home assistance

Speaking of health, another consideration that could factor into people’s decision to age in place is the prevalence of health issues among older adults. While this issue was not directly addressed in the preparedness report, other sources underscore this as a relevant senior living consideration.

According to data from the Centers for Disease Control and Prevention (CDC), 78% of Americans over the age of 55 have a chronic condition. This includes issues such as arthritis, asthma, cancer, cardiovascular disease, chronic obstructive pulmonary disease (COPD), diabetes, and many others. The incidence of chronic health concerns increases to 85% among adults over age 65.

And then there are age-related cognitive issues. This could range from normal age-related problems with memory to dementia, including Alzheimer’s disease. According to data from the National Institutes of Health (NIH), two out of three Americans will experience some level of cognitive decline by the time they reach age 70.

The above health conditions might mean a person who is aging in place could need not only accommodative home modifications but also potentially in-home assistance. Yet the realities painted by the healthy aging poll may mean that many people who want to age in place won’t have access to the assistance they need … at least not unpaid assistance (more on this later).

While most respondents said they have someone in their life who could help with tasks like shopping (84%), household chores (80%), and managing household finances (79%), only 67% said they had someone who could help with personal care. This is closely tied to the fact that 28% of respondents reported that they live alone. Indeed, those living alone were more likely to not have someone to help them with personal care tasks (48%) as compared to those who live with someone (27%).

Social connection and support systems

The prevalence of those living alone, in combination with the incidence of chronic health conditions, are significant when it comes to social connection and support systems. While overall, 77% of poll respondents said that over the past year, they had contact at least once a week with friends, family, or neighbors who did not live with them, that number decreases among people with a health issue.

Those with a disability, impairment, or chronic health condition that limits activities were less likely to have had contact with someone outside of their house in the past week than those without a disability — 68% vs. 80%. People with a health issue also were less likely to report they were “very satisfied” with their current social life — 22% vs. 39%.

Of note, research from the healthy aging poll finds that, overall, more than one in three older adults ages 50 to 80 (34%) report feelings of loneliness, lack of companionship, and/or isolation in the past year, which can have negative implications on both physical and mental health.

This type of social isolation is of particular concern among those living alone, living in more rural settings, or living with a health issue. What’s more, according to the preparedness report’s findings, many older adults (40%) don’t know where in their community to turn to find opportunities for increasing their social interactions and connections.

Costs

While wanting to maintain control and independence is a top priority among those who say they want to age in place, cost is often another key consideration. Many people believe it will be less expensive to remain in their current home as they grow older, rather than move to a different home or a retirement community.

If a person remains healthy and able to safely live on their own indefinitely, this calculation may be correct. However, should a person need to make home modifications or require some level of paid in-home care, that math can change rapidly.

U.S. Census data from 2020 estimates that only 10% of homes in the U.S. are “aging ready,” with features like step-free entryways, a first-floor bedroom, and accessible bathroom. Depending on what level of home modifications are necessary, the cost of modifying a home to include such features could potentially reach into the six-figure range.

And then there is the cost of paid in-home care. We have covered this topic in many other posts, but in short, the current (2024) average cost of 40 hours a week for homemaker services is $5,417 per month, according to Genworth’s Cost of Care Survey. Forty hours per week of home health aide services will cost $5,625 per month, on average. And the cost of these services is only going up. (Bear in mind too that this is only for 40 hours of assistance per week, leaving 128 hours each week that would potentially need to be covered by other paid care providers or loved ones.)

This cost of care is particularly significant because only one in five poll respondents (19%) said they were “very confident” in their ability to pay for any necessary help with household chores, grocery shopping, household finance management, or personal care. Of note, 39% were “somewhat confident” in paying for such expenses, and 43% did not have confidence they could afford these costs.

>> Related: The High Price of Family Caregiving

A refreshed meaning of aging in place

Overall, the 2022 National Poll on Healthy Aging shows a chasm between people’s desire to age in place and the feasibility of them aging in place safely, happily, and healthfully. But the poll also underscores that, while people place great importance on remaining in control, there can be a difference between aging in place and truly living independently.

One person who has decided to remain in their current home may find that they need numerous costly home modifications, as well as paid or unpaid care assistance, in order to remain in that home. Research shows they also run the risk of becoming socially isolated should their mobility decline.
Another person who has opted to move to a home that is “aging ready” may only need to account for their potential care needs, however, if they face health issues that limit their mobility, loneliness can still be a concern.
A third person who decides to proactively move to a retirement community — particularly one that includes access to any necessary care services, if needed, such as a continuing care retirement community (CCRC) — may find that nearly any safety or care scenario has already been foreseen. Such communities also place a high importance on the health benefits of socialization.

It is understandable that people want to remain autonomous and in control of their lives. While many people feel that aging in place is the best option to achieve this independence, some will discover that such independence can have a monetary, emotional, or even a physical price.

For those who put a high value on aging in place in their current home, the healthy aging poll drives home the importance of properly planning for a number of scenarios in order to achieve this senior living goal. But one could argue that making the proactive decision to move to a home that allows you to live safely and happily as you grow older is an equally empowering way of taking control of your future and remaining as independent as possible for as long as possible.

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