October 17, 2022
By Anna M. Rappaport, Society of Actuaries and WISER Board Member
In my research about life at higher ages, I have become very aware of the availability of different living choices and their implications. They are choices of both community and individual homes. Many higher age individuals interact with the people around them and often get help from them. Our choices about where to live define access to health care, transportation, support services, friends, activities, and much more.
There is an international movement focused on creating age friendly communities. Age friendly can mean a variety of different things. Important issues include transportation, access to health care services, parks, benches in convenient places, timing of traffic patterns, and many more. Here are some good and bad anecdotes from my experience:
- There was a problem on a major street in Chicago of traffic lights timed so that slower individuals did not have time to cross the street. There were some bad accidents and people in the community and community organizations fought for better timing of the lights.
- There is a park in Chicago that has installed exercise equipment designed to provide a good exercise environment for seniors. It is patterned after a park in Shanghai. The equipment was installed after advocacy from community leaders and the local alderman and support from community groups.
- A friend of mine reported that her father-in-law lived in a remote area of Texas and had health problems. If he had a health emergency and had to go to an emergency room, it required an ambulance ride of more than two hours or an airlift.
- A family member of mine moved to the big island in Hawaii. If he or his wife need specialty medical care, they need to fly to Honolulu. There are many areas in the U.S. that lack convenient access to specialty medical care.
Here at WISER, we are working to make managing your finances as you age easier. We are funding research, providing resources on our website, providing expert testimony to Congress, and more. And -luckily- we are not alone. There are many organizations working with and on behalf of higher age individuals. Continue reading to learn more about housing
The Village Movement
The Village movement in the United States offers a means to connect seniors in a local geographic area and provide them support. This is not like senior housing where seniors move into the same building or group of buildings. These are organizations of people who live in the same neighborhood or general geographic area. What they do varies by organization, but they generally connect people and offer some additional resources.
When I retired from my full-time job and became a caregiver, I found that many of the people who I saw regularly were not available or I saw them much less often. I also found that I had different needs. Through Skyline Village, a Chicago based village organization, I found out about a range of community resources, many of which I did not know about before. And I made some new friends. I was surprised to learn about the number of community resources that were available
Services available locally may include specialized educational programs, community centers, transportation, delivery of groceries and other items, etc. Meals on Wheels provides a source of meal delivery in some locations. Access to other people is very important.
I also have experience with a very friendly gated community. There are no formal support services, but quite a few people help others out. Some do so as a part-time job and others do so without any compensation. Some of the help people have given neighbors include doing their grocery shopping or taking them shopping or taking them to the doctor. Some also have provided help with “handy person type jobs.”
Specialized housing for seniors
There are also housing communities specifically for older individuals that offer a variety of levels of service. Some offer a range of service levels in the same community and some offer only one or two types of services.
My mother’s four children did not live near her, so she chose to move into an independent living community near where she had previously lived. She was able to continue contact with her friends a participate in the same activities she had before. Eventually, as her abilities declined, she moved to an assisted living facility near where two of her children lived. Finally, she moved to a nursing home in another area where one of my brothers lived. This last move was decided by the family as there was no choice about moving her and the new location seemed to be the best option. My brother was able to visit her daily during most of the time she was in the nursing home, and I and my other siblings went to see her several times a year.
One of the things that changed for my mother was her ability to communicate. When she moved to independent living, she was able to make phone calls, use an answering machine, respond to messages, etc. These skills gradually declined. By the time she moved to the nursing home, she could not communicate by phone at all, and she could not hold a verbal conversation or write. Her hands were crippled and her speech had failed. This made the situation much more difficult.
While the moves were complicated, I believe it was a good choice for her because of her changing needs, the way the family was scattered geographically, and because of the ability and willingness of various family members to offer help.
I recently entered a Continuing Care Retirement Community (also known as a lifecare community), which offers several levels of care on the same campus. I had studied CCRCs over the years and thought I knew quite a lot about them. I will share here a few observations that I learned through the process of evaluating some communities for myself and in spending a few months in a CCRC.
I was very aware of the need to think about facilities, what care is offered, contract terms, financial stability, price, activities, etc. What I did not realize is how much the culture and personality of different communities differs. The culture and personality are important in answering the question “Will I be happy here? Do I feel that I fit well in this community?”
In looking at three different communities in the same city, I found a radically different answer to these questions based on my personal situation. All three of the communities were well respected and stable. They appealed to well educated people who had previously had stable careers. In talking to other residents where I am now, they had similar reactions to mine. I’ve listed some of the differences here:
- One of the communities is resident driven and the residents (who are volunteers) run most of the activities and collaborate a great deal with management. This is an unusual model, but it keeps the residents very engaged.
- Two of the communities had personal art (or artifacts) in the hallways near apartments. This made every floor different and made the building seem much more like home.
- One of the communities had a bar and liquor license. The bar was a place for socialization before dinner. The other two had no bar or liquor license. For me, the idea of a bar was a negative – I wanted to participate in the social life of the community, but I did not want to see my access to social life centered in a bar.
- One of the communities had a dress code for dinner that required fancier dressing (and no sneakers in the dining room.) This was a turn off for me (and some others I know) but it could be a big plus for people who like to dress up.
- Each of the communities is in a different neighborhood. In each neighborhood, there are residents in the community with ties to the neighborhood that may find the community in their neighborhood a better fit for them. One of my friends is at a community which is a few blocks from where she lived for most of her adult life. When she made the transition to the community, she found several people she knew but had not been in touch with for years.
In addition to the question of culture, I looked for a match with the things I want to do. Two of my important interests are art and water aerobics. I found a community with friends, a culture I love and with a great creative arts facility and swimming pool with water aerobics classes. For me, these things all mattered.