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Minnesota 2020 Journal: Aging in Place is Reasonable, Necessary

July 18, 2014 By John Van Hecke, Publisher

A new national survey finds that the most independently minded, unapologetically insistent American generation expects to live in their homes as they age. Baby boomers are, once again, unyielding. That’s good news for every Minnesotan, good for our economy and good for healthcare’s future.

Georgetown University’s McDonough School of Business, Global Social Enterprise Initiative, in partnership with consumer and healthcare products giant Phillips NV, released a research report examining expectations about aging and lifestyle. In keeping with established trends, Americans aged 50-80 want more independent living options and strongly value staying in their homes.

Significantly, the survey also finds that respondents aren’t taking concrete steps to prepare for long-term independent living within aging’s reality. The finding reflects a similar pattern in woefully underfunded individual retirement savings. Wishful thinking rather than action dominates retirement planning.

Survey respondents indicate great interest in technology solutions from driverless cars to seamless lifestyle management through online connectivity software and services. Reading between the lines, people reveal a real faith in engineering and technology solutions’ promises.

That’s great. I’m all for the Jetsons dream of flying car futures but, speaking as a disabled Minnesotan, let me strongly suggest more initially practical and less expensive first steps: installing grab bars and eliminating small area rugs. Then, we can jump into our flying cars.

Consumer technology permeates our lives. This is not a recent development. Human history is the story of human will imposed on nature. We turn natural resources into tools, making our lives easier, meaningful and rewarding.

Consider bodily waste. Privy toilets improve on the designated defecation spot in the bushes. Septic systems and large-scale waste-water treatment plants improve on privies. We’ve quietly created extraordinary success to the degree that we’ve nearly forgotten about the common public health complications of open sewers.

Consumer products ease mobility limitations. Without a power wheelchair and an accessible minivan, I’d be functionally trapped at home for most of the week. I regularly invest my income in my mobility. Some families have lake cabins; we have an entrance ramp and my power wheelchair. WiFi and smartphones not only make my life safer, they make it productive and rewarding.

I have muscular dystrophy, a degenerative neuromuscular disease. I’ve had it all my life. Consequently, physical decline and the frustration that entails is a significant part of my life experience. It also means that I’m 20-30 years ahead of my peer group in living with growing physical limitations. When it comes to living independently, I have more in common with 80 year-olds, folks 30 years my senior, than with my peer group. I’m effectively aging in place, just sooner.

And, I’ve learned a few things.

First, preserve and strengthen existing physical capacity. Walk, exercise and move around. Yes, it may be hard but staying strong pays a life dividend. The body naturally declines; don’t accelerate the process. Independent living requires good health while aging. It’s as true at 80 as it is at 8.

Second, remove household stumble risks like area rugs, terrific candidates for causing falls. Choosing between a broken hip and a cute, thick-edged area rug is no choice at all.

Third, install horizontal and vertical grab bars in the shower and bathroom area. Steadiness and the feeling of security while transitioning over wet surfaces is a godsend. You’ll be stunned by the range of grab bar designs and finishes. Be sure that they’re installed properly and at appropriate heights. You want to live independently? These are the easy, cheap first steps.

Long term independent living requires systemic environmental change. This is an investment in your future. Approach it as such.

Chances are that your home was built to an earlier and, quite likely, non-existent accessibility standard. Our house was constructed in 1922. Anticipating my physical needs, we renovated eight years ago. We used an architect. It’s rare that a week passes that I don’t consciously encounter a design choice improving the experience of living in my house.

Renovation isn’t cheap but it was cheaper than new home construction. We didn’t have to change everything but, in effect, we removed and replaced the back half of the house. Most but not all door ways are wider for wheelchair access. Some kitchen counters are lower than others. We have a roll-in bathrooms and shower. Fundamentally, our house is more open, reached by a well-designed front ramp.

Driverless cars are a concept. Converted, accessible minivans are a not-inexpensive reality. Basically, buy a minivan and add another $20,000 for the conversion. Aging eventually requires giving up driving, relying on transit options from taxis to trains. Lifestyle and household management devices, linked through a smartphone application won’t replace the grocery store run. They will supplement and enhance it.

Finally and most critically, public policy is inadequate to the coming need. Aging in place, as opposed to a traditional nursing home, is a decentralized experience. Present policy largely facilitates centralization. Modest but growing homecare assistance is required to live independently with increasingly restricted physical mobility. Current service systems will, I believe, rapidly evolve as market demand spikes but, right now, care consumers only have expensive options while home care service providers are among the lowest compensated workers around. That’s unsustainable.

Preparing for independent living is an enormously economically stimulating activity. Employing carpenters and home healthcare aides, in concert with supportive public policy changes, creates a wide-ranging investment and retail multiplier effect. Generational transition grows communities; it doesn’t undermine them.

I’m tickled that people expect to age independently, living at home. People are assets, not liabilities. Technological advances serve people, not the other way around. Now, we just need public care and service policy that’s as good as the people working hard to find their own way.

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