David AmmonsDavid Ammons is president of Retirement Living Associates, Inc. (RLA), a company which provides planning, development, marketing, and management services for new and existing retirement communities. He has worked in and with Senior Living Communities since his graduation from Wake Forest University in 1985.
National Aging in Place Week will be celebrated October 15-21. When we hear the term aging in place, we think of being able to spend the rest of our lives in the comfort of our own home as opposed to a retirement community or health care facility. But once we get beyond that thought, what does it mean? What exactly does aging in place encompass?
I want to share my thoughts on this topic. Aging in place is associated in multiple ways with retirement communities. It is a broad and complex topic and, like many complex issues, it is often over-simplified. It’s a topic that at first thought may seem to be a patient or resident rights discussion but, in fact, it has ramifications that go far beyond that first consideration.
Aging in Place is just what it says, it is a goal of many to stay where they are and adapt to changes associated with aging. As a retirement community professional for almost 30 years, I am a strong advocate for residents/patient rights. Years ago I came to believe that decision-making, with a focus that is pro-resident, is the preferred course of action. In making a decision that is best for the resident, the time frame is relevant; a long term versus short term horizon often has different implications. When decision making involves the concept of Aging in Place factors beyond time frame come into play. Most significant of these additional factors is the impact and consequences that aging in place has on others such as family, friends, and neighbors.
Another area of consideration is the current health status of the resident/patient/person. For example, an Aging in Place decision for a hospice patient is far different from an Aging In Place decision for a healthy resident in an active adult community. In exploring this Aging In Place concept or debate, let’s consider a “typical” person (although I have never met anyone who agrees that he or she is typical) in his or her late 60s and what they may be considering.
This person is most likely concerned with living spaces that are upstairs versus downstairs, the width of doors, the ease of shopping for essentials as well as non-essentials, with access to emergency response assistance as well as social and cultural opportunities. Aging In Place for these will be easier near a city rather than in a remote, under-developed area. In this scenario, aging in place is a wonderful principle and with more companies available to help with home modifications, a retired person or a couple can plan how they will age, physically and mentally, yet remain in their current home and adjust, adapt, and cope. (“We are just fine, thank you.”)
For an older person, who is considering a move to a retirement community, the decision is often very different: Does the community provide levels of care beyond Independent Living, either through licensed areas or available services? In this situation the answer to the benefits of Aging In Place grow more complex.
For example, a community that offers assisted living residences or home health services can ensure that you live where its services are commensurate with your needs. A community that carries this too far, becoming “big brother”, or attempts to insist on a move because of changing needs, can appear to be, or in some cases may be, in opposition to Aging In Place. There is security in living where your needs are met, and there is freedom and satisfaction in living where you control your own destiny enough to realize your own definition of Aging In Place. I suggest that there is a very real potential for these two to be in conflict with one another.
A final aspect of potential conflict lies in whether the Aging In Place decision is being made for oneself, or a family member, or a client. In all cases the decision making needs to factor age, health, resources, impact on others, and more.