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Winter 2025
Winter 2025 Issue Aging in Place: Helping Patients Age at Home Aging in place reflects a desire to stay in your own home as you age, maintaining independence with the help of family, friends, and community services.1 According to the AARP’s 2021 Home and Community Preferences Survey, 77% of adults aged 50 and older want to age in place.2 Jodie Gawryluk, an associate professor in the department of psychology and division of medical sciences at the University of Victoria and director of the Institute on Aging and Lifelong Health, studies how lifestyle variables influence brain structure and function in aging and the challenges older adults face with cognitive decline while aging in place. “There are so many factors that go into how we age,” she says. “I’m very interested in understanding how we can have the most positive trajectories of aging so that we can age in place and enjoy our older years.” Aging in place is preferred by many older adults, and for good reason. It’s been linked to many benefits, including improved quality of life, reduced health care costs, and increased social connectedness. 3 According to Gawryluk, “Aging in place allows people to maintain their independence while being supported within a familiar environment. Aging at home can bring comfort and allows maintenance of routines that help support cognitive and emotional well-being.” Aging in Place With Dementia In her research, Gawryluk has discovered several common challenges that complicate aging in place for some older adults who’ve experienced changes in their thinking skills. These include social isolation and a lack of educational resources on cognitive change. “I highlight these areas because there are changes that we can make to help people age in place,” she explains, “by providing resources and tools and developing our communities to be age and dementia-friendly and inclusive.” With the right training for family caregivers, ample in-home services, and community support, more people with dementia can thrive while aging in place. Other barriers to aging in place include difficulty remembering, which can lead to safety concerns like forgetting to turn off the stove, and physical challenges that stand in the way of cleaning and selfcare. In one study, older adults aging in place with self-reported cognitive decline expressed emotional difficulties as well, experiencing low mood and irritability.7 Accommodations for Aging in Place Aging in place might require small changes to the home, such as decluttering, rearranging furniture, and removing throw rugs and other obstacles. It might involve larger renovations, like widening doorways or converting a main-floor living or dining space into a bedroom to accommodate one-story living. For others, aging in place is less about remaining in the home where they raised their children and more about downsizing to a condo or apartment in the community where they can live independently on a more manageable scale. Sandy Markwood, CEO of USAging, believes most people can age in place successfully with the proper support. “When you look at the demographics, less than 5% of older adults are in nursing homes,” she says. “Most people are aging at home and in the community. In saying that, we need to start thinking about if people want to age in their homes, how they can change their homes to make sure that they are safe and meet their needs across the lifespan? If they need to stop driving, how are they going to get to medical appointments, the pharmacy, or social engagement opportunities? It’s really taking a holistic approach to how we all interact and engage in a community. If you’re 60, 70, 80, or 90, you have so much to bring to your community.” Markwood encourages everyone to look at not only the needs but also the assets of aging and the important role older adults play in society. Aging in Community Markwood brings her background in urban planning and government work to her role in advocating for the needs of older Americans. “Oftentimes when people look into finding aging services, they look at home-delivered meals and transportation, or home supportive services,” she explained. “But really, to age well in the community, you need to have options around housing and transportation. You need to have a community that really responds to the needs of people across the lifespan.” Markwood envisions planned communities that take a lifespan approach, recognizing that we are all aging from the point that we are born and that health and abilities vary widely throughout the lifespan. The community can also support people aging in place with dementia by training bank tellers, cashiers, and others who work in customer service roles to slow down and better accommodate older adults with cognitive challenges. Markwood says restaurants and doctors’ offices can create quiet seating areas where people with dementia can have the peaceful space they need to feel safe in these public settings. Creating dementia-friendly communities requires an increased awareness among the general population about how to support someone with dementia and their caregivers. Aging in place also opens opportunities for older adults to engage in intergenerational social situations that are otherwise less available in nursing home facilities, a factor that boasts significant benefits on cognitive, social, and health outcomes for older adults.9 This also enriches the broader community—research shows that intergenerational relationships reduce loneliness, improve mental health, and challenge ageism for people of all ages.10 It seems that the more older adults can continue to reside and participate in the community, the healthier they will be as they age. How Geriatricians Can Support Aging in Place The overwhelming majority of older adults wish to age in place because at home in the community is where they feel most comfortable. “That’s where their history is, where their support system is, whether it’s a church or synagogue that they went to, neighbors, and friends,” Markwood says. “What we find as people age is how important those social connections are. Aging in place really supports successful aging.” With aging in place, families are the backbone of the long term care system in America, and the community plays a role in accommodating an aging nation. “In 2034, there will be more people over the age of 65 in this country than under the age of 18,” Markwood says. “It’s time we invested in aging.” — Heather Rose Artushin, LISW-CP, is a writer and bibliotherapist committed to making a difference, one word at a time. Connect at https://heatherrosewriter.com.
Resources
References 2. 2021 AARP home and community preferences survey. AARP website. https://www.aarp.org/pri/topics/livable-communities/housing/2021-home-community-preferences/ 3. Owusu B, Bivins B, Marseille BR, Baptiste DL. Aging in place: programs, challenges and opportunities for promoting healthy aging for older adults. Nursing Open. 2023;10(9):5784-5786. 4. Fact sheet: U.S. dementia trends. Population Reference Bureau website. https://www.prb.org/resources/fact-sheet-u-s-dementia-trends/. Updated October 21, 2021. 5. Dementia: symptoms and causes. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013. Updated August 30, 2023. 6. Why aging in place can be the best option for dementia patients. American Medical Association website. https://www.ama-assn.org/delivering-care/population-care/why-aging-place-can-be-best-option-dementia-patients. Updated April 27, 2023. 7. Mayo CD, Kenny R, Scarapicchia V, Ohlhauser L, Syme R, Gawryluk JR. Aging in place: challenges of older adults with self-reported cognitive decline. Can Geriatr J. 2021;24(2):138-143. 8. Rodakowski J, Mroz TM, Ciro C, et al. Stimulating research to enhance aging in place. OTJR (Thorofare N J). 2021;41(4):268-274. 9. Krzeczkowska A, Spalding DM, McGeown WJ, Gow AJ, Carlson MC, Nicholls LAB. A systematic review of the impacts of intergenerational engagement on older adults’ cognitive, social, and health outcomes. Ageing Res Rev. 2021;71:101400. 10. Campbell F, Whear R, Rogers M, et al. Non-familial intergenerational interventions and their impact on social and mental wellbeing of both younger and older people: a mapping review and evidence and gap map. Campbell Syst Rev. 2023;19(1):e1306. |
