Earlier this year, middle-aged suburbanite Ron Foster [name changed] left his condo and drove to his family home (in the same town) to visit his widowed mother. Not hearing a reply to his greeting, he left the house to run some errands and have lunch. When he returned a few hours later, he called out and again heard no response. Worried, he looked through the house and found his mother slumped on the bathroom floor upstairs. She had suffered a massive stroke earlier in the day; since precious time had been lost, her condition rapidly deteriorated. Mrs. Foster, now confined to a wheelchair, has been moved to a nursing home, where she receives 24-hour-a-day care.
This tragic event opens up numerous questions for reflection. Could Mrs. Foster’s stroke been prevented by the presence of in-home health care or remote monitoring? Since her son is unmarried, would it have made more sense for him to live with her, or her with him? Would she have been better off at a senior living facility in town?
Numerous personal stories demonstrate the need for concern regarding the health and safety of older people who live alone. One elderly man often leaves the burner on after cooking, and repeatedly forgets his keys when he leaves his house to walk to the grocery store. His daughter provided him with a cell phone, but is not always in the vicinity when the lock-outs occur. The same gentleman, wishing to be independent and not always ask for rides, once took the subway downtown for a doctor’s appointment but on his return, headed in the wrong direction and ended up at the far end of the line. Fortunately, a compassionate policeman drove him home.
An older woman living in a Sun City community several states away from her adult children was driving in the subdivision one sunny Friday morning. Without warning, she had a heart attack and veered off the road. She was taken to the hospital, where she fell into a coma and never regained consciousness; her four children all flew in that night, where they stood vigil until she died on Sunday.
No place like home?
Despite the risks involved in living alone, as well as the isolation inherent to this situation, many older people nonetheless resist leaving their family home (up to 70-85%, as estimated by AARP1 and other agencies involved in the “Aging in Place” movement). Even though they may find it difficult to keep up with indoor and outdoor maintenance chores, and have trouble climbing stairs and navigating the bathroom, there is a familiarity that is comforting in their aging years. Happy memories of their families seem preferable to what they perceive as a “sterile” institutional setting.
The financial industry has encouraged this trend with a HUD-approved instrument known as a “reverse mortgage”; this allows a homeowner aged 62 or older to borrow against his/her home while continuing to live in it during his/her lifetime. Over time, equity in the home decreases. This strategy, which entails high upfront costs and stringent conditions, may not be suitable for all homeowners.
Multi-generational housing arrangements
The current economic situation in the United States is affecting many segments of society. The New York Times reported on April 16, 2008 that home foreclosure filings “surged 57% in the 12-month period that ended in March, and bank repossessions soared 129% from a year ago,” according to data from RealtyTrac. Adult unemployment now stands at 5%, or 7.6 million residents of the U.S. This figures does not include the 1.4 million people “not in the labor force,” among whom are the “discouraged workers” who are no longer actively seeking employment. 2
Rising fuel and grocery prices are adding to consumers’ distress. The dire economic climate is already causing the re-populating of many baby boomers’ “empty nests”: a Focalyst survey featured in the May 2008 AARP Bulletin found that adult children have returned to live with 5 million “boomer” parents. The same article reports that many boomers are accommodating their own parent/s who move in with them.
The reverse situation is also common, when divorce or downsizing forces middle-aged people to move in with their parents, either on a “temporary” or long-term basis. Multi- generational living arrangements, while potentially stressful, can also solve a variety of problems in the lives of both parties. Indeed, many cultures have this expectation built into their lifestyles—in Jordan, for example, tradition dictates that a newly-married couple build a one-story home with the structural elements necessary to add a second floor (which they build and move into when the oldest son marries and takes over the first floor). As recently as 1963, there was only one nursing home in the entire country of Japan! 3 A transplant from Egypt explained that he and his two siblings each keep a special room for “sitti,” and that she spends the year traveling from one home to another, always staying with her family.
The American value of “fierce independence” may be counter-productive in facing the senior housing issue, especially vis-à-vis the financial hardships currently being faced by all adults. Those willing to design creative solutions for “communal” living have numerous resources available for adapting living spaces for handrails, wheelchair access, etc. What used to be termed “mother-in-law” rooms by realtors can be transformed into surroundings that offer privacy yet ready access. Or…the elderly parent’s home can be remodeled in order to meet the needs of younger inhabitants.
We can also question the assumption that intergenerational living be restricted to family members. Mrs. Foster’s home is in a college town; it’s feasible that one or more students and/or professors would be interested in sharing her home and finding it a mutually beneficial situation. As an active church member, she might also consider inviting one or two single parishioners—or even the interim minister– to share her space.
“Intentional communities” have thrived in the U.S. for decades.4 Somewhat utopian in nature, they gather like-minded people of all ages who desire to pursue a vision together. One successful model is that of Koinonia Partners in Georgia, where the popular Habitat for Humanity program was initiated. Residents of Koinonia pool their income and in turn are provided with housing, a food pantry, and health insurance. Everyone works on the farm and helps out with the mail-order business. An on-site child care center is available; a dining hall serves common meals. Aging residents are gracefully incorporated into community life, and the social support system is admirable.
The idealism that has been the trademark of the “baby boom” generation may well re- invent the intentional community concept, adapting it for the 21st century.
Obstacles to success
The advantages of shared living space, whether on a small or large scale, are obvious: reduced financial burden, increased social interaction, division of labor for household chores, built-in safety/ security protection, opportunity to teach and learn skills, assistance with transport, etc. What factors would interfere with adoption of this type of housing arrangement?
–Perceived loss of autonomy: not “having the freedom” to come and go at will; sharing grocery items and/or electronics, books, etc.; entertaining guests at home
–Financial/legal complications: who has title to the property? How is the rent divided, expenses shared fairly? Are there zoning restrictions and/or tax implications?
–Setting up guidelines: how are new residents selected (is unanimous agreement required?); how can residents leave? Is there a procedure for removal of a resident due to non-payment of rent, illegal drug use, etc.? How will furnishings in common areas be inventoried? How will the decision-making process evolve? What provisions need to be made for medical monitoring and in-home health care for older residents?
–Establishing “rules of living”: how will the group address pets, smoking, TV use, groceries, vehicles, babysitting, tidiness, quiet hours, overnight guests? How will responsibility for cooking, cleaning, and bill-paying be distributed?
–Need for increased personal care: senior residents who feel that they require more monitoring/medical care than is reasonable to expect in a group housing situation must be ready to move to the “next step”, whether assisted living or continuing care.
In a smaller private home limited to relatives and/or close friends as fellow inhabitants, many of these issues may not surface—e.g. the existing owner holds title and makes most major decisions. But it is strongly advisable for new cohabiters to engage in frank discussions of practical matters so that the living situation is a pleasant one.
The institutional option
The literature indicates a growing interest in “congregational housing” (or group homes/ board-and-care), a more formal version of what has been described above. In this case, all residents are of a similar age and are initially unknown to each other; a defined management process is in place. However, some of the principles remain valid: creation of a home-like setting with a blend of private space (one’s own bedroom) with communal areas (kitchen, dining room, living room). A range of nursing care can be available, and some subsidized programs exist.
While providing a structured and reliable means of health monitoring, this housing option loses the advantage of a multi-generational mix. Yet having the presence of other residents—at meals, or simply watching TV— contributes towards a balanced social life, something often missing for people who stay in their individual homes.
1 formerly the American Association of Retired Persons
2 U.S. Bureau of Labor Statistics, April 2008
3 Pacific Affairs, Spring 1984
4 cf. B.F. Skinner, Walden Two