“Aging-in-place” refers to schemes that use housing designs and renovations that allow elderly citizens to remain in their homes longer by including such amenities or renovations as eliminating stairs/installing residential elevators, widening doors and hallways, easy-to-use light switches and door handles, and custom bathrooms for residents with limited mobility. Traditional “aging-in-place” entails a single individual or couple living in their homes well into their twilight years. Yet, the prospect of aging-in-place with your elderly friends, neighbors, or finding roommates holds interesting and significant possibilities for reducing healthcare and general living costs, while maintaining a higher quality of life for an aging population.
Low-Cost, High Quality Assisted Living: Look for Elderly Roommates for Age-in-Place Housing
One hidden advantage of citizens converting their private residence into a miniature retirement home is the recent over-building and sprawling floor plans of the housing stock, commonly known as McMansions. Today, the sub-prime mortgage crisis has many of these homes occupied by multi-generational families trying to find a way to make ends meet. Eventually, as the economy recovers so will the financial circumstances of these individuals and these multi-generational families will separate once again. So, what happens to these large homes? A generation from now, with moderate renovations, these homes could provide sufficient room to house three or four or five elderly residents and a live-in nurse or caregiver.
To make this arrangement work, these homes would need intensive home healthcare, most likely some type of live-in nurse or primary caregiver. Needless to say, this isn’t cheap. The average salary for many nurse practitioners, such as Licensed Practical Nurses, is $35,000-$40,000. Of course, with time-off, one live-in nurse won’t be enough to cover all the healthcare needs for a group of 3 or 4 elderly residents. Still, an annual expense of $50,000-$75,000 for nursing care for the entire home isn’t implausible, depending on the relative health and needs of the individuals. Considering that the average cost of nursing home care now tops $80,000 a year per individual, this arrangement could save thousands of dollars while maintaining the dignity of “living at home.” Perhaps, one resident owns one of these accommodating homes; the other residents help cover the expenses of the healthcare.
Obstacles, Advantages in Terms of Labor Shortage
The nursing shortage is already severe, projected to become critical and under-publicized. Worse yet, historically, the problem has also been underestimated. In 2002, the Bureau of Labor Statistics (BLS) projected that, by 2020, the U.S. would have 800,000 fewer registered nurses (RNs) than the national need by 2020. According to the latest projections from the BLS, more than one million new and replacement nurses will be needed by 2016.
At the same time, the labor shortage is causing high burnout rates for nurses in virtually every sector of the healthcare industry. From the American Association of Colleges of Nursing website:
In the March-April 2005 issue of Nursing Economics, Dr. Peter Buerhaus and colleagues found that more than 75% of RNs believe the nursing shortage presents a major problem for the quality of their work life, the quality of patient care, and the amount of time nurses can spend with patients….nurses see the shortage in the future as a catalyst for increasing stress on nurses (98%), lowering patient care quality (93%) and causing nurses to leave the profession (93%).
Often, these shortages are the catalyst for draconian measures, friction with management, and bureaucratic injustice. But the nurses are out there. In Florida, for example, there are currently 250,000 licensed RNs and Advanced Registered Nurse Practitioners (ARNPs), but only 162,000 are working in the Florida nursing industry. Small groups, aging-in-place, holds the potential to bring these disillusioned nurses back into the workforce of the healthcare industry by circumventing the stress-inducing relationship of large-scale, healthcare bureaucracy and individual nurses.
The Role of Government, Reducing Costs, and Improving Quality Through Age-in-Place Homes
In the sense that all aging-in-place residents leave more available beds in nursing homes, this form of assisted living already helps reduce the national cost of healthcare. Undeniably, aging-in-place will play a more important role for the next generation of retired persons. Looking at and extending the possibilities for this form of retirement and assisted living is one more piece of the puzzle in controlling costs and improving quality of healthcare in this country. In making a recommendation that the government temporarily increase Medicaid payments to the states for home- and community-based services, the Service Employees International Union has said that Medicaid and Medicare could save money by encouraging the use of home care services, instead of nursing homes.
But we must start now. From the future condition of today’s housing stock to accommodating less stressful employment opportunities for nurses, effective implementation of resources involves urgent planning and cooperative policy-making. True fiscal responsibility lies not just in reducing this year’s annual budget deficit but in planning 10, 20, and 50 years down the road.
How to Plan Ahead and Make Aging in Place Happen?
You can read more about smart renovations for Aging-in-Place and find a Certified Aging-in-Place Specialist (CAPS) in your area.
