From INDEPENDENT FOR LIFE: HOMES AND NEIGHBORHOODS FOR AN AGING AMERICA
edited by Henry Cisneros, Margaret Dyer-Chamberlain, and Jane Hickie, forward by John W. Rowe,
Copyright © 2012. Courtesy of the University of Texas Press.
Do you want to age independently in your own home and neighborhood? Staying home, aging in place, is most people’s preference, but most American housing and communities are not adapted to the needs of older people. And with the fastest population growth among people over 65, finding solutions for successful aging is important not only for individual families, but for our whole society. In Independent for Life, former HUD Secretary Henry Cisneros and a team of experts on aging, architecture, construction, health, finance, and politics assess the current state of housing and present new possibilities that realistically address the interrelated issues of housing, communities, services, and financial concerns.
Independent for Life covers a wide range of smart solutions, including remodeling current housing and building new homes for accessibility and safety, retrofitting existing neighborhoods to connect needed services and amenities, and planning new communities that work well for people of all ages. Case studies show how the proposals can be implemented. The authors offer action plans for working with policy makers at local, state, and national levels to address the larger issues of aging in place, including family financial security, real estate markets, and the limitations of public support. Lists of essential resources, including a detailed “to do” list of aging in place priorities and an individual home assessment, complete the volume.
Henry Cisneros, former Secretary of Housing and Urban Development and four-term mayor of San Antonio, is Executive Chairman of CityView, a company that specializes in urban real estate, in-city housing, and metropolitan infrastructure. Cisneros is the author of several books, including Interwoven Destinies: Cities and Nation and Our Communities, Our Homes: Pathways to Housing and Homeownership in America’s Cities and States.
Margaret Dyer-Chamberlain is Senior Research Scholar and Managing Director at the Stanford Center on Longevity.
Jane Hickie is Senior Research Scholar and Director of the Politics, Scholars, and the Public Program at the Stanford Center on Longevity.
John W. Rowe
According to a recent report issued by the MacArthur Network on an Aging Society, an aging society is one in which people over sixty outnumber those under fifteen. The MacArthur Network, an interdisciplinary group of experts on longevity, conducts analyses and proposes public policies relevant to the challenges and opportunities of an aging society. The Network has pointed out that inevitable demographic shifts mean that our country will become increasingly older in coming decades. We are woefully unprepared to deal with the myriad consequences of this impending reality, nor have we challenged ourselves to imagine the opportunities that an aging America will present.
The aging of our society is not merely a possibility, contingent on future increases in life expectancy. It is a certainty driven by well-defined factors, including the aging of the baby boom generation, dramatic increases in life expectancy that occurred in the 20th century and the more recent compression of morbidity. Compression of morbidity means that many more of us will live disease and illness free right up until the end of our lives. These forces, despite sustained fertility rates and continued immigration, will result in an America populated by increasing numbers and percentages of older people.
As we enter these uncharted waters, the greatest unknowns relate to the future behavior of the baby boom generation. How will they work, save, spend, study, help others and vote? How and when will they retire? As they withdraw from paid employment, how will they cope with their lack of engagement and control? Will the innovative and entrepreneurial spirit that has characterized this generation endure? What new ideas will they pursue? And, as investigated in detail in this volume, where and how will they live?
Considerable analysis and much political discussion have focused on the future of the U.S. health care system and the solvency and sustainability of the Social Security and Medicare Trust Funds. There has been much less focus on the realities of life in an aging America. We are entering a period of rapid change in many of our society’s key institutions including housing, retirement, labor markets, education, transportation, religious communities, neighborhoods, political parties, national defense and the family itself. To cope with an aging population, these institutions must adapt to emerging structural and cultural changes. We also need to develop policies and strategies at the local, state and national levels that will optimize opportunities for all age groups. Our whole society needs to think creatively about how to best support people to a very old age.
The future design, structure and function of our housing, neighborhoods and communities are central issues as we try to come to grips with an aging America. One important strategy will be to develop healthy communities that engage all residents and foster intergenerational experiences. Former U.S. Secretary of Housing and Urban Development, the Honorable Henry Cisneros, joined with the Stanford Center on Longevity (SCL) to produce this volume, Independent for Life: Homes and Neighborhoods for an Aging America. The basic premise of this book is that Americans are aging in traditional homes, age-segregated neighborhoods and communities that are designed for yesterday’s demographic realities. Future demographic changes demand transformative efforts for successful aging in place. As Professor Andrew Scharlach says, “The ultimate goal of aging in place efforts is true choice in housing; the ability to live wherever you want regardless of age or ability.”
This important and timely volume is an edited work from an interdisciplinary group of architects, urban planners, gerontologists, economists, civic leaders, elected officials, developers and builders. It represents a very important contribution to the national discourse on strategies to assure the emergence of a productive and equitable aging America.
Independent for Life has been funded with generous grants from The Home Depot Foundation, the MetLife Foundation and the Federal Home Loan Mortgage Corporation (Freddie Mac). Lead funding has been provided by the MacArthur Foundation Research Network on an Aging Society.
It is our hope that this book will stimulate thinking about how we can change the culture of our society to support successful aging in place. We are aware that the challenges are great and that the opportunities are real.
John W. Rowe is a professor in the Department of Health Policy and Management at the Columbia University Mailman School of Public Health. Previously, he served as chairman and CEO of Aetna Inc., one of the nation’s leading health care and related benefits organizations, from 2000-2006. He is former president and CEO of Mount Sinai NYU Health; prior to the Mount Sinai-NYU Health merger, he was president of the Mount Sinai Hospital and the Mount Sinai School of Medicine in New York City. He was a professor of medicine and founding director of the Division on Aging at the Harvard Medical School, as well as Chief of Gerontology at Boston’s Beth Israel Hospital.
Currently, he leads the MacArthur Foundation’s Initiative on An Aging Society and chairs the Institute of Medicine’s Committee on the Future Health Care Workforce for Older Americans. He serves on the Board of Trustees of the Rockefeller Foundation and is a former member of the Medicare Payment Advisory Commission. He chairs the Board of Trustees at the University of Connecticut and the Marine Biological Laboratory in Woods Hole, MA. He received an MD from the University of Rochester School of Medicine and Dentistry and BS from Canisius College.
Table of Contents
Table of Contents
Foreword by John W. Rowe
Section I, Introduction: Independent/Successful Longevity
1. New Visions for Aging in Place, Henry Cisneros
2. A Hopeful Future, Laura Carstensen
Section II: Demographics and Challenges
3. Changing Demographic Realities, Adele Hayutin
4. Future Social and Economic Changes, Anthony Downs
Section III:Housing and Services
5. From Home to Hospice: The Range of Housing Alternatives, Elinor Ginzler
6. Community Services, Jennie Chin Hansen and Andrew Scharlach
Section IV: Homes
7. The Home Environment and Aging, Esther Greenhouse
8. Technology Solutions, Eric Dishman
9. A Contractor’s Perspective, Greg Miedema
10. A Case Study: Interior Design for Aging in Place, M. Robbins Black
11. Multifamily Housing, Hipolito Roldan
12. A Case Study: The Freedom Home, Keith Collins
Section V: Neighborhoods
13. Healthy Communities, Lawrence D. Frank
14. How to Get Started – Local Community Action, Ron Littlefield and Robert H. McNulty
15. Retrofitting Suburbs, Ellen Dunham-Jones and June Williamson
16. Longevity and Urbanism, Scott Ball and Elizabeth Plater-Zyberk
17. Neighborhood Development, Christopher B. Leinberger and Michael Glynn
Section VI: Strategies for Change
18. Vulnerable Populations, Fernando Torres-Gil and Brian Hofland
19. Housing Finance, Richard K. Green and Gary D. Painter
20. A Political Strategy, Shirley Franklin and Jane Hickie
mHealthTalk Editor: In U.S. Should Make ‘Life-Long Homes’ A Priority, Judith Graham interviews Former HUD Secretary Henry Cisneros about aging-in-place and this new book.