Over 33 million people in the United States are now above 65 years of age and by the year 2020 it will increase to about 53 million, or one in every six Americans. As the elderly individual grows old, their time on this earth becomes very valuable. Consequently, a problem like “where will these individuals choose to live out these precious years?” becomes even more critical. Accordingly, it is important to provide housing options which recognize the value placed upon the latter years of ones’ life. Most importantly, housing programs must be created which seek funding sources from the government.
The decision of where to live is one of the most challenging ordeals to deal with as one gets older. One of the main contributing factors to the difficult challenge of choosing appropriate housing is the unpredictably of “how we will age and how long we will live”. Over and above the unpredictability of aging, one must be concerned with the actuality that the average life expectancy for the elderly is increasing, which results to higher possibility that the elderly these days will have to cope with some sort of chronic health condition. For this reason, one’s ability to keep up the well-being and self-sufficiency while living out one’s abridged life tends to become a very expensive aim. This expense has an unfortunate effect on the majority of the elderly owing to the decreases in income after retirement. This paper presents selections of strategies that give support to the elderly in this challenging struggle like several housing options, and usually the first and most common option applied is government aid.
The elderly population is fast expanding while the core tax-paying population is decreasing. As the elderly population increases, and consequently the need for adequate elderly housing services intensify, the resources to offer services will drop off. Finding a more effective method of service delivery is of supreme importance. In the present day, however, the existing connections between elderly health and housing are weak at best. Accordingly, the most pleasing and most cost-efficient method of aging — aging in place — is not easy to achieve, even under the most ideal conditions.
There 34 million Americans over the age of 65. On average they constitute 10 to 13 percent of each state’s population. Those states with the highest concentration of the elderly are Florida, the northeastern region and the Midwestern corridor. Nevertheless, the number of elderly in Washington becomes alarming as well as its number rapidly increases. In 55 years, the number of people aging 65 years and above will more than double, the number of those 75 and older will triple and the number of people 85 and older will quintuple. The elderly population is projected to multiply twice as much in size to well over 70 million by 2025. The states that will experience the greatest growth in the number of residents over the age of 65 are in the west and south. As a percent of the total state population, states in the west and southwest will experience the greatest increases ( Lawler, 2001).
As the portion of the population having the need of integrated services continues to get bigger, service providers at the local, state and federal level will have to find a technique to bring together elderly health and housing since the costs of isolated services are too high.
The goal of this paper is to arrive at a housing program beneficial for the elderly that seeks financial assistance or funding sources from the government.
I. Housing and Health Concerns
Kathryn Lawler (2001) stated that the health and housing concerns of an elderly individual are frequently interconnected. As separate services, the current systems of health and housing delivery do not meet the necessities or needs of aging Americans. Health concerns can make or compound the problems of an aging housing stock, and housing concerns can make or compound health problems for aging individuals. When a living environment is reasonably priced and suitable, an aging individual is more likely to stay healthy and independent. When an individual maintains good health, he or she is more able to carry on with the maintenance of his or her living environment.
To improve an effective method of service delivery, the long-term care system must mirror this interrelationship between health and housing. Most of the present inefficiencies in the delivery of aging services take place during the provision of both overcare, providing more housing or health care than necessary, and undercare, when insufficient service provision compounds problems and increases expense. A modified model of care steers clear of the inefficiencies of overcare and undercare by matching services and facilities to an individual’s need instead of matching an individual to an existing service or facility.
Nearly all seniors own the homes in which they reside. The home-ownership rate for individuals between the age of 62 and 74 is 81.2 percent; between the ages of 75 and 84, it remains high at 76.9 percent. As these homeowners age and their bodies become weaker, the regular maintenance and preservation of a home can become bodily demanding to manage. As the health needs of an aging senior and the repair needs of an aging house increase, both place necessitates on the fixed income of a retiree (Lawler, 2001).
In spite of this relationship, the health concerns of an aging individual are attended to by one agency or set of services while the same individual’s housing concerns are tackled by different sets of nonprofit and/or government organizations. This separation is directly related to the way the housing and health industries were planned and considered and continue to function in distinct markets. While the private sector has created a greater number of models that unite both health and housing services, the public sector has continued to branch out the two.
Public subsidies are intended to create either health or housing services but not both. Government-sponsored health programs and housing programs were devised to give off distinct public goods (Burkhardt, 1999). They were formed in isolation, as different line items in local, state and federal governments. Public housing programs and government mortgage subsidies were shaped to increase the number of inexpensive and sufficient housing units. The public system of health services was set up to support general public health and well-being, to offer health care for the very poor and to lessen the possibility of an outbreak or epidemic. The undertakings of public health and housing agencies were not only independent but mutually exclusive.
As a consequence of this separation, there are very few programs which deal with both the health and housing needs of a senior, making it complicated for seniors to stay in their communities as they age. Retirees are faced by two unwanted options as they become weaker — overcare and undercare. They are often required to select between entering a costly, restrictive elderly institution before the need arises and staying in their homes alone, to confront the pressures of rising medical expenses and a worsening shelter while on a fixed income.
Conquering these impediments to the coordination of health and housing services takes on greater importance as more Americans live longer and the elderly population continues to increase at a very fast pace. The Department of Housing and Urban Development (1999) presented housing options available for the elderly individuals must meet these concerns to combat the likelihood that millions of senior citizens across this country will undergo a crisis of secured and affordable housing.
II. Housing Options for the Elderly Individuals
There are numerous housing selections open to the elderly. That is why it is necessary for them to start the planning for later-life housing needs before retirement, if at all possible when they are in their fifties (Travis, 2006).
One important factor in preparation for housing for the elderly is the elderly individual’s financial circumstances. The majority of the elderly at the retirement level are at their financial peaks, so it is significant to understand that while their capital will remain stable upon retirement, it is likely that their consumable income will go down In view of that, the type of housing designed for in an individual’s mid-fifties may have to be rethought. With this in mind, it would be advantageous for the elderly to have more than one housing option in mind in the course of the planning process.
A. House Sharing
Family considerations act a big role in where the elderly are willing to reside One of the biggest worries that an elderly person copes with is growing old unaccompanied or by himself in a place that they particularly don’t care for. What is more, most elderly would sincerely desire to live or remain where they are, if possible in their own homes. For these individuals, a suitable option is shared housing. A shared housing option is appealing to the elderly for the reason that it could imply living with other family members. The opportunity of living with family members could be both advantageous and disadvantageous to the parties involved, comfortable companionship or never ending disagreements between the elderly and their relatives. Hence, it is important for the parties to talk about how the situation might develop as the homeowner ages (Travis, 2006).
B. Restricted Communities
Regardless of the comfort of living in ones’ own home, there are several elderly that may favor the option to relocate. When working at the option to relocate, one common selection is the planned communities. If this option of housing is selected by the elderly individual, it is a must for them to understand that they could be owners in common of the planned unit development. One more appealing aspect of these planned communities is that the homeowners’ association controls the communities. Thus, the elderly individual can join in the making of the rules and regulations, which in turn are set up to preserve the quality of life of the residents.
Living in an age-restricted community is an option of housing for the elderly individual who would desire to reside in an apartment, housing development, etc. The types of housing accustom to this selection of housing consist of apartment buildings, retirement hotels, condominiums, mobile home parks, villages, etc (Travis, 2006).
C. Congregate Housing for Older Residents or Supportive Housing
Even though the average elderly individual would desire to stay in their original home; frailty, chronic illness, and disability often prevent this desire from ever happening. When health is in a unstable or frail condition, the elderly individuals’ selections are pretty much restricted to some form of assisted housing or institutionalization (Smith, 2000). The majority of the elderly prefer the former over latter, for the reason that service-rich housing presents a far more appealing setting then institutionalization.
Furthermore, it should be noted that the elderly that are not capable to keep up themselves without the aid of the supportive services are not restricted to the choice of institutionalization. An appealing option for this category of the elderly is a group home setting, which is staffed by qualified personnel that offer nutrition, housekeeping, personal care and service. This is just one of many housing options for the elderly, and the concentration here is to help inform the elderly people and their relatives of these options, so that the elderly person can live out there lives in a condition of their choice (Travis, 2006).
Supportive housing is an ideal housing option for those elderly individuals that are plagued by physical infirmity, mental decline, or chronic illness, but are essentially self-sufficient and value their personal autonomy (Kochera, 2001). The support housing setting gives services that can help the elderly individual in their daily activity; although, these services fall short of offering the care that nursing homes offer. The supportive housing environment may be composed of regular meal service, social activities intended to promote continued interaction with one’s age peers, transportation to cultural activities, religious outings, promptly accessible services like beauty and barbershops, handy pharmaceutical outlets and recreational outings. Other accessories consist of the usual grab bars and other security features in the restrooms and pull cords or similar alert/alarm systems whose intention is to guarantee the security of the residence and wellbeing of the residents.
The major producers of the supportive housing project comprise of not-for-profit organizations. One example would be the religious groups. These groups accept subsidies from the federal government. These federal subsidies are normally accompanied by prerequisites. The most frequently seen prerequisites are that the project(s) be governed or administrated by the local public housing administrators and must be able to comply with the low-rent category of housing. The latter of these prerequisites makes these supportive housing communities very attractive to the elderly (Kochera, 2001).
In addition, the elderly individual should be conscious that his or her rent can be lessened even more, conditional on their financial situation. This decrease in rent can be accredited to “Section 8” rent subsidies. What generally takes place during the Section 8 process is the “federal government pays the difference between the actual rent charged and the market rental rate for that unit.” The age an elderly individual must be to gain from this subsidy is 62 years old. One more factor the elderly individual should be conscious of is, that their income cannot “exceed 80% of the median income in the local area, as adjusted for family size.” This income is measured by exactly all the elderly individuals’ sources of income.
Aging in place with supportive services is not only the most pleasing method of aging, but can accomplish the efficiencies of the customized care model. Effective aging-in-place approaches reduce the provision of unfitting care, and as a result the overall costs, by offering a range of flexible services and adjusting those services to suit to the needs of the individual. Instead of a stiff service-delivery system, aging-in-place with supportive services strategies make both health care and housing options that offer support at the margin of need as defined by an individual’s personal longing and efforts to live independently. Aging-in-place works best as part of a wide-ranging and holistic tactic to the support needs of an aging individual and an aging community. The existing regulatory, structural, financing and implementation hindrances, though, prevent providers from improving a comprehensive approach to the health and housing needs of America’s seniors. Federally funded health and housing subsidies were considered to operate in isolation, each achieving separate public goods — adequate health cares for the poorest Americans and affordable housing units not given by the market. Consequently, the organizational systems through which these services are delivered, in addition to the regulations, performance measurements and implementation guidelines that establish which services can be delivered to which individuals, can often conflict and obstruct coordination (Lawler, 2001).
III. Section 202 Housing for the Elderly Program
Even at present, the United States General Accounting Office and the United States Department of Housing and Urban Development (1999) have ascertained that at least 1.4 million senior citizens are already going through worst-case housing needs. Seniors are more likely than any other adults to be poor, and almost 40 percent of senior citizens not in nursing homes are restricted by chronic conditions, unable to do the simplest activities related with independent living. Washington is one among the states with the highest number of low-income senior households with housing difficulties.
The major worry today at the housing issue meeting was the lack of new rental housing and the poor quality of the existing rental housing stock. Additionally, another issue that caused a lot of arguments was the topic of the increasing senior population and the housing requirements that would be required to house this age group. Many wished to make sure that the adequate housing availability for seniors would continue to remain a priority. There were also those who were worried with the condition of rural housing that tends to deteriorate when they are senior owned and the owner passes away. Proponents of increasing housing availability affirmed that there could be more single-family housing construction, over and above the rehabilitation of existing vacated elderly housing units, so as for the city to steer clear of costs for homes that decay to an irreparable point.
The most apparent response lies in establishing additional reasonably priced housing units for the elderly and other low-income Americans. The Department of Housing and Urban Development (1999) predicts that more than one million elderly families have worst-case housing needs. That is to say, they pay more than 50 percent of their income for rent or live in severely poor quality housing. Thus, there is a need for the government to grant full funding for HUD’s mark-to-market preservation initiative as is or with modifications or expansions that maintain HUD’s basic approach of targeting scarce resources to those projects most at risk.
IV. Government’s Participation in the Program
Government assistance for the elderly comes in the form of a cash subsidy, subsidized home maintenance programs or a matching service to locate a paying tenant to share an older person’s house and help preserve it. Public housing programs and government mortgage subsidies were made to increase the number of affordable and adequate housing units.
Moving forward, in quest for a more effective use of limited resources to satisfy the growing demand, individuals can continue to look for and increase the connections between health and housing services. Congress can modify eligibility criteria and the Departments of Housing and Urban Development and Health and Human Services can scrutinize their numerous standards and regulations to clear up conflicts. As the elderly population doubles in size all through the coming decades, these “patches” may not hold up the demand, let alone accomplish the efficiencies needed, to stretch decreasing public funds. While it is very significant that these two systems start to operate together rather than carry on in the current state of isolation, connecting these systems may not be sufficient. Opportunities exist, though, on the federal, state and local level to re-imagine a health and housing system that mirrors the interrelationship between the health and housing concerns of seniors, assisting rather than inhibiting the harmonization necessary to meet the growing demand. Kathryn Lawler presented the following concerns in her paper (2001).
Federal. Instead of delivering funds by way of separate funding channels to separate state and local agencies with different jurisdictions, the current isolated budgeting systems could come together or merge in a local or state level agency. This agency would then be in charge for contracting with local or state private or public providers to provide comprehensive and coordinated health and housing services, eliminating the need for providers to navigate their own way through the separate systems.
State. Each state is in the process of examining and restructuring its current community-based term care system as an outcome of the 1999 Supreme Court Olmstead ruling. This takes in, but is not restricted to, Medicaid waivers. Housing is a critical component of community-based care, but has not been incorporated in the current planning process. State and local housing providers should be incorporated in this important planning process if the mandates of the Supreme Court are to be satisfied.
Local. Community-based nonprofit organizations can play a number of significant roles in the development of aging-in-place programs. Using the powerful assets of their community networks and revitalization programs, these organizations can assist the Naturally Occurring Retirement Communities in their neighborhoods; make use of the paraprofessionals needed for a range of health and housing services (e.g., handymen and personal care assistants); inject aging into the local community planning process; and acknowledge the benefits of keeping the economic and social contributions of seniors in their communities.
Government participation in housing started as a solution to health and safety problems. It was not until the federal government became concerned in housing, in the 1930s and 1940s that the concentration of government efforts shifted to individual housing units and the welfare of individual households. Ironically, as the concern in housing widened and moved from local to federal levels, the concentration of that concern became narrower and shifted from the “public” issues of general health and safety to more individual, “private” concerns for the affordability and sufficiency of individual housing units for individual households. With this change to a broadly based but narrowly focused public interest in the housing stock, the natural connection between health and housing was lost. Consequently, over the past half-century housing and health agencies diverged in the channels of government appropriations, budgetary cycles and subcommittees. The separate budgeting structures that have developed now make it harder to understand the original link between pubic health and private housing that originally drew the government into the housing arena.
No one should acknowledge the possibility of a future where our grandparents, parents and the generations to come are required to live in crowded institutions, or worse, live secluded or alone and without hope in dilapidated buildings as their homes deteriorate around them. If we work together, most especially with the support from the government, we can maintain what we have built today and develop opportunities for more Americans tomorrow. A great tool in this effort has been the Section 202 housing for the elderly program. Although the present Administration has constantly attempted to lessen Federal funding for reasonably priced senior housing, congressional efforts have been effective in maintaining the resources essential for the program.
Burkhardt, John. (1999). Mobility Needs in a Maturing Society. Coming of Age, Federal Agencies and the Longevity Revolution.
Department of Housing and Urban Development. (1999). Housing Our Elders. Washington.
Kochera, Andrew. (2001). A Summary of Federal Rental Housing Programs. AARP Public Policy Institute.
Lawler, Kathryn. (2001). Aging in Place, Coordinating Housing and Health Care Provision for America’s Growing Elderly Population. Fellowship Program for Emerging Leaders in Community and Economic Development. Washington: Neighborhood Reinvestment Corporation.
Smith, Gary, et al. (2000). Understanding Medicaid Home and Community Services: A Primer. Department of Health and Human Services.
Soldier, Travis W. Housing options for the Elderly. Retrieved June 19, 2006 from http://www.usd.edu/elderlaw/archives/housing_options_for_the_elderly.htm