The time has come

My name is Chris Moore. I am the Director of Education for the Western and Central Virginia Aging in Place Council. I have been involved in construction in one form or another for thirty years and have owned my contracting business for fifteen. I have been actively involved in promoting Aging in Place issues for about eight years. I am passionate about people having the right, the availability, and the resources to remain in the home of their choice throughout the course of their lives. I don’t think that it is too strong of an opinion to state that the idea of the ability to stay in our own homes is as foundational to our way of life as these words from the Declaration of Independence, “We hold these truths to be self evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are Life, Liberty, and the pursuit of Happiness.” If any of you have spent much time listening to someone who feels that circumstances are forcing them out of the home that they love into some sort of living arrangement that they detest, then you have seen someone struggling with the core issues of Life, Liberty, and the pursuit of Happiness. Studies show that more seniors fear being admitted to a nursing home than fear death. The ability to live independently on one’s own terms is really at the very heart of who we are as people. What these people desire is what we call Aging in Place. Aging in place is commonly defined as the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level. Aging in Place is simply the idea that we can continue living in the home we are comfortable in throughout the course of our lives rather than be forced to move somewhere else because of the consequences of aging or disability. I don’t particularly like the term Aging in Place because it seems to suggest that there is a certain point in our lives when we start aging and at that point, when most people move, we decide to stay put instead. However, we will continue to use it until someone comes up with a better term. There are some who advocate using the term living in place to indicate the idea that it is a lifelong process. Whatever we call it, our challenge as advocates is to make the “place” as conducive as possible to the process of continuing to live there throughout the course of our lives.

My interest in Aging in Place began in earnest when my mother’s health began to decline. My parents had been living in Arizona for quite a few years. When she began to have health issues, they moved back to the area to be closer to family. Like most family caregivers, we found ourselves in a caregiving role quite suddenly. Being a contractor, I knew how to build a ramp for getting in and out of the house and to install some grab bars in the bathroom to help prevent falls, but I really didn’t know what other kinds of modifications to make, nor did I have any idea what other products and services my mother might need or where to find them.

Since that time I have become a Certified Aging in Place Specialist, a Certified Environmental Access Consultant, earned an Executive Certificate in Home Modification, and performed dozens of home modifications and consulted with hundreds of family members and caregivers who had grave concerns about their loved one’s safety. Throughout these experiences I have found that my experience of suddenly finding myself in a caregiving role is typical. Most people simply do not anticipate that they may become the primary caregiver for a parent, a spouse, or other loved one, who to some degree, is now unable to care for themselves. Whether the need is sudden such as from a fall or accident or the knowledge of the need is sudden because it has been kept hidden due to embarrassment or not wanting to bother anyone, the result is the same. Suddenly you are a caregiver. Now what?

When you suddenly find yourself in a caregiving role there are really two issues at play and it is at the point that the two issues intersect that the adjustment must be made. One issue is the physical, mental, emotional, or spiritual ability of the individual with regard to mobility, sight, hearing, balance, range of motion, cognition, memory, well being, overall health, etc. This issue generally falls into the jurisdiction of a health care practitioner, such as a doctor, nurse, or occupational, physical, or speech therapist, counselor, pastor, or minister among others. The other issue is the built environment with regard to obstacles to activities of daily living. These obstacles can include stairs, raised thresholds, narrow doorways and hallways, slippery floors, poor lighting, inaccessible bathrooms, doorknobs that are difficult to turn, and a host of other fixtures found in a typical home. These items generally fall into the realm of architects, interior designers, contractors, builders, and remodelers. However it is at the point that these two issues meet that is critically important to the individual struggling to live in their home. That is why it is so important to have professionals from different disciplines at the table in order for us to offer real world solutions to people trying to age in place in our community. A home that is perfectly suited to someone with one type of disability would be totally inappropriate for someone with a different type of disability. The solution must meet the need. As an example as long as I am wearing these glasses, I can read my notes. The minute I take them off, I have become visually handicapped. The long term approach is to build homes that we can all live in comfortably for our entire lifespan. I have read studies that show that only 15% of us go through our entire lives without facing a temporary or permanent mobility impairment at some point during our lives. So why are we building homes that at best inconvenience 85% of the population and at worst or uninhabitable for many. We should be building homes that contain features that are usable by people of all ages to the greatest degree possible without the need for adaptation or specialized design. This is known as Universal Design. I also like to call it Lifespan Design, a term coined by Wally Dutcher, the world’s longest living quadriplegic, and in my opinion, the foremost authority on the subject. Until Universal Design becomes the rule rather than the exception, we are faced with a choice when an individual’s abilities and their home are no longer a match.

The traditional approach at this point is to place your loved one in a facility of some kind such as an assisted living or nursing home. While this approach may work for some, many people are embracing a different approach, remaining in their homes by making modifications to the home and bringing services into the home as needed. In other words, Aging in Place. Aging in Place means receiving the care you need in the familiar surroundings of your own home. Studies show that up to 90% of those surveyed prefer to remain in their own homes when given a choice. The challenge of the Aging in Place model is that all of the services required to successfully age in place must be coordinated and brought into the home environment. These services include such areas as health care, legal services, financial planning, medication management, help with activities of daily living, meal preparation, home maintenance, shopping, errands, and a host of other activities. In order for the benefits of aging in place such as lower costs, happier residents, and better healthcare outcomes to be available to our senior population, someone has to step up to the plate and screen and coordinate these services in a way that makes it easier for those needing these services to readily access them instead of those who suddenly find themselves as caregivers feeling overwhelmed and not knowing where to turn.

That’s where the Aging in Place Council comes in. We are a group of service providers and concerned citizens who have a heart to see that members of our community have the opportunity and the resources to live gracefully in the home of their choice as long as they choose to. We don’t like the idea of people being forced out of their homes because they cannot access the resources they need in order to stay there. In addition, we are willing to do something about it. If you can recognize this need, and would like to be part of the solution, we would like to have you join us. You see, the broader our coalition and the stronger our voice, the more we can get done.

And trust me, there is a lot to do. We are only just seeing the tip of the iceberg. With 10,000 people turning 65 each and every day and 3,000 people a day turning 85, our society is aging rapidly. By the year 2050, the number of Americans over 65 is projected to be nearly 90 million, twice the number as there were in 2010, and over 20% of the population. We clearly need a new paradigm to care for this rapidly growing segment of our population. Yet in some ways, it is not new at all. Until about seventy five years ago, everyone took care of their extended family as a matter of course and no one really even considered doing anything else. It was just what you did. As our society became more mobile, and families were often spread all over the country, retirement communities increasingly became the norm. However as the baby boomers age, the sheer number of seniors, the rising cost of health care, and the more independent streak of the baby boomers make that model increasingly obsolete. I read somewhere that even if the number of facilities doubled in the next twenty years there wouldn’t be enough room. So seniors are going to be staying home because they choose to, for cost saving reasons, or because there is nowhere else to go, but they WILL be staying home. So what now?

I, along with the other members of this chapter, and members of other chapters of the National Aging in Place Council all over this country believe that it is up to us to step up and form the coalition that will create the infrastructure that will help care for our seniors in their homes. We are rapidly losing members of what has been called the greatest generation. Those hearty souls who endured the great depression, fought, and bled, and died during World War Two to protect the world from tyranny and sacrificed to build the freedom and prosperity that we have a tendency to take for granted today. It is time for us to give back. We are here today because we want to make a difference in our community. We have a passion to help seniors stay in the homes they love. We want to help the family caregivers who care for them access the resources to make their jobs just a little bit easier. Won’t you join us to help those who have gone before us to successfully age in place?

How can we accomplish this goal? First and foremost we must educate the public. Over the last eight years, as I have spoken to people about Aging in Place, some of the common reactions I have gotten from people have been, “I have never heard of such a thing!”, or “I wish I knew about that a year or two ago when my grandmother (or father or mother) was living.” As more people become aware of the idea of Aging in Place the more the demand will grow. When demand grows, the supply will grow to fill it. Secondly, we need to recruit service providers who have a heart to help seniors stay in their homes and who will treat them with dignity and respect. We need to help train and educate people to provide care for our seniors in their homes. Third, we need to organize our services and present them to the public in a way that makes it easy for people who suddenly find themselves in the role of caregivers to find reputable and reliable service providers.

The need is great, the challenge is large, but the reward is even larger. Both personally and professionally, the opportunity to be part of the solution to the needs of our aging population is a tremendous opportunity. Please consider joining our chapter and become part of the solution that will honor the lives and contributions of those who have gone before us by helping them live their golden years with dignity, safety, and comfort.

There is a tipping point coming. One morning in the not too distant future, we as a society will wake up and realize that we have a senior housing crisis in this country. I am planning on being prepared to be part of the solution on that day. Won’t you join me?

(This is the transcript of a talk given by Chris Moore on March 24, 2016 to the Western and Central Virginia Aging in Place Council)