This book looks at the issues of housing for seniors, and the range of possible solutions that are being developed by those who have been prepared to ask ‘how do I want to live as I get older?’ The narrative is balanced between highlighting research on housing, health and wellbeing of older people, with the practical schemes that the author has investigated. The strongest messages that emerge are:
• The importance of community and social networks in achieving a ‘good’ old age.
• The success of ground-up rather than top-down solutions.
• People are more willing to accept help in an environment where they are also encouraged to provide help.
• People want to be in control of the balance between possible risk and accepting an element of intrusion into their lives in order to live how and where they want.
The book first considers the existing situation; a generation of baby-boomers who pushed back the definition of old age and are recognising the limitations of available housing options. Those who have moved past denial are considering whether they can reorder ageing in the same way that they have been tackling other societal problems, with a particular emphasis on community and self-help. Based on the situation in America, there are no assumptions about looking to the state for solutions, but the experience is still relevant for those countries with a stronger history of public provision that is now under increasing pressure from the changing demographic.
The main part of the book looks at the range of housing options and supporting structures that are emerging. Through site visits, research and interviews, the author has covered a lot of ground looking at projects that are, for the most part, fairly successful in offering ways to ‘age in place’. To be successful, these solutions must address not just the physical suitability of the home but create a social dynamic that can combat isolation.
Examples range from formal to informal, with different levels of paid and voluntary support and include:
• Bespoke housing developments such as co-operatives and co-housing communities.
• Support organisations such as the Village model, Communities without Walls or NORCs (Naturally Occurring Retirement Communities). These are self-organised networks where members continue to live in their own homes but provide and receive support from each other and/or from professionals who are paid for through membership.
• Individually focused solutions such as house sharing, living with friends or extended family housing.
The author also encounters some interesting examples of communities based around a shared interest or experience, such as one for retired postal workers in Florida set up by their trade union or a retired artists' colony in California. The US basis of the book is most evident in the section titled ‘Getting from Here to There’, which considers the financial and social support infrastructure that exists, as well as issues for developers and city planners. But as this is an ideas book and not a how-to manual, there are questions and possibilities raised which should be of interest to anyone involved in provision of services for older people. In addition, a number of the models have been spearheaded and maintained by a few dynamic individuals and attract more financially secure owner/occupiers so there is also the challenge to see how these could be realised for people in other circumstances.
By their own admission, most of the communities visited have not yet formulated their response to serious levels of illness, dementia or frailty. But the author looks at the role of technology in enhancing the home environment (alas probably not in the form of a humanoid-type robot). In particular, the Full Circle model, pioneered by a local family doctor in Maine, has brought together elements of technology, community networks, volunteers and some limited paid support to enable people to remain in their own homes successfully when the normal expectation would be a move into care.
The anecdotal style of the book makes it very accessible and the references to research and other supporting documents provide a good starting point for anyone who wants to delve deeper. Also, given that most people hope to grow old, it's probably a book that everyone should read if they want to take control of their future.