We’re all getting older. We all need a place to live. We all need healthcare. Although none of these facts are a surprise, especially to those in the long-term care (LTC) world, some may find it difficult to believe that in the future there may not be enough places in which we can live. And live affordably.
Well-heeled retirees are set. They get “amenities,” can afford luxurious, resort-like accommodations and meals, and receive many healthcare services. We mustn’t forget the tens of millions of older adults with low incomes, however. Their opportunities for a safe, affordable home and needed healthcare services are fewer and more difficult to obtain.
With the fact that 10,000 baby boomers are reaching age 65 each day, we need to do something, and soon. In 35 years, the number of people in the United States who are 65 or older will more than double, increasing from 40 million to 88 million.1
SHOW ME THE MONEY
A full 40 percent of those 65 years old and older have very low incomes, typically less than half of the area median income in the communities where they live.1 An income of $14,000 a year is typical of this group, which numbers approximately 10.5 million households in the United States.1 More than 33 percent of all seniors had annual incomes below 200 percent of the national poverty level—approximately $20,000—in 2010.2
Although low income is a significant barrier for older adults who need to secure safe housing, it’s troubling to know nearly half of the poorest elderly spend 50 percent of their income to pay for it.2 This makes necessities such as food and healthcare, or even a little bit of fun, such as going to the movies, difficult or impossible to realize.
Assets among low-income elderly are lagging. Older adults—77 years old and younger to 88 years old and older—have assets of $50,000 or less.3 That’s the bad news. The good news is more and more LTC organizations are focusing on housing for low-income elderly by providing safe, affordable homes in the communities they already love, enabling them to age in place.
AFFORDABLE HOUSING IS POSSIBLE
To get to this point—where older adults can age in place in an affordable, purpose-built home—isn’t easy, but it can be done. Building high-quality, low-income housing isn’t cheap. An in-depth study of the senior housing market and the demographics of the area’s population ensures that this type of facility can be built effectively and well.
And there’s a demand for it. Today, most of the country isn’t prepared to meet the housing needs of older adults in the future.4 Those in the senior living industry must create a strategy and build today for tomorrow’s older adults.
There’s a dearth of high-quality affordable housing for low-income older adults. And much of what is available isn’t designed with them in mind. Some senior housing is not easily accessible for those with physical issues or for those who use a wheelchair. Simple things, like the ability to grasp a doorknob, can’t be accomplished by some older adults.
InnovAge recently built a 72-unit low-income apartment complex in Colorado to meet these requirements for a senior population. The units in this purpose-built low-income complex are affordable, safe and accessible with easy access to healthcare.
By bringing these elements together, aging in place becomes a reality for the older adult. These apartments specifically target older adults with limited incomes. The need is real: The complex is 100 percent leased and has a waiting list.
Residents span a wide range of ages, from 66 to 99 years. Most of the residents fall in the 66-to-75 age range (46 percent).
Independent housing programs often don’t have a good link between residents and healthcare providers. This is important because it puts “many older adults with disabilities or [LTC] needs at risk of premature institutionalization.”4 As providers of LTC services, our goal is to help those in our community remain independent for as long as possible. We want to do all we can to keep them healthy and aging in place.
A promising approach addressing this issue is something we call “wrapping.” Just as one would wrap up in a warm coat in winter to stave off the cold, we endeavor to wrap these older adults with a layer of healthcare services through PACE (Program of All-inclusive Care for the Elderly), run by the Centers for Medicare & Medicaid Services). Although not every resident is eligible, those who are may enroll in the program. Note: Residency in the apartment community, however, is not predicated in any way on joining PACE. The same is true of PACE-only participants, who can choose where they want to live.
PACE programs are available across the United States and typically include medical, dental and rehabilitation services, activities and meals. Participants must be eligible for Medicaid and Medicare to be fully covered. Many have multiple chronic health conditions; some have dementia.
In addition to the medical treatment available at a PACE facility, socialization is extremely important. Participants may have up to two meals a day at the center, providing an opportunity for friendly conversation. Some centers offer group field trips to museums or nature preserves. In totality, a PACE center is really a micro-community: a place to receive needed medical care, meals, activities and make new friends.