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The Big Problem & Paths to Solution

by Louis on February 3, 2016

What is the biggest challenge America faces regarding aging? Housing and caring for the growing number of older Americans. Finances, transportation in urban, rural and suburban situations, isolation and attitudes about aging cannot be ignored but if we solve the big problem, Where can older people live with choice, dignity and control as health changes and more help is needed? the other aspects will be solved as parts of the big picture solution.

First we must tune the problem a bit.

Where can older people live with choice, dignity and control as health changes and more help is needed within the bounds of available resources (finance, medical, caregiving)?

Focusing the problem this way tracks the Housing First  shift adopted in fighting homelessness with significant results. Technology has the potential to play a significant role in using resources well but the basic need for a home that meets the individual’s desires and needs and supports independence and safe caregiving is just that – basic. Aging happens somewhere – whether that home is purpose built, congregant, service enriched or isolated single family. We need all the options.

What transformational changes to current services, systems and houses do we need to reach the GOAL...housing that preserves dignity, control and choice while using resources wisely?
1. Remake housing infrastructure so it is safer and better care sites. We already have lots of housing, a good deal of it privately owned. Tuning up this infrastructure for the current aging demographic is the most economical way to our goal.
2. Add foci on middle and upper middle income populations- almost all policy, programming, research and attention is focused on poverty. This is critical and important but people with resources also have problems aging well. It will be different and easier to innovate and test solutions when regulations and poverty are not part of the problem. These innovations can be adjusted and adapted for those with fewer resources.

  • Adding attention to those with more money will encourage market based iterations of service delivery models.
  • Incentives can leverage private resources to update private homes bringing lots more money to solve the problem

3. Facilitate family caregiving – Family and friends provide the bulk of caregiving. We need to maximize the easy capture of these critical, important valuable and irreplaceable resources. That happens best in homes in community.

Just as I am not ignoring the importance of continuing to serve the most vulnerable I am not ignoring technology. Technology will help manage health care to avoid crises and costs, manage caregivers, organize transportation and activities as well as organize, maintain and manage connections. Technology helps us breath a sigh of relief that the scale of the problem can be managed, but it is a tool, not the solution.

How do we get started? The big problem is clearly stated. Approaches are outlined. To move toward our goal we must look outside the box of aging. The conversations are too entrenched. The silos are too strong.  We need to look to methods, techniques and experiences from other sectors and industries, to business and the marketplace not social service models.

“You never change things by fighting the existing reality.
To change something, build a new model that makes the existing model obsolete.”
R. Buckminster Fuller

{ 1 comment… read it below or add one }

YVONNE MENDENHALL February 3, 2016 at 5:28 pm

Excellent post. I’ve sent to to my group of GERO GURUS and Neighborhood Connection colleagues. Thanks for supporting aging in place and keeping the wisdom of elders in our diverse communities!


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