Aging in Place Has Always Been About Community—Just Look to ‘The Golden Girls’

On this episode of The Long View, author, speaker, and consultant Joy Loverde discusses the complexities of caregiving, how to navigate family relationships when planning care as we age, why housing is the number-one issue in eldercare, and lessons on aging successfully from her books Who Will Take Care Of Me When I’m Old? and The Complete Eldercare Planner.

Here are a few excerpts from Loverde’s conversation with Morningstar’s Christine Benz and Amy Arnott.

Why Housing Is One of the Biggest Concerns in Eldercare

Christine Benz: You look at aging through a number of lenses—the eldercare aspect of it, as well as setting ourselves up to age successfully. I wanted to talk about some dimensions of that as we all look forward to our later years. Can we talk about housing? Starting with continuing-care retirement communities, which have become an increasingly popular option for older adults as they’re thinking about their housing later in life.

Joy Loverde: I think that housing is the number-one issue. When people say to me, Where do I start? Where you live matters. And why it matters where we live is because it’s all about an informal network of help. And we all know that the care working crisis—it is just moving forward faster than the speed of light. And that more and more people are becoming unavailable to help us. And we will depend more and more on our friends and our neighbors. So, where we live has everything to do with someone having immediate access to us, and also, we have forged relationships. It’s a process that takes time. And right now, if you’re sitting in your own house, all alone in a neighborhood where it requires you to get in a car and go somewhere, and people don’t knock on your door, and you’re not in a community environment, that is a setup for failure for the aging process.

Unless, of course, you have tons of money to bring people in to help with services. But as I mentioned a few minutes ago, those people who are going to be helping us are going by the wayside. So, where we live is super important. And you mentioned continuing-care communities. They are now referred to as life-plan communities, where people go in healthy, live independently, stay there for the rest of their lives, and have wonderful relationships. Someone to always rely on, no matter what.

Can You Really Age in Place?

Amy Arnott: A lot of older adults have a very strong desire to stay in their own homes. What are some of the challenges of aging in place? You mentioned that if you are isolated, that can be a big problem. But are there steps elders can take to have a more positive experience if they have a strong desire not to move to a community-based facility?

Loverde: It definitely can be a positive experience if you have time to forge relationships, if you have a lot of money to pay for services, and you have designated other people to manage the process. For example, if you do have people coming in, and let’s say you get more forgetful or you are diagnosed with dementia or Alzheimer’s, who is going to manage the staff? Who is going to manage the people coming in and out? What’s the safety factor here? Technology is also going to play a very important part in staying home, aging in place. What happens if the internet goes down? What if the technology is not up to date? Who is going to manage technology? Another focus of aging in place that nobody ever thinks about is nutrition. The idea of aging in place has to do with staying healthy. So, if you’re healthy, great, but that requires eating right and exercising. Because nobody ever says we have to fall apart when we get old, right? You can be healthy. You can eat right. You can have a high quality of life. And one of those days, you never wake up, game over. But aging in place requires a diligence that is constant until you decide, “No, this is too hard. I need to put myself more in a community setting.” As I said, it’s not an impossible task. However, it has a shelf life, and it’s very difficult.

How Elders Can Mitigate the ‘Despair, Disease, Dementia, Dying, and Death’ in Assisted Living

Benz: You talk about a number of different care settings in the book, including assisted living. And you write that they can be disempowering because one of the challenges is the daily relentless exposure to, in your words, despair, disease, dementia, dying, and death. How can people mitigate the negative impact of this exposure, avoid getting depressed if they’re in this situation? And I’d also like you to address, Joy, the fact that family may pull back a little bit if they know that you are fully cared for in this setting, that your basic needs are being met. They may be a little less engaged with you. Can you talk about that?

Loverde: The first part of your question about how you live in that kind of environment, where the truth of the matter is, people are not so healthy. Well, the good news is, I have had over 40 years of going all over the country, in fact, all over the world. And I have seen for myself excellent assisted living communities. We have one here in Chicago that’s in Clarendon Hills called the Birches. There are assisted living communities that are excellent. And they also have therapists, and they have spiritual programs, and they have a family environment that helps us in the midst of that kind of truthful home situation. So, number one, you really have to do your homework and look around for assisted living communities that are not ignoring the residents’ needs.

The second part about families not visiting so much is absolutely true, unfortunately, which means all our lives, we must be diligent about creating our own needs. Family could go away at any given time, and they do. Especially in this day and age, family estrangement has been skyrocketing. And the reason is because of social media. Articles coming out in newspapers and magazines about, “Hey, daughters and sons, if you don’t want to take care of your parents, it’s OK, say goodbye.” And books are coming out that say how to separate from your parents. I mean, this is a serious problem in America, how the family is disengaging, and social media is playing a big part.

So, whether you’re living at home or whether you’re living in assisted living, know for a fact that family members do not expect to be taken advantage of in any given way. I talk about this in my presentations. I tell the people in the room, please do your homework and understand how much stress your adult children are under, raising children in this environment, working full-time, and thinking about you. All of this is in the mix. You must prepare so that you don’t lean on them unless they’re totally fine with it. So, there’s a certain amount of respect for the adult child that I also am adamant about.

How Children and Their Parents Navigate Aging Together

Arnott: It seems like it goes back to open communication on both sides, where if you’re the aging parent, you want to be able to tell your children what you need and if you would like them to visit more often. But also, if you’re the adult child, you want to be able to communicate with your parents about what else is going on with your life and try to find the middle ground.

Loverde: The family has changed dramatically in the past 15 years. A lot of it has to do with people living longer. So, you have people who are living 90, 100, no big deal anymore, right? And the adult child now can be 70 or even 80 years old. How about that?

Arnott: So, you could have the parents and the child both aging at the same time.

Loverde: Correct. Yes, I’ve seen a lot of adult children visit the life-plan communities together with the intention of moving in together. And they’re both over 65.

What Naturally Occurring Retirement Communities Can Teach Us About Housing as We Age

Arnott: You also write about some less traditional housing options, such as naturally occurring retirement communities or the village-to-village network. Are there any other kinds of creative approaches to senior housing that seem promising to you?

Loverde: One really interesting concept is a company in Scottsdale, Arizona, that has a template. If you gather seven of your rich friends, if you have friends who have money, you can go to this company, and you can say, “OK, we want to set up our own assisted living community.” And then this company helps seven friends set up their own house, including purchasing a house, a single-family dwelling. And then people all move in who know each other, and they have enough money to sustain and pay the staff and go nine yards. How’s that? You buy your own assisted living community. That’s one real creative idea.

Arnott: Like a more structured approach to The Golden Girls.

Loverde: Exactly. Only this time, your nurse is right in the next room.

That’s one fun thing that I’ve learned about. Definitely, people are taking it upon themselves to create their own home environment. But like I said, it’s no different, just because you get three friends to move in with you, you’re still aging in place, and eventually that whole system falls apart. If you get sick, somebody has to move, somebody dies, can’t find help. It’s a problem. So, I’m a real believer.

Now I live in a NORC, the naturally occurring retirement community. So, I live in a big high-rise in Chicago. And we definitely have a solid system of an informal network of support. I’ve helped facilitate with families the deaths of neighbors, and they were surrounded by loved ones, including me, and food and everything that is needed to help someone transition to a peaceful and dignified death. And that’s what happens here in my apartment building. But we have a lot of young people and dogs. And so, we have all generations. Unfortunately, you can’t hang the sign up that says, “we’re a naturally occurring retirement committee,” because it’s young and old.