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How Aging at Home Became 'Aging at Home'

Our grandparents had arthritis; we'll have arthritis. The difference is we'll live with it longer. The difference is we've had fewer kids. The difference is we may have higher expectations. The difference is that there are vastly many more of us.
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When did aging at home become "Aging at Home?" Having watched my grandparents age at home with little mishap, aided by living in apartments near public buses, shopping and grown children, I wondered when living out one's life in the most natural way became a self-conscious choice, a forecast trend depicted as a near-rebellion on the part of today's "aging boomers."

Perhaps the answer lies in recent history.

People now in their mid-50s (like me) -- the largest single age slice of the Baby Boom -- grew up with grandparents who, if they lived long enough, aged at home with a lower-case "a" and "h." Those grandparents were born around the turn of the last century, allowing them to be the first generation of older Americans to benefit from (U.S.) Medicare. It began in 1965, just around the time they retired. With guaranteed insurance to cover their medical bills, they started to enjoy healthier, more secure later years, benefiting from medical advances such as antibiotic use, cancer therapies and better management of diabetes, heart conditions and high blood pressure.

As our grandparents stayed alive through their 70s and even into their 80s, we mid-Boomers assumed that was normal. It also was normal for those grandparents to be old at home -- their homes, and sometimes your home if they could not be alone any more. They cooked and cleaned, made crafts, played bridge, read the paper, listened to the radio and generally went on with their lives. Their ends, when they came, tended to be quicker than they are today, with clean, if sorrowful, breaks.

What they did in their retirement years wasn't called "aging at home." It wasn't anything official. It wasn't a named process, a market, a phenomenon, a trend or a "thing." So, how did we get to where we are today, with so much discussion and planning for Aging at Home?

To start, we have the numbers and the need.

First, the numbers. The numbers are big: 10,000 Americans turning 65 every day. Their implications are bigger: We've never faced the prospect of a top-heavy population that is more old than young. A 2008 U.S. census report forecast that within 10 years, older people would outnumber children for the first time. Time-wise, we're halfway there. Canadian census data from 2011 gave a parallel forecast that four years hence, Canada will experience a "cross-over" and have more old people (age 65 and older) than children.

Second, the need. The numbers, while absolute, should also been seen in relative terms. More people are not only getting "old," but they are staying old for longer periods. Many of them are, thankfully, staying old relatively healthy (at least till near the end). But even relatively healthy older people tend to have some greater needs than healthy younger people.

In short, the sheer bigness of the situation changes everything. We're used to it, though. We grew up under scrutiny, the sheer size of our cohort inviting endless study -- from the rise of the "teenager" to the birth of the "midlife crisis" to the so-called "silver tsunami." This generation (born 1946-1964) is the legendary 800-pound gorilla. As we start crashing through the demographic jungle, whatever we do as a collective force is going to change nearly every aspect of society. And that includes the basic need for shelter.

Thus, although change won't happen overnight, the challenge of appropriately housing so many older and sometimes disabled, ill or frail people -- with fewer younger people to naturally manage or help to fund our care -- is daunting. Shelter is a survival need; the emotions surrounding "home" run high; the costs of modern housing are great. Mix these factors with the numbers and you get a new phenomenon.

Yet there's one more key piece to this puzzle.

The generations following our grandparents were the first to be given choices: stay home or to move to a "retirement" community or otherwise resettle, maybe in the Sunbelt. Life offered a shiny new stage in housing, with clubhouses and golf courses and age-exclusive settings. Then, as people began to live even longer, and families spread out even more, continuing-care communities came along to fill more gaps. Housing options multiplied. The discussion began to center not about getting old, but about where to live when you got old. And that was a new question.

That question still lingers, but it seems that up-and-coming older people want to say "no" to non-home options. Whether for reasons of family or finance or "other," they're saying "no" to aging-not-at-home. And what is the opposite of aging-not-at-home? Well, Aging at Home.

A phrase is born.

So, we may soon come full circle to the older lives our grandparents led -- cleaning, cooking and coping. They had arthritis; we'll have arthritis. The difference is we'll live with it longer. The difference is we've had fewer kids. The difference is we may have higher expectations. The difference is that there are vastly many more of us.

Perhaps ennobling Aging at Home with its own official term will draw attention not only to ourselves, but more importantly to the need for new approaches to housing. Maybe it will move the discussion to the real world of public policy. Perhaps Aging at Home, a seemingly artificial concept, is sounding the alarm about a big, emerging social need and will help us prepare for the future.