Aging In Place—Myth or Reality?
By Glenn Miller, FCIP, RPP
In some respects, the rapid aging of our population is the most dramatic public policy challenge facing Canada since we officially became an urban nation back in the 1930s, when the percentage of Canadians living in urban areas surpassed the percentage of rural residents (the rest of the world only reached this milestone within the past decade!). Ninety years later, we are still struggling with the implications for governance linked to the rise of cities. For those interested in the plight of Canada’s seniors, however, business as usual is not an option.
The stark findings of the 2016 census, released last year, suggest that it is time to acknowledge Canada’s new demographic reality. There are now more seniors than school-aged children, and there is every reason to believe that in fewer than 25 years, one in four Canadians will be collecting Old Age Security. A lesser known fact is that a majority of the country’s older adults live in single detached housing in suburban neighbourhoods, where the quality of the built environment is incompatible with the desire to maintain a good quality of life as people age.
So, in addition to targeting government policies that foster good health and economic well-being, I would add “ensuring access to housing that best matches a senior’s individual circumstances” to requirements for seniors’ health. For some, the issue is affordability. For others, it is the type of housing or its location. In many cases, where you live determines how you live. The physical design of the built environment—the neighbourhoods and transportation networks that determine how we interact with our physical surroundings—is a key determinant affecting quality of life for people of all ages, but most critically for seniors.
Canadians want to stay put
Survey after survey suggest that the vast majority of Canadians want to “age in place.” The Canada Mortgage and Housing Corporation, major financial institutions and public opinion pollsters trying to forecast consumer demand all agree that aging in place is a priority. But what does this really mean? What are the alternatives? Do we really understand what is meant by the term?
Traditionally, aging in place has meant living out our lives in the homes where we raised our families. This thinking has been reinforced over the years by government policies that have prioritized “aging at home,” bringing health-related services and other supports to the individual as required. But this approach is starting to evolve.
A good example is research that I carried out five years ago with colleagues at the Canadian Urban Institute on behalf of the Region of Waterloo. We offered an alternative perspective—based in part on reviewing the literature, but also inspired by conversations with urban planners, health providers and groups of seniors. We suggested that survey respondents who state they want to age in place are in effect talking about a set of deeply felt values, not necessarily associated with their long-time residence. Aging in place can also mean a desire to stay in one’s familiar neighbourhood, close to friends and amenities that hold meaning, such as a community centre, a place of worship or even a row of shops run by people who know you on a first-name basis. The prerequisite, of course, is finding appropriate housing, which is harder than you might think.
The literature identifies two complementary elements that determine our ability to stay put. The first is the quality of the physical environment in which we live. This includes one’s house or apartment and the layout of the neighbourhood. Are there multiple steps to the sidewalk? Are there sidewalks? Can a senior walk to the shops or is it necessary to drive to all the amenities required to support daily living? Most of us will outlive our ability to drive, so seniors living in car-dependent suburbs face a significant challenge.
The second factor relates to our personal circumstances. This concept covers financial resources as well as physical health and basic mobility (i.e., our capacity to walk and be physically active). Research shows that when declining mobility impairs the degree of connectedness with friends and family locally, this can lead to isolation and depression.
Building on important research by the late Gerald Hodge, a professor emeritus at Queen’s University, we described a series of “push” factors—things likely to trigger relocation—and “pull” factors—conditions where the potential to improve on current conditions are sufficiently strong to inspire a move to a new home.
We identified six “push” factors
• Declining health, a reduced ability to manage the daily necessities of life or physical disabilities, such as difficulty with stairs or the absence of ramps for people using mobility aids.
• The need to access equity tied up in one’s dwelling, either because of reduced income in retirement or in response to rising maintenance costs, including increasing taxes and expenses for items such as hydro and repairs. Most municipalities offer some form of property tax rebate or deferment, but the process by which one can access these benefits is not well publicized and in the eyes of some homeowners carries a stigma.
• When rents increase at a greater rate than income, this can lead to a need to find less-costly accommodation. Changes in lifestyle or personal circumstance, such as loss of a spouse, divorce or some other factor affecting household size and/or viability, can also create a “push.”
• Pressure to relocate closer to where the children live.
• Isolation from friends and family (who might have moved away or died) or declining ambience of the neighbourhood, which
has become less attractive than it once was.
We also described four “pull” factors
• A wish to reduce the responsibility for maintaining a house and to move to a place that allows more time to travel or undertake other activities—the quintessential “empty nesters.” This can be beneficial to mature neighbourhoods because it frees up housing for younger couples. With house prices in most communities continuing to rise, however, the “natural” cycle of location and relocation can be negatively affected.
• A decision to sell the family home can liberate equity which can be re-invested in a smaller (possibly less expensive) dwelling or reinvested for the purpose of providing a better cash flow to support a different lifestyle, resulting from a decision to rent rather than tie up equity in housing. Although this approach is attractive in principle, the lack of good-quality rental housing in many cities can be a barrier.
• Seeing an opportunity to relocate to a place more conducive to a desired lifestyle, defined by opportunities to volunteer or pursue recreational opportunities. Examples include “adult lifestyle” communities that stress the ability to maintain independence while enjoying access to hiking, cycling and other recreational pursuits. Although such projects receive lots of media coverage, the absolute number of people who choose this option is relatively small.
• Becoming drawn to an area— possibly within the neighbourhood where they have lived for many years—that possesses a range of housing opportunities and other amenities that are sufficiently attractive to warrant a change.
Public health and urban planning begin a new collaboration
When urban planning began to emerge as a profession more than a century ago, it was closely associated with public health issues that led to interventions designed to improve the quality of drinking water, avoid conflicts with air pollution and establish standards for safer building construction. With specialization, the two professions of public health and urban planning drifted apart. More recently, however, they have begun a new phase of collaboration—loosely defined as a push for “healthy communities,” a broad concept that embraces many ideas, ranging from aging in place to age-friendly communities.
The latter approach emerged just over a decade ago when the Public Health Agency of Canada launched “age-friendly communities,” a World Health Organization initiative dedicated to promoting active aging. Since then, more than 500 cities and towns across Canada have made a commitment to become “age friendly.”
Our research shows, however, that although cities are using the age-friendly concept to engage with seniors to identify local needs and priorities, little progress is being made to upgrade the quality of the built environment, which obviously affects the ability to age in place. A 2016 Canadian Urban Institute survey of the 25 largest Ontario cities committed to becoming age friendly found that none of these cities had acknowledged their commitment to becoming age friendly in their land-use plans.
But changes are underway. The Ontario government’s latest “Growth Plan for the Greater Golden Horseshoe” explicitly directs cities in the region to recognize age-friendly design and development as a municipal priority. At the local level, the City of Toronto recently agreed that it would acknowledge age-friendly design and development when the process of updating the city’s official plan begins later this year. This is an essential precondition for a municipality to begin the time-consuming process of retrofitting car-dependent suburbs and ensuring that no opportunities are missed to improve the quality of the built environment when neighbourhood plans are recalibrated as part of the development process.
There is no shortage of significant policy issues facing federal, provincial and municipal governments. But if we define aging as an opportunity, finding ways to improve the quality of seniors’ housing and the rest of the built environment will become everyone’s business.
References available upon request.
Glenn Miller, FCIP, RPP, is a senior associate with the Canadian Urban Institute in Toronto. The Canadian Urban Institute (alongside SHS Consulting) is currently updating the Canada Mortgage and Housing Corporation’s “Housing for Older Canadians” guide.