‘Rotting In Place’

Laura Mitchell, who was one of the key people behind GrandCare Systems and now is a marketing consultant and healthy aging advocate, has written an interesting article on LinkedIn Pulse, now on her website, springing off an AgingInPlaceTech article by Laurie Orlov.  Like the latter’s article, it commented on the Washington Post profile of Prof. Stephen Golant, whose POV on ‘aging in place’ was mostly that AIP is oversold–that in many cases, it’s ‘rotting in place in their own homes’. It’s a highly provocative topic with equally provocative statements and Ms Mitchell does take him to the woodshed, as does Ms Orlov in a different way. Prof. Galant seems to take a more moderate tone in his book (publicity perhaps?), citing (in the Amazon summary) that “older people often must settle for the least imperfect places to live. They are offered solutions that are poorly implemented or do not respond to the totality of their unmet needs.” a statement with which this Editor finds it difficult to disagree.

This Editor will largely cite her previous LinkedIn comment with a few embellishments/edits:

Dr. Golant does have a point–that ‘aging in place’ has been twisted into a pretzel by AARP, some parts of the media and reverse mortgage shills. There’s even an implied slam on we who advocate care technologies. However, he offers, based on this article, no statistics and no solutions beyond what I sense is the forcible–removing those incompetent or unplanful older people from their homes for their own good into ‘retirement communities’. “The United States has so far failed to provide decent alternatives for older people to relocate.” In other words, is he saying that government should ‘nudge’ (that statist word) old people out of their present communities? Who decides? To where?

Here in the Northeast, there are two major incentives–high state/local/property taxes and winter! The dampers? Weak property values in many of those same places. Finances eroded by this grinding recession and zero interest rates. I’m not holding my breath for those affordable model homes and communities to appear like mushrooms after rain because they are not cute and sexy to VCs. The alternative is ghettoes of the aged? Toss me under the M42 bus, please.

I’d bet Dr. Golant is a big fan of Ezekiel Emanuel’s ‘remove personal medical interventions’ policy for those over 75 too. That’s one way to rid ourselves of the old people problem! (s/o)

Considering what Laurie Orlov’s written on the CCRC model, that can be a nightmare, yet I know people who’ve thrived in such communities. Perhaps we should be looking more at NORCs (naturally occurring retirement communities–Ed.) in larger communities and how they work, realizing that we have to bring the support–medical, emotional and physical–where the people are already, and making it attractive to us not-thinking-old-yet people. Yet what gets developed and funded are cute apps and fitness wearables–not a thought in the bunch about making them useful for or accessible to older adults.

The Brits are increasingly calling it technology enabled care support (TECS), a term I really like rather than arguing over what is telehealth, telemedicine etc. We should be looking at what GreatCall does right. That is why I am so cheered by the UnaliWear Kanega and buddi, and so disappointed that Apple is concentrating on the young and wealthy with the Apple Watch. Yes, there’s personal responsibility and planfulness. There is also a right to want to hang on to what is familiar (and the consequences, often devastating, of the emotional wrench when one can’t) and yes, to be cussedly stubborn.

We also have the right to be left alone from ‘make way for tomorrow’ types. At least for now. But ‘Houston, we still have a problem’ with aging, the sheer numbers of Boomers and ‘Silent Generation’, as to where and how we are going to live.

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  1. I appreciated the discussion generated by my book, Aging in the Right Place (Health Professions Press, 2016). http://www.healthpropress.com/product/aging-in-the-right-place/ Yes, I am plugging my so-called simplistic book that took me over two years to complete. I am a slow writer but I also took the time (unlike many journalists– although the Washington Post account was extremely thoughtful) to exhaustively examine the pros and cons of older people staying put in their own homes as opposed to downsizing or relocating to such senior housing options as active adult communities, independent living communities, assisted living, or CCRCs. I emphasized the importance of older people being proactive and coping with their inappropriate places and examine a host of options (e.g., family support, smart home technologies, and elder villages) now available to them. Many of these strategies will be successful; others not. Much depends on whether older persons are rich or poor, how serious are their health conditions, their personalities and importantly, the quality of their alternatives. The bottom line of my book was to avoid hyping any options and seriously recognize both the potentials and limitations of strategies designed to help older people age successfully—whether in their homes or elsewhere. And no, I do not want to stop living at age 75. As I frequently emphasize in my book, older persons in poor health, with disabilities, or unfavorable demographics are not precluded from happy lives, if they make the right living choices.

  2. Very thought provoking – I’ve sent it out to my social media channels to get more people thinking about this. Why does it seem that Europe is so far ahead of us with solutions and what I believe is actual caring. I’m in the Atlanta area and on April 1 a new organization called Perimeter North Villages (perimeternorthvillages.org) is opening up. Their mission: We are a volunteer and membership organization dedicated to enabling older adults to continue living in their own homes safely and comfortably. They will support 5 Atlanta suburbs with this mission and the services. I look forward to seeing how it work and the level of satisfaction with the seniors living in the selected communities. We have a Huge transportation issue in Atlanta and providing solutions within the communities where seniors already live is a real solution versus figuring out how to make transportation work in a city where there is 1 driver to 1 car and only highway with minimal a public transportation system with a small reach,.