Stephen M. Golant

Housing America's elderly : many possibilities, few choices

Introduction Problems in Conventional Dwellings and Neighborhoods Localities With Large Concentrations of Elderly Residents Assets or Liabilities Planned Age-Segregated Housing for Active and Independent Retirees Financial Relief for the Older Homeowner Rent-Subsidized Housing for the Lower-Income Elderly Home- and Community-Based Formal Care That Facilitates Aging in Place Using Formal Care Barriers and Benefits Household Strategies Sharing Space with Family or Housemate Group Housing Options for Less Independent Elderly Continuing Care (Life Care) Retirement Facilities Multiple Levels of Shelter and Care Public Opposition, Land Use Restrictions, and the Fair Housing Act Conclusion

The Effects of Residential and Activity Behaviors on Old People’s Environmental Experiences

The quality of life in a community is often judged from the perspective of its residents. Their subjective accounts reveal the contents of the environment with which they transact,1 defining “all the actual things or ongoing events” (Leff, 1978, p. 112) that provide them with information about their place’s “people, activities, buildings, vegetation, weather conditions, media messages, and so on.” Their reported awareness of the services and facilities in their communities, the boundaries of their neighborhoods, the people and stores that leave their community, and the architectural forms of their houses are examples. Their accounts further reveal how they evaluate the outcomes or consequences of their environmental transactions. Reports by residents of their dwelling or community satisfaction, difficulties in walking on sidewalks, fear of driving at night, and postponing plans because of bad weather are examples. Together, these responses, describing an environment’s subjectively interpreted content and consequences, are referred to in this chapter as people’s environmental experiences or experiential environment. Such a conceptualization of the environment has many precedents in the psychological literature. Environments defined by perceiving and thinking individuals are exemplified by Koffka’s (1935) “behavioral environment,” Murray’s (1938) “beta environmental press,” Rogers’s (1951) “phenomenal field,” Gibson’s (1960) “effective stimulus,” and Ittelson’s (1973) “perceptual information.”

Residential Normalcy and the Enriched Coping Repertoires of Successfully Aging Older Adults

An earlier theoretical model equated the construct of residential normalcy with older persons positively appraising their residential environments. Failing to achieve congruent places to live, they initiate assimilative (action) or accommodative (mind) coping strategies. This paper theorizes that the assimilative coping strategies of older persons depend on their secondary appraisal processes whereby they judge the availability, efficaciousness, and viability of their coping options. Older persons with more enriched coping repertoires are theorized as more resilient, making their own decisions, and with access to more resource-rich objectively defined resilient environments. Successful aging formulations infrequently examine how residential environmental adaptations of people influence the quality of their lives. Programmatically, the theory emphasizes the potential of individual and environmental interventions targeting older persons who are not aging successfully.

Factors influencing the locational context of old people's activities.

Individual characteristics and environmental constraints were assessed as influences of where old people usually carry out their daily activities. Data were obtained from structured interviews given to a random sample of 400 persons aged 60 and older living in a middle-class urban community. Respondents selected from 4 possible locations (dwelling, neighborhood, community, outside community) to identify where they usually pursued 13 different activities. Multiple regression analyses revealed that old people who pursued their activities outside their proximate residential environment were more likely to be white, separated-divorced, Jewish, employed, had fewer hearing difficulties, had less likely experienced a decline in health, and had available to them more flexible means of transportation. Results had implications for interpreting the effects of old age and environment on the voluntariness of activity patterns.

Out of Their Residential Comfort and Mastery Zones: Toward a More Relevant Environmental Gerontology

To advance the field of environmental gerontology and make it more relevant to other social and behavioral scientists, this paper proposes a holistic, emotion-based theoretical model to judge whether older adults occupy residential environments that are congruent with their needs and goals. The model theorizes that older persons achieve this individual-environment fittingness or “residential normalcy” when they have two overall favorable and relevant sets of emotional experiences: (1) pleasurable, hassle-free, and memorable feelings—and are in their residential comfort zones; and (2) competence and in control feelings—and are in their residential mastery zones. Older persons often find that their residential environments have become emotional battlefields because although they are in their comfort zones, they are out of their mastery zones, or vice versa. Distinguishing these constructs becomes critical as we increasingly judge residential settings not just for their home-like qualities, but also for their ability to provide long-term care.

The Changing Residential Environments of Older People

Publisher Summary A vast literature on the appropriateness of residential environments shows that except for their disdain for institutional settings, older people are open to aging in place in many different residential settings. A large and multidisciplinary literature is now focusing on the aging-in-place capabilities and downsides of older peoples residential environments, the potential of different residential transformations, the feasibility of environmental interventions, and the difficulties of achieving residential normalcy in places that are responsible for the care of more vulnerable older people. All these studies agree that judgments concerning older persons aging successfully are increasingly less credible if they do not consider the role played by their place of residence. They also share the belief that their findings can contribute to positive changes. They assume that the residential settings of older people can be changed or modified to achieve better outcomes. This chapter focuses on three broad categories of residential environments: dwelling or home environments; neighborhood and community environments; and the planned residential care environments of assisted-living facilities.

The Unequal Availability of Affordable Assisted Living Units in Florida’s Counties

The supply of affordable assisted living facilities (ALFs) is now insufficient to meet the demands of low-income, frail older persons. This gap between demand and supply is much more apparent in some locations than others. This article uses various measures of locational inequality to assess the extent to which counties in Florida have less than their fair share of ALFs, particularly in comparison to the locations of Medicaid nursing home beds. It employs least squares regression models to identify the demographic and economic antecedents underlying the variation in the number and prevalence of affordable ALF units and Medicaid nursing home beds. The findings show that a large percentage of the older population who are vulnerable are underserved by affordable ALFs and that it is possible to explain adequately the variation in the number but not the unequal prevalence of affordable ALF units in Florida’s counties.

Differences in the Housing Quality of White, Black, and Hispanic U.S. Elderly Households

Research has consistently linked minority status with the higher rates of housing problems found among elderly households. Given the projected increase in the relative size of Black and Hispanic elderly population groups, their housing needs are of particular interest to policymakers. Drawing on data from the American Housing Survey, this article assesses how the physical housing conditions of elderly (age 60+) White, Black, and Hispanic homeowners and renters differ and whether these differences persist after controlling for other relevant influences of housing quality. Black elderly households and to a lesser extent Hispanic elderly households were living in worse quality housing than White elderly households. Elderly Hispanic households were also living in overall better housing than elderly Black households. The findings argue for the targeting of elderly Black homeowners and renters and Hispanic owners as housing-deprived groups.

A theoretical model to explain the smart technology adoption behaviors of elder consumers (Elderadopt)

A growing global population of older adults is potential consumers of a category of products referred to as smart technologies, but also known as telehealth, telecare, information and communication technologies, robotics, and gerontechnology. This paper constructs a theoretical model to explain whether older people will adopt smart technology options to cope with their discrepant individual or environmental circumstances, thereby enabling them to age in place. Its proposed constructs and relationships are drawn from multiple academic disciplines and professional specialties, and an extensive literature focused on the factors influencing the acceptance of these smart technologies. It specifically examines whether older adults will substitute these new technologies for traditional coping solutions that rely on informal and formal care assistance and low technology related products. The model argues that older people will more positively evaluate smart technology alternatives when they feel more stressed because of their unmet needs, have greater resilience (stronger perceptions of self-efficacy and greater openness to new information), and are more strongly persuaded by their sources of outside messaging (external information) and their past experiences (internal information). It proposes that older people distinguish three attributes of these coping options when they appraise them: perceived efficaciousness, perceived usability, and perceived collateral damages. The more positively older people evaluate these attributes, the more likely that they will adopt these smart technology products.

The Origins, Programs, and Benefits of Age-Friendly Communities

The emergence of the age-friendly community movement is a programmatic affirmation of what environmental gerontologists have long argued, namely, that the residential environments occupied by older individuals can influence their ability to age successfully and that solutions are available to optimize individual-environment congruence (Golant, 2015a; Scheidt & Windley, 2006). This global initiative has been most prominently advanced by the AdvantAge Initiative sponsored by the Visiting Nurse Service of New York (2004), AARP’s Livable Communities initiative (2000), and by the World Health Organization’s (WHO’s), Global Network of Age-Friendly Cities and Communities (2007) (Feldman, Oberlink, Simantov, & Gursen, 2004; Kihl, 2005; World Health Organization, 2007). A major goal of this movement is for communities across the world to assess whether they offer “policies, services, settings and structures [that] support and enable people to age actively” (World Health Organization, 2007, p. 10). Now, assessments of how communities should address the unmet needs of their older residents are far from new. As early as 1972, Chicago Mayor’s Office for Senior Citizens sponsored such an investigation of its over-60 population (Bild & Havighurst, 1976). So, what is different? First, we have a more positive and evidenced-based interpretation of what it means to age well. Older people must strive to be physically and mentally healthy and actively engaged in life. Second, we have a better understanding of how environments influence both the objective and the subjective well-being of older people (Golant 2015a, Golant 2015b). Communities should have physical infrastructures, social engagement opportunities, employment and volunteer activities, and services that optimize the happiness, health, independence, participation, and security of their older occupants. Third, once establishing unmet needs, communities can and should implement a broad array of responsive organizational and policy strategies. The topics covered in the first half of this book focus on the first two of these distinctions (Parts I and II). Readers greatly benefit from a primer on how both individual and age-friendly environment factors influence how well people age, emphasizing the relevance of both life span developmental concepts and environmental gerontology. Indeed, the title of this book understates the scope of its contents because of its focus on these foundational areas of inquiry. Only in the book’s second half (Parts III and IV) are agefriendly programmatic and policy approaches, solutions, and best practices mostly covered. In Chapter 1, the authors offer an overview of the social and demographic status of the aging population in the United States and the need for aging-friendly communities. Chapter 2 reviews what we currently know about why older people age well, and the authors offer their own integrated model of the six developmental tasks achieved by successfully aging individuals. Chapter 3 shifts the focus to older people’s everyday physical and social environments. It summarizes the most prominent environmental gerontology theoretical formulations that increase our understanding of whether older people are occupying congruent places to live. Chapter 4 presents a short overview of the meanings of age friendliness and the major organizations responsible for defining and creating this global movement. Chapter 5 focuses on the physical infrastructure challenges (related to dwellings, neighborhoods, communities, and transportation) confronted by older people. Chapter 6 focuses on why the social relationships and participation of older people matter, and on how community environments and programs influence their social engagement. Chapter 7 examines various community-based programs designed to prevent, delay, or abate health problems and disabilities. These are all well-written chapters although tighter editing would have prevented the repetition of some of this material later in the book—but this is a minor concern. The second half of the book (Chapters 8–13) includes chapters that focus on the organizational and programmatic features of age-friendly community initiatives and their strengths and limitations. The authors offer a useful typology of community planning models (Chapter 9), cross-sector collaborations (Chapter 10), and community development initiatives (Chapter 11). Readers would have benefited, however, from a tabular presentation of case studies that showed how communities in the United States and elsewhere have specifically implemented these age-friendly strategies. The final two chapters focus on the challenges of making communities more aging friendly and needed future directions. The Gerontologist, 2016, Vol. 56, No. 3 597