Aging in Place: Creating the Reality

State and Local Governments Have a Powerful Role to Play

Earlier this month a research report co-authored by the National Conference of State Legislatures (NCSL) and the AARP Public Policy Institute compiled real-world examples of how public policy and programs can foster aging in place. The report "Aging in Place: A State Survey of Livability, Policies and Practices" focused specifically on how land use, transportation and housing strategies can be employed to help older adults age in their communities.

Although I am tempted to focus exclusively on how Illinois is positioned in this great debate, I believe it more useful to simply focus on a few notable examples from around the nation on how government can foster and nurture livable communities. As defined by AARP a livable community is one where affordable and appropriate housing, supportive community features and services, and adequate mobility options, which together facilitate personal independence and the engagement of residents in civic and social life.

Land Use

With the oldest baby boomers reaching age 65 this year, suburbia is turning from the "ideal" postwar community, to a prison for older adults. Communities that rely exclusively on the automobile can pose problems for this population. Of Americans over the age of 65, 21% do not drive and 50% of those normally do not leave home most days! Integrated land use and transportation policy, transit-orientated design (TOD), and joint use of community facilities can all play a significant role in fostering livable communities. Florida has a comprehensive plan certification program (here) for communities which (among other requirements) manage transportation and land use, in order to support public transportation, pedestrian and non-motorized transportation." Laws in at least 12 states substantively deal with TOD and many states also have laws which address joint use of schools (and other community facilities) in some way.


In Germany, 50 to 55 percent of all trips for adults 65 and older are made on foot or by bicycle, in the United States only 9.4 percent make their trips on foot. Complete Streets (here) can go a long way towards fostering a more pedestrian and public transit friendly environment. Features of Complete Streets include (but are not limited to): wider shoulders, sidewalks, safe crossings, etc. These streets are planned, designed, built, operated and maintained to accommodate the safety and convenience of all users, including bicyclists, pedestrians, transit users and motorists, regardless of age or ability. In 2007, Illinois became the first state to adopt a Complete Street policy (here) since the movement began in 2003.  There are now 17 states with a Complete Street policy in place.


Initiatives ranging from low-income housing tax credits for properties near transit, to state housing trust funds (now present in 40 states) and building standards promoting universal design can all promote and sustain livable communities. For example, the  Center for Neighborhood Technology's  Housing + Transportation Index, which calculates "the true cost of housing based on its location by measuring the transportation costs associated with place." is now utilized to make better investment Most recently, in 2010 the Illinois legislature required state agencies to use the Index (or an equivalent) to screen and prioritize investments for public transportation, housing and economic development projects in Metropolitan Planning Organization areas.

Where do we go from here?

Unfortunately, although the pursuit of creating livable communities is critical to maintaining the health and dignity of older adults, competing demands for limited government funds and voter antipathy (perceived and real) to government are undermining its ability to address this issue. This is especially ironic considering the explosive growth of the older adult population (every  eight seconds a baby boomer reaches age 65) and their expressed desire is to age in place. The report reminds us that along with the traditional concerns of home and community based services, policies affecting land use, transportation and housing are critical to supporting an individual's choice to age in place.

What do you think?

I will blog again on January 4, 2012. Seasons greetings to all and best wishes for the new year!





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    Bruce Lederman has over 25 years experience in the senior care field as a direct care provider and thought leader. Bruce was CEO and president of his own firm that operated skilled nursing facilities in Illinois. He is a former nursing home administrator and has consulted to numerous elder care providers on planning for strategic growth as well as process improvement. Recently he served as board chair of CJE SeniorLife, a leading non-profit elder care provider in the Chicago area. Bruce is currently employed as chief strategy officer for a company providing skilled nursing services in communities throughout Illinois and Missouri.

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