Healthy Ageing 2

Back in 2011, the Ministry of Health for British Columbia looked at what the literature said about healthy ageing. Here is some of what was in this report which was called Planning for Healthy Ageing A Literature Review, written by Eleanor Kallio, Senior Policy Analyst, Research, Knowledge Translation and Library Services Branch, Planning and Innovation Division, Ministry of Health, Victoria, British Columbia, published in 2011

Housing

The majority of older adults live in their own homes and would prefer to stay there as long as possible. Both the home physical environment and surrounding environment play roles in healthy ageing. Safe, appropriate housing has features that support optimum independence, even if changes in function or ability occur. In the surrounding environment, neighbourhoods that are perceived as safe and offer walking routes to local services and parks encourage residents to rely less on their cars. Many older adults are realizing the benefits of living close to essential services and are leaving suburban and rural areas for the city.

The sooner older adults assess their living environment, the easier it will be to make changes or adaptations to support healthy ageing. If they remain until their home is no longer suitable and must move, their housing options will narrow, and they may be less able to adapt. Studies show the longer older adults remain at home, the less likely it is that they’ll move, because of financial, emotional and logistical barriers, even if the home becomes unsuitable.

Housing Options for Seniors in BC

Another topic that is important but I have not spent a lot of time on is the issue of housing options for seniors. 

Most seniors live independently but not all own their own homes. Many seniors who live independently may rent. In BC there appears to be not many options for seniors who want to continue to live independently.  This is important because as rents and other costs go up seniors on fixed incomes find it increasingly difficult to rent so they will have a place to stay. The more options that are available may help the pending housing crises for seniors in BC. According to the CHMC there are the following housing options for seniors in Canada who do not own or want to continue to rent, but some of these are not available in BC and the question is why not? An examination of the options available to seniors in BC, may help the government provide policies that encourage the use of some of the options not available currently in BC.

Assisted Living

Assisted Living is a combination of: Housing, Hospitality Services, and Personal Assistance Services. It also offers medication reminders, cash management, nutrition monitoring, and management by ‘non-medical’ professionals. Housing is usually self-contained units typically with full bath, small kitchenette, living room and bedroom

Co-housing

Co-housing involves sharing a home with a friend or family member. In addition to cutting costs, sharing a home can provide mutual benefits like companionship, help with daily tasks and extra support in case of an emergency.

Co-operative Housing (Co-ops)

Co-ops are legal associations that provide housing in return for a share in the maintenance or other tasks. Some co-ops cater specifically to seniors and may be seniors-only buildings.

Life Lease Housing

Religious or charitable organizations often operate this condominium-like option. Residents pay upfront and monthly fees for the right to live in the home for a specific period.

Supportive Housing

Supportive housing refers to independent apartments with access to services like housekeeping, personal support and healthcare available for free or at a reduced cost. Residents usually pay their own rent and any other living expenses.

Retirement Communities

These residences combine independent living with access to support and recreational facilities. They provide a community setting for active seniors.

Retirement Homes

Retirement homes are for-profit businesses that offer a full range of accommodations, services and healthcare support. The costs vary depending on the facilities and the level of service and support offered.

Nursing Homes and Assisted Living Facilities

These are similar to retirement homes but are sometimes operated as not-for-profit residences by the federal government. They also offer a wider range of healthcare and support services for seniors with more demanding care needs. 

Housing Solutions for Social Isolation.

Some interesting options in housing can help combat isolation and loneliness among older adults.  Especially as we get older, the type of housing we occupy can greatly affect not only our physical but also our mental wellbeing. 

Here are a few of the various community living and care arrangements which can help provide companionship. 

All-age residential hotels.  Some explorers spoke highly of ‘all age’ living facilities, compared to more age-segregated communities.  More specifically, they like the atmosphere and higher energy, as well as the increased opportunities to connect with different ages and learn new things.   

Accessory unit rentals.  As one becomes older, and as family situations change, a current house could become too big for one person.  Accessory units (or ‘granny units’) on the property can be rented out, or maybe separate living quarters can be made of current house space.  Housing rental could also be exchanged for home maintenance, help, and companionship.  Graduate students would be good candidates for this option.  Discussions also included the importance of careful screening for this housing option.

Co-housing.  Somewhat of a newer option that seems well received thus far is co-housing, where residents (old and young) share living facilities.  The benefits for older adults are shared help, companionship and contact with younger generations.  

However, such facilities are few in a number of areas, and efforts need to be made to ensure residents are harmonious with each other.

Apartment-complex social programs.  Some apartment complexes also provide organized social programs, which can provide multigenerational contacts to avoid isolation.

Ageing at Home

A growing trend among retirees is the desire to remain in one's home as long as possible. In fact, a recent study quoted by AARP shows 87% of those 65+ want to age in place for as long as it is safe. Even among those 10 years younger, 71% would opt to stay put. Familiarity and community ties are the biggest draws.

In BC 93% of seniors live independently, with 80% owning their own homes and 20% renting. The three biggest challenges to senior homeowners are:

• Taxes and utilities increasing faster than inflation
• Maintenance costs
• Major repairs may force a move
• Home equity becomes difficult to assess.

The biggest challenges to senior rentals are

• Affordability
• Availability
• Appropriateness

 The following chart from the office of the Senior Advocate of BC shows how in BC senior renters and homeowners are in trouble:

Homeowners and renters Living expenses 2016
Metro Vancouver	Home Owner	Renter
After Tax Income	1902	1902
Total Homeowner Expense	966
Basic Cost of Living	1064
Remaining Funds	-371
Average Rent 1 Bedroom		1079
Basic Living Costs		1008
Safer Subsidy*		108
Remaining Funds		-81

*Shelter Aid for Elderly Renters

So We want people to age in place, but we make it almost economically impossible to do this, so we have to advocate the government to give more consideration to this particular aspect of ageing. 

The research shows that if more seniors end up in homes than the health care costs will go very much higher. This issue is not just an issue for us in BC, but it is an issue in almost every jurisdiction. Allowing seniors to age in place reduces costs to society, and makes ageing a more pleasant experience.

Co housing for Seniors

The issue of social connectedness for seniors is a big issue and a concern. Many of my age group, do not want to go into Assisted Living or other senior housing options. I talked about co-housing a few years ago, and I was surprised when one of my facebook friends Paul shared a post about the first Senior Cohousing Neighbourhood in BC.  Harbourside is co-housing for seniors. It is one of the first of its kind in Canada. They have a mandate is to build a neighbourhood of strata-titled housing for seniors that are affordable, environmentally friendly, and socially/culturally supportive, allowing people to flourish through mutual support as they age in place and in the community.

Their mission is to be a sustainable senior cohousing homeowner community that promotes healthy ageing in place. The physical structures, as well as the social fabric of our community, will nurture an innovative culture with lively connections to the larger society. While respecting personal privacy, we will foster cooperation, social connection and affordability through design and through mutual support.

They say that they are - active, energetic people in the second half of life. They go on to say: "We are starting now before we’re ‘ready for the home’ to develop senior cohousing for ourselves and to welcome others who share our vision and values."

What is Co-housing? More information on this idea can be found at the Cohousing Development Corporation (a private consulting company) or Groundswell Cohousing, or the Canadian Cohousing Network, which was formed in 1992 in British Columbia, Canada.  It is a registered non-profit organization that promotes the creation of cohousing communities as a model for sustainable development by raising public awareness about cohousing and by bringing people together to form communities, 

There are eight cohousing projects in BC. One of the earliest projects is The Yarrow Ecovillage The Yarrow Ecovillage was set up to (taken from the website BC Ideas: Solutions for Stronger Communities)  and written by Vivian Vaillant in 2012.  

She states that the project tackles the issue of isolation and need for'belonging' by taking a multi-faceted approach to land use. Some of the specific gaps and issues identified and engaged by this project are: (1) the scarcity of affordable housing in British Columbia that is also environmentally sustainable; (2) the negative environmental impacts of chemical farming and the relative lack of support for organic practices; (3) the lack of alternatives to nursing homes for seniors and the growing crisis of an aging population; (4) the reluctance of children to play outside in their neighbourhoods and the resulting issues of childhood health and social problems. Our project addresses all of these problems in a way that doesn't try to isolate any one problem from another. A holistic approach.

Some people call them a return to the best of small-town communities. Others say they are like a traditional village or the close-knit neighbourhood where they grew up, while futurists call them an altogether new response to social, economic and environmental challenges of the 21st century. Each holds a piece of the truth. Cohousing is a concept that came to North America in 1988 from Denmark where it emerged over 25 years ago. It describes neighbourhoods that combine the autonomy of private dwellings with the advantages of shared resources and community living.

The idea of cohousing for seniors who are not quite ready for a home is a great one whose time is close or is at hand. In cohousing, as I understand it, residents usually own their individual homes, which are clustered around a “common house” with shared amenities. These amenities may include a kitchen and dining room, children’s playroom, workshops, guest rooms, home office support, arts and crafts area, laundry and more. Each home is self-sufficient with a complete kitchen, but resident-cooked dinners are often available at the common house for those who wish to participate. In some communities, participants will join a cooking team once or twice a month – then sit and enjoy meals cooked by fellow residents the remaining evenings of that month.

Cohousing residents participate in the planning, design, ongoing management and maintenance of their community, meeting frequently to address each of these processes. Cohousing neighbourhoods tend to offer an environmentally sensitive design with a pedestrian orientation. They typically range from 10-35 households emphasizing a multi-generational mix singles, couples, families with children, and elders.

In North America, 119 cohousing communities have been completed since 1991 and there are currently more than 100 new communities in various stages of development. The level of social interaction and shared resources varies among communities. A cohousing development seems limited only by the imagination, desire and resources of the group of people who are actively creating their own neighbourhood. Cohousing groups are based in democratic principles that espouse no ideology other than the desire for a more practical and social home environment.

Cohousing provides personal privacy combined with the benefits of living in a community where people know and interact with their neighbours. It’s about living in a way that’s responsive to a world that has changed dramatically in the last fifty years-a world in which the home life has changed, women are integral in the labour force, resource limitations and environmental concerns are on the rise, and many people feel overextended. Cohousing offers hope in our often dissociated society. Through cohousing, we can build a better place to live, a place where we know our neighbours, a place where we can enjoy a rich sense of community and contribute to a more sustainable world.The concept is called co-housing and it originated in Denmark. Now it's big on the west coast of North America and is gaining ground across Canada, as people search for new forms of community, support and caring. I think cohousing is great idea if you are interested you can start by looking at the sites mentioned in this post.

Retirement living

Retirement living arrangements may have to be flexible and many will break the traditional mould. Some people have embraced co-housing, where people band together to buy land, build a cluster of homes and share some responsibilities. Intentional communities - Beacon Hill Village in Boston is the pioneer - are grassroots organizations that support residents who want to age in place by providing services and a sense of community.

U.S. Census Bureau data shows about 4 million households inhabited by unrelated adults, but many of them are younger room-mates. However, a variation on the room-mate arrangement is cooperative housing, a legal partnership where all own, live in and manage the house. 

Cooperative housing is the quick and easy alternative to the larger community concepts It has many of the advantages, but there's a big difference in the level of community involvement and community-building effort required to make it work.

Aging alone is a challenge facing many Americans. One-third of baby boomers are not married, according to the National Centre for Family & Marriage Research at Bowling Green State University, which also reports that the divorce rate among adults ages 50 and older doubled between 1990 and 2009.

HOW COOP HOUSING WORKS IN CANADA

Housing cooperatives provide not-for-profit residential units for their members. Across Canada, more than 2,100 non-profit housing co-ops are home to about 250,000 people in more than 90,000 residences. In B.C., there are 264 co-ops with 14,698 residential units.

The members do not own equity in their housing. If they move, their home is returned to the coop, to be offered to another individual or family who needs an affordable home.

About half of coop households pay a lower reduced monthly rent (housing charge) geared to their income. Government funds cover the difference between this payment and the coop’s full charge. Other households pay the full monthly charge based on cost.

Because coops charge their members only enough to cover costs, repairs and reserves, they can offer housing that is much more affordable than average private-sector rental costs.

Coop housing also offers security. Coops are controlled by their members, who have a vote in decisions about their housing. There is no outside property owner.

A 2003 Canadian Mortgage and Housing Center study found that housing coops cost less to operate — about 14 percent less than municipal or private non-profit housing.

Over the years, federal and provincial governments have funded various programs to help Canadians create non-profit housing co-ops. The co-ops developed under these programs provide good quality, affordable housing. 

All coops in Canada operate under the following principles:

1. Open membership  Co-ops are open without exception to anyone who needs their services and freely accepts the obligations of membership.
2. Democratic control Co-ops are controlled by their members, who together set policy, make decisions and elect leaders who report to them. In primary co-ops, each member has one vote.
3. Economic participation All members contribute fairly to their co-ops, which they own in common. Co-ops pay a limited return (if any) on money people have to invest to become members.   Surpluses are held for the future and used to improve the co-op’s services.
4. Independence All agreements co-ops sign with outside organizations or governments should leave the members in control of the co-op.
5. Co-operative education Co-ops offer training to their members, directors and staff. Co-ops tell the public what they are and what they do.
6. Co-operation among co-operatives Co-ops work together through local, national and international structures to serve their members.
7. Community Co-ops meet members’ needs in ways that build lasting communities within and beyond each co-op.

SAVING MONEY

Co-ops come in various forms, but in general, they are not-for-profit housing for people who become members through a share purchase. Many co-ops offer a rental subsidy, paid by the government, based on 30 percent of income, for a portion of their units; the other units pay a rental amount that is determined based on costs. In some co-ops, such as the Athletes’ Village Housing Co-operative or the recently announced Fraserview Co-op, there are no government subsidies, but 25 percent of the units must be rented to low or moderate-income people who pay just 30 percent of their income. 

SOCIAL INTERACTION

Where I live can be a lonely place. Last year, the Vancouver Foundation surveyed city residents and found that one in four respondents felt alone more often than they would like, and one-third considered Vancouver a difficult place to make friends. One-third said they have little interest in getting to know their neighbours, while half said they don’t volunteer in their community. Most co-ops are designed to be inclusive of all residents. 

For example, members are expected to participate in everything from cleaning the common areas to sitting on the board of directors. One of the committees at the China Creek Co-op is a social committee, which plans community-building events, such as last year’s Christmas party that one of the community said attracted more than 60 people. One of the members said, “It actually bonds us. We spent $10,000 to retrofit our common room into a community kitchen that can have a sit-down dinner for 30 people. At our Christmas dinner, we do the whole thing with turkeys, hams — the whole nine yards”.