Ensuring Suitable Housing

Overview

Enabling the elderly to remain in their homes as long as possible appears to be an almost universal goal. However, many of the world’s elders have never owned their own home and have never had a separate residence. Many live with families through most of their mature lives, as head of household and later as dependant. This is almost always the case in less developed countries, reflecting widespread housing shortages. In Brazil, Kenya, India, the Philippines, and other nations, an urgent priority is improved housing for all. In these countries, the hope is that the elderly will benefit as the general need is addressed. In the more developed countries, the problems of suitable housing for the elderly emphasize their particular characteristics and needs.

In all the surveyed countries, the elderly tend to live in poor housing. In less developed countries, they have elementary needs for a secure roof and potable water. In the more developed countries, they tend to occupy the oldest and most deteriorated houses, which may jeopardize their health and survival.

The issue of suitable housing merges with other issues which, discussed in detail in other chapters, are simply noted in passing here. Housing may be the physical embodiment of poverty, relationships with younger family members, and relationships with the community and society at large. A dwelling may be run-down because the occupant lacks income to make repairs, or to move to housing that is more suitable to his or her stage of dependency, or because of need for proximity to services. Housing may be too small to permit a family headed by a younger adult to incorporate aged parents or relatives. This in itself may disrupt -in the context of population shifts due to urbanization and industrialization -traditional patterns of family life. The disruption may bring emotional upset and even mental illness.

The ability of a chronically ill aged person to live independently may be restricted by lack of local supportive services, especially home-delivered health, social, and chore services. This absence may, eventually and prematurely, force re-location to a hospital, nursing home, hostel, or congregate-living facility, if any are available. The search for inexpensive quarters may concentrate the poor elderly into slums, expose them to disease and crime, and isolate or segregate them from society at large. The wealthy elderly may choose privately developed communities, but these individuals may not escape difficulties attached to the aging population around them and the needs and costs of community services. Whether rich or poor, elderly persons face the probability that, over time, suitable housing will become unsuitable because mobility and other abilities for self-care may change. Only recently has thought been given to housing design that is adaptable to changing circumstances, so that the aged individual need not change residence.

The experts responding to the Sandoz Institute survey point out that costs of maintaining a dwelling often become prohibitive on a declining old-age income. Older people may be permanently displaced because there are no services available to tide them over an emergency, or temporary incapacity, in their own homes. At times, older people who would benefit from living in a smaller dwelling, or one without barriers to getting around, or that is less conducive to falls and other accidents, cannot move because of the expense of doing so or the price of other, especially newer, housing. Indeed, they may become prisoners of inflation, urbanization, construction costs, and other factors that push up the price of suitable housing.

Housing problems of the elderly overlap housing problems of their adult children. The very increases in costs of living that prompt conjoint living may intensify inter-family tensions. If an aged and sick parent is accommodated, the parent’s care and supervision may add to stresses on younger women in the family who, while retaining home-maker responsibility, have to find paid work. The double burden adds to conflicts over authority between young and old. In Egypt, for example, the elderly living with adult children often criticize the younger women for having abandoned traditional roles to go to work. However, it is also true that an aged parent may contribute money and labor to the running of a household.