The Social and Built Environment in an Older Society (1988) / Chapter Skim
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SUMMARY
SUMMARY
Pages 1-25
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What policies should be formulated to effect these changes, and what more do we need to know to carry out our plans effectively? To address these issues, the Committee on an Aging Society convened a symposium in Washington, D.C., in December 1985.
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Byerts. This multifaceted project treated many of the topics presented in this volume and resulted in a series of conferences, books, policy statements, and teaching materials on aging persons and the built environment.
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THE CURRENT FRAMEWORK The current framework of research on the social and built environment of an aging society acknowledges a basic tenet that has been suggested by Howell (among others) : to understand and address the interaction between the environment and an aging population, one must take into account concepts from and the knowledge bases of diverse fields (Howell, 19801.
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and the changes that are likely to occur in that structure will influence the demand for "needs" and even influence what these needs are and will be. For example, temporal patterns of childbearing (when combined with increased longevity)
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A substantial group of poor elderly persons, combined with the increased longevity of the subpopulations of all older people is a factor that must be reckoned with in planning social services and housing for the elderly. Other recent demographic trends that are also likely to affect the social and built environment of older persons include changes in labor force participation (in particular, the increased numbers of women working)
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One segment of the aging population in particular-those 85 years and older, the oldest of the old, frequently characterized as the frail or vulnerable elderly has grown at a dramatic rate over the past four decades and is likely to exercise a strong influence on the social and built environment of the future. Between the census periods of 1940 and 1980, the population aged 85 and older expanded by more than 500 percent from 364,752 to 2,240,067.
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· A supportive social or physical environment or positive change can retard the rate of functional loss to some degree. These findings, which were derived from research by Soldo and Longino and others, suggest not only that changes associated with the aging process are multidimensional but that vulnerability among aging persons should be conceptualized similarly because it includes physical, environmental, economic, social, and mental health factors.
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Barring changes in service delivery approaches, Glick's projections also suggest that the proportion of the elderly with an unmet need for Tong-term care and the proportion with multiple social and environmental deficiencies may increase over time. To understand better why this mismatch of need and service exists, it is necessary to examine recent federal housing policies and what current policies portend.
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Although the low-income housing created under the Housing Act of 1937 was not initially intended to provide special assistance to the elderly, it has evolved into one of the principal forms of housing assistance for this age group. As a result of legislative changes enacted in the late l950s, the proportion of housing units occupied by people over age 65 jumped from 10 percent in 1956 to 46 percent in 1984 (U.S.
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Administrative and legislative initiatives in the early l980s substantially reduced assisted housing programs, resulting in a 70 percent loss of budget authority since 1981. In light of these economic and political changes, many observers believe that federal housing programs are undergoing a gradual evolution that may alter the future of housing policy for the aging.
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Research on congregate housing demonstration programs at both the federal and state levels has shown that a mix of support services tailored to individual needs in an assisted housing environment can reduce more costly institutional alternatives (U.S. House of Representatives, Select Committee on Aging, Subcommittee on Housing and Consumer Interests, 19871.
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What is required but is currently absent as part of an effective social and built environment is a set of national policies and practical, flexible options to respond to the elderly, whose housing demands may change as subjective conditions change in the course of the process of aging. In analyzing the extent to which older persons in need of supportive services should remain at home, Struyk (in this volLume)
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reports that a 1982 study showed that only 10 percent of the elderly who resided in households with at least one member with health and mobility problems carried out any modification of the dwelling. The second strategy, relocation to alternative housing, may include moving to a smaller home, entering a shared housing arrangement, or moving into one of several forms of residential congregate housing.
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The tasks are divided: those tasks requiring specialized knowledge and skill are performed by the paid staff, and those tasks that are routine and easily manageable are performed by the volunteers. It is not unusual for the home helper to undertake minor health care such as help with medications, but full nursing service is not provided by this individual.
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Many urban elderly have never driven and, being economically limited to infrequent taxi use, must rely on public transit or relatives and friends who drive. Depend
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Although attention has been directed toward the removal of such physical barriers, Wachs found a distressing lack of security for persons using public transit (incidence rates of crime perpetrated on older people are 30 times the crime victimization cases reported by local transit police)
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The utility of the life-style concept, in terms of mobility among elderly persons, is that it raises the possibility of differentiating among their travel patterns according to variations in housing location, car ownership, reliance on public transportation, and degree of vulnerability. The Swedish Perspective on Housing and Social Environments for the Elderly The pattern of growth of the elderly population in industrial countries tends to be similar, but the cultural interpretation of independence in old age differs among countries.
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In Sweden, the national policy is that an independent life is desirable and that it can only be attained if older people live in their own homes; in Japan, the state advocates that the elderly shall live with their relatives. Great efforts are made in Sweden to support old people living on their own; in Japan, no reason is seen to develop such support because it is considered to conflict with the desirable social pattern.
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The primary purpose of the service block is to provide housing and support services for its elderly residents. The internal services offered in the blocks vary but are likely to include a central dining room, hobby shops, social services, podiatry services on a scheduled basis, and limited medical supervision.
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For aging persons to pursue an independent life in old age requires economic, social, and cultural measures in support of the goal of normalization. New Technology and the Productivity and Indepenclence of the Elderly With increased longevity and, in general, a more affluent old age for the elderly in the United States, the possibilities for enhancing the productivity and independence of older persons have attracted considerable interest.
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Regnier also emphasizes that housing designs must be evaluated empirically in a formal postoccupancy study. Thus, the design model that he proposes for the built physical environment must be carefully integrated with considerations about the intended social environment.
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Morgan's thesis (in this volume) calls for a radical reshaping of the physical and social environments of elderly persons.
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The design of the symposium and of similar efforts to address systematically a major social issue relevant to the aging illustrate a basic principle that is recognized especially, but not exclusively, by researchers and planners in social gerontology. One way of conceptualizing this principle is to characterize it as the vertical-horizontal dilemma in the social problem-solving process.
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1987. Evaluating the Congregate Housing Services Program.
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549623 in Handbook of Social Gerontology, C Tibbitts, ed.
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