The Necessary Support for Aging in Place: Heads Up, Nonprofits!

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jan kranendonk /

July 8, 2013; NBC News, “Health”


The vast majority of older Americans aspire to “age in place,” staying in their own homes and living independently for as long as possible. But as AP reporter Lauran Neergaard noted in a recent article, sometimes the ability to stay at home is less about the health of an aging senior and more about the home itself. A major research project now underway through Johns Hopkins University hopes to demonstrate that inexpensive home fix-up projects, combined with customized strategies for daily living, may help many seniors delay entry into nursing homes for up to a year. With an average cost for nursing home care in the U.S. of $6,700/month, much of it subsidized by government programs, it’s not hard to understand why the National Institutes of Health and the Centers for Medicare and Medicaid Services have invested more than $8 million in the research project.

The Capable project—that’s an acronym for Community Aging in Place, Advancing Better Living for Elders—will bring handymen, occupational therapists, and nurses into the homes of 800 low-income seniors in Baltimore to see if modest safety improvements in their environments and modified strategies for daily living can keep them independent for longer, potentially saving millions of taxpayer dollars along the way. Each senior participating in the study will receive 10 home visits over four months, beginning with a full-scale assessment of individual needs. Nurses and occupational therapists will help seniors address challenges like managing multiple medications, mobility within the home, or independently cooking and feeding themselves. Each participant will receive about $1,100 in home repairs or modifications, such as new banisters, raised toilet seats and grab bars in bathrooms, better lighting, carbon monoxide monitors, or wider doorways to accommodate walkers; the work is done by employees of the nonprofit Civic Works.

While the Capable project is new, the realization that home modifications can prolong independence is not. For nearly 25 years, Rebuilding Together, a nonprofit with national headquarters in D.C. and nearly 200 local affiliates, has been helping low-income homeowners—some elderly, some not—to remain independent by engaging skilled tradespeople and hands-on volunteers in fix-up projects relating to areas such as safety, weatherization, and home maintenance.

The National Aging in Place Council is a nonprofit with 14 chapters to date, and more on the horizon. It describes itself as a “senior support network.” Its members include for-profit businesses (e.g., senior law, financial planning, contractors) as well as academic, public and nonprofit agencies.

It’s clear that aging-in-place issues will require further study in the years ahead as Baby Boomers create yet another ripple in the social fabric of the 21st century. For-profit businesses are already springing up to cater to aging Boomers and their home-modification needs. As noted a few years ago in an AARP fact sheet, the public sector has work to do in this area, too, addressing issues such as zoning, permitting and tax relief for home modifications, as well as a whole host of issues relating to landlords and tenants for seniors who don’t own their homes.

No doubt the nonprofit sector will be an important voice in the ongoing aging-in-place conversation, and an important player in areas such as research, advocacy, and coalition-building.—Eileen Cunniffe