Abstract
Housing choices for older adults in the United States generally fall into two categories: continuing to live relatively independently or moving into designated senior housing with formal services. Interest in a third option is growing: innovative housing models that bridge the gap between facing aging alone and paying for services. Three options drawing increasing attention include elder cohousing, senior cooperative housing, and home sharing. These models create an environment for older adults to “age better together intentionally,” encouraging them to approach aging through mutual support and healthy interdependence.
Key Words:
senior cohousing, housing cooperative, shared housing, aging in place
The number of households headed by individuals ages 75 and older will double from 14.1 million in 2018, to 28.2 million in 2038 (Herbert and Molinsky, 2019). This increase, especially in the oldest-old population, brings significant challenges for individuals as well as society. Housing is one such challenge.
No consensus exists on the answers to fundamental questions, such as determining the best living situation for older adults, and these questions are complicated by the older population’s diversity. More options are needed to meet this diversity and the increased expectations of the Baby Boomer Generation, many of whom are looking for alternatives beyond those their parents had. Most people hope to remain in their current home for as long as possible (i.e., age in place). Of people ages 65 and older, 69 percent “strongly” and 17 percent “somewhat” agree that they want to remain in their current residences (AARP, 2018). However, aging in place is not without its challenges. The physical structure of the home, its location within the community, the issue of living alone, emergent care needs, and affordability all can make it difficult to achieve this goal.
Challenges to Aging in Place
According to the environmental press model (Lawton and Nahemow, 1973), in order to support aging in place, ideally the home matches the personal competence of the individuals to the demands of their environment (individual home, social environment, and surrounding neighborhood). An initial requirement to enable aging in place would be meeting the criteria of the visibility initiative (Center for Inclusive Design and Environmental Access, 2013). This initiative requires at least one no-step entrance, a bathroom on the entry-level (we would add one bedroom as well), and interior doorways of at least 32 inches in width.
Unfortunately, we have a mismatch in our country. According to Herbert and Molinsky (2019), 43 percent of people ages 80 and older have trouble walking and climbing stairs. But only 3.5 percent of homes in the United States have all three requirements: a no-step entry, first floor living, and wide doorways.
A second issue is the community location, which presents its own set of questions, particularly in terms of accessibility, walkability, and neighborhood environmental safety. Is there access to public transportation? What happens when you cannot drive and you need to get food at a grocery store? Is the neighborhood safe? Does the community situation provide natural opportunities to connect? Do you know your neighbors? Are air and water quality sufficiently monitored?
Additionally, a perfect storm of several demographic trends is merging to cause people ages 65 and older to be increasingly likely to live alone; nearly 12.8 million older adults lived alone in 2016 (Molinsky, 2018). Women are particularly affected, with almost half (45 percent) of women ages 75 and older living alone (Administration on Aging, 2018).
Older men are more often married (70 percent), compared to women (46 percent), and there are three times more widows (8.9 million) than widowers (2.5 million) (Hotz, McGarry, and Wiemers, 2008). The divorce rate has tripled since 1990 for older women, from 1.4 to 6.3 per 1,000, and has doubled for men from 2.1 to 5.5 per 1,000 (Brown, Lin, and Payne, 2014). In addition, fertility has been declining (Joint Economic Committee, 2019).
Of adults ages 55 and older, 6.6 percent have neither a spouse nor biological children still living, and 1 percent have no living relatives whatsoever (Verdery and Margolis, 2017). The number of older adults with no living relatives is expected to rise dramatically between now and 2060. At the same time, evidence is increasing that social isolation is bad for your health. One study has compared it to the damage of smoking fifteen cigarettes a day (Holt-Lunstad et al., 2015). Living alone does not equate to being isolated, but it does place an individual at greater risk, as do mobility limitations (National Institutes of Health, 2019).
‘Ideally, the home matches the personal competence of the individuals to the demands of their environment.’
In addition, there is the inarguable concern that people will need someone to take care of them at some point, and who will provide that care is unclear. In 2010, there were more than eight potential caregivers in the age range of 45 to 64 for each person ages 80 and older; that figure is projected to decline to four to one in 2030 and to three to one in 2050 (Redford, Feinberg, and Houser, 2013).
Given the likely needs for care, it is striking that many people, even those in the middle-income bracket, will not be able to afford housing that provides services. Pearson et al. (2019) estimate that among those ages 75 and older in 2029, 14.4 million will fall into the middle-income bracket, defined as the forty-first to eightieth percentile of individual financial resources. Of these, 60 percent have mobility limitations and 20 percent would be considered to have high care needs. More than half (54 percent) of these middle-income older Americans will not have enough money to pay for senior housing that provides care and services.
Options
Typically, in the United States, housing options for older adults have fallen into two broad categories. One—by far the most popular choice—is to continue to live independently, ideally aging in place in your own home. The other is to move into designated senior housing that offers formal services. This type of housing could vary from an independent living community, which provides moderate support such as transportation, housekeeping, and perhaps some meals, to full support, such as is provided in a skilled nursing facility.
Given the issues outlined above, the need for more innovative alternatives is clear. We suggest a third option: what we call, “aging better together intentionally.” Aging better together means living in a housing situation where older adults look out for one another without a formal service net to support them. Already there are at least three options that fall into this category: elder cohousing, senior housing cooperatives, and shared housing. Of these, elder cohousing is the newest, but possibly the most well-researched. To varying degrees, these alternatives reflect the model of aging better together intentionally (Glass and Vander Plaats, 2013).
Aging Better Together Intentionally
The foundation of this model (Glass and Vander Plaats, 2013) is that the individuals involved are all older and are open to accepting that they are aging. They see aging as a stressor to some degree and they welcome solidarity in dealing with it. The model also requires that individuals live in close proximity and frequently interact.
The process is adapted from the concept of communal coping developed by Lyons, et al. (1998), and suggests that “we are in this together.” There is communication about the stressor by pooling information and having group discussions, and there is cooperative action to develop strategies. As identified in the model, cooperative action includes the ability to find humor in aging, inspiration for healthier choices, informal monitoring, helping each other to recognize limits, care coordination, and planning to meet future needs. Benefits outlined in this model include mutual support, increased acceptance of aging, feelings of safety, less social isolation through an interdependent community, and less loneliness.
Elder Cohousing
The cohousing model started a few decades ago in Europe, primarily in Denmark, Sweden, and the Netherlands. In this model, people rent or buy private homes in a defined neighborhood, but they share common green space and common indoor spaces. Indoor space typically includes a common house in which members of these communities may come together for meals at least a couple times a week. The cohousing community is run by the people who live there, which distinguishes it from other types of senior living. Cohousing is designed to promote social contact and has been proven to serve as an antidote to social isolation (Glass, 2016; Glass, 2020a). People who move into cohousing are those who want to take a participative role in shaping their lives; they are actively engaged, they make the decisions for the community, and mutual support is facilitated.
Intergenerational cohousing began in the United States as early as 1991, yet the trend of age-specific, 55-and-older communities only started to emerge in 2005–2006 (Glass, 2020a). In addition to the four communities that existed by 2009, at least ten have opened since 2012 and more communities are in development (Glass, 2020a). Some are specifically designed to provide affordable units (Glass, 2012). Senior cohousing communities in the United States average twenty-four to twenty-five units housing about thirty people (Glass, 2020a). The average age at move-in is 70, and the majority of members are white, female, and well-educated. Most report good to excellent physical and mental health. Sense of community, mutual support, the housing concept, and the location were among the top reasons given to move into cohousing (Glass, 2020a).
The type of mutual support typically provided is neighborly help. It could be walking the dog for someone who is in the hospital, or bringing meals when they come home. In some cases, people are providing daily assistance to neighbors, but it is not an assisted living facility. We have learned that for mutual support to work well, it requires people asking for, accepting, and providing help as they are able (Glass, 2009). At the same time, people must also take responsibility for self-care.
Moving into a cohousing community has immediate advantages, as one would know one’s neighbors within a few days, compared to potentially never knowing one’s neighbors in an apartment, condominium, or suburban neighborhood. Factoring in cohousing neighbors reduced the percentage at risk of social isolation from 25 percent to less than 10 percent (Glass, 2016). Community members reported high satisfaction with neighborly assistance, feeling secure and safe, and having someone close by to help in an emergency. This type of support can be particularly important for marginalized populations, providing security and stability in shared experiences. For instance, the country’s first community specifically focused on LGBTQ adults and allies opened in spring 2020 (Village Hearth Cohousing, 2020).
‘The cohousing community is run by the people who live there, which distinguishes it from other types of senior living.’
However, these benefits do not come without challenges, so cohousing is not for everybody. First, it means living in a close community, which requires tolerance and patience. At a glance, it would appear to be particularly challenging for those who have privacy concerns, but it is designed to provide every member with their own space to which to retreat, and surprisingly, more than half of elder cohousing members consider themselves introverted (Glass, 2020a). Some people do not participate in the community, which can be frustrating for the others. There is also the issue of “future proofing,” which is the question of what to do as people get older. Can they live there until they die? Most communities have had significant discussion about this topic, and some have planned ahead for the use of home care aides. The consensus seems to be that neighbors can and do care for each other but it should only be expected for a finite time period (Glass, 2020b).
Senior Housing Cooperatives
Nonprofit senior housing cooperatives (ages 55 and older), in which members buy shares, are not new. The first was opened in 1978 in Minnesota, and the majority are still located in Minnesota (Fontaine, 2013; Sudo, 2019). The favorable financing provided through the Minnesota Housing and Urban Development (HUD) is one reason it has thrived here; this HUD office now processes all cooperative housing financing applications (Fontaine, 2013; Sudo, 2019). However, the idea is slowly spreading overall; the number of senior co-ops has increased from 103 in 2013 to 125 in 2019, and is expanding to other states (Sudo, 2019). Limited equity co-ops are the most common type, which aim to guarantee long-term affordability by limiting the resale price of shares, and are designed for adults of moderate income. In 2013, it was estimated that to purchase a share and reside in a senior co-op required an income between $18,000 and $37,000 per year (Fontaine, 2013).
The ultimate intention of cooperatives is to provide a sense of community at an affordable price. Members own a share of the collective whole, not an individual unit. This can create a deeper sense of community than in traditional housing, as residents’ investment and active participation make a direct impact on all (Fontaine, 2013). The median age of residents is 73 to 74 years, with a range in the past of 56 to 92 years (Fontaine, 2013).
Senior cooperatives are commonly high-rise apartment buildings (Fontaine, 2013). The board of directors overseeing the co-op is composed of resident members elected by their peers to ensure the best interests of all are maintained. Subcommittees also may be established to perform upkeep or coordinate social events within the co-op, as well as to further develop suggestions for the board to consider. Cooperatives offer an array of community spaces and amenities, such as common rooms, workshops, libraries, fitness centers, and community gardens (Senior Cooperative Foundation, 2020).
Monthly fees contribute to general up-keep and maintenance, overseen by an on-site resident manager. A portion of monthly fees also is kept in a fund reserved to cover any fluctuations in operating expenses, assessments, repairs, and the periodic replacement of communal appliances and fixtures (Senior Cooperative Foundation, 2020). This feature can provide stability for those on fixed incomes or budgets and, ultimately, create a shared financial responsibility among the cooperative members.
Shared Housing or Home Sharing—the “Golden Girls” Model
Although many people use the terms interchangeably, “shared housing” or “home sharing” is quite different from cohousing. Home sharing is when two or more unrelated people live together in the same house. It has been formally recognized in the United States since 1972, when Maggie Kuhn, the radical founder and leader of the Gray Panthers, started the first programs (National Shared Housing Resource Center, 2019). Today, there are several organizations dedicated to safe, mutually beneficial home sharing that can assist in recruitment, placement, and conflict-resolution (Kaysen, 2019).
Ideally, each person has a private bedroom and bath, but they share the kitchen and living room as common space. Sometimes this is an intergenerational model, in which the older person has a large house with more space than they need. The younger person obtains a place to live and can help the older person in exchange for lower rent. Home-sharing homeowners ages 65 and older reported benefits of companionship, security, support in performing tasks, and supplemental income (Martinez et al., 2020). Increasingly, older people, in particular women, are turning to sharing a house for companionship and as a way to make ends meet (Molinsky, 2018). Half (50 percent) of the 879,000 older Americans who lived with, or as, a roommate-housemate-boarder in 2016 lived only with another older person. Sixteen percent of Americans ages 50 and older are willing to share their home or do so already (AARP, 2018).
In one example in Canada, four unrelated women came together and bought a house (Langone, 2019). Their ages ranged from 67 to 74. The house was a six-bedroom, wheelchair-accessible 5,000-square-foot farmhouse. They made renovations to the house, including installing an elevator, roll-in showers, extra wide doorways, and a caregiver suite. Buying a new home is not necessary, however.
‘Sharing also can be a solution for adults who otherwise cannot remain in their homes due to financial limitations.’
Sharing also can be a solution for adults who otherwise cannot remain in their homes due to financial limitations, particularly among single adults. Approximately 60 percent of roommate households are house rich and cash poor and living on a fixed income (Affordable Living for the Aging [ALA], 2012). In 2016, only 29.3 percent of older roommate households were cost-burdened, or spending more than 30 percent of their income on housing (Molinsky, 2018). Likewise, only 12.9 percent of roommate households were severely cost-burdened, spending more than 50 percent of their income on housing, compared to the 25 percent of single-adult households.
Unlike the cohousing and cooperative models, shared housing relies on more intensely shared space and expenses, thus, some interpersonal issues can arise. Important considerations include the division of expenses and household responsibilities, as well as general compatibility of all residents. The shared home must also abide by local ordinances. In some localities, the presence of two or more unrelated adults requires registration as a rental property, while single-family home ordinances may disallow renting (ALA, 2012). Utilizing formal resources can help navigate these legalities.
Conclusion
While these innovative intentional models are attractive alternatives for many elders, they are not for everyone. In addition, cultural bias and a general lack of awareness pose obstacles to wider acceptance (ALA, 2012; Weeks et al., 2020). Fundamentally, the idea of intentional housing, in any capacity, contradicts independent American values. “Sharing housing is not the American Dream” (Kaysen, 2019). Other challenges, such as zoning issues and financing, may further limit the overall accessibility. However, the growing interest and relative success of these housing options cannot be ignored, especially in the context of today’s older adult population.
Current trends, such as the growth and diversification of the older adult population, will bring a different reality to aging in society. As we begin to think about the new era ushered in by the COVID-19 pandemic, the challenges will be even greater. It seems fair to say that living in any of these arrangements during stay-at-home restrictions is preferable to living completely alone. It is likely that the development of new elder cohousing will slow temporarily, as it did during the 2008 recession (Glass, 2020a), and the building of new senior housing cooperatives may slow as well. However, it might be possible to extend the concept of aging better together intentionally to other existent housing. Without requiring new building construction, organizing a “family of friends” (Glass and Vander Plaats, 2013) who look out for each other may be possible in an apartment or condo building, or even a neighborhood.
Considering the widespread, devastating financial effects caused by the pandemic on income and savings, we expect the market for shared housing to significantly increase. Shared housing benefits not only the residents but also the community (ALA, 2012), through stabilizing the neighborhood and even through savings on healthcare costs. Most importantly, it effectively uses existing housing stock to help provide more affordable housing units without new construction. With current demand already outstripping supply (ALA, 2012), the need will become increasingly critical. Research about who is best served by these options is also increasingly relevant.
As a society, we must meet these challenges. The concept of aging better together meets the needs of aging for diverse individuals, without infringing upon the sense of agency that many people fear they will lose over time. Innovative housing models, such as cohousing, home sharing, or senior cooperatives, promote mutual support, foster a sense of community, and curb social isolation among community-dwelling older adults. This notion bridges the gap between what longstanding conventions have previously led us to believe—that housing for older adults must be either entirely independent or provided as a formal service. The latter option is often associated with negative connotations of aging, such as loss of independence or fragility, that feed into the ageism exacerbated by the COVID-19 response (Eisenberg, 2020).
By living together intentionally, the pressure of these ageist perceptions can be relieved and older adults can more freely and actively approach aging with the mutual support, humor, and healthy interdependence of their shared community. While these innovative living arrangements account for a relatively small percentage of elder housing, interest is growing. The time is ripe for the recognition and support of a third housing option for older adults: aging better together intentionally.
Anne P. Glass, Ph.D., is a professor of gerontology in the College of Health and Human Services at the University of North Carolina Wilmington (UNCW). She can be contacted at glassa@uncw.edu. Lauretta Lawlor is completing their Master’s in Applied Gerontology degree at UNCW in 2020.
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Additional Resources:
Elder Cohousing: www.eldercohousing.info
www.cohousing.org/
Senior Housing Cooperatives:
www.seniorcoopliving.org/faqs/
Home Sharing:
National Shared Housing Resource Center
