LEARNING OBJECTIVES

• What is aging in place?

• How do people decide the best option?

• How can a home be modified to provide a supportive environment?

• What options and services are provided in adult day care?

• What is congregate housing?

• What are the characteristics of assisted living?

M

ark was diagnosed as having vascular demen­tia about six months ago. Because he now has difficulty in remembering to turn off his gas stove, his daughter and son-in-law think that it may be best for him to move into an assisted living facility. They have had Mark evaluated by his physician, who indicates that she thinks it is a good idea for safety reasons, especially because Mark’s family lives several hundred miles away.

Most people go through young adulthood, mid­dle age, and into later life performing routine daily tasks without much thought. As we grow older, though, the normative changes that occur often result in more challenges in dealing with environ­ments that were once not a problem at all. Even our homes, formerly a comfortable supportive place, can present difficult challenges; for example, the walk up the stairs to a bedroom may become an equivalent of climbing a mountain.

Mark is typical of a growing number of older adults in the United States and other countries—he is experiencing a significant decline in functioning, lives alone, and his adult child and family live in another city some distance away. As a result, he, like many other older adults, needs a different liv­ing situation. He does not need full-time nursing care at this point, but does need a more supportive environment.

Changes in functional status and how these changes are helped or hurt by the environments in which we live are an important aspect of the experience of growing older for many people. These changes are studied in a field called the ecology of aging or environmental psychology, which seeks to understand the dynamic relations between older

158 CHAPTER 5 adults and the environments they inhabit (Scheidt & Schwarz, in press). It is important to understand how even seemingly small changes in a person’s environment can result in major changes in behav­ior, changes that can make the difference between a person being able to live independently or needing a more supportive situation.

In this section, we will consider options for older adults that help them maintain as much inde­pendence as possible. First, we will consider the concept of aging in place. Then we will consider three approaches to helping people live in the com­munity as long as possible: home modification, and two living situations that provide various levels of support—congregate housing and assisted living.