ABSTRACT

In the United States and throughout the world, older people are opting to age in place, that is, remaining in their current dwellings as long as possible. However, research shows that aging in place is not necessarily aging in the right place. Older adults who do not move often find themselves in housing arrangements that are unaffordable, in physical disrepair, and with design features that make independent living difficult or dangerous. Their neighborhoods have sometimes become physically inhospitable and unsafe. This chapter focuses on yet another set of problems: the difficulties older persons have accessing or connecting to their everyday needs, such as grocery stores, pharmacies, doctors, social and religious activities, and health and long-term care providers. To highlight these challenges, this chapter examines the advantages and disadvantages of five categories of connectivity options: (1) auto and public transit vehicle transportation options including demand-responsive paratransit and Uber and Lyft services, as well as driverless cars; (2) reaching places by walking, more feasible in dense, physically compact, and mixed land-use neighborhoods; (3) the on-site availability or the home delivery of all manner of goods, services, and care sometimes facilitated when older persons occupy home sharing household arrangements; (4) the delivery of goods, services, and care to population concentrations of older persons found in buildings and neighborhoods, such as in NORC-SSPs, Elder Villages, and government-subsidized rental apartments; and (5) the connecting of older people to their activities, people, services, and care by using information and communication technologies, ranging from facetiming and texting to smart home, telemedicine, and telehealth strategies. The chapter concludes that there is currently no one-size-fits-all connectivity solution that will enable all older adults to achieve their aging-in-place goals. Moreover, even the most innovative and efficacious strategies have unintended downsides.