Why Senior Living Must Change ‘Dramatically’ by 2050

Ideas abound about the future of senior living—what it will look like, where it will be located, and whether it will take the form of the traditional communities of the past.

Certainly today’s innovators in senior living are interested not just in what works today, but what will work tomorrow on the forefront of senior care and senior housing.

Dr. Dilip V. Jeste, M.D., senior associate dean for Healthy Aging and Senior Care at the University of California, San Diego, and head of the university’s Stein Institute for Research on Aging, and Center for Healthy Aging, has given the topic a lot of thought. Through his continued research at UCSD’s Center for Aging, he has come up with ideas around “model” assisted living facilities, nursing homes and independent living settings that will contribute to maintaining health throughout the aging process.

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Technology plays a role, but Jeste’s approach also encompasses some newer ideas, such as the role of intergenerational partnerships and activities that can revolutionize the way consumers and providers envision aging.

We talked with Dr. Jeste, a distinguished professor of psychiatry and neurosciences, to hear his thoughts on what’s next for senior living.

SHN: First of all, what’s changing? 

DJ: Several relevant changes are occurring in society. Globally, the number of people over age 60 will increase from 550 million today to 2 billion in 2050. In an unprecedented demographic shift, world-wide, adults over 65 will soon outnumber children under 5. Two-thirds of the older adults ultimately will need some form of long-term care. At the same time, the number of trained geriatric healthcare providers is too small to meet the growing need. Therefore, senior housing will become increasingly important for healthcare. Another change is in the attitude toward aging. More than the previous generations, aging Baby Boomers want an active, sociable life in their own community. Most of them wish to stay in their own homes as long as possible. Given all these trends, senior housing will be changing dramatically.

SHN: How does your research play in? 

DJ: As the senior housing industry contemplates changes, research will be needed to determine which changes lead to better quality of life for the residents and also reduce the cost of their healthcare. Real data are needed; anecdotal stories are not enough. If there is an evidence-based demonstration that a new program or activity not only increases the seniors’ happiness, but is also cost-effective, it might be reimbursed by Medicare, Medicaid, and insurance companies. This approach requires a partnership of the senior housing industry with researchers in geriatric healthcare, engineering, technology, and health economics. This is exactly what we seek to do in our newly established UC San Diego Center for Healthy Aging. My goal as a researcher is to bring all these stakeholders together to help develop and conduct science-based studies that the consumers as well as the regulators want.

SHN: What are you finding needs to change about physical environments? 

DJ: I believe that senior housing will need to provide better facilities for healthcare and lifestyle-oriented activities. For example, it should be possible to collect relevant information on a resident’s health and transmit it in real time to his or her healthcare provider. Similarly, there should be affordable equipment for physically, cognitively and socially stimulating activities at home.

SHN: How is technology working toward this shift?

DJ: Technology can help in several ways. It may include person-centered health care-related technology (e.g., telemedicine, fall alert systems), activity monitoring technology (e.g., physical activity monitors), and social media to reduce loneliness (e.g., social networks). Most senior living places today are not equipped with user-friendly and healthcare-related technology.

SHN: Will new homes need to be built to accommodate the changes? 

DJ: I think it will be a combination of construction of new homes and retrofitting of existing residential facilities. On the one hand, most seniors prefer to stay in their current homes and communities as long as possible. On the other hand, about half of the people over age 50 say that their homes would not be able to accommodate them as they age. Thus, many existing homes will require modifications or specialized devices to help with the seniors’ hearing, vision, or mobility problems. Retrofitting of existing houses will become increasingly common. Of course, not every home can be accommodated, and the challenge comes when a person can no longer carry out all the necessary tasks and activities. Therefore, new construction will also rise.

SHN: How do you see the generations interacting? Are there any present-day examples? 

DJ: Intergenerational approach will be used much more frequently than it is today. Currently, many cities seem to be compartmentalized into largely age-segregated living communities. Yet, intergenerational connections offer unique benefits for all the age group included. A good example is the Grace Living Center in Tulsa, Oklahoma, which is home to about 200 older adults and also to a kindergarten and pre-kindergarten. The seniors help the children with reading, storytelling, and crafts, while the kids give their new grandmas and grandpas heartfelt affection, warmth and gratitude. This is a win-win in terms of well-being and life satisfaction as well as education for everyone.

SHN: What are the barriers to getting to this “future” of senior living? 

DJ: There are several barriers, such as the previously mentioned lack of evidence-based practices and initial high cost of some new technologies. Another is a preference for status quo. Changes in traditional operations are challenging and stressful, but we must embrace the changes or they will be forced on us. Finally, it is often difficult for people from different fields to break the silos and work with one another.

SHN: What are some next steps toward these goals? 

DJ: An important next step is facilitating collaboration among various stakeholders. Senior housing specialists, geriatric healthcare experts, engineers, architects, economists, and representatives from the community need to come together. If we put our heads together, we can find solutions to the problems facing tomorrow’s society.

Interview by Elizabeth

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