THE BLOG
04/08/2013 05:59 pm ET Updated Jun 08, 2013

When 'Aging at Home' Isn't the Answer

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This is going to sound really odd coming from someone with a book about aging at home, but sometimes, aging at home is not the answer.

• It is not the answer for people who lack safe, comfortable, affordable homes (yeah, I know, duh).

• It is not the answer for people who can't take care of their homes, for whatever reason.

• It is not the answer for people who can't get to the places they need from their homes, or when the people and the things they need can't get to them.

• It is not the answer for people who are cut off from the people they love and things they cherish.

• And it is almost certainly not the answer for people who are frail or seriously disabled, and need a level of attention higher than can be provided even by a qualified caregiver.

That doesn't mean the whole idea of aging at home is an unrealistic farce or a marketing ploy. Far from it.

Aging at home is an ideal solution -- and, as we know from survey after survey, the preferred solution -- for people who have safe, comfortable, affordable housing (which people deserve at any age), in places they are happy to remain. It's for people who can still maintain their homes, whether that means fixing them by themselves, calling on friends or relatives or building superintendents or hiring outside help. Aging in place is for people who can still drive in the 'burbs, or get on a city bus or call and pay for cabs. It's for people who don't live tucked away in hard-to-reach places, especially in bad weather. Above all, aging in place is for people who want to stay home because they feel connected there -- to nearby friends, relatives, shops and services. They feel connected to the stuff of their lives.

Aging at home works best for people who are still relatively young and healthy enough to have and enjoy all of the above. It is for them (and the folks who want to help them) that I wrote my book.

For many lucky people, those years of aging in place can last for decades. But for others, those years can be cut short -- by an accident, an illness, a condition that deteriorates past the point of no return. It can happen for external reasons, as well... a child moving away, a change in the bus route, a financial setback, a tornado or a flood.

Very often, people move into a life stage during which attempts at independence become too arduous or risky. After all, old age doesn't cement us in the space-time continuum, no more than childhood does. As in any stage in development, we pass through different phases. We can't expect to be old at 85 or 95 the way we were at 75. But we'll still be old, sure as a child of 2 or 5 or 8 is still a child. We need to adjust our domestic worlds to match the way that we are old at any given age, the way we change a child's toys and furniture to match her growth.

I hope my book helps people remain at home as long as they like and are able, whether through changes they make themselves or changes others help them make. What's more, we don't have enough places for people to go to instead. The structures -- the literal structures, the social structures (including financial resources) -- simply are not there. At least not yet.

But there's a key phrase buried in the paragraph above: "as long as they like and are able." I'd hate to think aging at home becomes a "lifestyle" choice that people feel compelled to undertake. It would be dreadful to pile on yet another unrealistic expectation for (cough) "successful aging."

To live a long and productive life only to find yourself facing a stringent new measure of success or failure, based on factors that may be out of your control, would be a cruel joke. If you can age at home for as long as that option makes sense, terrific. If you can't, then best wishes for finding another safe, comfortable, affordable alternative, with the connections and care you might need.

Aging at home may work for you if you stay strong and fit, and adapt your home to make it as secure, comfortable, functional and manageable as you possibly can. Through those efforts, you can raise the odds of prolonging your period of independence. That, in turn, can shorten any period of dependence.

Longer independence: When it comes to aging in place, that might be the most realistic goal.