Key facts
- Aging in place is becoming a financial necessity due to high institutional care costs and limited capacity.
- Less than 5% of U.S. homes are suitable for aging in place without modifications.
- Most housing predates accessibility standards, and current regulations often exclude private residences.
- Demographic shifts show more homebuyers over 70 than under 35 in some regions.
- The integration of health outcomes with housing design is a critical gap in current practices.
The traditional notion of aging in place is increasingly clashing with the reality of housing stock that is not designed for the needs of older adults. Cameron Carter, founder and CEO of Rosarium Health, is working to bridge this gap by transforming homes into central sites for healthcare delivery. His company connects health plans, clinicians, and contractors to implement safety modifications aimed at preventing falls and reducing hospital readmissions.
Carter explains that the shift towards aging in place is driven by two primary factors: the escalating costs and limited capacity of institutional long-term care, and evolving cultural preferences for multigenerational living, particularly among African American, South Asian, and Latin American families. He notes that in some areas, the cost of skilled nursing facilities and assisted living makes aging at home a more financially viable option, especially when waitlists for institutional care can extend for years.
Regarding the current housing stock, Carter estimates that fewer than 5% of homes are realistically suitable for aging in place without modifications. He points out that 90% of U.S. housing was built before the Americans With Disabilities Act (ADA), and the ADA's accessibility requirements do not extend to private residences. Even in multi-unit dwellings, only a small percentage of units are mandated to be accessible, a stark contrast to industries like the cruise line sector, which requires at least 20% of its rooms to be accessible.
Carter believes a key barrier to progress is a misunderstanding of the evolving buyer demographic. Developers often continue to build homes assuming they will be purchased by younger families, overlooking the growing segment of older adults who intend to stay in their homes for the remainder of their lives and may need to accommodate memory care or multigenerational living. He highlights that in some regions, there are now more homebuyers over the age of 70 than under 35, and 15 states have more residents over 65 than under 18, indicating a significant demographic shift that the housing industry needs to address.
Housing professionals, such as real estate agents and mortgage lenders, are encouraged to integrate accessibility and adaptability into their services. Carter points to the emergence of "senior real estate specialists" who focus on finding accessible housing and connecting clients with healthcare providers. He also notes the role of senior moving managers in assisting with relocation logistics. However, he acknowledges that terms like "accessibility" and "home modifications" still carry negative connotations in marketing, hindering broader adoption. He suggests that highlighting the independence enabled by these modifications could be more effective.
Carter identifies a significant gap between what families assume aging in place requires and what is actually needed, particularly concerning the integration with health outcomes. He emphasizes that most individuals will age in their current homes and that a clinical plan should guide housing decisions. Current housing inspections primarily focus on property damage rather than identifying physical barriers that could impact an individual's frailty. Looking ahead, Carter envisions an optimal aging-in-place home that seamlessly integrates health outcomes with the living environment.