Aging-in-Place: Present Realities and Future Directions

Abstract Elderly populations are growing globally, due in large part to increasing longevity (United Nations 2002). With the number of moderately or severely disabled older persons in the United States predicted to increase by as much as 350% in the next 40 years (Administration on Aging n.d.), the increased need for assistance will be dramatic. A number of technologies available to the general public are not available to the elderly because of non-intuitive interfaces. Because living arrangements of the elderly are linked to income, health status, and availability of caregivers (Federal Interagency Forum on Aging-Related Statistics 2004), the need for assistive technologies to facilitate aging-in-place becomes more prominent for researchers and legislators. This paper will establish the need for assistance to the elderly in aging-in-place and describe available technology for assisting elderly persons' functioning in their own homes. The paper will go on to discuss identified gaps in areas of need for the elderly which new research may help to fill. Finally, implications of aging-in-place for policy makers will be discussed. Introduction The proportion of the elderly population is growing globally, due in large part to increasing longevity and decreasing birth rates (United Nations [UN] 2002). The United Nations estimates that in 20 years more than one billion people will be over the age of 60 world-wide and by 2050 that number will reach 2 billion (United Nations [UN] 2003a; World Health Organization [WHO] 2004). The over 80 group is the fastest growing age group, a trend that is expected to continue for at least the next 50 years (UN 2002). Further, the majority of older people will live in developing nations who are, often, the least prepared to meet changing societal needs (UN 2002). This shift in age structure will have a profound effect on social, economic and political conditions (UN 2002). With an elderly population of 36 million people in the United States, persons over the age of 65 currently make up 12% of the population (Federal Interagency Forum 2004). The future growth of this population is staggering. The Census Bureau projects that by 2030, there will be more than 71 million persons over the age of 65, representing nearly 20% of the population (Administration on Aging [AOA] n.d.a). The United States had 16.1 persons age 60 and older per 100 persons in the population in 2000. By 2025 that figure is expected to rise to 24.8 and, by 2050, 26.9 (UN 2002). Other countries expect staggering growth as well. For example, Japan's population of persons 60 and over per 100 persons in the population is expected to rise from 23.2 in 2000 to 35.1 in 2025 and 42.3 in 2050 (UN). In addition, the dependency ratios show the number of older persons in relation to younger persons. The old age dependency ratio is the number of persons 65 years and over per 100 persons 15 to 64 years old (UN 2002). In the United States, the old age dependency ratios for the years 2000, 2025, and 2050 are 18.6, 29.3, and 34.9 respectively (UN). Japan has a grim future if the old age dependency ratios are even close to correct. In 2000, their ratio was 25.2; predictions are the ratios will climb to 49 by 2025 and 71.3 by 2050 (UN). The demographics clearly demonstrate that increasing numbers of persons will need care and decreasing numbers of caregivers will be available, resulting in a societal chasm. Lengthening the time the elderly can safely age-in-place will positively affect the elderly, their families, and society (Tinker et al. 2004). The critical gap, represented by the numbers above, requires action. This action must encompass quality of life; that is, meeting both the physical and psychological needs of the elderly. Quality of life, according to the elderly, is linked to their health, family and social networks, home and independence (Tinker et al. 2004). The elderly are not one homogeneous population. …