Eldercare solutions today

Responding to the paradigm shift

Posted 2/19/20

A central prayer of the Jewish High Holy Day period invokes a plea to God that we not be cast off in old age or abandoned when our strength has abated. And the Bible in Leviticus 19 mandates that …

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Eldercare solutions today

Responding to the paradigm shift


A central prayer of the Jewish High Holy Day period invokes a plea to God that we not be cast off in old age or abandoned when our strength has abated. And the Bible in Leviticus 19 mandates that “we rise before a hoary head, and honor the countenance of the elderly.” Surely these scriptural sources, others from the teachings of our various faith communities and our social ethos have inspired the creation of facilities to care for our elderly once the rigors of aging have reduced their ability to live alone and independently.

But there is a silver tsunami coming, born out of an aging baby boomer generation (those born between 1946 and 1964) and other advances in health care and lifestyle changes that have markedly increased the average lifespan. By 2050, the number of Americans aged 65 will double and the number over 85 will triple.

This extreme demographic shift—in many ways an answer to our shared prayers for “length of days and years”—beckons us to address a number of prominent and pressing issues. For one, we will never be able to build enough senior facilities to accommodate and properly care for this burgeoning senior population. To properly care for means to not only honor but also empower and realize the yet myriad possibilities that these seasoned and reasoned cohorts can still share with society. The costs to government in terms of reimbursements to these facilities is staggering with shortfalls often the norm. Studies and statistics confirm the challenge when they assert that some 90 percent of today’s seniors wish to remain in their homes.

In considering this emerging trend, two solutions are worthy of mention.

For one, most homes were built as multi-level structures. Given the physical changes faced by our aging friends and family members, there is a need to repurpose those spaces with the necessary adjustments for safety and easy living.

Adjustments can be made to expand the width of doorways, to implement better lighting that eliminates shadows and install non-slip flooring. Kitchens and bathrooms can be retooled by replacing faucets with levers, raising the height of toilets, installing grab bars and the like. In the kitchen, cabinets can be mounted on movable tracks for easier reach, and open space can be made to a kitchen island for a chair or wheelchair. In fact, many appliance manufacturers are involved in product redesign—like shifting to button controls instead of knobs—and regularly participate in the deliberations and training programs to accredit experts in the design and building fields; these include Certified Aging in Place Specialist (CAPS), a program of the National Association of Home Builders, and Certified Living in Place Specialist (CLIPS), offered by an independent, Denver-based organization.

It used to be that a couple and/or family tended to live through three chapters of housing: the home you were born and raised in, the home you raised your family in and the home you retired to.

But a whole field of novel new construction has developed following what is known as Universal Home Design. This incorporates various means of design accommodation in non-obvious ways, allowing for the contingencies of aging so that people can ultimately remain in their homes and safely age in place. Home-sharing is another solution for older persons who wish to remain in their homes without facing the concerns of loneliness or the burden of carrying the costs of upkeep and taxes.

Additionally, various groups offer solutions to watch over these aging groups through the creation of neighborhood cooperative entities. Known as Naturally Occurring Retirement Communities (NORCS), these groups provide anything from transportation to shopping and appointments, and home maintenance and repair resources.

The Village to Village Network consists of more than 230 like-minded groups operating nationwide. In our own area, Growing Older Together (GOT) has trained and screened volunteers who have been performing such services for members. Their mission is to provide Wayne County, PA and Sullivan County, NY senior residents with the practical means and the social connections to remain and live independently in their homes. While the supply of well-trained home aides for medical needs and memory care remains a challenge, given the many situations that call for such supports, great efforts and strides are being made to address these demands.

At present, homeowners will find scant governmental help with related expenses. Some states offer reimbursements through tax credits and Medicaid, and the Department of Veteran Affairs offers some grants. A bill to offer seniors $30,000 in federal tax credits for such home modifications was introduced in Congress in 2016 with bipartisan support but has not yet come to fruition.

But we can expect more progress around this new horizon, as the costs to age in place will remain much less than the cost of building senior care facilities, not to mention the salutary effects of remaining in one’s home with dignity, surrounded by what is familiar and reassuring.

Rabbi Lawrence S. Zierler is the president and CEO of Sayva Associates, an elder-care practice based in Sullivan County. He has served as a pulpit rabbi, hospital and hospice chaplain, Jewish educator and communal executive.


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