Aging in Place: Setting Goals for Public Health Policy

Elders overwhelmingly prefer to remain in their homes as they age.  Long-term relationships with neighbors and friends provide social stimulation and contribute to quality of life.  Maintaining familial bonds provides benefit to elders and their loved ones.

Innovative use of resources can assist seniors wishing to age in place.  HUD offers programs to finance assistive remodeling services.  Volunteer groups such as Habitat for Humanity help renovate homes.  Medicare covers some home health services.  Expanding the home health benefit could meet the needs of aging elders for less cost than long-term care.

A survey of the National Center on Elder Abuse newsfeed found alarming incidence of elder abuse in long-term care.  Case studies from California demonstrate unmet needs and diminished quality of life in long-term care, as well as profound knowledge gaps concerning indicators of abuse.  Case studies also demonstrate deficiencies in law enforcement policy concerning investigation of abuse in facilities.

Reports from the Government Accountability Office address the need for increased oversight of guardianships.  The American Bar Association developed materials for Court Volunteer Guardianship Monitoring Programs, modeled after child advocate programs that benefit foster children.  A number of jurisdictions are implementing guardianship monitoring programs.  Results are excellent.  

The public health profession can drive policies to encourage aging in place and the associated medical, mental health, and socioeconomic benefits.  Enhanced wellness and reduced health care costs can benefit individual elders and the communities where they reside.  Well-crafted public health policy can inform practice across multiple domains.