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Are Incentives the Next Innovation in Aging in Place?

Jess Stonefield January 7, 2019
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With the right incentives, aging in place can be made safer, more enjoyable and more profitable for companies in the longevity market.

When it comes to innovation, we often think of the next big “disruption.” In the longevity marketplace, that means things like telemedicine, companion robots, smart sensors and the Internet of Things. While new technologies do hold lots of promise for aging Americans, there may be an even more important element in increasing the ability of our loved ones to age in place. (Hint: it has nothing to do with the technology we put in our homes. It has to do with our homes themselves.)

Many of us are familiar with the statistics: nearly 90 percent of older people would prefer to age in the homes they’re currently occupying than move to a nursing home or assisted living community. The only problem: according to a report from Harvard University’s Joint Center for Housing studies, most U.S. homes are not accessible to older people with limited mobility.

Why does it matter? Without proper home design, new technologies being developed today are inconsequential. And, without a cultural willingness to build and renovate homes to be universally accessible, they always will be. For example:

  • If I can’t get down the stairs to open the door for Instacart, Instacart still can’t deliver my groceries.
  • If I can’t take my wheelchair over the front step out of my home, I can’t make it to my driverless car.
  • If I can’t make it safely to the medicine cabinet, I can’t take the medicine Alexa reminds me about.
  • If I have a fall sensor inside an un-accessible home, I can’t prevent falls—I can only alert someone about them after they’ve already happened.

Indeed, according to Louis Tenenbaum, a Next Avenue Influencer in Aging and author of Aging in Place 2.0, even the most advanced technology today is still dependent upon homes that are built with safety and accessibility in mind. Which begs the question: how do we get home accessibility to catch up with aging in place technologies that are advancing so rapidly?

Forget Logic—Can Incentives Make Us Care About Smarter Home Design?

Every 11 seconds, an older American visits an emergency room due to a fall. Every 19 minutes, an older American dies due to a fall. In 2014 alone, older adults experienced 29 million falls and 7 million fall-related injuries. Logic would tell us that universal design could help prevent these falls—thereby lowering insurance costs and saving countless lives. Yet, we still have not made it a priority. Why?

Research from the Frameworks Institute shows that in some ways, it’s a cultural thing. American society views aging as a threat—an obstacle—something to be avoided, rather than faced head on. These types of deeply entrenched cultural frames hold us back from taking a proactive approach to aging—including preparing our homes for aging in place. 

Liddy Manson, director of the AgingWell Hub at Georgetown University, believes the issue is even more complex.

“The reasons people delay renovation are as diverse as human beings themselves,” she says. “Many are so overwhelmed by the idea of uprooting their routine for a home renovation—or the cost of renovating—that they put it off as long as they possibly can. Others simply feel far younger than they physically are and don’t feel a need to confront the aging process quite yet. For instance, my father-in-law is in his 80s. He’s thinking about his next vacation, not installing a grab bar.”

Indeed, home renovations provide a “cost/benefit” quandary for many. No one knows if or when accessibility will become an issue for them. Is it better to spend the money in anticipation of physical health issues, or accept the risk of going without?

“Is the investment worth it?” she asks. “Many people can get stuck trying to answer that question. Tax incentives will make that choice easier. It’s more effective dealing in carrots rather than sticks.”

She, like Tenenbaum, agrees that cold-hard incentives—rather than educational and advocacy campaigns—could be the innovative solution that finally pushes aging in place into the mainstream.

“Aging in Place: A Toolkit for Local Governments,” created by the Atlanta Regional Commission, offers a similar perspective. The resource recommends governments limit the hidden costs of home renovation, such as the potential increase in post-renovation property taxes, which could prevent some homeowners from making necessary safety modifications.

“Think of solar energy,” Tenenbaum says. “Logically, we all knew solar energy was better for the environment and cheaper than purchasing electricity from our local electric company. But most of us were unwilling to put solar panels on our homes until we were offered a cash incentive to do it. I believe the same could be true for making home enhancements that enable aging in place. We in the industry right now need to fight for the incentive, not the good idea.”

For instance, with an understanding that the average fall costs $30,000, health insurance companies could begin offering premium breaks for those with universal design/aging in place enhancements. Local governments could start offering tax breaks for those meeting minimum home renovation standards. The federal government could make home renovations 401K compliable to make it easier for today’s families to afford preventative remodeling. And those in the construction industry could begin making attractive universal housing design, such as no-step entry, a standard for new homes going forward.  

“This is a ‘yes, and’ not an ‘either/or,” Tenenbaum says. “The greater longevity economy needs to recognize that smarter aging in place will benefit all of us.”

With more safer homes come more seniors able to age in place. And more seniors at home means meal and grocery delivery businesses will gain customers, transportation services will flourish, in-home healthcare will become more popular. Even more, economies of scaled demand will make those businesses run even more efficiently.

Still, that’s not the only benefit, Tenenbaum says. By making homes safer, healthcare costs will drop—and so will insurance costs. Families will be less stressed, leading to less time lost at work. Even independent and assisted living communities, which compete for the business of aging seniors, could benefit by outsourcing their tightly run menu of services to a stable local community of healthier seniors. It’s a win-win for the entire industry.

Moving the Industry Forward

Manson points to innovations like Lyft, Uber,and Alexa as being pivotal tech advancements for aging in place—but believes there will likely never be a time when technology renders home accessibility a non-issue.

Until smart home design catches up with today’s tech advances, industry innovators will likely focus on B2B partnerships, rather than marketing to consumers themselves. That means the bulk of new aging technologies will be available in places like assisted living communities, where they can be utilized to their fullest. K4Connect’s successful partnership with Kisco Senior Living is a good example.


Outside of technology, Tenenbaum sees a huge market for the management of aging services, which could also help move aging in place forward. Today’s unpaid caregivers now total more than 34 million. Research from MetLife has estimated the cost of lost productivity from family caregiving at $17 billion to $34 billion. Employee Assistance Programs may begin forming partnerships with local assisted living communities or aging experts to provide routine ongoing safety checks of family homes or guidance in choosing the right in-home products.

Services like these could provide new income streams for senior housing providers—and peace of mind for both employers and caregivers. In fact, a number of assisted living communities, such as Goodwin House (Virginia) and Keswick (Virginia), are already doing just that, showing that aging in place is not a competitor of assisted living, but a potential partner to it.

“Aging in place and assisted living are part of a continuum,” Manson says. “There will be plenty of opportunity to go around for everyone. Assisted living providers expanding to offer services in the community would be a good business opportunity.”

We still have a tremendous way to go in making aging in place safer and more realistic option for older adults. As an industry, we need to realize that aging in place is a benefit across the board—in-home care providers, assisted living communities, and technology disrupters alike.

The aging of our population doesn’t have to be defined by isolation, immobility and increasing fall rates. With the right incentives, it can be made safer, more enjoyable, and more profitable for all of us.

Jess Stonefield

Jess Stonefield is a contributing writer on aging, mental health and the greater longevity economy for publications such as Changing Aging, The Mighty and Next Avenue. She is passionate about impact investing and the greater concept of “equitable equity”—spreading wealth to all levels of our society. She is a communications expert for Senior Living Fund.

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