Aging In Place: A Global Challenge (Blog 3/25/25)
Have you heard the story of the elderly woman who for years told her adult son that if she became unable to care for herself, she didn’t want to be placed in a nursing home? The thought of leaving her home and familiar surroundings terrified her. She wanted to remain in her own home until her death. Cut to the chase – the woman became disabled and her son felt he had no choice but to put his mom in a nursing facility. She died in the transport vehicle on the way there. True story.
The caregiving term for what the mom in this story wanted to do is called “aging in place.” It refers to an elderly individual being able to maintain independence as they age and staying in their home for as long as possible. (National Institute on Aging) This concept has become a significant challenge for countries around the world as global, elderly populations continue to increase.
A Glance at the Numbers
According to the World Health Organization (WHO), longevity is now a global trend that is affecting all countries around the world. In fact, by the year 2050 the worldwide population of people over 60 years-old will have increased from 12% to 22%. This percentage represents 2.1 billion people who will be over the age of 60. To put this number in perspective, the number of people worldwide who were over 60 in 2019 was 1 billion. So in just over 30 years, this number is expected to double.
So What?
So what does all this mean for our communities and particularly for our family caregivers and care recipients? Consider the following statement made by WHO:
“Every person – in every country in the world – should have the opportunity to live a long and healthy life. Yet, the environments in which we live can favour health or be harmful to it.”
WHO went on to say that an elderly person’s health to a large extent has to do with their social and physical environments which include the homes, the neighborhoods and the communities where they live. The literature is clear that seniors who age in place experience a better quality of life. To this end, many elderly individuals around the world wish to age in place, and countries are grappling with the challenges of making this concept a reality.
Some Countries and Their Challenges
Many countries have seriously embraced the aging in place idea, however, their efforts are met by various challenges that make aging in place difficult – accessibility and affordability of services to name a few. Below is a short summary of some of the issues from example countries:
United Kingdom
Aging in place is widely supported by focusing on community-based care. Government policies provide funding for home care services and home adaptations. Local authorities support key social programs and older adult services like Meals on Wheels.
Challenge: Funding of public health and social care services to meet the rise in demand for care as the population continues to age.
Japan
Introduced in 2000, Japan’s long-term care insurance system is one of the most advanced in the world. It provides funding for community-based services, home care and nursing care.
Challenge: Ensuring there are enough caregivers as the workforce decreases while the elderly population increases.
China
Traditionally, in Chinese culture, adult children were expected to care for aging parents. With urbanization and changing family structures, the government has started to focus on policies to support elder care including home-based services.
Challenge: Still a strong reliance on family caregiving. Need for formal systems to support aging in place.
United States:
According to the literature, the majority (77%) of people 50 years-old and older want to remain in their own residences and communities as they age. This has led to a growing industry of artificial intelligence (like remote monitoring), home modifications and healthcare services.
Challenge: Rising healthcare costs make access to services difficult and the availability of trained care providers is shrinking.
Canada:
Canada’s approach focuses on balancing independence and safety for seniors. Provincial governments provide in-home and community-based care and funding support for home accommodations.
Challenge: Lack of adequate support due to the growing elderly population.
Conclusion
We can’t help but wonder what was communicated between the mother and son in the story that began this blog. Had the son promised not to put his mother in a nursing home no matter what? Or, did he tell her that a nursing home might be a serious possibility for her? Perhaps they never even had a conversation about it. Maybe she just continued to tell him she didn’t want to go there, and he never responded either way. We don’t know. But it’s certainly something to think about.
Think about what you can do now to help your aging loved one age in place. Perhaps a good place to start is simply to begin the conversation. Keep in mind however, that despite their wishes, not everyone is a candidate for aging in place. Physical wellness and mental health will be key determinants in making this decision. Still, it’s important to have this conversation with your loved one beforehand so that all involved have a clear understanding of the possibilities and the limitations. Communication is key.
In closing, here are some questions for you to consider regarding your own care journey:
If you are a caregiver have you had conversations with your loved one about their options for long-term care?
If you are a care recipient have you made your wishes clear about wanting to age in place, or relocate to a family member residence or nursing home?
Have you or your caregiver reached out to community services to see what type of resources might be available to help in your situation?
Perhaps our northern neighbors in Ontario summed it up best in their recent Spotlight Report which stated: “As a society, we often speak of ‘aging at home.’ This is what most of us want for ourselves and others. However, achieving this goal will require support beyond what healthcare and social systems alone can provide…. If aging at home is truly a priority, supporting caregivers must be one as well.”
Until the next blog. Thank you for stopping by, reading, and for caring!
References:
World Health Organization, Ageing, February 28, 2018.
World Health Organization, Ageing and Health, October 1, 2022.
National Institute on Aging, Aging in Place: Growing Older at Home, www.nia.gov, October 12, 2023.
AARP, Percentage of Older Adults Who Want to Age in Place Stays Steady, by Michelle R. Davis, November 18, 2021.
Ontario Caregiver Organization’s Spotlight Report, December 2024.