The Graying of America: Preparing for What Comes Next

By now, we all know we are in the midst of a tsunami. In just seven short years, the number of Americans age 65 and older will increase by 65 percent, from 35 million to 55 million. By 2050, there will be 88 million Americans in this age group, representing one in every five Americans.

Baby boomers have significantly impacted every institution and stage of life they have encountered. We can blame them for this massive aging of the American populace as well. This demographic shift will cause a tremendous change in the demand for housing, and will exponentially increase the need for services to help older adults age in place. Yet, many communities are not prepared—or preparing—to negotiate the profound effect of this transition on our communities.

Recognizing an increase in the number of grant requests for aging-related issues and media attention on the impact of the baby boomers, the Plough Foundation decided to dive deeper into this issue. Plough is an independent, private, philanthropic foundation that provides grants to address social and economic issues exclusively in Memphis and Shelby County, Tenn. Mike Carpenter, executive director of the foundation, says, “As grantmakers, we want to find good ideas and solutions to deal with the challenges of aging in place. We want to uncover those organizations with capacity to deliver solutions.”

Plough hired a program associate, Katie Midgley, to research the scope of services available to the elderly in Shelby County. Midgley began by gathering local and regional demographics to understand what was happening in the Memphis community. A review of the demographic data confirmed that the tsunami had not skipped Memphis. The aging population in the region was growing rapidly, increasing by more than 55,000 between 2000 and 2010.

Midgley next completed an internal scan of Plough’s funding related to aging; consulted with local and national grantmakers and experts in aging; determined the existing status of programs and funding sources for local aging programs; reviewed information and literature on aging issues and trends; and identified and reviewed comprehensive programs nationwide. Out of this process and through conversations with more than 70 major players with expertise in all aspects of aging, seven important issues for Memphis and Shelby County emerged:

• Caregiver support and respite
• Transportation
• Basic needs (food, utilities)
• Home repair and modifications
• Elder maltreatment
• End-of-life care plans, advanced directives, etc.
• Opportunities for community engagement

But before any priorities were established, Midgley realized that one important voice was missing … that of the elderly. So Plough commissioned the AdvantAge Initiative to conduct a survey of more than 500 adults ages 65 and older. The survey results are delivered in Report to the Community on Older Adults in Shelby County: Results from the 2012 AdvantAge Initiative Survey (PDF). The survey revealed that in the Memphis area, people want to stay in their own homes as they age; however, the existing housing stock is not suitable—without modifications and maintenance—for aging in place. Primary modifications needed include exterior wheelchair-accessible ramps; wider doorways, halls and bathrooms; and grab rails in bathrooms. Roof and heat/air-conditioning improvements are the biggest maintenance needs. Regardless of income level, there is a need for accessibility and home-repair modifications. However, many seniors cannot afford to make these modifications to their homes. Armed with this data, the Plough Foundation has decided to select this issue as a priority.

MetLife City Leaders Institute on Aging in Place

To help cities figure out how to improve the quality of life of seniors who remain at home as they age, in 2012 the MetLife Foundation launched the City Leaders Institute on Aging in Place. This one-year pilot program is funded by the MetLife Foundation and implemented by Partners for Livable Communities. The pilot focuses on making local-level changes to facilitate aging in place.

Memphis was one of 10 cities selected in 2013 for the second pilot, working with national leaders to implement new ways to improve the lives of seniors who remain at home as they age. Other cities included in the second pilot are San Diego, Calif.; Washington, D.C.; Chicago, Ill.; Louisville, Ky.; Kansas City, Mo.; Asheville, N.C.; Oklahoma City, Okla.; Salt Lake City, Utah; and Alexandria, Va. The city teams traveled to Washington, D.C., earlier in the year with projects that addressed arts, culture and civic engagement or mobility and transportation issues. Each city team was provided with issue experts and a facilitator to assist them in brainstorming, planning and developing their road map to action for the year.

Building on the work and leadership of the Plough Foundation, the Memphis pilot is a collaborative effort led by the foundation, along with the Aging Commission of the Mid-South, Tennessee Housing and Development Agency, Shelby County Government, and the Community Development Council of Greater Memphis. The goals of the Memphis pilot include identifying viable funding and volunteer sources; developing a set of criteria for determining necessary home modifications; and creating an implementation plan for a kickoff event in March 2014. The team will develop a centralized system that determines the home modification needs of older adults, directs them to services and provides funding for those who cannot afford to make such changes themselves. By the end of the year, the foundation plans to have an opportunity fund to help implement the strategies.

Louisville—another city in the Fed’s Eighth District—is addressing mobility and transportation issues. The Louisville pilot will bring the city’s Complete Streets policy from concept to action. During the next 12 months, Louisville will engage in a three-pronged effort of engaging, raising awareness and celebrating successes. Specifically, they will create a Photovoice initiative with older adults. Photovoice provides cameras to people with least access to those who make decisions affecting their lives, blending a grass-roots approach to photography and social action. This initiative will determine and document barriers to access; identifying and executing at least two (one urban, one suburban) publicly visible demonstration projects that respond to such barriers; and sharing their findings through a high-profile, communitywide celebration.

The dramatic rise in the number of older Americans will have an impact on every aspect of life in U.S. communities. The entire social, physical and fiscal fabric of this country will be affected by the coming age wave. To ensure that older Americans add more than years to their lives, communities must start now to plan for successful aging—because we’re not getting any younger.