Housing preferences and housing decision-making in later life are critical aspects of aging in place, which is a public health priority in many Western countries. However, few studies have examined the economic, social, and health factors that guide older adults' preferences and decisions about where to live, and even less so among older adults with low income or disabilities who may face greater barriers to aging in place. We sought to understand what housing decision-making and residential reasoning means for low-income older adult homeowners in Baltimore, Maryland. Using a grounded theory approach, we interviewed 12 adults with disabilities in June 2017 and February 2018. Our findings revealed how the strong desire to age in place turned into the realization that they had to age in place due to limited resources and options. The core category "shifting between wanting to age in place and having to age in place" was influenced by family needs, being a homeowner, the neighborhood, and coping at home. In conclusion, for low-income older adults with disabilities, it is important to acknowledge that sometimes aging in place may be equivalent to being stuck in place.
Bibliographical noteFunding Information:
The study was conducted at the Center for Innovative Care in Aging at Johns Hopkins University School of Nursing. First author was supported by the Swedish Research Council FORMAS (RF: 942-2015-403), The Crafoord Foundation, Sweden (RF: 20160604), and the Helge Ax:son Johnsons Foundation, Sweden.The second author was supported by the Robert Wood Johnson Foundation Health Policy Research Scholar program and the National Institute on Aging (NIA# 1F31AG057166-01). The authors are solely responsible for the content of this study which does not necessarily represent the official view of the funders.
We recruited participants from the Community Aging in Place, Advancing Better Living for Elders (CAPABLE) study in Baltimore, Maryland, sponsored by the National Institute of Aging and the Robert Wood Johnson Foundation (Szanton et al., ). The intervention study aimed at improving function and addressing disabilities of low-income, older adults living at home by providing services from a nurse, an occupational therapist, and a handyman. The 300 participants in the CAPABLE study were homeowners and were low-income (below 200% of the U.S. federal poverty level), 65 years and older, and faced difficulties with Activities of Daily Living (ADL) or Instrumental ADLs (IADL). Of all participants, 259 (86%) self-identified as Black, 40 (13%) as non-Hispanic White, and one as Asian (Szanton et al., ). Participants from both the intervention and the control group expressed thoughts and concerns about aging in place when they met with study team members (Szanton et al., ). That awareness, in combination with the inclusion criteria of the study, made the participants a suitable group for recruitment to our study. Thus, CAPABLE participants who stated an interest in participating in future research constituted the pool of possible participants (N=215).
© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
- Community living
- aging in place
- meaning of home