Aging in Place: Why Most People Want It and Why Our Homes and Communities Aren't Ready

Most older adults want to age in place: AARP found 75% of people over 50 hope to stay in their current homes. The obstacle is supply. Very few homes are accessible, care is hard to find and afford, and many communities aren't designed for people who no longer drive. Closing the gap means modifying homes, building livable communities, connecting care, and using technology that supports people instead of replacing the humans around them.

What do people actually want?

The answer has been consistent for years. In AARP's 2024 Home and Community Preferences Survey of more than 3,000 adults, 75% of people 50 and older said they want to remain in their current homes as they age, and 73% want to stay in their communities (AARP).

That makes sense to me. Home is more than four walls. It's the neighbor who waves every morning, the pharmacist who knows your name, the garden you've worked on for twenty years. Moving late in life can mean losing all of that at once.

But the same survey found that 44% of adults over 50 expect to move anyway. Housing costs are a major reason. So is the simple fact that many homes become hard to live in as bodies change.

Why are homes the bottleneck?

Because most were built for people in their thirties. Stairs to every bedroom, narrow doorways, bathtubs you have to climb into, steps at every entrance.

The numbers are stark. AARP's Deb Whitman has pointed out that fewer than 1% of single-family homes in the US are fully wheelchair accessible, and fewer than 4% can be easily modified for people with mobility challenges (Home Care Magazine). So the house many people want to stay in is the same house that may eventually push them out.

A fall is often the moment this becomes real. One bad night on the stairs can turn "I'll deal with it later" into an urgent family crisis and a move nobody planned for.

Is aging in place only about the house?

No. I'd argue the community matters just as much.

Think about what it takes to live well at home at 85. You need to get groceries and to the doctor, which is hard in places where everything requires a car and you can no longer drive. You need help with some daily tasks, which means home care workers, and those are in short supply in many regions. You need people around you, since isolation is one of the biggest threats to health in later life. And you need to feel safe, from falls and from the scammers who target older people living alone.

That's why AARP and the World Health Organization talk about age-friendly and livable communities. Sidewalks, benches, good lighting, accessible transit, mixed housing types and places to gather all make it possible for people to stay put. They also make neighborhoods better for families with young children and for people with disabilities.

Where can technology help?

Technology for aging in place, often called age tech, has moved fast. Fall detection, medication reminders, video calls with family and clinicians, smart thermostats and lights, door sensors and remote monitoring of blood pressure or blood sugar are all widely available now. AI is starting to show up in voice assistants and in tools that spot changes in daily routines that might signal illness.

These tools can extend independence for years. I've seen a simple video tablet reconnect a widower with grandchildren who live across the country. I've also seen expensive sensor systems sit unplugged because nobody asked the person living there whether they wanted them.

Three principles separate the useful from the unused:

Design with older adults, not for them. Involve real users early. Watch them set it up. If it needs a twenty-page manual, it won't get used.

Respect privacy and choice. Monitoring can slide quickly from reassuring to intrusive. The person being monitored should understand what is collected and who sees it, and should be able to say no.

Support human care, don't replace it. A sensor that alerts a daughter when her mother hasn't opened the fridge by noon is helpful. A system sold as a substitute for visits is not. Connection is part of health.

What can leaders do?

The gap between what people want and what exists is an opportunity for almost every sector.

Housing developers and policymakers can build and permit more accessible and flexible homes, such as single-floor designs, step-free entries and accessory dwelling units where a family member or caregiver can live close by. Universal design costs far less when it's built in from the start.

Health systems and home care providers can invest in care at home, from hospital-at-home programs to stable, well-paid home care jobs. The workforce shortage is the hardest constraint, and it won't fix itself.

Employers can recognize that many of their employees are helping parents age in place, often while working full time, and offer caregiver support and flexibility that makes that sustainable.

Technology companies can test with older adults, design for the realities of hearing, vision and dexterity changes, and price fairly. Many families will pay for a product that keeps a parent safely at home.

Families can have the conversation early, while everyone is well. What would make this house work at 85? What would we change now? Where would help come from? Planning ahead turns a crisis into a choice.

Why do falls matter so much?

Because a fall is often the event that ends aging in place. The National Safety Council, using federal data, reports that 43,020 people aged 65 and older died from preventable falls in 2024, and fall deaths in this age group rose 51% over the past decade. More than 3.85 million older adults were treated in emergency departments for fall injuries in 2023 (NSC Injury Facts). The CDC has estimated that about one in four adults over 65 falls each year.

Many of those falls happen at home, on stairs, in bathrooms, or on the way to the toilet at night. And many are preventable. The evidence points to a familiar mix: strength and balance exercise such as tai chi, a medication review to catch drugs that cause dizziness, regular eye checks, and simple home fixes like lighting, grab bars and removing trip hazards. The CDC's STEADI program gives clinicians a structured way to screen older patients for fall risk, and it is worth asking whether your health system or clinic uses it.

For leaders, the link is direct. Every dollar spent on fall prevention protects the thing most people say they want, which is staying home.

Who pays for modifications?

Cost stops a lot of families. A ramp, a walk-in shower or a stair lift can run into thousands of dollars. Help exists but is patchy. Local Area Agencies on Aging can point people to repair and modification programs, some states use Medicaid waivers to fund home changes, and veterans may qualify for VA grants. Nonprofits such as Rebuilding Together repair homes for low-income older owners. Employers and insurers that want to help could start by making these routes easier to find, because most families don't know they exist until a crisis forces the question.

What does a good plan look like?

It starts with a walk-through of the home, ideally with an occupational therapist, to spot risks and easy fixes such as grab bars, better lighting, removing loose rugs, and a bedroom and bathroom on the ground floor if possible. It includes a realistic look at transport and support. It names who will check in and how often. And it is revisited every year or two, because needs change.

People want to grow old where their lives are. Making that possible takes good design, good policy and, increasingly, good business.

If your organization is working on housing, care or technology for an aging population, I'd be glad to help your leaders think it through. My keynote "Brain Health and the Future of Well-Being" and the "Aging, Brain Health & Human Connection" workshop explore what it takes to age well. You can reach me through the Book Ki page on siadatan.com.