Aging in Place: How Transportation and Policy can Support Mobility for Older Adults

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Ivis Garcia Zambrana, University of Utah; Alan DeLaTorre, Portland State University

Research on older adults frequently explores the notion of “aging in place”—providing older adults the opportunity to continue to live in their own homes and communities. However one’s ability to stay or leave, particularly in old age, often depends on the built environment. An accessible neighborhood that prioritizes mobility affords the ability to meet basic needs like goods, services, and social activities.

This life-space mobility is rarely applied in the field of urban planning and architecture.  A NITC project led by Ivis Garcia Zambrana of the University of Utah and Alan DeLaTorre of Portland State University sought to operationalize this concept and draw policy implications for the architecture and urban planning fields.

INTERDISCIPLINARY FOCUS ON LOW-INCOME OLDER ADULTS IN MEDIUM-SIZED CITIES

This research builds upon previous research in four significant ways:

  • It explores the connections between home, neighborhood, and mobility in the field of architecture and urban planning using an interdisciplinary lens.
  • Current research on elderhood has particularly focused on the vulnerability of individuals as opposed to how they have been able to overcome their barriers—that is, their empowerment.
  • Whereas previous studies have been preoccupied with middle- and higher-income suburban residents, this study examines life within and beyond an urban-suburban schema and includes lower-income older adults.
  • Unlike previous research, which has emphasized studies of large urban areas like New York and Chicago, this study focuses on medium-sized U.S. cities and counties.

DEFINING “AGING IN PLACE”

The authors developed a life-space mobility instrument that speaks to the relationship between architecture (home) and the urban planning field (neighborhood). This instrument was developed in close partnership with community organizations and other community stakeholders, using a mixed-methods approach including a survey and interviews of 50 older participants from Salt Lake County, Utah and Portland, Oregon.

What does “aging in place” mean to them?

Some common themes emerged: staying at home as long as possible; living at home until they died; living comfortably and safely in their home; living independently or with minimal supports; being able to access local services and amenities; and having social supports.

“I think, to me, it means being able to not only live in my home and feel safe, say, taking a shower or something like that, but also to be able to go to the grocery store…and be able to come back….Mainly, aging in place is whether I can live comfortably and safely in my house but also be able to go to other places.”

Quality of life for the growing older adult population depends on living in places where they can receive support as they age. One participant pointed out the importance of having access to activities nearby:

"There were concerts last year and the year before at Dalton Park. I don’t think they did that this year at all. It’s something I would like to go to. More free things to do in the neighborhood. It’s just not enough. If there’s something to do it normally costs more money to do, but you’re on a limited income. It depends on how much income you have for what you can do."

HOME MODIFICATIONS AND THE BUILT ENVIRONMENT

A notable barrier to life-space mobility is the transition from inside one’s home to outside, and vice versa. In particular, if there was no way to get a wheelchair or walker into or out of one’s home, mobility was significantly impacted.

Home modifications such as railings on stairs, grab bars, replacing showers with bathtubs, and adding raised toilets were reported to increase in-home mobility and independence. However, not many older adults can easily access resources about home modification, and a more systematic approach is necessary to raise awareness on the ways home modifications can support their mobility.

Once outside the home with their mobility aids, individuals confronted more barriers such as a lack of sidewalks, uneven or non-existent paving, and obstructed sidewalks. Participants’ self-defined neighborhood boundaries were influenced by mobility barriers (e.g., no sidewalks, no crosswalks), as well as service and amenity destinations (e.g., shopping, medical services).

KEY CONCLUSIONS AND RECOMMENDATIONS

Researchers should integrate validated research instruments and semi-structured interview questions as a starting place for life-space mobility research for older adults and people with disabilities. Future research is needed to better understand how home and community design affects aging in place across different populations (e.g., race and ethnicity, socioeconomic status).

Planners and policymakers should consider that individuals have a variety of experiences, even when living in the same general vicinity. Major streets and lack of infrastructure can confine some older adults to certain areas of a neighborhood, creating what might be considered unknown or invisible barriers that limit access to services, amenities, and social connections.

Proactive funding for home modifications should be considered at the federal, state, and local levels. Home modifications were found to be incredibly important in supporting and enabling mobility, and may lead to lower costs associated with long term care options.

Access to transit is a key factor in mobility: Demographic and built-environment characteristics of the participants in Salt Lake County and Portland were moderately different. There were a significantly higher proportion of transit users in Portland, and this was related to the fact that transit users were more mobile, independent, and lived in high WalkScore neighborhoods with higher neighborhood satisfaction. A Salt Lake County respondent mentioned that even with a mobility aid her husband could not walk to the nearest transit stop: “There’s not a prayer [my husband] could walk from here to the Trax stop. Even with a walker, he couldn’t do that.”

Funding for services such as Meals on Wheels, which delivers meals to low-income individuals who are homebound, is essential. It is important to keep advocating to be able to maintain the Department of Health and Human Services’ budget, which has been continuously decreasing.

A more comprehensive list of recommendations, along with a wealth of quotes and insights from survey participants, can be found in the final report (PDF). Learn more about this research by tuning in for the webinar on July 24.

THE INTERDISCIPLINARY RESEARCH TEAM

The research team consisted of Ivis Garcia Zambrana, University of Utah; Alan DeLaTorre, Portland State University; Ja Young Kim, University of Utah; Julianne Reno, Portland State University; Keith Diaz Moore, University of Utah; Jordan Pieper, University of Utah; Jason Wheeler, Assist Inc.; Nicole Zinnanti, Assist Inc.; and Brenda Jose, Unlimited Choices.

This research was funded by the National Institute for Transportation and Communities, with additional support from Portland State University, the University of Utah, and community partners Assist Inc. and Unlimited Choices.

RELATED RESEARCH

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The National Institute for Transportation and Communities (NITC), one of five U.S. Department of Transportation national university transportation centers, is a program of the Transportation Research and Education Center (TREC) at Portland State University. The NITC program is a Portland State-led partnership with the University of Oregon, Oregon Institute of Technology, University of Utah and new partners University of Arizona and University of Texas at Arlington. We pursue our theme — improving mobility of people and goods to build strong communities — through research, education and technology transfer.

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