Welcome to this month’s installment of Dear Urbaneer, where I answer questions from my clients and followers about real estate, housing, and home. I’m Steve Fudge – the proprietor of Urbaneer.com – who has been operating as a realtor and property consultant for 34 years in Toronto, Ontario, Canada.
This month, I am helping readers who, after decades in their property, are exploring the possibility of staying in their current residence to age in place and delay a move into assisted living.
Dear Urbaneer:
My husband and I read and enjoyed your posts over the last couple of months, chronicling the challenges and opportunities faced by homeowners at various stages in their lives and their property journeys. We can relate both to the young couple trying to decide on the right home and the right location to start their family in Dear Urbaneer: Should I Choose The City Or The Suburbs?, and the couple looking to modify their newly empty nest to suit and support their newfound family freedom in Dear Urbaneer: Do You Have Any Advice For Parents Renovating Their Empty Nest?.
As seniors in our late 60s and early 70s, we are becoming more aware of our health and well-being both at home and when we’re out and about. We love our two-storey, North Toronto home, not only for the house itself but also because the location, centrally located close to shopping and transit, has been perfect for us. Also, our son and his family live nearby, which makes it quick and easy to visit, and we’ve been able to help them out with childcare as a result.
In part because of our love for our location, we are exploring the pros and cons of modifying our house so we can age in place here, including installing a stairlift or possibly adding a shower to the powder room located in the family room. However, we’re also considering downsizing into a condominium or moving directly into a retirement-focused assisted living residence. We’re open to options, which may become clearer once we’ve gathered all of our research.
In the Empty Nest article, you say that design considerations should accommodate changes to the occupant’s mobility, with a focus on safety and ease of navigating. You mention that technology is streamlining and automating many household operations, and monitoring and communication systems allow family members and health care providers to be connected. Is there anything else that we need to consider? And are there other options where we could move that we haven’t thought of?
Signed:
Happy & Hopeful About Aging In Place
Here’s my reply:
Dear Aging in Place:
The first, and most important point here, is that you are now considering your options. Too many times a move is initiated reactively because of an unanticipated rapid illness or injury. It’s important to proactively complete your research and weigh your options well in advance of when it’s necessary so you can maintain control of the decision-making process and demonstrate, if necessary, that you have planned and prepared with goals and intentions in how you will live your Golden Years.
More broadly, your journey is being exponentially replicated by the largest cohort existing in Canada. The fastest-growing demographic in Canada right now is seniors aged 85 and up, with its proportional share expected to grow as the bulk of Baby Boomers age. According to Statistics Canada, in 1947, the Total Fertility Rate was 3.6 children per woman which was the highest level since 1921 and totaled 372,600 births in Canada. And the numbers would keep climbing. At the height of the baby boom in 1959, annual births exceeded 479,000, the highest number recorded since comparable Canada-wide vital statistics were first compiled in 1921 before it dropped sharply in 1964 when parents presumably found themselves collectively exhausted by so many children.
The baby boom helped Canada recover from the devastating Great Depression and raise the standard of living. This generation created and commodified knowledge, products, and services that helped our young country advance economically in the global market and on the international political stage. Now this cohort is entering their Golden Years which is not always golden.
Statistically, the Golden Years for most Canadians spans their post-employment years until they’re anywhere from 80 to 85 years old, at which point they’ll be facing physical, emotional, and cognitive age-related limitations. However, the number of Canadians who are living beyond the age of 100 is increasing. Here’s a Fun Fact: In 1971, just 4.9 people out of every 100,000 Canadians were 100 or older; in 2021, it was 25.8 per 100,000. And of those centenarian pluses, 80% are female, which is one more reason why women should earn equal pay, and why Canada should introduce a Universal Income. Until that time, you may want to intentionally prepare for your Golden Years to extend another full generation. For those who can and will be financially secure, who do or will foster goodwill within their communities, and who actively nurture or intend to cultivate enriching relationships with the people they like and love, their acts of kindness making the world a better place will ensure their Golden Years sparkle in joy and positivity.
But it’s up to you to proactively make the right decisions.
What Options Are There?
This post explores the following shelter options:
• Staying In Your Home To Age In Place
• Downsizing To A Condo Or Rental Apartment
• Moving Into Public and Subsidized Assisted Living & Seniors Housing.
• Retiring Into Residential LifeCare Options.
• Trying Home-Sharing
• Cohousing With (Your Chosen) Family
… Along Came Covid
When the World Health Organization declared the COVID-19 viral disease a pandemic in March 2020, Canadians quickly learned that residents in long-term care facilities suffered the most during the first wave of the pandemic in Canada, with more than 70 percent of deaths from COVID-19 occurring in those aged over 80. Health experts say people with pre-existing chronic conditions or compromised immune systems have a higher risk of dying from COVID-19 than those who do not. Fortunately, those who could take precautions and isolate during lockdown reduced their risk. Meanwhile, seniors over the age of 80 living in long-term care homes became instantly vulnerable because the design, systems, and operations of these living environments exposed many of them to the virus.
A June 2020 report by the Royal Society of Canada described the arrival of COVID-19 as “a shock wave that cracked wide all the fractures in our nursing home system.” Although long-term care is a provincial jurisdiction, it called on the federal government to act “immediately” on creating national standards of care to correct systemic issues across the country. In Ontario, what was particularly telling was that for-profit long-term care homes had a higher proportion of deaths than municipal, charitable, and non-profit nursing homes.
According to this CBC article “In the first few months of the pandemic, more than 80 percent of Canada’s known COVID-19 deaths happened in long-term care and retirement homes — about twice the average of rates among nations in the Organisation for Economic Co-operation and Development (OECD).”
Because of this, in the Spring of 2021 the Health Standards Organization (HSO) began to conduct three national surveys on long-term care, and in January 2023 they “published 60 pages of comprehensive standards, to complement the release of 15 pages of standards from the Canadian Standards Association Group (CSA) in December 2022” providing a comprehensive 75-page list of new standards for Long Term Care Homes to serve as a resource for “operational staff, infection prevention, and control personnel, directors of care, architects, designers, engineers, governmental bodies, LTCH associations, residents, families, and caregivers”.
However, rather than adapting space plans, upgrading operating systems, and improving mechanical systems to mitigate viruses in long-term care homes, the Ontario government disclosed these new standards are completely voluntary, as reported in CBC’s “New Voluntary Standards Released For Long-Term Care Homes Devastated By The Pandemic“. This was shocking to me. The unwillingness to enact a new set of standards – even as a requirement for future to-be-built long-term care homes – signals that the provincial government has put profits ahead of people. If we do not legislate standards that make the basic foundation of a shelter physiologically safe and secure for residents and staff at long-term care homes then they remain at risk.
According to Statscan, as of December 9th, 2023, 57.8% of COVID-19 deaths in Canada have been people 80 years old or older, even though this demographic accounts for just 1% of the total number of COVID-19 cases in Canada. How strange to be a senior living in a time when a virus that wasn’t here four years ago now has a target on your back, and instead of your country demonstrating how genuinely committed it is to your long-term care, refuses to mandate standards to keep you and your generation safe and secure in old age. And how bizarre for younger Canadians to know that our elderly at-risk populations are now even less secure and more vulnerable than pre-pandemic and that one day – should they live into their Golden Years – they may also move into a shelter that increases their risk of illness and death. To consider this acceptable makes me feel like I’m disrespecting my elders while gambling with my future. And, well, it seems very un-Canadian.
More Homeowners Are Saying That They Want To Age In Place
Last month, CMHC released a report referenced in this BNN Bloomberg story “More Seniors Choosing To Age In Home Instead Of Downsizing: CMHC Report“. The report shows that more seniors are choosing to age in place, rather than selling their houses and downsizing into condominiums for example.
The report attributes this behavioural shift to people generally living longer (and therefore assumedly being more independent longer) and to changing wealth profiles (more diversified savings). Also, living in a dwelling that you’ve occupied for many years allows for relative autonomy including more control over schedule and lifestyle. It’s also familiar. And comfortable. But for some folks, it also invites complacency which is why I applaud you for doing your research. After all, it’s human nature to resist change when the status quo is working for you.
It’s also important for younger people to understand that for seniors there is still an enormous elephant in the room called COVID-19. Many people who were considering changing their living environments have been hesitating because they are, demographically, more at risk. For this cohort, the pandemic is still a daily consideration so the overarching goal for many is to stay at home as long as possible, either avoiding assisted living altogether or minimizing the time required in that shelter environment.
‘Yes’, they are staying in their family homes as long as possible, and ‘Yes’ the age at which elderly homeowners sell is going up, but there’s more nuance to this trend than you might originally think; for many, it is a lack of options – in terms of both space and affordability, as discussed in this Globe & Mail article: “Forget Downsizing: Canadian Seniors Staying In Large Houses Well Into Their 80s, Due In Part To Lack Of Options“.
Gaps In Community Care & The Question Of Loneliness At Home
While the COVID-19 pandemic cast a bright light on the many systemic failures in assisted living and long-term institutional care homes, this isn’t the only area where there are significant gaps, as has become evident recently. This eye-opening article from the Toronto Star – “They Spend All Day Alone — In A Chair. Some Seniors Are Aging At Home So Quietly Few Know They Exist” explores some of the darker realities of aging in place which often means that many seniors are aging at home alone – by themselves. Furthermore, although there are government and community agencies to assist with medical and daily care for seniors at home, the article says the community support as it exists is for relatively “able” seniors with less complex medical needs, and more needs to be done to reach those aging at home with more intensive medical – and even palliative-care needs.
Because these resources tend to fall short, life care often falls on family members which isn’t always possible or sustainable. And it’s not just care – it’s companionship. As health declines, seniors may be less inclined to partake in activities and hobbies that they used to enjoy. And social circles may change as partners and friends fall ill or pass away. This means as one ages one is more susceptible to finding themselves isolated and slipping into depression.
Loneliness isn’t just an unpleasant state of mind; it negatively impacts cognitive function and has a physical health impact as well. And it’s exacerbated in big cities where the intensity of a fast-paced high-density more-anonymous environment and its housing typologies, by physical design, makes it inherently more isolating, especially for seniors who may not be inclined to leave their suite or apartment.
This means that to combat the loneliness, and all the physical and mental issues that come along with it, a conscious effort must be made, either through organized community support or other means to combat this isolation.
This article from the CBC in 2018 is telling: “The Architecture Of Loneliness: How Vancouver’s Highrises Contribute To Isolation.”
All of these considerations need to be addressed before you decide on what is right for you. This, in itself, can be overwhelming.
In 2023’s first installment of Dear Urbaneer called What Is The Best Process For My Elderly Parents To Downsize And Sell Their House?, I shared my process of how best to downsize, and the journey of my own Auntie’s transition from living independently in her condominium to moving into Assisted Living during the pandemic. It has several truths, insights, and nuggets of guidance that may be helpful.
Back to your initial question. What are some of the details around the options you are considering for aging in place?
Considerations For Aging In Place
If you decide to stay put and age in place, certain design considerations should be incorporated to ensure your residence is functional, safe, and yes, beautiful.
Universal design – also known as Inclusive Design or Barrier-Free Design – is the design and composition of an environment so that it can be accessed, understood, and used to the greatest extent possible by all people regardless of age, disability, or other factors. It’s about intelligent thoughtful efficient design that elevates space to its highest and best use so it’s accessible by most people.
As I dug deeper into this, I realized I wanted to do right by you and include more specificity, so I’m currently working on a post about tips and tricks using principles behind universal design (UD). Stay tuned- it’s coming soon!
Based on our correspondence, given your residence is centrally located, close to amenities and transit, with family nearby, and you are established in the fabric of the community, it sounds like it’s an ideal location to age in place. But before you consider the design part of aging in place, research what health and wellness supports are available in your community that you can access regarding mental health, medical care, and help with tasks such as cooking and cleaning. It’s also smart to have an understanding of what the process is to access these services because it’s not uncommon to require assistance quickly because of an unexpected health event.
This checklist from the government of Canada for aging in place covers several tasks that should be investigated to support life at home. In addition, there are a plethora of government-funded programs available to assist seniors and their caregivers, with things like subsidizing private nursing care, paying for equipment that might be out of pocket (i.e. shower/bath chairs, walkers, etc.), arranging for respite care to give caregivers a break. You may have to dig a little, but it’s definitely worth a search. In Ontario, many of these programs are delivered through the Home and Community Care Support Services.
Questions To Consider
What sort of health and community care are available to you in your chosen location?
What will you do for transportation (i.e. is there access to public transportation near your home, mobility-friendly access, etc.)? Reportedly most people live 7-10 years after they stop driving.
Also important to consider are your finances. If you need to pay for private health care services at home, can you afford it?
And what is the state of your (and your partner’s) health? Although the goal is to stay put in your residence, is it realistic to remain indefinitely or are you willing to move elsewhere if your current state of health declines?
And there is the issue of safety. Is your home outfitted correctly to safely allow you to age in place?
• The safest designs, in general terms, are open-concept floor plans (wither fewer corners and obstacles to run into, as well as better sightlines and lighting).
• Transitions on flooring should be seamless, and hardwoods or tile are preferred over carpet because of tripping hazards.
• There should be adequate clearance around furniture and space around unmovable architectural features to permit easy passage with a walker or other mobility device.
• Single-storey living is preferable, or if you are in a two-storey dwelling, an elevator or stairlift is generally required.
• In washrooms, showers should be curbless, and have a shower bench and hand-held shower, or room for a shower chair.
In my upcoming universal design post, I will go more deeply into some of these design elements, how to incorporate them into home design beautifully, as well as some of the tech capabilities that should exist for safe and healthy living at home.
Finding Your Community
In the February 2023 issue of Maclean’s Magazine, Jen Recknagel – the director of innovation and design at the University Health Network’s NORC Innovation Centre in Toronto, wrote this piece –> “The Big Idea: Help Seniors Age At Home” that shares the phenomenon of naturally occurring retirement communities, or NORCs. “NORCs might be regular residential apartments, condos, co-ops or even entire neighbourhoods —geographic areas that weren’t specifically designed with older adults in mind, but which have a lot of them regardless”.
The University Health Network proposes bringing programming tailored to the needs of seniors who live in these locations, whether that is health services, organizing community dinner parties, or even using space in a condo building’s rec room to set up a wellness hub. According to the article “In Ontario alone, there are more older adults living in NORCs than in long-term care and retirement homes combined. Almost 2,000 buildings across the province qualify as NORCs. Together, they house more than 200,000 seniors.”
The article cites an innovative program called Oasis Senior Supportive Living that operates in Kington, London, and Hamilton, Ontario which supports seniors aging in place and addresses important determinants of healthy aging such as isolation, nutrition, physical fitness, and sense of purpose.
How amazing is that?
Moving Smaller, With A Plan In Place
For those who are electing to downsize, the CMHC report I mentioned earlier indicates that homeowners in Toronto and Vancouver are most likely to go to condominiums, whereas seniors in places such as Montreal prefer to transition to rental housing. Either way, downsizing to a smaller space as you age is a common move because it requires less maintenance, it usually costs less, and it creates the opportunity for a simpler turnkey lifestyle.
Frequently, condominiums and rental apartments offer elevator access and single-storey living as well, which are necessary design features as we age, though when I have discussions about this many people are quick to express their opinion that when you have stairs, you’re keeping your body more able which is essential for longevity. I’m not going to dispute this but I would suggest any dwelling you occupy have the ability to accommodate anyone with mobility issues. This post ultimately is about preparedness.
As a realtor who has sold hundreds of properties over 3+ decades, I’ve learned the dwellings that take the longest time to prepare for sale are those where the Sellers are downsizing. After all, it takes time to empty a home filled with memories and mementos. I recommend beginning the process by identifying what pieces you are keeping. If you have the time, energy, and finances you might move your most cherished possessions into your next accommodations and then return to your nearly vacant house to donate, gift, or sell what’s remaining. Ultimately you know what is best, but click here to read Urbaneer’s Secrets To Successfully Downsizing To Smaller Accommodations and How To Begin Your Downsizing Journey for additional guidance.
Pros and Cons For Retirement Communities & Assisted Living
The options available to seniors vary depending on where one lives, including public subsidized municipal, charitable, and non-profit senior accommodations and privately operated assisted living and residential care options. There are also Continuing Care Retirement Homes that offer a range of housing typologies as well as care options in one location. These can range from independent living where one has minimal care requirements but wants to live in a community of peers to memory care and/or long-term care, including those who require attention around the clock because of dementia or other chronic health problems.
The definite upside of Seniors Housing is that there is a ready-made community. Not only will you have tons of neighbours also seeking community connection, but you will also have lots of opportunities to pursue hobbies, and interests – and maybe even learn a few new ones – right beyond your front door.
For those with deep pockets, some retirement residences have resort-style amenities, from lush outdoor spaces to golf greens to saltwater pools. In some complexes, you might have all of your meals prepared for you, or you may have the option to cook in your suite, or a combination of both. It’s truly maintenance-free living.
There is also an element of security. Unfortunately, many seniors living alone are vulnerable, and living in an assisted living residence generally means that you’ve got around-the-clock security, as well as medical staff onsite to assist in the case of emergencies, and also with daily medical needs, such as attending to smaller, less urgent medical problems and administering medication.
But many of these benefits are also downsides for some people. Yes, you’ve got tons of activities and meals to share to be part of a community, but it is a very scheduled existence, which is off-putting for some people. Another concern is the loss of independence.
The cost of retirement living is expensive. Some people have insurance and benefits that cover some of the cost of care, but often the higher-end homes with all the amenities are for the wealthy, because of the out-of-pocket costs.
There is no right or wrong answer as to where the best place to be for you is. It’s really about priorities and your comfort level (and goals) around care. As well as your budget.
Creating Your Community
I really like the recent arrival of home-sharing platforms that match students with seniors who have empty bedrooms. This includes Humber College which is pairing international students with seniors to help ease the housing crunch. The opportunity to provide shelter to someone in need at market rent, or room and board in exchange for assisting with household chores, meal preparation, running errands, and yes, company, is a win-win in my opinion. Yes, both parties would have to agree in writing on the terms and conditions of cohabitation, but that’s just common sense. I think this could be a marvelous match for many seniors and students.
I give praise to the Canadian Cohousing Network (CCN), which is a registered non-profit organization that promotes the creation of cohousing communities as a model for sustainable development by raising public awareness about cohousing and by bringing people together to form communities. They’ve established cohousing communities in seven provinces that are remarkable.
Another option is to create your own “community” a la Golden Girls – where you combine resources with like-minded friends or family to ensure you can age in place with all the necessary support. By living in a cluster, you have a built-in community, where you can collectively engage in making each other’s lives better. And given that Toronto has recently approved the As-of-Right Zoning For Multiplexes, this is becoming easier to do from a zoning and policy standpoint. If you were to cohouse with friends who are of a similar age, you could have common areas and private zones for living while sharing the costs of having life care support. Or you could co-purchase a multiunit dwelling with your multigenerational family and each contribute to the welfare of your loved ones. Here’s my post about The Important Considerations Surrounding Multi-Generational Housing.
I can speak to the benefit of purchasing property with a bestie. In 2008, my dear friend James & I purchased a ‘Forever Home’ triplex on the East Coast to age in place ‘one day’. He would take the Attic Apartment, I would take the Garden Suite, and the second floor would be for friends, family, or an income generator, when necessary. That ‘one day’ hasn’t come yet – even though 15 years have passed – but we’re certainly one day closer to retirement. And we’re grateful that we did. We recognize neither of us would have purchased The Black House on our own because both our families live on the west coast; the energy, time, and capital required were more than we could afford individually; and managing the house is a lot of responsibility for one person. For these reasons alone, we marvel to find ourselves – 2 dear friends of 41 years – stewards of an 1880s residence that we visit regularly.
Was it a difficult decision to take this leap of face? To most everyone’s surprise, when we found the property – or rather I should say when the property found us – we instantly said ‘Yes’. We trusted our intuition. We trusted our friendship. And we embarked on establishing a community who have already touched our lives and warmed our hearts. We can confidently say that when we do retire we will transition to a space to age in place with all the support we believe we will require. Because of this, I encourage those who are single and in their 30s, 40s, 50s – or you’ve stopped counting – to consider creating a ‘Forever Home’ with your friend(s) to ‘age in place’. Here’s –> A Story Of Friendship – Plus Tips & Tricks For A Bedroom Refresh – At The Black House On PEI.
I hope my counsel has helped.
No one tells you when you’re a young adult that the process of aging will require us to channel more of our time and energy into navigating and nurturing whatever ails us, whether it be mental, emotional, physical, or spiritual. It is often for this reason that the responsibilities of a house become less appealing, or less possible, in favour of living in a community where care and company are at hand, especially when you are on your own with limited support.
Because of this, I’ve learned that while most of my clients are deeply attached to the meaning and memories contained in the bricks and mortar that have sheltered them, including having even enjoyed attending to the maintenance, repairs, and upgrades that accompany the privilege of homeownership, the majority admit there comes a moment when they’re ready to let go of all the time, energy and commitment associated with operating a property. This frequently occurs when they realize they need to shift their focus off the roof over their heads and onto their health and well-being.
Furthermore, I want to reiterate how important it is that you are being proactive. The circumstances and timing of making this decision are rarely according to an individual’s preferences or choices. For example, after being on a waiting list for many moons, a suite becomes available in a preferred long-term care home, requiring a move to be put into action. Or an unexpected health issue – like one that impacts mobility – may fast-track the need to move into assisted living. Living with this possibility or resisting it can be unsettling and can easily leave one feeling overwhelmed and fraught with anxiety. In this respect, it’s never too soon to start having conversations with friends and family about the inevitable journey we all face, which is where will our last move be, and under what terms and conditions.
Finally, I want to acknowledge we live in complex times. One of the issues with our housing crisis is that in the past it was much more common for seniors to sell their family domicile and downsize. That long-term care homes – in particular for-profit homes – are being called out on questionable standards is causing seniors to look at alternatives which include aging in place in their existing residence as long as possible. The result of this is that the natural filtering of households at different life stages up and down the property ladder is not as it once was. I hope this post sheds more insights into the challenges seniors face.
Looking for a multigenerational family-friendly property or a purpose-built duplex to age in place with your bestie? Here’s a past listing that might be of interest!
A Smash Hit Trophy In The Making On Tennis Crescent In Riverdale – NOW SOLD!
Well-situated, well-proportioned, and welcoming, this family-friendly residence is an ideal opportunity for those seeking customizable space (and a lot of it!) in a superb coveted neighbourhood. Check it out!
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Since 1989, I’ve steered my career through a real estate market crash and burn; survived a slow painful cross-country recession; completed an M.E.S. graduate degree from York University called ‘Planning Housing Environments’; executed the concept, sales & marketing of multiple new condo and vintage loft conversions; and guided hundreds of clients through the purchase and sale of hundreds of freehold and condominium dwellings across the original City of Toronto. From a gritty port industrial city into a glittering post-industrial global centre, I’ve navigated the ebbs and flows of a property market as a consistent Top Producer. And I remain as passionate about it today as when I started.
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-The Urbaneer Team
Steven Fudge, Sales Representative
& The Innovative Urbaneer Team
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