Aging is a function of time and is a natural and integral part of the life cycle. Aging process differs among individuals and brings all kinds of changes, affecting not just the physical body and its functions, but also to the social, psychological and financial situations to individuals. Aging in place (AIP) is a common preference among older people for remaining in their local community and maintaining their social networks throughout the aging process. Issues about appropriateness of aging in place, long-term care, and residential homes are discussed. Some models and recommendations are discussed, completed with thoughts on future studies.
TopIntroduction
Life, aging, sickness and death are the four phases in life. People enjoy life. Everyone strikes to avoid sickness, but nobody can escape aging and death. Aging is a function of time and is a natural and integral part of the life cycle. However, the aging process differs among individuals, depending on genetic inheritance, early life development, nutritional status, degenerative bodily workload, healthy lifestyle, psychological wellness, etc. Death is the ultimate end-point to all living creatures, and human beings are no exception.
Aging is associated with the gradual accumulation of a wide variety of molecular and cellular damage at the biological level (Steves et al., 2012). Aging brings all kinds of changes, affecting not just the physical body and its functions, but the social, psychological, and financial situations to individuals. Dynamics in the family, personal life and work alter with age. Understanding the changes and knowing how to deal with the inevitable changes in life are learnable essential skills. The elderly encounter decrease in strength and endurance of the body frame, impairment in vision and hearing, compromise in immunity, deterioration of brain functions and reactions, etc., leading to risks of falls, restricted mobility and more frequent illnesses, including degenerative chronic conditions like high blood pressure, heart disease, diabetes, arthritis, and dementia. Undoubtedly healthy aging will have far reaching affections on the elderly by balancing the interaction between the body, mind, social and economic status, as well as between life and environment (Fenton & Draper, 2014).
Definitions of Aging in Place
“Aging in place” (or “age in place”) is a contested concept (Rowles, 1993) and the term is widely used in aging policy and research but underexplored with the elderly themselves (Wiles et al., 2012). Golant (2015) even suggested that aging in place (AIP) has been romanticized while its associated challenges minimized.
Rowles (1993) refers aging in place to the ability to remain in one’s residence of choice as one ages, avoiding unwanted relocation associated with age-related personal or environmental limitations. Aging in place is the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level (Centers for Disease Control and Prevention, 2013). It emphasizes that older people to remain living in the locality with which they are familiar for as long as they wish (Chui, 2008). Some view aging in place as the situation whereby older adults remain at home or a similar preferred setting for as long as possible with as much ability and dignity as possible (Benefield & Holtzclaw, 2014).
This chapter presents the perspectives of aging in place and illustrate two models as the appropriate solutions for AIP. Living in own homes and long-term care are discussed. Finally, problems arising from relocation to residential care homes and to another country will be described.
Background
Many industrialized countries are facing with population aging. The World Health Organization (2007) estimated the number of people aged 60 and over will be doubled from 11% of the global population in 2006 to 22% by 2050. Many retirees will be expected to live for another 25 years for men and 30 years for women after their economically productive time is over. The elderly will be a burden to the society in terms of health services and daily care.
Traditionally, in an extended family, three and more generations live under the same roof. With the large population living in limited developed lands in Hong Kong, nuclear families become the norm in the younger generation, who are much influenced by the Western culture. Even the unmarried grow-ups do not live with their parent. Therefore, many of the elderly are likely to live with their spouse or alone. These old people will remain at home while aging. There are elderly who chose to relocate to residential care homes or to another country.