Housing the frail elderly : history, contemporary practice and future options

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Sek, Steven T.
Burayidi, Michael A.
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Thesis (M.U.R.P.)
Department of Urban Planning
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Starting in 2012, thousands of the baby boom generation will begin to turn 65 every day. Yet, little has been done to prepare for this increased need and demand for elderly care. This thesis traces the history of elderly care and progresses through time to show the evolution of change in the elderly care industry. I begin with a discussion of the provision of elderly care at home by family members and progress to the institutional of elderly care by the public sector for those who were too destitute to pay for their own care at home. Additionally, the commercialization of elderly care and the federal government's subsidy of such care through medicare is discussed. I examine the rationale for changes in elderly care through the ages and the advantages and limitations of each form of care. From there I look to the future of elderly care and discuss the housing and institutional facilities that will be needed to take care of the growing elderly population. My findings from the examination of the history and contemporary practices in elderly care lead me to make a number of suggestions for improving the care of this population. These suggestions relate to changing planning regulations to allow for the use of ancillary dwelling units (ADUs) in existing residential neighborhoods, the incorporation of universal design principles in housing design for the elderly, and changing the design and operation of nursing care facilities by using the Eden Alternative as a model. The adoption of these proposals by both the public and private sectors will hopefully help move us towards more compassion in elderly care and enable us to meet the growing demand for appropriate elderly housing and institutional facilities.