American adults are tackling something new—caring for each other and being cared for, physically, on a larger scale than ever before. We’re used to hands-on caretaking when it comes to children and people with disabilities, but it’s unprecedented to expect most adults to experience roughly a decade of dependent life.
San Diego gerontologist Judi Bonilla explained the incoming status quo: “You have either been a caregiver, will be a caregiver, or will need caregiving.” She noted that in previous years we “never had this many people living this long.”
America needs to change to accommodate the aging population. Our infrastructure is unfriendly to people with mobility issues, who either walk slowly and tire quickly, or rely on walkers and wheelchairs.
Bonilla cited airlines as an example of an institution that is going to have to drastically adjust, which makes sense considering how little legroom passengers are allotted on airplanes. Facilities like banks also need to be reconfigured to make life easier for people who cannot stand up for thirty minutes while waiting for a teller to be ready.
“Some might say that buildings can’t cater to every group with special needs. But silver architecture and design aren’t about indulging a special interest group. They’re about maximizing quality of life and independence for a life stage most of us will reach.”
Aronson explains, “While patients often end up in [UCSF’s house call] practice because they can no longer leave their homes, not infrequently the problem is at the other end: the hospital or clinic is too hard to navigate.”
When we met in her office, Aronson cited problems like hospitals choosing long hallways and not providing places to rest, or buildings that require a person to ascend several steps before reaching the elevator. To a young, able-bodied person, climbing three steps is no big deal, but even minor accessibility issues can be exhausting and dangerous for frail seniors.
Aronson insisted that someone needs to revamp “silver design” the way Apple spruced up computers: bring fashion into the picture. She wants manufacturers to consider the aesthetics of utilitarian devices like bathroom grab bars, to make them beautiful. If safety appliances blend in with normal decor, more people will use them, making physical aging that much easier to handle.
Edit: Aronson emailed me to clarify that “it wouldn’t just make aging easier to handle, it would make the whole world more senior-friendly so people could more easily age in place, visit friends, travel, get out and spend their money and engage with society which benefits everyone socially and economically.”
As it is, the world can seem intimidating to elderly people, with good reason. On the blog Age With Spirit, an anonymous sixty-eight-year-old writer describes how the aftermath of an accident brought home the reality of being old:
“I am much more risk averse. I don’t want to do anything that is likely to cause me grievous injury, since there is no prediction I will be so lucky if I fall again. […] I walk more hesitantly, and considerably more slowly and carefully. When I descend stairs, my hand is on or very near the handrail. […] My body is now my reminder of the limitations that accompany old age rather than my armor against it.”
Edit: Doctor Louise Aronson emailed me to explain that fear of falling actually increases the risk. She suggested exercise guided by a physical therapist or trainer, which “could increase [the blogger’s] strength and balance, decrease her fall risk, [and] increase her confidence.” Aronson continued:
“Exercise is the best drug we have; it works for more and more varied conditions than any other, and the tragedy is that because it’s free, people think it’s no good, or they think they are too old. We can get stronger, more agile, more fit and more capable—not to mention healthier, decreasing blood pressure, risks of diabetes, heart disease and dementia—through exercise at any age.”
She enthused that some studies have included people in their nineties and even centenarians.
Humans can’t stop the aging process, and we don’t need to try. As Judi Bonilla pointed out, old age and eventual death are perfectly natural parts of life. What we can do is decide to make old age easier for everyone.
The next step, after embracing the human interdependence that old age highlights, is to change our physical landscape, making it easier to navigate. Architects must design buildings—city halls, offices, apartment complexes, suburban homes, etc—to be fully accessible by people with varying levels of mobility.
This means paying attention to the little things, like door thresholds that can trip people up. We need clear signs in large text, and we need to consider technological ease-of-use for elderly citizens.
The future is highlighted by projects like News for Betty, a simplified web-news experience created by public-media expert Melody Kramer and tech talent Daniel Davis. Kramer’s elderly neighbor Betty had difficulty navigating news websites on her iPad, so Kramer sent out an email newsletter asking her contacts to think about ways to make web navigation more accessible.
Daniel Davis responded by building a website with clear navigation and no clutter. Several other people jumped in to improve the site, adding local news sources. Kramer introduced Betty to the new option built specifically for her needs, and Betty loved it. News for Betty shows that communities are willing to tackle problems collaboratively in order to improve the oldest members’ experience.
So here’s what you do: Participate. Make small changes whenever you have the opportunity; improve things a little bit at a time. Be intentional about your part in building the world.
As aging-in-place specialist Rosanna Fay points out, accessibility happens by design rather than by accident. Communal efforts are the most effective—reach out to collaborate whenever possible, especially with elderly people themselves.