Growing older, staying at home

Wendy Yacura never spent a lot of time thinking about where she would live as she got older. But she knew one thing for sure.

I could not afford to go into a $5,000-a-month retirement home, said the 76-year-old from Hamilton, Ont. 

Yacura ended up moving to an apartment 11 years ago; now, 75 per cent of the tenants are seniors. Two years ago, they got together and brought services to them, like lectures, potluck dinners and exercise classes.

I cant imagine myself moving at this point, she said.

For Yacura, a former business owner, staying in the same place as she gets older gives her a sense of control as well as new friends in the building. She can incorporate activities into her daily routine along with going to grocery stores, banks, and doctors that are in the area.

By 2030, almost a quarter of the Canadian population will be over 65. Like Yacura, they face questions on where to live out the rest of their lives. Scared off by the cost of retirement homes, and hearing stories of understaffed long-term care facilities, many say they want to age in place, living in their own homes and communities independently.   

There isnt one single way to age in place how it looks depends on an individuals preferences. And, from buying a house with friends to creating communities together, some seniors are adopting new, experimental ways of living.

Retirement homes are getting more expensive, upwards of $3,100 a month, not including extra care. The toll on long-term care residents during the COVID-19 pandemic, when stories emerged of neglect, outbreaks and loneliness, left many seniors terrified of that option. 

According to the 2016 Canadian census, over 85 per cent of aging seniors prefer to keep living at home and pay for support as needed. They want to stay in a familiar environment for as long as possible. For many, aging in place is less costly, has less rules and regulations, and, perhaps most importantly, gives them a sense of freedom.

This, according to Lori Letts, a rehabilitation science professor at McMaster University, is the essence of aging in place.

I think generally as people age, they do want to maintain that sense of agency or control in terms of making decisions, about where they live, who they socialize with, she said. 

And, she said, there are other options that are gaining popularity.

Back in 2018, Phyllis Brady, Barb Coughlin and Mary Townley embarked on a new housing option for themselves known as co-living, where individuals make arrangements to live together, sharing the burden of everything from chores to living expenses. 

We didnt like living alone anymore. We didnt laugh very much, said Coughlin, who was 70 at the time, and a retired teacher.

The three women, dubbed the Golden Girls, pooled their resources and bought a home together in London, Ont. 

WATCH | The Golden Girls in 2018:

When a CBC team caught up with them six years ago, the women, all widowed or divorced and with grown children, had just moved in together. Each of them had their room and carefully made sure the food and maintenance bills were evenly split. 

Above all, they said at the time, co-living meant they were less lonely.

Today, Townley has moved out to be closer to her family. However, Coughlin and Brady are still living together, though they plan to move to a smaller home. According to Brady, a 72-year-old retired hospital administrator, the arrangement has paid dividends, both socially and financially.

WATCH | The Golden Girls talk about how they're aging in place:

I think that what we expected as far as supporting each other, looking after each other when we werent well, sharing the work and the responsibilities thats all come true, and the financial rewards have been wonderful, she said.

The women still share grocery bills and maintenance costs. A little bowl with their receipts sits in their dining room.

Anything I spend on groceries, I put the receipt in there with my initials on it, says Coughlin, adding they sort out the bills at the end of each month. 

Their monthly costs which include taxes, insurance, utilities, food and other supplies are around $750 each. When Brady was on her own, rent alone was $1,300 a month.

Kitchen duties are also a shared responsibility.

The most you would have to cook in a week is twice, because there would be leftovers, said Brady.

Still, theres one question Brady and Coughlin get most often: How do they manage to get along?

I think you cant be stuck in the way youve done things," said Brady. "You need to be open to more than one way to do something.

First developed in Denmark in the 1980s, co-housing is a structured, planned community, where each resident has their own place and amenities are shared. Some co-housing projects are constructed from scratch, but they can also include retrofitted buildings.

The Canadian Cohousing Network (CCN) has 49 such communities in Canada, either built, under construction or forming groups, with a variety of amenities.

Residents of Belterra on B.C.s Bowen Island, for example, share a vegetable garden and a 3,700-square-foot common house that includes guest rooms and a workshop. 

No communities are currently age-restricted, according to Lysa Dixon, a CCN board member. But at least one, Harbourside Cohousing in Sooke, B.C., has a senior focus. It has a studio apartment in its common house that can be used as a care suite in case someone needs extra help.   

A European study published in 2022 on older co-housing residents found a high level of satisfaction, closer social ties, a greater sense of personal security and the ability to manage their own lives longer.

According to Dixon, each co-housing project has its own design based on the footprint of the space. Dixon, for example, lives in a B.C co-housing community made up of four townhouses and 21 apartments all in one building. Yet in another part of the province, a co-housing development is made up of 31 units spread out on a piece of land, mainly a mixture of duplexes and family homes. 

WATCH | Why co-housing is gaining popularity:

The economic savings in co-housing mainly come from what residents share. Many communities have vegetable gardens. Others, like the Prairie Sky co-housing community in Alberta, have a common house with amenities including a kitchen, a childrens play room and an office. 

A shared meal can be a money-saver. But the greater sense of working together and socializing with ones neighbours is what can really allow seniors to age well and in place. 

Dixon says that if there are more seniors in a co-housing project, they can prioritize other features, such as social programs or an added caregiver suite.

First started in New York City in the 1980s, naturally occurring retirement communities (NORC) allow older people to age in place by bringing services to existing buildings or even whole neighbourhoods, where at least 30 per cent of the residents are older adults. 

Its a place, its a geographic description, said Dr. Howard Abrams, an attending physician at University Health Network (UHN) in Toronto and the director of the UHN Open Lab, of which the NORC program is one project. 

Abramss team mapped nearly 2,000 potential NORCS in Ontario. They looked primarily at high rises, rental apartments, condos and co-ops, totalling about 217,000 older adults. 

As a physician, Abrams sees first-hand the impact of elderly people ending up in hospitals with little or no support. They can become cognitively impaired and physically weakened, making it difficult for them to return to their previous life. 

We can try to do things within the hospital to mitigate that. But I think the biggest benefit would be to do this in the community, creating supportive communities so that cascade of things doesnt even start.

One example of that is home care. Research shows that NORCs can streamline publicly funded services like personal support workers, who could spend less time traveling and more time with a number of clients in the same building. 

The services are completely up to residents. Christine Doyle, 84, has lived in the Stanley Knowles Housing Co-operative in Toronto for decades. Seventy per cent of the building is over the age of 65. Doyle wanted to age in place, so in 2019 she and others in the building created a committee to look at options. Thats when she learned about the idea of a NORC and contacted UHN. 

They started off giving us a health co-ordinator and it sort of blossomed from there, she said. 

Today, there are outings and speakers, as well as an onsite co-ordinator who can help with individual issues. At the El Mirador apartment building in Hamilton where Wendy Yacura lives, the residents emphasize physical fitness programs that can be brought to them. They are supported by Oasis Senior Supportive Living, which started with one NORC building in Kingston, Ont., over a decade ago. Now it has 19 sites across Canada.  

Letts, the McMaster professor, is the Hamilton lead for Oasis, and helped develop the programs at El Mirador.

We had flip charts around the room where people could give us suggestions of kinds of activities they were interested in," she said, which empowered residents with a sense of purpose.

Letts co-authored a study that found NORCs can create an opportunity for governments to support healthy aging in their communities.

Both the UNH and Oasis NORC programs get their money through a network of public funding and private donors. Yet it is limited, and they agree this is a model governments should be pursuing. 

It is very logical that we would bring services to where people are and services that are not necessarily high-cost, said Letts.  

I see health benefits across the spectrum, said Abrams.

For Wendy Yacura, weekly programs in her Hamilton building, like the balancing and fitness class, offer her much more than just physical health: They give her a sense of independence, and the ability to do things she enjoys. 

And like many seniors, she fears losing that capacity.

If I couldnt continue to live on my own, it would probably be a nursing home, she said. And I hate that thought. 

WATCH | How June Southall, an El Mirador resident, benefits from a fitness and balance class:

A rise in aging in place doesnt mean long-term care homes will disappear. They can serve a need if someone has complex health issues. However, according to doctors like Abrams at UHN, these questions will take on an added urgency as Canadas population ages. 

That impacts being felt all the way through society, both in terms of housing, in terms of health care, in terms of, where are these older adults going to live? 

The goal for many seniors is to find a living situation that supports them socially, financially, and medically for as long as possible. 

To learn about co-housing, you can contact the Canadian Cohousing Network https://cohousing.ca/.

If you want to learn how to create a NORC in Ontario, you can go to https://norcinnovationcentre.ca/. If youre in another part of the country, Oasis can provide some guidance at https://www.oasis-aging-in-place.com/.