Health Care/Joan Retsinas

The Gray Wave Rises

Forget the Blue Wave and the Red Wave, the political tsumani that cleaves the nation. The Gray Wave, a.k.a. the aging of America, is not a storm that we watch, wondering where it will hit, whom it will devastate. This Wave does not divide us. It unites us. Those of us who have not yet passed that Rubicon will soon pass it. Vision, mobility, hearing – those senses that Shakespeare predicted would wane in the last stage might wane. Chronic illnesses will hover. Our children will morph into caregivers; and some of them will be Gray.

Consider: half the households in the United States are headed by somebody aged 50 or older. (Housing Americas Older Adults 2018 / Joint Center for Housing Studies — jchs.harvard.edu/housing-americas-older-adults-2018/.)

This is not necessarily grim news. Most people who pass that Rubicon are thrilled to enter this next stage (given the alternative).

But we need some commonsense help. Here are wake-up memos to people who don’t see this Wave even as it rises.

A memo to builders: Redesign housing for residents who need walkers and/or wheelchairs, as well as residents who cannot run up and down flights of stairs several times a day – in short, single-floor homes. And don’t forget entryways: too many have stairways, or “lips” that emerge as major barriers, the kind that necessitate after-the-fact ramps. At the same time, widen doorways. These are hardly draconian changes to a floor plan – these are doable features that builders can incorporate from the start. The Harvard report estimate that 17% of households headed by a person age 50 or older, and 43% headed by a person age 80 or older included a member who had difficulty walking. Yet only 3.5% of homes have user-friendly features.

A memo to community planners (as well as local residents): rethink your passion for huge-lot, huge-home construction. Communities today fight density, waving the sword of “zoning.” They fear an onslaught of children needing schools, and lower-income tenants needing services. The toniest suburbs have resisted the hardest. Yet a lot of elderly people live in low-density communities. Thirty-two percent of older adults live in low-density census tracts, up from 24% in 20001. Lower density works for forty-somethings, who can jump into SUVs to buy groceries. It does not work well for septuagenarians and older, especially those who live alone. (The Harvard study estimated that 57% of households headed by somebody age 80 and older lived alone.) The car-less exurbanite is isolated – not just from friends, but from social and health services. So planners: design denser community-spaces; and communities, accept — no, welcome — these smaller structures. Your parents and grandparents need them now; eventually you will.

A memo to physicians: open your offices to patients with disabilities. Patients in wheelchairs, like ambulatory patients, need to be weighed, measured, x-rayed, and sit on examining tables – the common protocols for office visits. Yet many physicians’ offices lack those amenities. The solution is simple: adjustable examining tables, as well as equipment that works for patients who are not mobile. The key excuse is petty: too expensive, as though a few thousand dollars for an adjustable examining table will strain the budget of a medical practice.

Admittedly, offices don’t “need” to make these accommodations. The 1990 federal Americans with Disabilities Act did not touch office furnishings. In January 2017, under the Obama Administration, an Architecture and Transportation Barriers Compliance Board made recommendations for office equipment; but this current Administration halted those recommendations. So it is left to insurers and states (notably California) to require “access.” These changes, though, should not need governmental edicts: common sense, coupled with compassion, should dictate the changes.

The market has responded to the Gray Wave. Big-Box stores, like Walmart and its ilk, feature wide doors that open electronically, without pushing. Their aisles are wide; their staff, willing to help shoppers who need help (whatever the age, whatever the reason). Ride-sharing services, like Uber, Lyft and their spawn, have tapped into demand from people who can’t jump into cars, and who generally can’t use public transportation, often because it doesn’t exist near where they live. Pharmacies have drop-in clinics for flu shots, sometimes for primary care visits. Libraries stock large-print books and books on tape. Some banks have lowered their ATM machines.

The year 2019 promises to be the year of government retrenchment, or stasis, at the federal level. To improve our lives, we cannot look to Uncle Sam. But we can look to ourselves. Surely we can adapt our country to this Wave.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, January 1-15, 2019

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