Building for Aging: Introductory Letter

Dear Reader,

Housing costs are the biggest driver of economic insecurity for older adults. Unfortunately, after spending their working years making our many Massachusetts communities thrive, they face the reality that they may not have the resources necessary to age in community. We owe it to our older residents to create a future state where this is not a reality. By strengthening our older adult housing ecosystem, Massachusetts can maintain our economic competitiveness while countering rising housing development and healthcare costs.

We envision a Massachusetts where every resident has the resources and support that allow them to grow old in the manner they wish. Achieving this requires three core elements:

1. Economic security. Housing affordability needs to be measured against an older adult’s likely long-term medical costs. We know that 70% of baby boomers will need significant in-home care during their lives, and that this care is expensive.¹ Therefore, when we calculate what older adults can pay for housing, we need to make sure that they either have their own financial resources to support these costs, or we have a public way to subsidize/provide homecare. While Medicaid pays for some homecare, Medicare does not. Homecare costs are one of the biggest reasons middle-class older adults fall into bankruptcy, resulting in more older adults enrolling in Medicaid and increased taxpayer spending on healthcare.
2. Social connection. Loneliness not only spurs depression, but it also significantly increases the risk of dementia, heart attack, stroke, and accelerates the loss of ability to care for oneself. It is imperative that older adults are in situations that facilitate new friendships and social connections.
3. Appropriate healthcare and homecare. At any age, but especially for older adults, it can be difficult to navigate these systems. Professional partnership is needed to determine the right health pathways. Without it, Massachusetts will see rising healthcare costs as a result of preventable increased utilization of costly emergency medical care. 5 Housing is the most effective platform to ensure economic security, safety and autonomy of older adults. It is imperative that older adults have the resources to support their own choice regarding where they live—whether that be in their own home or in multifamily housing. The Senior Housing Commission’s goal is to ensure that housing is the foundational element for optimal aging.

Older adults in Massachusetts are not a monolith, but they all deserve the same thing: safe, affordable housing that supports them through this phase of their lives. Many of our seniors are active, healthy and working. Other seniors are struggling to afford retirement. Some want to remain in the homes where they raised their children. Others would prefer to downsize. We are seeing seniors investing in top-of-the-line ADUs to create multigenerational living on their properties and seniors struggling in housing that does not meet their changing mobility requirements.

We must strive to ensure that older residents can safely and affordably remain in their homes and communities as long as possible, or if they choose, relocate to homes that are right-sized for their present stage of life. Without building a wide range of housing choices in every community, we risk removing people from the communities where they have flourished for decades.

The importance of social connections, especially for older adults, cannot be overstated. Social isolation has a negative effect on the health of an older person. While these connections may be fulfilled by dedicated senior housing communities, they can also be seen in a casual interaction with neighbors in the town someone has lived in for decades. People in Massachusetts look out for each other: delivering groceries, shoveling snow, or just stopping by to chat.

While many of the suggestions in this report will reference new, purpose-built housing, we are just as dedicated to accommodating those who wish to remain in their cherished homes or neighborhoods.

Most importantly, behind every data point is a person. They may be your neighbor, a mentor, a former teacher or coach, or a parent that is now a grandparent.

We are likewise grateful for the work of the Special Commissions on Accessible Housing and Extremely Low-Income Housing, which have developed parallel reports addressing many similar issues given the high degree of overlap between the populations on which each Commission focused. We encourage you to review the reports of those Commissions as well.