Why Home May be the Assisted Living of the Future

Most older Americans want to stay in their homes for as long as they possibly can. Put in negative terms, almost all of us want to avoid moving into senior housing, at least until we have no other choice. But most also agree that assistance may become necessary as our capacities decline and our needs multiply.

It seems we have to choose: Either hold onto the comfort and independence of living at home or take the improved care found in senior housing.

But what if there was a way to bring the many functions of today’s assisted living into the home? That sounds like a luxury that only a comparative few can afford, but with the growth of smart technologies and on-demand services such as car transportation or telemedicine or grocery delivery, it could actually be the more affordable option.

The MIT AgeLab published an exploratory study examining the cost of senior housing vs. staying at home with the support of on-demand services. The results were surprising. For older adults with relatively few needs, the cost of using on-demand services at home was higher than the nation’s monthly average entry cost of assisted living. But for an older person who required higher levels of support, the cost of using on-demand services from home could actually be half the cost of the nation’s average monthly assisted-living fee.

Perhaps equally surprising are a second set of findings from the AgeLab study. Researchers explored the willingness of adults 85 years old and older to use and accept on-demand services as a way of living independently. Discussions with AgeLab’s Lifestyle Leaders Panel, a select group of 85-plus older adults, revealed not only a willingness to use home care, food delivery, home maintenance and other services on-demand, but many were already using these services to remain independent or to simply make life easier.

In fact, some members of the group were shocked that researchers even would ask–responding emphatically with an “of course I use these services, why wouldn’t I?”

This new way of living, where countless branded services are provided on-demand and proactively to older adults and caregivers, is transforming the home into what the MIT AgeLab refers to as home-as-service.

What exactly does this look like?

For one thing, the home is increasingly aware of its occupant’s well-being. Soon, sensors throughout the home will be able to measure how active Mom or Dad is and even notify emergency services if they are incapacitated. Checking in with a telemedicine provider or with a virtual physical therapist using a tablet could help keep an older person in good health and at home. Services already enable a family member or an older adult living alone to order home care by app. See a short video the MIT AgeLab created here.

It’s not only high-level health-care needs that can be fulfilled via the home-service platform. Nutrition can be delivered and curated for an older care recipient via services. Older adults who cannot drive can obtain convenient transportation via ride-sharing services. Other companies can bring a vetted professional into the home to change a light bulb, mow the lawn or install a door handle.

The freedom the connected home provides for one to choose services a la carte, rather than being incorporated into the one-size-fits-all environment of the facility, is an enormous benefit not only for older adults’ wallets, but for their own sense of independence and personal control.

It does, however, upend the business model for assisted-living facilities. The assisted-living model has rested on the compelling assumption that the most affordable way to provide for the needs of older adults is to house them in one place. But in our new reality of smart technology and on-demand services, that may no longer be the case.

The senior-housing industry may have to adapt to a more complex and challenging environment that challenges their traditional investment thesis, even as the number of older adults in the U.S. continues to increase. Rather than investing purely in the development of more facilities, the industry should develop strategies that enable it to competitively bring services into the home thereby building a pipeline to prospective customers.


Joseph Coughlin

Joseph Coughlin is director of the Massachusetts Institute of Technology AgeLab and author of “The Longevity Economy: Unlocking the Fastest-Growing, Most Misunderstood Market.”

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