What will it take?

At first blush the small homes for aging idea makes so much sense it’s a wonder that it’s not more commonplace already. The truth is, there are several obstacles in the way, and removing them will require profound change in several areas:

Zoning: The largest practical obstacle of all at the moment, with the vast majority of municipalities still favoring that post-World War 2 staple of community development, the single-family home. Long held forward as “the American dream,” the single-family home is the bedrock of suburbia and, more and more of late, exurbia (the large rural and semi-rural tracts between cities). And many of the occupants of those structures want nothing that will interfere with their community mores, parking arrangements or taxes.

Which points to a related obstacle, called NIMBY, not in my back yard. Years ago I wrote in my book The Big Surprise that it wasn’t unusual for community members to turn out at municipal planning meetings to oppose development of nursing homes and assisted living facilities in their neighborhoods. The thought of changing the nature of a single-family neighborhood, with the supposed impacts on traffic and parking, was intolerable. The same possibly unfriendly reception is true of the small home, be it accessory dwelling unit (ADU), pocket neighborhood or backyard granny pod.

Choice: A big problem is simply availability of information about small home choices. You must find the solution that works best for you in contemplating caring for a loved one at or near the home, but the choices are several. ADUs come in various flavors: attached, detached, upstairs, basement—not to mention sizes varying from, roughly, 300 to 1,500 square feet. Granny pods—temporary backyard structures that can be installed and removed at will and incorporate sophisticated tracking and other supportive technologies—are another option. Somewhat larger practical assisted living (PAL) homes constructed in backyards or nearby are yet another. Understanding these requires significant research and, if possible, input from an informed consultant, if you can find one.

Finance: Two issues here: cost and the availability of capital.

As noted in the previous installment of this blog (“Sticker Shock,” below), the cost of an ADU was found to be irreducible below $180,000 in the “ADU capitol” of the U.S., Portland, Oregon. Granted, the urban northwest is already a relatively high-cost area, but one of the major drivers of that cost is a problem afflicting much of the country: the cost of construction labor. With the loss of much of their skilled labor force during the Great Recession, contractors are scrambling to find, develop and hire the plumbers, electricians and carpenters they need to complete housing developments of all kinds. The inevitable cost of this is a sharp rise in the cost of construction labor. One major Portland contractor I spoke with at a recent ADU conference told me, “This is a growing problem, and I see no end in sight.” Another general problem with contractors is that many just don’t see how they can make sufficient money in the small home market.

Even where costs are not daunting there can still be the problem of raising sufficient money from conventional sources, such as banks and other mortgage lenders. Many financiers are still unfamiliar with the challenge of meeting the needs of the so-called “middle market,” that large and growing group of middle income families who can’t afford sustained facility care running tens of thousands a year, and yet make too much money to qualify for Medicaid assistance. Robert G. Kramer, a founder and strategic advisor for the National Investment Center for Seniors Housing and Care (or NIC, the national organization of seniors housing financiers), says members have been “spoiled” by the relative ease of marketing big-ticket facilities to upscale seniors, but wonder where the return on equity will come from middle market models. He says figuring this out will be seniors housing financiers’ major challenge for the next decade before the full impact of middle income seniors slams into the market.

Technology: As a caring environment, the small house won’t work without supportive technology. These are devices and systems available today that do much of the work a caring staff would do in a formal facility, such as a nursing home or assisted living structure. Residents’ daily activity is monitored closely enough so that any significant slowing down or disruption of that activity will be quickly identified and dealt with. In the small house motion sensors and alarm systems play that role, connecting directly with the main home and its occupants, whether at home or away. Another, not really new, automated device offers medication management, alerting the senior or caregiver when certain drugs must be taken, and tracking serious deviations in drug-taking behavior. More recently voice-activated technology, such as Amazon’s Alexa and Echo Dot, gives the senior communication and environmental control options never before available. (See “New Technology for Small Home Living”, below). Not too far down the road will undoubtedly emerge useful and pleasantly acceptable robots to help seniors with home maintenance and perhaps even provide entertaining company. Also telehealth, with seniors conducting virtual visits online with healthcare providers, is another growing option.

The point for now, though, is that all this emerging technology remains on the cusp of general acceptance, and even existing supportive technologies such as motion sensing can be controversial, perceived by some as an invasion of privacy. The senior care environment has a ways to go to catch up with the smart home revolution currently underway.

Home care knowledge: A major issue right now, and one that continues to evolve, is family knowledge of home care techniques needed to keep senior safe without burning caregivers out. The “right time” to move a frail senior from a normal, day-to-day home environment to facility care has long been contentious. Seniors, for their part, don’t want to leave the home, vowing never to do so even when it’s clearly necessary.

Meanwhile caregivers find themselves becoming ever more deeply involved in senior care—feeding, bathing, dressing, even toileting—as the need grows, often at the cost of their jobs and working hours. The question is, how much can you and others living at home be expected to take on, practically speaking, in the family home? When will transfer to a formal caregiving facility become unavoidable? These questions have highly individualized answers and must be explored early and often.

In view of all this, the path to the small home as a practical alternative may well be long and challenging. But these issues will be worked through over time, based on the accumulated experience of families and homeowners addressing them individually starting now.