The most populated and fastest growing section of the United States is the South, which attracts migrants of all ages. More Americans, particularly minority groups, live in urban than in rural areas. The concentration of older adults in metropolitan areas is somewhat less than that of younger adults, but three-fourths or more of all age groups live in cities and towns. Greater percentages of minority groups also live in the South and West than in the Northeast and Midwest.
The rate of migration from one geographical location to another varies inversely with age, being greater for younger than older adults. But retirement and poor health lead to a slight increase in the frequency of relocation in late life. Residential moves produce a certain degree of relocation stress, but it is less for young adults, for those of higher educational and socioeconomic status, and for those who understand the reasons for moving and can control the process.
Three types of relocations or migrations by older adults were discussed in this chapter: assistance migration, amenity migration, and kinship migration. An example of assistance migration is moving into a nursing home. Amenity migration consists of moving in order to change one's lifestyle or to maintain a friendship network. Kinship migration is moving to an area inhabited by one's children or other close relatives.
Life for the 225,000 to 2.5 million homeless people in the United States is an uncertain, often dangerous experience. Shelters, free meals, and other amenities supported by governmental and charitable organizations are of some benefit to the homeless, but such programs do not solve the problem. The living situation for single-room occupants in large cities is better than that of the homeless, but, in many cases, not much more so.
Most Americans live in single-family dwellings and in family contexts.
The percentage of Americans who live alone is greater in older adulthood than in young or middle adulthood, and higher for women and whites than for men and minority groups.
The proportion of Americans who own their own homes increases with age, is greater for men than for women, and for whites than for minority groups. Home ownership is also more common among suburban residents than among those who live in the central cities, and higher in certain states than others. Many young adults were able to purchase homes in the 1960s and 1970s, but the increasing cost of housing and the decline in the real-dollar incomes of young adults during the 1980s and 1990s reversed this trend somewhat.
Older adults who own their own homes pay a smaller portion of their income than the average citizen on housing. On the other hand, older adults who rent spend a higher percentage of their income on housing than other age groups. Whether owned or rented, the dwellings of older adults are often old and in need of repair but in most instances in fairly sound condition. Most older adults prefer to remain in their own homes and are fairly well satisfied with their home and neighborhood. House-rich but cash-poor older adults may be aware of the availability of home equity conversion, a reverse annuity mortgage (RAM), or a sales leaseback, but a very small percentage actually use such strategies for solving their financial problems.
Among the wide range of plans for meeting the housing needs of older Americans are shared housing, ECHO houses, congregate housing, continuing-care retirement communities, and retirement villages. For older adults with mild physical impairments, a congregate housing community may be appropriate. In this arrangement, residents have their own apartments but eat in a common dining room and are provided with housekeeping and security. More services are offered by continuing-care retirement communities (CCRCs), but the cost is greater. For a minority of active and affluent older adults, a retirement village such as Leisure Worlds or Park West has proven to be a suitable living arrangement.
Long-term care is provided by residential care homes, intermediate care facilities, and nursing homes. The residents of residential care homes (retirement homes) are typically less ill than those in intermediate care facilities or nursing homes. Residents of intermediate care facilities are, in turn, typically less ill than those in nursing homes. The majority of nursing homes are privately owned and expected to make a profit, but some are voluntary, nonprofit institutions and others are government-run. The Nursing Home Reform Act of 1987 has led to improvements in the conditions and services of nursing homes in the United States. Many older adults who would formerly have been placed in nursing homes are now able to remain in their own homes, being cared for during the day in adult day-care centers and/or taken care of at home by home health care agencies.
The great majority of adult Americans—old and young—drive their own automobiles to get from place to place. The percentage who drive declines somewhat with age, but most of those who do not drive depend on family and friends for rides. Governmental agencies have sponsored less expensive and more convenient modes of transportation, such as Medicabs and Dial-a-Ride, for older Americans, but support for these programs has wavered. Assisting older Americans who have difficulties performing activities of daily living (ADLs) and instrumental activities of daily living (IADLs) is a function of other government programs (Meals on Wheels, Aids to the Elderly, and so forth).
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