‘Til Death Do Us Part: Cutting-Edge Concepts and Legal Tools for Helping Couples “Age In Place”

Virginia M. George

While the numbers of elderly couples are growing exponentially, new options exist for them to successfully ‘age in place’ and avoid the negative impact of moving out of their homes. This article will focus on the concept and practicality of elder villages as well as several legal tools to assist senior couples as they make the important decision of whether to move out of their residence and on to more institutionalized settings.

According to the United States Census, there will be a spike in the age 60+ population from 43,043,000 in 2005 to 73,769,000 in 2020, an increase of 71 percent. California is projected to be one of the fastest growing states in the nation in total population. In California, the elderly population is expected to grow more than twice as fast as the total national population and this growth will vary by region.

The elderly age group (age 60-84) in California will have an overall increase of 112 percent from 1990 to 2020. More than half the counties will have over a 100 percent  increase  in this age group. Eleven of these counties will have growth rates of over 150 percent.  The influence of the 60 and over age group on California is expected to emerge most strongly between 2000 to 2020.

The oldest old-age group (age 85+) will increase at even a faster rate, having an overall increase of 143 percent from 1990 to 2020. Of California’s 58 counties, 38 will have increases of more than 150 percent, 26 will have increases of more than 200 percent, and 11 will have over a 300 percent increase in the number of persons aged 85 and older. Of these 11 counties, all but one are located in the central and northern areas of the State. Counties can expect to experience even higher growth rates after 2020. In particular, the influence of the 85 and over age group on California will emerge most strongly between 2030 to 2040 as the first of the baby boomers reach 85 years of age.

With these staggering statistics, demographers project that by 2050 one in five Americans will be age 65 or older, part of what has been called a “silver tsunami.”

Whether single, married, or life partners, the elderly face increasingly difficult decisions as they age, not the least of which is where to live as the years progress.  One of the most difficult decisions entails whether to leave the home, and in couples’ cases, whether the couple should split up (not necessarily by choice, but by necessity due to medical, care and/or living circumstances.)

As senior couples confront care-giving decisions, the couples’ desire to continue to live together is a huge challenge.  Most senior couples prefer to continue living together at home.  But when one spouse is in need of extra help, it places the healthier spouse in a care-giving role.  While remaining at home may be the goal for the majority of couples, doing so without the right support can result in negative and clearly unintended consequences for both elderly partners.

“Aging in place” is a concept that addresses the reality that an overwhelming majority of older Americans want to remain in their homes for as long as possible.  There are many positive aspects of aging in place, which include keeping elderly couples together, maintaining social networks and routines, continuing the sense of independence desired by elders, and ensuring physical as well as psychological comfort.

Elder Villages: A Viable Option

Within the past few years, elder “villages” have emerged as a realistic and successful way to handle a multitude of issues, including legal concerns, that arise as seniors age.  The volunteer-driven, primarily non-profit networks are meant to help seniors continue to live in their homes by delivering a multitude of services they are no longer able to do for themselves and to help seniors stay actively engaged through social events.  What started with the first village in 2001 in Boston (Beacon Hill Village) has become a fast-growing phenomenon that has huge potential to fill a crucial gap for care, housing and legal services as baby boomers age and longevity increases.

As non-profit organizations, these villages are operated by board members and/or volunteers. Most members pay annual dues generally ranging from $35 to more than $900, depending on the village structure.  The idea is to provide senior couples and individuals the capability to remain in their homes, rather than splitting them up or moving them out to more institutionalized settings. Members are provided assistance with medical, home maintenance, daily activities, legal concerns and transportation issues. Vendors usually offer lower rates for their services in exchange for the loyalty and repeat business derived from village residents.

Elder villages, seen as the way of the future, serve a large population falling in a wide gap in care for aging Americans. Medicaid covers nursing homes and some in-home care for lower-income seniors while the wealthy can afford costly assisted-living facilities or hired help.  For the middle- to upper middle-class, however, there remains a huge un-served need.

In the Bay Area, Ashby Village in Berkeley was launched in 2010.  It is now one of 65 senior villages in the United States with an estimated 120 more in the planning stages. Ashby Village now has 170 members, with 95 percent of its members renewing for this year.  Senior villages have been such a success that the Archstone Foundation has funded a three-year evaluation for UC Berkeley researchers to determine the qualities that are most likely to ensure the long-term viability of non-profit villages.

Finally, the elder village movement is catching on fast.  With the economic crisis draining retirement accounts and impacting home values (that many seniors expected to fall back on if they needed residential care) along with the huge percentage of seniors expressing a preference for remaining at home as long as possible, low-cost, self-help models like senior villages continue to gain momentum as a practical, compassionate and successful option for the elderly to age in place.

Legal Tools Available

Additionally, several standard but important legal tools should not be overlooked when working with elderly couples who wish to age in place.

• Powers of Attorney: Known by various labels, the most common of which are Durable Powers of Attorney for Financial Issues and Advance Health Care Directives for Medical Issues, couples and legal practitioners should not only confirm these documents are validly in place, but also that they express the current wishes of the elder.  All too often, people fail to review and revisit these documents after they have been prepared and time has passed; not only do preferences in who the agents are to make such decisions change, important issues, such as life-support and organ donation, may need to be modified over time.  Consistent periodic review and/or revision is a must.
• Title to Residential and Other Real Property: Confirm that title to all real properties, particularly the primary residence, is accurate and up-to-date.  Oftentimes, parties fail to put their homes back into correct legal title from which it came, such as in a revocable trust, after refinancing a home.  Some parties who use commercial agencies to write their trusts fail to correctly title their homes after the trust is complete, which can cause moderate to severe problems in the future.  Checking the title of real property is critical so that fraudulent real estate transactions can be avoided and, if present, quickly addressed.
• Reverse Mortgages for Seniors: A reverse mortgage is a special type of home loan that allows homeowners to convert a portion of the equity in their home to cash.  The equity built up over years of making mortgage payments may be paid to the senior homeowner to give greater financial security, supplement social security income, or make home improvements to assist senior homeowners as they age in place.  Generally, unlike a traditional home equity loan or second mortgage, borrowers do not have to repay the loan until the borrowers no longer use the home as their principal residence or fail to meet the obligations of the mortgage.  If used in the correct manner, reverse mortgages can be a viable option for older Americans to age in their homes.  However, anyone considering such an option should be acutely aware of scam artists that exist and prey upon elders who are seeking such loans in good faith.  Seniors or clients interested in this option should consult the website for the U.S. Department of Housing and Urban Development at the following address: http://hud.gov/buying/rvrsmort.cfm.  Be aware also that HUD offers free HUD-approved housing counselors services to seniors considering reverse mortgages.  If considering such an option, potential borrowers should never sign without first having an opportunity to review the document with either a HUD counselor, a qualified legal professional or both.