When most people think of Laguna Beach, California, they think of its scenic coves and beaches.
But the small coastal city — with a population of around 22,600 — is also pioneering a new model for elder care.
About 77% of adults ages 50 and up hope to stay in their homes long term, according to AARP. In Laguna Beach, the rate is even higher, with about 90% of residents, according to Rickie Redman, director of the city’s aging-in-place services, dubbed Lifelong Laguna.
The program, which provides services through a hometown nonprofit, was piloted in 2017. Lifelong Laguna is based on the Village movement, where aging in place is encouraged with community support.
The Laguna Beach program aims to fulfill a specific need for a city where approximately 28% of residents are age 65 and over, while local assisted living and memory care services are scarce.
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Many of the older residents have lived in the city since they were in their 20s and 30s, and now find themselves in their 70s and 80s, according to Redman. Many of them trace back to the city’s artistic roots, she said.
“They make this city unique,” Redman said. “They’re the placeholders for the Laguna that we now know.”
Notably, there is no cost for the city’s older adults to participate in most of the services.
The program, which currently has around 200 participants, relies on grants and local fundraising, according to Redman. Its services address a wide range of needs, including a home repair program the city operates in collaboration with Habitat for Humanity, nutrition counseling and end-of-life planning.
Other cities have also adopted community support models for residents who age in place through the Village movement. That includes tens of thousands of older adults in 26 states and Washington, D.C., according to Manuel Acevedo, founder and CEO of Helpful Village, which provides technology support to seniors and participating communities.
Retirees confront high costs to stay at home
The high costs of aging in place are one of the biggest obstacles that prevents older adults from fulfilling their desire to stay put, experts say.
About 10,000 baby boomers are expected to turn age 65 every day until 2030. An estimated 70% of those individuals will need long-term care services at some point, according to Genworth Financial.
In 2021, the highest year-over-year increase in cost was in home-care services, Genworth’s research found. The median annual cost for in-home care was $61,776 for a home health aide to provide hands-on personal care and $59,488 for homemaker services to help with household tasks.
Those costs have been influenced by supply and demand, according to Genworth.
As more people age and require care, the Covid pandemic led to an insufficient supply of professionals to meet care needs, as well as a high turnover rate.
Preferences for aging in place are also showing up in the real estate market.
Baby boomers currently represent the biggest portion of home buyers, according to Jessica Lautz, deputy chief economist and vice president of research at the National Association of Realtors. More than half of boomers are saying that the property they are purchasing now is where they plan on living for the rest of their lives, a sentiment that has increased since the Covid pandemic.
“There definitely is a mindset change, where people are saying, ‘I do want to stay put, I don’t necessarily want to move into a nursing home or into assisted care,'” Lautz said.
‘Forever grateful’ for community
Sylvia Bradshaw, an 84-year-old Laguna Beach resident who moved to the city in 1983, describes it as “paradise.”
She has lived there since that time, apart from a stint when she and her husband relocated to Ireland. Still, the couple held on to their home, the city’s third-oldest house, which was built in 1897.
“My husband had ideas about selling our home,” Bradshaw said. “But I would never sell it, because I said ‘Once it’s gone, it’s gone forever.'”
Bradshaw’s husband was a teacher in the city’s high school and later became a lawyer. More recently, he had health struggles that made it difficult for the couple to keep up with yard work, Bradshaw said.
As members of the Laguna aging-in-place community, they had access to help.
Redman helped arrange for a team of workers to come to clean up the yard, which included removing 17 bags of scraps and trimming a roughly 30-year-old fig tree.
“Now people can see that there’s a house there; they just couldn’t see it [before],” said Bradshaw, who said she is “forever grateful” for the gesture.
The support of the community also was especially helpful in sorting through the hospice care issues prior to her husband’s recent death.
“Anything that I’ve needed, I’ve gotten help,” Bradshaw said.
That has included help sorting through insurance choices, legal advice, transportation assistance and classes and social events, said John Bradshaw, Sylvia’s son.
Having the elder community support his parents is a “big comfort,” John said, particularly as he no longer lives in Laguna Beach.
“It is just such a wonderful relief,” John said. “It’s like having a second family, this team of people really supporting my parents, and others like them, to be able to stay and enjoy this part of the country.”
What to do if you want to age in place
If you want to age in place, it helps to start planning early to make sure it’s feasible, said Carolyn McClanahan, a physician and certified financial planner who is the founder of Life Planning Partners in Jacksonville, Florida.
“We actually start bringing it up with clients in their 50s and 60s: Where do you want to live out the end of your life?” McClanahan said. “Of course, most people do say, ‘I want to live in my home.'”
It’s important to be realistic about those plans.
Ask yourself whether the decision to age in place is just “rationalized inertia,” or giving yourself an out when it comes to confronting other important aging decisions, said Tom West, senior partner at Signature Estate and Investment Advisors in Tysons Corner, Virginia.
If you do decide staying in your home is the best option, be prepared to make changes to your home, he said. That may include wider doorways to accommodate wheelchairs or walkers, as well as grab bars to help prevent falls.
Like the aging-in-place models established in Laguna Beach and elsewhere, it helps to have community support. McClanahan recommends developing strong relationships with your neighbors where you agree to look out for each other.
It also helps to set certain boundaries for when staying at home no longer makes sense.
For example, it may cost $240,000 a year to stay home if you need 24-hour care, McClanahan said.
“Even if you’re super rich, a lot of families hate seeing that much money go out the window, when you would pay half the cost to actually go into a facility,” McClanahan said.
Further, be sure to outline your wishes in all potential circumstances. While you may want your children to promise not to put you in a nursing home, it may come to a point where it is more cost effective and safer to go to a care unit, McClanahan said.