Economics Make a Case for Universal Design

The good news is that there are a lot more of us and we're living longer. The downside is that we are headed toward an unparalleled economic crisis that we seem woefully unprepared to meet. The crisis is our inability to pay for long-term care services and supports.

We have heard the sobering statistics about how many Baby Boomers are turning 60 on a daily basis. According to the World Economic Forum, our global population is projected to increase by a factor of 3.7 from 1950 to 2050, but the global population of those over 60 is expected to increase by a factor of nearly 10, and the population over age 80 by a factor of nearly 26 during those hundred years.

Looking at it another way, our global population is expected to increase by 2 billion people from 2010 to 2050 and, of that, the older population will contribute 1.3 billion. By 2050 the population over 65 years of age will outnumber those under age five for the first time in human history.

Living longer doesn't equate to living healthier

Unfortunately, living longer doesn't necessarily equate to living healthier. Although the population over 65 only accounts for about 13 percent of our population today, it accounts for 27 percent of all doctor visits, 38 percent of all hospital stays, and 45 percent of all in-hospital days of care.

It was recently estimated that for every one percent shift in the population over age 65, health care costs are increased by $254 per capita. Today, healthcare in the U.S. costs equal 17.6 percent of the Gross Domestic Product (GDP) and that is projected to increase to 21.4 percent by 2020, 28 percent by 2030, and 34 percent by 2040.

With so many of us aging, two questions come to mind:

•    Where will we live?
•    Who is going to take care of us?

The Practical Guide to Universal Home Design is available for free online (click here). A limited number of print booklets are available through the Northwest Universal Design Council (e-mail requests to


Who will be our caregivers?

When our parents in the "Greatest Generation" came of age, 94 percent of them got married after the war. Each household averaged just less than four children. Today, 65 percent are still married to the same person. There was usually a pretty good chance that someone in the family would step up to help take care of mom and dad in their later years.

Today it is estimated that 78 million adults receive long-term care based solely on their family. The majority of those caregivers are women (56 percent) and they average 20 hours per week as caregivers on top of other jobs.

When we—their children—came of age, only 87 percent of us got married, and we had an average of just less than two children. Already, only 68 percent of us remain married. More concerning is the fact that the trend is continuing in that direction.

More than 56 million single adults (60 percent) have always been single and, in 2005, single homebuyers surpassed married buyers for the first time, becoming the new norm. By 2009, unmarried women accounted for 21 percent of all home purchases, while unwed males were 10 percent of the buyers. Single has become more of a lifestyle choice than a condition. Odds of a caretaker in there goes down significantly!

Generally, in-depth discussions about our nation's long-term care system have not resulted in change. We need to create large enough insurance pools to manage the kinds of risk that people are going to face over time, and include long-term care services and supports. We need new toolsets for people who are working today so they have enough time to participate and to save. Five years from now, the majority of boomers will be retired or be within five to seven years of retirement. It's much harder to save at that point.

There is an entire industry out there selling us long-term care insurance, but very few professionals in the industry who understand enough to talk to you about where you live. One solution is to work on a solution right under your own roof.

Will your home allow you to age in place?

We always hear that your home is greatest asset, yet there is little discussion about the economic sense of putting some of that money into modifying your homes to accommodate your changing needs. According to a recent AARP survey, 95 percent of those age 75 and older want to stay in their homes as they age but, in reality, only five percent to seven percent of their homes will enable them to do so. It isn't necessarily declining health itself that prevents people from living independently; rather, our living spaces and daily strategies fail to change along with us.

According to Louis Tenenbaum, founder of the Aging in Place Institute, there are good reasons to consider our homes as one element in our retirement and long term care planning:

  1. Updating your home makes it more pleasant, a better match for your current taste and activities.
  2. Long term care at home means the ability to get the care you need in the residence you choose. You own the venue, so you control what happens there. The folks who own an assisted living facility make the rules you would live by there. Plan to live in your house, make your own rules, and maintain control.
  3. A well-prepared home helps avoid injury, one reason people are forced to move to a traditional long-term care facility.
  4. A well-prepared home is the most economical place to recover from an accident or illness.
  5. A well-prepared home makes it easier for family and friends to provide informal support—the most important source of care.
  6. Long-term care at home allows paid care to be used selectively. Various services can be ramped up or withdrawn to match changing needs, rather than the "package deal" that assisted living or nursing homes provide. Custom care and "just in time" service is a much more economical use of resources.
  7. An energy-efficient home saves fixed-income homeowners from rising energy costs.

Try as we might, there are some homes that really don't lend themselves to being adapted, so we need to help shift the paradigm of how new housing is constructed. We need Universal Design that accommodates people of all ages and abilities all the time. It is our responsibility to understand what we really need and want and to communicate those needs to the housing industry with our dollars.

Learn about the principles of Universal Design on the Northwest Universal Design Council website (

Contributor Tom Minty, a Realtor and small business owner who serves on the Seattle-King County Advisory Council on Aging & Disability Services as well as the Northwest Universal Design Council, is passionate about promoting an awareness of the unique housing needs of people with disabilities and our aging population.

Principles of Universal Design

Equitable Use
Flexibility in Use
Simple and Intuitive Use
Perceptible Information
Tolerance for Error
Low Physical Effort
Size and Space for Approach and Use

The Principles of Universal Design was developed by the Center for Universal Design at North Carolina State University, a national information, technical assistance, and research center that evaluates, develops, and promotes accessible and universal design in housing, commercial and public facilities, outdoor environments, and products.

Locally, these principles are promoted by the Northwest Universal Design Council, staffed by Aging and Disability Services—the Area Agency on Aging for Seattle-King County.