As an architect, I constantly think about how the built environment enables us—physically and emotionally. Take something as basic as a sink. What’s the right height? Is a deeper bowl—say, eight inches—better, so a person can not only brush their teeth and wash their hands but also rinse their hair or do some hand washing? Where should that sink sit in the bathroom?

Nowadays, we defer to building and plumbing codes that standardize many of these decisions regardless of our preferences, abilities, or body types. Mostly, this is a good thing. It guarantees a baseline, and because codes have adopted guidelines for accessibility, they help create spaces—at least in the public realm—that are built to work for a wide range of abilities. But standards are not one size fits all.

I’d argue it all starts with the body itself. As the dancer and choreographer Joe Goode, who I interviewed a couple of years ago (Podcast with Joe Goode) when he was in his seventies, put it, “because I work with movement, I do a lot of work with the body as the home. It’s our first territory. It’s the first thing that we know.”

Getting to know my own territory

Prompted by a health event that stopped a forty-year trail running habit in its tracks, I feel like I’m only now, in my late sixties, really understanding what Goode meant; and it took me five months of resistance to see this setback as the boon Goode describes: “That opportunity to really embody this territory, really know it, and continue to discover it in all of its wrinkles and misfires and in all of its incompleteness…There’s still so much to discover, and it can be such a balm.”

So how does any of this connect to how I use my sink, or how my home shows up for me? These days I try to stand on one leg—my “bad” leg, for as long as it feels okay while I brush my teeth—to renew my relationship with it. A few weeks ago, before I crawled out of what I’ve come to think of as pain country, I finally made real use of the wooden bench in my bathroom, which up to that point had mostly served as a place to stack towels. I noticed it sat too low to be comfortable, so I folded a few towels into a cushion. I also started paying attention to where I could easily lounge, and I recruited pillows of every size to adapt the furniture to my aching body.

Then one day, I had a vision: soaking my aching body in hot water. My height has its advantages, but with two-thirds of me sticking out over the edge, it makes my standard five-foot bathtub useless. So, I texted an architect-builder friend about my dream; and low and behold, he had a larger tub, returned by a client, sitting in his yard; and he gave it to me. In a couple of weeks, I’ll be soaking outdoors, and when I drain the tub, the water will irrigate the plants in my yard.

Befriending my body

This personal journey has not only informed the workshop I’ve taught for many years, Aging 360, which empowers participants to make simple adaptations to their own homes. At the same time, it’s opened the door to new ways of moving my body in space—swimming, Feldenkrais, Pilates—that I wouldn’t have tried before. And it’s expanded what I consider home: my body, my house, and even the public pool in the park around the corner. And I understand more clearly something else Goode said: “We don’t have to fix our bodies. We just have to know them, familiarize ourselves, and befriend them. That can be a huge step toward healing and toward finding comfort and finding ease.“

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The New York Times has done a wonderful job putting the realities of older age on everybody’s radar—offering practical, accessible tips on how to navigate it well. Their recent piece The Everyday Essentials That Longevity Experts in Their 50s, 60s and 70s Use in Their Own Homes, is a great example; everything mentioned is achievable by most people and costs little or nothing. The main takeaways include adapting routines, compensating for certain changes, and recognizing that you have real agency over your aging experience. Simple concepts, meaningful differences.

These align with the essence of our Aging 360 workshops, which we’ve been running since 2017 and now have the opportunity to scale nationwide thanks to the Thome Aging Well Innovation Grant.

But here’s what doesn’t get said enough: aging well is not a solo endeavor. It takes a team.

Recently, I was reminded of this while watching Nyad, the film about Diana Nyad’s extraordinary swim from Cuba to Florida at age 64. What struck me wasn’t just her feat—it was her team of 40 people, who made it possible. 40 people. For one swimmer. That stayed with me.

As we bring Aging 360 to nonprofits, affordable housing developers, and community-based organizations across the country, we are meeting the people I think of as the “first responders” to aging needs—the professionals on the front lines who actually make aging in place and in community possible. We are training selected staff in these organizations to deliver Aging 360 as part of their health and wellness programming, and in doing so, we are learning as much from them as they are from us.

Who are these team members?

Resident Services Coordinators or Resident Engagement Specialists in affordable senior housing are often the heartbeat of their buildings—the go-to person for everything from organizing classes and celebrating holidays to helping fill out forms and simply making someone feel at home in a community they’ve often moved to after decades living elsewhere.

Geriatric care managers help clients navigate the genuinely confusing world of healthcare and home-based care, often serving as the translator between medical systems and the people trying to live well within them.

Program managers work to identify what will actually resonate and benefit somebody’s experience—what’s fun, stimulating, practical, and relevant for people in this phase of life—and then make it happen.

Social service professionals and case managers help people access housing, benefits, healthcare, and the broader systems that determine their quality of life—often for people who have very few other advocates.

These are the people we now have the privilege of working with and learning from. Whatever their title, they are showing up as motivators, cheerleaders, and troubleshooters—sometimes all three in the same conversation.

A few things they’ve taught us:

A sense of humor goes a long way. The ability to laugh together—at the absurdities of aging, bureaucracy, life—is no small thing. It’s connective tissue.

We are all in it together. Everyone’s personal experience matters and enriches the conversation. The facilitator’s story is as relevant as the participants’.

Older adults have complex, demanding lives. It may not look that way from the outside—they’re not “working” in the conventional sense—but they absolutely are working: managing medical appointments, navigating family dynamics, dealing with health changes, stretching fixed incomes, and absorbing an endless stream of information about how to age well. That deserves acknowledgement and respect.

Personal outreach and trust-building are the foundations of everything. No program, however well-designed, works without relationships. These professionals know that, and they invest in them daily.

And yet, we all know these team members are often stretched thin, carrying our workshop alongside a dozen other responsibilities because it helps the people they serve to live with safety, more connection and delight and because, as they often tell us, the workshop speaks to their own lives, too. Many are navigating aging parents, their own health, or perhaps the same concerns about what it means to live well.

So here is an invitation: the next time someone on your aging team falls short of what you needed—take a breath before frustration takes over. Tell them who you are. Educate them about your needs. Say, thank you. These are fellow humans doing demanding, often invisible work, and a moment of genuine connection can shift everything—for them and for you.

“In the shelter of each other the people live.”

–Old Celtic proverb

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My thinking about older age began decades ago, when I studied architecture in Berkeley and rented an in-law apartment from Jean, who was in her mid-70s. It was the first time I had made friends with someone that much older than me.

In Austria, where I grew up, there was a hierarchy between young and old—we respected older people, but frankly, we were a little scared of them and kept them at a distance. But I was encouraged to dismantle that cultural barrier when I moved into Jean’s house.

She lived without self-judgment, acknowledged challenges frankly, and was endlessly curious. Her example set me on the path to my current work: helping older adults live optimally in their homes on their own terms. This approach starts with continuing to value who you are despite increasing frailties and cognitive changes. Not easy, as it turns out—for oneself, one’s family, and one’s friends.

In 2025, decades after Jean, this lesson started to hit home. At 68, I’m noticing changes in myself. Sometimes I have to defend that I’m still doing certain things but some things actually have changed. What happened to easy, carefree entertaining, for instance? I used to invite people for dinner or throw a party without much forethought, but now, it feels like work; it takes more effort. I can’t just start cooking an hour before guests arrive like I used to—cramming it all in is now more tiring than fun.

I’m also shocked to learn my blood sugar is too high and my cholesterol’s above normal. What did I do wrong? I’m slim, run 15 miles a week, eat healthy, and am more engaged than ever in my work. I’m used to not having to pay attention to a well-functioning body. Now, I have to. It bothers me that I can’t “fix” these health concerns with willpower. And I know I’m not alone in feeling like this. It’s what most people fear about getting old—a failing body and loss of control.

I’m also aware that this is just the beginning, and so I look to older friends and participants in the Aging 360 workshop our nonprofit offers to see how they navigate such changes in body and mind.

Recently, I had dinner with a friend, who turned 90 last year. She’s had two hip replacements, several falls, and lives with chronic back pain. So, walking now requires two canes, which makes going out complicated.

She has a caregiver at night, mostly because she can’t get out of bed on her own to use the bathroom. But she found a remote-control bed that converts into a chair that she can get out of by herself. She proudly demonstrates it, practicing the mechanics, perfecting her technique, getting up and sitting down from this mattress-turned-chair. Fortunately, she has the financial means for these tools and the help she needs; but more than that, it’s her attitude that impresses me. She doesn’t see these adjustments as signs of decline. Her approach is practical and outcome-oriented—a means to continue her work, publishing her autobiography and remaining in her longtime home and garden.

The other major adjustment older adults often face is learning to live alone after losing a life partner. For another friend, who also turned 90 last year, the death of her husband of more than 70 years proved pivotal. After years serving as his primary caregiver, she now relies on caregivers 24/7, walks with a walker, and has fallen and broken bones several times. Her cognition is shifting, meaning she’s living more and more in the past while constantly being reminded of her present reality and physical frailties. In her assisted living residence, late breakfast and dinner provide her main social contact, which now is more crucial than ever. Her dog cuddles and makes her laugh. Yet something else sustains her through this diminished autonomy: her sense of self, which is rooted in family and a close-knit circle of friends she’s nurtured over decades. She’s grateful for the care she receives; she knows it allows her to retain some control. And when she feels well enough, it’s her curiosity that enables her to think toward the future.

The takeaways for me? First, I’ll borrow a phrase my friend used when talking about the launch party for her biography set for the spring of 2026: “Before I leave this earth.” It’s a fitting way to think about the future in older age. It refers to a departure rather than an end, which implies possibility and purpose. Second, I’m strengthened in my resolve to continue nurturing friendships and relationships, to not let the old ones slip away even when those friends don’t make the effort. It means investing in them and acknowledging this may take more and more energy. Third, I vow to continue to feed my curiosity, to stay open to new encounters, those young and old, to do my best not to block them through judgment, and to focus on the future, trusting it holds adventures yet unknown.

With gratitude to all my mentors. I wish you all a safe and sound new year and the moxie to navigate the ‘trip hazards’ of older age.

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We recently conducted interviews with alumni of our Aging 360 workshop at the Cadillac Hotel in San Francisco's Tenderloin district. Our goal was to amplify their voices, demonstrate the workshop's impact to funders, and highlight how our living spaces profoundly shape our aging experience, regardless of our circumstances.

Aging 360 empowers participants to make simple adaptations to their home, enhancing their connection, safety, comfort, and delight. Most older adults at the Cadillac (an SRO or Single Room Occupancy hotel) have experienced homelessness at some point. Their rooms typically measure just 8 by 10 feet. Only 30% of residents have a private bathroom and none have a kitchen. Despite these constraints, Aging 360 has been remarkably impactful–-many residents participate multiple times and report meaningful shifts in how they perceive themselves and their living spaces. Over the past two years, we've built deep relationships with our students and learned tremendously from them.

When asked how she'd benefited from the workshop, one longtime student, Eva, replied: "It helped me come out as an older person."

No one had ever phrased it quite that way before—coming out as an older person. This term, popularized by the LGBTQ+ community, perfectly captures the courage required to express who you are and what you need, even when it differs from societal norms. And It appropriately describes life as an older adult.

Coming out as an older person means acknowledging that some days you feel good, others bad, and asking to be welcomed regardless, without judgment. You may no longer be considered "cute." You might need help with once-simple tasks. Activities that previously brought joy, like traveling, might now feel stressful, and what you truly desire might simply be to stay at home. You may become less enthusiastic about outings with others because fatigue and frustration with diminished abilities can make you irritated and maybe even angry.

So how can you embrace the inevitable changes of growing older without becoming a recluse, potentially leading to depression and loneliness? Coming out likely requires support from the people as well as the environment around you. Others must adapt to your abilities as much as environments must. This may mean listening with compassion, taking extra time—something we all need more of as we age—being flexible with plans whenever possible.

Our physical environments must also be designed to facilitate participation in public life and socialization—literally lowering the threshold to go out, helping older adults feel strong despite frailties. Providing a handrail on both sides of stairs, for example, is a simple design solution with potentially high impact.

For older adults, coming out means attaching value to the aging experience rather than viewing it solely as a time of decline. This isn't easy, as we often compare ourselves to our younger selves. We make excuses for no longer being able to do things that once came easily.

How might we reframe this? Perhaps: "I'm coming out as an older adult, and it's harder for me to get up from this chair. Could you please provide a pillow to see if making the seat higher helps? Or could you stand beside me and offer support?" In other words, we need to equip ourselves with information to teach others how to enable and empower us to remain engaged so that we can share our invaluable insights about life and aging like our friends at the Cadillac do.

These lessons will prove immensely valuable for all of us as we approach the later phases of life.

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This week, I experienced awe. It came in several doses; today, through an introduction to the work of Dacher Keltner, a professor of psychology at the University of California, Berkeley and the director of the Greater Good Science Center, I learned to name it.

Recognizing awe has added a new dimension to the work I do as the leader of a nonprofit, which empowers older adults to age in place and within their communities more fulfilled, safe, and delighted. Keltner’s research finds that the most universal source of awe lies in “the moral beauty of others, when we are moved and touched by others’ kindness, courage, and ability to overcome adversity.” The benefits of experiencing awe prompt us to engage with the world, unleashing “what William James called the ‘saintly tendencies’ of religious experience—sharing, cooperation, and care.”

The beauty of this notion is that it can be found all around us and often happens when you ‘take yourself out’. This week, I took myself out three days in a row, and I experienced the moral beauty of others every time!

My first moment of awe came at The Table Talks, a gathering we co-produce with Ruth’s Table, a community arts hub in San Francisco’s Mission District. At these events, we explore various facets of aging in an urban environment, particularly in San Francisco, through discussions, art-making, and playful exercises. Last Thursday, our topic was "Picnic with Friends"—the simple, joyful act of eating outside, where even when picnicking alone we often feel more connected than eating at home by ourselves.

The evening began with a delightful performance by two local artists and close friends, Rowena Richie and Beth Wilmurt. Both are involved in creative work with older adults. They invited us into their playful interaction by reading a dialogue from a Finnish children’s book series, The Moomins. In a beautifully intergenerational exchange, Moomin papa advises Moomin children to create their world, if they cannot find it. Rowena brought this idea to life through a shadow play from inside a tent, while Beth serenaded us with a camp song on the ukulele. This magical scene brought tears to my eyes. As one participant put it, the "love and care" displayed in their performance and the friendship it reflected was deeply moving.

The following day, while I was in the San Francisco Tenderloin, one of the toughest and most vulnerable districts in the City, I witnessed moral beauty yet again. I was standing with an alumni of the workshop we teach there in front of the Cadillac Hotel, an SRO (Single Room Occupancy). A few feet away, a frail man with a cane leaned against a door, struggling to stand. In an area like this where you often see people sitting or sleeping on the sidewalk, it’s easy to just walk by; but without hesitation my companion, a formerly unhoused man and a vet, offered assistance. He found the right words, treated the man with utmost respect, and offered his arm for support. The man accepted his help but when he tried to walk, his knees buckled and he was unable to get up again. Others from the building came out, brought him a chair, and helped him sit, as they waited for an ambulance. When the paramedics arrived they, too were extremely caring and respectful as they interacted with the man. I left before the situation was resolved, feeling a deep sense of awe at this display of human kindness.

Then today, I attended a screening of a new documentary about Betty Reid Soskin, who gained fame as the oldest park ranger in the U.S. She retired from the Rosie the Riveter National Historical Park in Richmond, California at age 100. The film tells Betty’s (now 103) story, from her life as a musician and civil rights activist to her experience in the early 70s as the first black family to live in the suburban Bay Area city of Walnut Creek. In the documentary, Betty’s moral beauty shines through in her music and her interaction with students at the Oakland School for the Arts, who performed one of her songs during a concert in her honor, and in her eloquence and candidness sharing the stories of black women during WWII in her role as park ranger. In addition, she offers perspective on living a rich life in older age, as her current life exemplifies, connecting everything she has ever done. We also felt the power of public libraries, which serve as community hubs, where experiences like this can unfold every day.

To experience awe, to connect with love and care, take yourself out, engage with others, offer an arm to someone, or simply pick up some trash. Opportunities to show simple acts of kindness and witness others treating each other with goodness can be found everywhere.

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Over the holidays I spent some time in Boise, Idaho with my daughter-in-law’s family, and being close to the mountains we all went skiing for a day. I consider myself a confident and elegant skier. I started skiing at age six, because back then - growing up in Austria - it was like learning to ride a bicycle, nearly everybody did it. That’s probably changed because, now even in Austria, skiing has become much less affordable.

My day of connecting with the prowess of my younger years was a humbling experience. At the ski rental place, I stated, without hesitation, that I was an advanced skier. Once on the slope I quickly realized my status had changed. Okay, I hadn’t skied for about eight years; the visibility was very poor as a thick layer of fog hung over the mountain; the slopes were poorly groomed, and there had been a fresh snow dump overnight. But still, I am used to taking some handicaps in my stride.

It was humbling to see that my body was not a reliable anchor anymore. I became super winded even though I am a runner. Instead of elegant, tight turns with skis close together, I took a long time between turns and my skis were not closely coordinated, making it much harder to get into a good rhythm. Additionally, I fell three times and once my son had to heave me up and I felt like a bug on his back - unable to get onto my feet without help.

As we get older, we need to forge a new relationship with our bodies and our surroundings, the physical world we live in, and the people we interact with. Many of us have figured out, over time, how to accompany ourselves as we are; however, as we get older we need to figure this out anew, when the periodic shifts of an aging body and mind occur. Often it catches us by surprise because, like my recent skiing debacle, we have a mental image of our physical self, an assumed identity that does not align with reality anymore. But instead of downgrading ourselves because of these changes, how can we accompany ourselves as we are now and in the future?

This was the topic of our monthly Mindful Self Compassion group last Saturday. The first step is to be compassionate with ourselves, maybe find additional anchors for our self-worth besides our physical body and then create a caring context for our life.

A caring context for our life could mean, for my benign example, only to go skiing when the sun shines, the slopes are groomed and the runs are not Black Diamond. By choosing the right context, I would probably ski better, feel stronger and more joyful by choosing the right context. And one day, my caring context might be to go on a walk in the snow instead of strapping on skis. Of course, creating a caring context becomes much more challenging when faced with a health issue that impacts daily life.

As an architect I often think of how to create a caring home. The first thing is to recognize that our home has the potential to be a caring space and then assess what changes this might entail. For instance, if you find yourself needing to get up frequently at night, you might consider moving your bed closer to the bathroom or installing a string of lights to help guide you on your nightly journeys.

Or if you find yourself losing your appetite and mealtime becomes a chore, consider lightening the load by asking friends to bring a meal and to join you, just as my 90-year-old friend did recently when she set up a “meal train”. However, even if you're dining solo, creating a welcoming atmosphere can make all the difference: set a beautiful table and choose a comfortable chair that invites you to linger, so you are turning a mealtime into a moment of care and self-compassion.

And yes, there will be moments when you lose yourself and when creating a caring context is not in your capacity. What helps then is to remember that you have practice in doing this. And maybe this gives you confidence that you will be able to do it again, and in the meantime, be compassionate with who you are in this moment.

(Many thanks for the inspiration for this article to my Mindful Self Compassion teacher and friend David Fredrickson)

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It was Thanksgiving weekend and a balmy day in Northern California. Autumn blue skies reigned with amazing visibility. A close friend and my canine companion in tow, I set out for my favorite coastline.

It was an ideal beach day—people and dogs playing, kids digging in the sand, ubiquitous picnics, somebody building a fire. We set out on a seemingly endless walk along the shore on the firm sand, created by the low tide.

Surprise treasure

Along the way, a sculpture woven out of driftwood and kelp set away from the water and protected from the surf caught our attention. As we walked up to the structure and then stood in front of it, we noticed a further surprise: a mermaid sculpted out of the sand, holding a seaweed spear with scales carved into her tail, and wearing a shell necklace.

We marveled that someone had taken the time to create this space—a marker that offered an unexpected gift; it had transformed this stretch of beach and invited people to pause, engage, and appreciate. It sparked a conversation between us as well as created opportunities for conversations with fellow beachgoers.

This find made us so happy. We started talking about the importance of having the opportunity and time to make something together—something beautiful, playful, or fun that’s accessible to everyone. Continuing as grown ups what we did as kids—build forts, sand castles, make things–-without concern for time or profit—totally carefree.

With their bounty of free building materials, beaches, forests, and open spaces in nature invite such spontaneous outbursts of creativity. But there are also plenty of opportunities for “guerilla art” in urban settings, too.

Urban Oases

For example, the Little Libraries, lovingly-built repositories for free books, you see along sidewalks in some urban neighborhoods or the re-invention of speaker’s corners, like the "Grandma Stand", which recently popped up in New York City, where grandma’s take turns answering questions from passersby.

Especially in later life, many people often feel invisible and disconnected from the world. But when creative spaces like these invite spontaneous engagement, whether through art, music, or shared communal activities, it reinforces the sense that our existence matters. The simple act of holding space for another person, whether physically or emotionally, helps break down social isolation.

Inviting interaction

How can we all set aside time to create space for others? Imagine if the practice of generously offering time and space became part of everyday life. There would be much less social isolation, lack of purpose, and divisiveness. Afterall, who could resist a mermaid resting in the sand or asking a question of someone with much more life experience? So, don’t stifle your creative urges; take a risk, experiment, and act as if nobody’s looking. Chances are, it will inspire others to follow your lead.

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Recently, I rented a house in Mendocino, a charming, old coastal town in California. My siblings were visiting from Austria, and I wanted a special getaway, where we could spend a couple of nights together. 

The moment I opened the door to the house, I felt an immediate sense of belonging. No IKEA furnishings in sight—I could have moved in as is. The decor was perfectly imperfect, a mix of styles that came together, creating a warm atmosphere. Even before I learned that this was one of the original houses in town, built in 1883, I sensed layers of memories woven into its very fabric. From the well-placed, well-worn reading chairs and sofas in the living room to the driftwood benches that resembled creatures in the backyard, the house and garden told stories of their own. 

In my work, I lead a workshop aimed at helping people make their homes allies in healthy aging. A common obstacle we discuss is how clutter often hinders our ability to feel at home, to invite friends over, and to find space for what truly matters to us. While experts often emphasize the importance of an environment that’s accessible and functional in later life, this vacation rental reminded me that a home should also be a storyteller. Perhaps we need another criterion for curating our belongings: Does this object hold a meaningful memory or contribute to the story my home tells?

As we approach Día de los Muertos, I've been reflecting on how the people in my life have left their mark on my home through the things they’ve gifted or passed down to me. I'm not just talking about photographs, though those can also evoke a flood of memories. I’m reminded of a trunk from my family home in Austria that my mom shipped to me more than 30 years ago or the red chest of drawers my dear friend Jean, my first landlady in the Bay Area, gave me. Then there are all the items, gifts from friends and family, who are now distant, either geographically or emotionally—that beautiful vase or the cozy cardigan from my friend in Greece. Each piece bears witness to how our lives intertwined.

However, sometimes these memory-laden objects can feel burdensome rather than delightful, especially for the next generation which might inherit them. Some items may not withstand the test of time; their next owners might not relate to them, necessitating a new journey for these pieces. In such cases, it might be best to pass them along to someone who can forge new memories with them. Alternatively, some things may find fresh life in public spaces, allowing others to engage with their stories. For example, a participant in one of my workshops decorated an altar for Día de los Muertos at her church using an intricately woven shawl she inherited from her mother—making an ofrenda or offering. 

In the end, our homes are filled with echoes of the people in our lives. Through the furnishings and objects we choose to keep,  their stories continue to resonate. Even in the spaces we enter as strangers, unaware of the memories preserved within those walls, they create a sense of home.

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In the past three weeks, I received heartbreaking news from Austria, my country of origin: two close friends from my youth passed away. A month ago, a dear friend in the Bay Area got married, and another friend, five years my senior, recently started law school at 72.

These events seem to defy traditional life stage frameworks or what psychoanalyst Erik Erikson once defined as the Eight Stages of Psychosocial Development (ideally, ranging from ‘Trust’ to ‘Integrity’), which have long served as a foundation for understanding human growth. 

Later, his wife, Joan Erikson, added a ninth stage—advanced old age—characterized by a shift from material concerns to a more spiritual perspective, increased reflection on life experiences, and acceptance of mortality.

While these stages of identity may still represent the norm, it seems many of us experience a jumble of life stages in our later years, as we navigate everything from grabbling with mortality to forming new intimate relationships and enjoying fresh surges of productivity.

Shifting perceptions

This new reality reaffirms my belief in the need for an "age reset”. We must rethink the services available to people in later life, the quality of medical care they receive, and how society views the value of older adults. 

Recently, The American Society on Aging declared October 9th Ageism Awareness Day. While this initiative is essential, it doesn’t fully capture my feelings. I want age to be one of many factors in how I’m treated, not the only or main criteria. 

Beyond raising awareness 

I propose our goal should be to enhance healthspan—to empower everyone to live a healthy life for as long as possible. What if we aimed to make America the best country in the world for healthy living? This could include things like

1. Free access to higher education in older age.

2. Doctors making home visits to homebound patients (like they do at the Berkeley Free Clinic).

3. Safe, well-maintained sidewalks and parks that enable people of all abilities to enjoy public life.

4. Tax breaks for small businesses to acknowledge their vital role in social connections.

5. Easy to access government services that support healthy living at home.

6. Reimagining the arts and artists as essential contributors to enrichment of everyday life.

Perhaps we could start with a simple goal: ensuring that everyone in America has the right to equally and joyfully walk the streets in their cities and neighborhoods. Taking a page from Gabrielle Bendiner-Viani’s book, The Cities We Need: Essential Stories of Everyday Places, city governments could prioritize action items #3 and #4 from the list above. At the very least, this would help foster connection, conversation, and trust—essential components for healthy living at any age.

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Traveling by plane has become increasingly challenging, especially if you’re older like me. United Airlines’ famous ad campaign, promoting "friendly skies" back in 1965 may have been appealing at the time, but air travel has always had its hurdles. What has changed significantly since then is the lack of knowledgeable staff available to help travelers navigate these challenges. Despite claims that travel has become more accessible, the reality is quite the opposite. Air travel remains one of the least inclusive experiences, often discriminating against age, abilities, income, and race.

During a recent trip to the East Coast, I encountered some of these disparities firsthand. For example, when my boarding pass was issued without my first name, it became my responsibility to correct the error and navigate airport security. With no human-staffed check-in counters for economy passengers—only kiosks—the task of finding an airline agent to resolve issues or answer questions became nearly impossible. Additionally, most shops in the terminal no longer accept cash and rely heavily on self-checkout, leaving those less comfortable with technology or lacking a bank card at a real disadvantage.

Travel responsibilities have shifted entirely to the consumer unless you’re willing to pay a premium. Essential principles of universal or inclusive design, such as equitable use (ensuring design doesn’t disadvantage or stigmatize any group) and flexibility of use (accommodating a wide range of preferences and abilities), are not even considered.

This situation not only stymies travelers but also affects airline staff. The few employees I encountered—from gate agents to flight attendants and airport shop workers—seemed disheartened. Working in a rigid, process-driven environment that focuses on following rules rather than offering genuine assistance or kindness is likely demoralizing.

For older adults and many other people who are not ”skilled” at navigating the obstacle course of airline travel–from booking the right flight and deciding if it is worth buying a seat to upgrade, or buying your way out of standing in line and shortening the often strenuous and stressful experience of getting through airport security—options are limited. So, the choice often boils down to not traveling, relying on a younger companion, or requesting a wheelchair, even if it’s not regularly needed. Something has gone awfully wrong here. 

It seems clear that airlines have prioritized profit over the old promise of "friendly skies." With airline industry net profits projected at $30.5 billion in 2024, the drive for financial gain has overtaken the commitment to making air travel accessible and inclusive.

To design a more universally accessible and age-friendly air travel experience, we could draw on principles of healthy aging: connection, safety, comfort, and delight. For example:

• Staffed Check-in Counters: Provide counters with staff specifically geared toward travelers over 65 and those with special needs.

• Airport Ambassadors: Employ staff who have the authority to assist and guide travelers through the airport.

• Redesign Security: Make the security process less intimidating and more efficient.

• Priority Boarding: Offer the opportunity to elders to board first, regardless of their ticket class or boarding group.

Implementing these changes would require retraining, reallocating resources, and potentially increase costs. However, the benefits—such as improved employee satisfaction, fewer emergencies, and enhanced overall efficiency—could outweigh the expense. A human-centered, universal design approach to airline travel would not only improve the travel experience for everyone but especially for older adults, who so often live on opposite sides of the country from their families. In fact, this could transform unfriendly skies into truly “friendly skies” for more people like me.

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I love walking, running, and hiking. Being on foot gives me a sense of control over my movement and path. It makes me feel empowered and free—whether it's skinny dipping in a cool mountain lake or finding the perfect spot to pitch my tent. 

I discovered this freedom at the age of 26, when I moved to the United States forty years ago. In my native Austria, hiking usually involves moving from hut to hut in a landscape long domesticated for human use, where bears and wolves no longer roam, replaced by summer cattle grazing and logging.

As I grow older, I recognize the need for creative strategies to maintain this freedom. Recently, I reconnected with an old friend, who introduced me to backpacking in California decades ago. We planned a weekend trip, intending to cover eight miles the first day, but managed only five. The second day, we skipped breaking camp and opted for a day hike, which lightened our 30-pound packs. Also, I noticed that familiar tasks like getting in and out of my tent or jumping in the lake were no longer effortless; I moved less gracefully and more cautiously.

It was humbling to see how advancing age diminishes strength, stamina, and flexibility, despite willpower. Just as President Biden believed in his ability to continue, my own hiking memories sometimes tempt me to overestimate my current capabilities, compared to even months ago.

Decline is not linear.  As Joanne Lynn, a pioneering geriatrician, identifies different trajectories of decline up to the end of life, Atul Gawande echoes the gradual wear and tear our bodies endure and how medical care should adapt in his article ‘The Way We Age’. 

I’m 14 years behind Biden. But I can relate; I know how hard it is not only to find creative strategies to preserve my freedom but also to not blame myself for my diminishing capacities and the limitations they impose. 

Artists provide inspiring examples of how to adjust to the aging process. Arthur Rubinstein, who adapted his piano repertoire and technique to sustain his performance into his eighties, despite declining health, beautifully exemplifies psychologist Paul Baltes' SOC (or selective optimization with compensation) model. When asked how he did it, he explained that he reduced the range of pieces he played, practiced each of the remaining pieces more often, and learned to play very slowly just before beginning a fast passage to increase the contrast between them, since he couldn’t play as fast as when he was younger. 

Facing physical limitations painter Henri Matisse used a 12-foot bamboo stick, which allowed him broader motion to draw from one position; and later, when he needed to work from his bed or wheelchair, used scissors to cut out shapes from colored paper instead of using a pencil or paint. 

In order to continue to enjoy the freedom of being on foot—one of my creative expressions, I now stretch every day to regain some of my flexibility. On my next hiking trip I’ll also work on further reducing my backpack weight, hike shorter distances and do more day trips from a basecamp instead of packing up a tent every day. Additionally, I continue my daily run/walk routine, as it fits my comfort level and keep up my mindful self-compassion practice, learning to be kind to myself, as I navigate the challenges of aging.

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In 1977, the photographer Imogen Cunningham published a book of photographs featuring people aged ninety or more, when she herself was that age. I discovered this book more than 30 years ago when I was researching my architecture thesis, “At Home With Growing Old.” My thesis project focused on mixing housing options, envisioning living spaces for older adults that serve as civic hubs, which include public libraries, movie theaters, sports arenas, and more. 

I was fascinated by these portraits of people whose lives were imprinted on their faces and bodies. Some of my friends are over ninety now. A decade which, with few exceptions, likely will be the final chapter of life. But I’m learning that despite the limited time left, ninety doesn’t necessarily keep nonagenarians from thinking about the future. They may be older, but they hold the same hopes, concerns, passions and often fears as when they were younger. 

A friend of mine, who’s in her early nineties and whose husband of 70 years just died, told me that she’s not going to look for a new relationship. Another friend, who recently celebrated her ninetieth birthday, just finished her autobiography, which will be published next year. At one of our forums (Growing Up And Growing Older), a 93-year-old participant shared that she recently told the receptionist at her doctor’s office that she was 106 and relished how funny it was that the gal believed her! 

A few years ago, a great Bay Area Jazz vocalist performed at one of our learning events, shortly after his ninetieth birthday. Before he began singing, he made everyone laugh. “I turned ninety this past February, and it freaked me out. I was fine until February 2nd, and then everything fell apart. I thought it was all over.“ Then he offered the most beautiful renditions of some of the best jazz tunes, like Here’s to Life*.  

Part of the gift of growing older is passing the torch to your children, or the next generation—an ongoing process, which continues until you die. One of my ninety-year-old friends compared it to a relay race: it’s a pleasure to pass it onto the next person but also distinctly disturbing because you’re losing control—your children are making decisions for you. 

A common mistake we make when we think about age-friendly housing, services, and programs is that we don’t consider the full spectrum of who we are in older age. Instead, we mostly offer solutions focused on disaster preparedness (i.e. fall prevention) and damage control (like emergency buttons); while important, they make up a relatively small part of everyday life, something most of us would rather not think about at any age. Unfortunately, most of these design solutions/gadgets are marketed to the children of older adults or senior housing administrators, instead of the people who actually use them. No wonder the acceptance rate is low. 

I don’t have all the answers but here are a few thoughts on what’s needed to help us live to our fullest potential as we grow older.

1. Imagination: In her essay on how to survive in a disaster, author Rebecca Solnit writes, “Love and empathy are acts of imagination, imagination is an act of courage, of risk…” Designers and manufacturers of assistive devices rarely take business risks or show courage when designing, say, a walker. Care facilities, even rental housing, places strict rules around how residents can modify their spaces. (All the time, I see residents come up with imaginative solutions in adapting their homes; unique and not replicable, they often inspire others to be creative with their own spaces, as well.) 

2. Connection: None of us can navigate the complexity of life on our own. This becomes even more true in older age, when life is more uncertain. Just being aware of the importance of human connections should spur us into action—taking a walk with a neighbor, holding the door for somebody at the grocery store, offering a hand. 

3. Agency: Passing the torch shouldn’t mean losing total control. While it may be uncomfortable, discussing the likelihood of disasters or accidents and how to manage them is well worth the effort (see Roz Chast: Can’t we talk about something more pleasant?). For instance, practicing disaster preparedness in small, creative ways in one’s home helps to maintain agency and positively shape one’s aging experience. This could be as simple as reorganizing one’s kitchen for easier use. 

Beyond disaster preparedness, At Home With Growing Older’s Aging 360 workshops inspire participants to find value in older age, after ninety, and beyond. 

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I just got a 3-minute reminder on my phone about a performance, with a great internationally renowned singer, that I was really looking forward to. I was standing at my stove, throwing together a dinner, when I got the alert. It was kind of devastating. I had forgotten! And of course, I immediately blamed it on my age. 

It would’ve been a great treat to take myself out. I was immersed in writing a grant application but somehow that didn’t seem a legitimate excuse. My home has become the hub for everything I do—from work to entertainment to medical appointments, and yes, I mostly shop online. Sometimes I don't even know where to go to get the simplest item, like garbage bags.

I find I go out much less often. The pull to stay home is so strong. At the same time, I realize that whenever I do go out, something good seems to happen—from running into a friend, who I have not seen in years at the grocery store, to feeling good when I get a smile from the postal clerk. 

The loneliness epidemic

Somebody just forwarded me yet another newspaper article about the current loneliness crisis —this one occurring in San Mateo County, California. Tonight’s experience makes me think that taking yourself out at my age, especially in these times, takes real effort, a commitment. A walk to the bakery is no longer a casual thing—you do it with the awareness that it’s not just about buying a scone, it’s about keeping yourself healthy and engaged.

I think we may need to invent new reasons for taking ourselves out; because it’s no longer necessary to leave our homes to  live our daily lives, and as my experience tonight demonstrates, I’ve also grown out of the habit. 

Artists may offer a remedy

Personally, I believe artists can play a big role in getting us out of the house—from muralists to street artists to our own creative impulses. For instance Laura Nova, a New York City public artist makes art through connecting people. I‘d call her a public animator. She organizes parades, turns people into tree buddies, and uncovers neighborhood histories through residents' storytelling. Most of all, what she does is fun. Having fun, feeling carefree, playful, not worried about overstepping boundaries, creating group experiences-–that’s the antidote to loneliness.

Take yourself out

Having fun can come in different shades and often doesn’t take much effort. The first step is to get out there; though that’s easier said than done. Obstacles abound, like a staircase that feels unsafe because the steps are slippery to a broken sidewalk, which requires sure footing, to simply feeling vulnerable because we don’t know the people we might encounter, or we feel invisible in older age. 

Taking a risk

The second step is to take a risk—just do it! Then watch what happens: do you exchange a glance with someone, watch others having fun, hear some birds screeching or music wafting from a nearby house? What a rich experience already. Then you might run into somebody you actually know but had forgotten about; then maybe you take a chance and start a conversation with somebody, who you find attractive—no matter their age, or you ask if you can join a Qigong group that you’ve noticed for a long time in your local park? 

Art as public policy

What if we made it even more fun and worthwhile to take ourselves out? What if each neighborhood had something like an artist-animator? City employees, with the simple task of engaging people and having fun in their neighborhood. What if you looked out in the morning and your neighborhood animator invited you to a Spring parade or pulled a cart with giveaway plants from the City, or you found a flier in your mailbox announcing that Friday would be a “slow-street” day because some of your neighbors were organizing line dancing in the street—everyone invited? Would that bring you out of the house? Might you rethink your street as a new venue that served so many more purposes than just an avenue for cars?

So, please, we need artist-animators and artists in residence as public health and city employees, not a ministry of loneliness!

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I’m in my mid sixties now (wow!), healthy and live alone with my dog in a very modest house. I bought my home about 25 years ago so, it's affordable. My dog is a great snuggler and also my exercise coach. Most days, we run (or at this point, trot) on trails in the nearby hills. 

My neighborhood is largely middle class, pretty racially diverse and therefore, wonderfully stimulating. Technically, I could live here without a car; there’s a park close by, along with other amenities, like a library, cafe, bakery, grocery store, and bus stops.  

I’m very friendly with my neighbors—some of whom have become close friends. I’m also friends with my ex-husband, and I have a great relationship with my 25-year-old son and his partner. Over the last few years, I've rented out a downstairs studio apartment to a succession of young women, who need an affordable launch pad amid rising costs in the Bay Area.

I have a fabulously engaging and challenging job. An architect by profession, I now run a nonprofit, At Home With Growing Older, that I co-founded 15 years ago. Our main goal is to help people make simple, yet impactful changes to their homes, which enable them to continue to feel confident at home as they age. Central to our approach is a belief in the power of valuing oneself as we age. To reinforce this, we invite influencers from a range of backgrounds and disciplines to share their experiences and perspectives on growing older. 

Understanding how we can adapt our homes to different lifestyles and household configurations throughout the arc of life has been the focus of my architectural work. I’ve found that our homes serve not only as private residences, but also as public spaces. They’re part of the fabric of public life. This reciprocity extends to public spaces, which, in turn, are extensions of our homes. As individuals and as a society, we therefore should create both private and public spaces that are inviting to people of varying abilities and ages.

Not by design but through a combination of good luck and certain life decisions—buying a small home, investing in my relationships, nurturing an endless curiosity, switching professional tracks from banker to architect, moving from my country of origin, Austria to the Bay Area—currently, my life meets all the contributors to healthy aging:  social connection, a sense of purpose, an affordable home and movement (both physical and mental). 

As long as my body and mind stay reasonably healthy, right now, I’d say, I’m in one of the happiest phases of my life. Even though I know this intellectually, I became aware of the fact emotionally recently, when I listened to an interview with Jane Fonda by Julia Louis Dreyfus (on Women Wiser Than Me). A big reason why I am happy aligns with something the actress said about getting older. ”What you realize is you go back to your girlhood and you become all the things that she was supposed to be that you never knew at the time was really who she was because you were trying to be what other people thought she should be.”

I also agree with her when she says, “I unfortunately don't think that I can totally be myself in a romantic relationship with a man.”  With the benefit of having lived and gathered many years of experiences, I now have the luxury of being able to live my authentic self, and I’m grateful for it every day. And as an architect, who’s deeply engaged in the mission of At Home With Growing Older, I reflect on the profound journey of making one's home a lifelong companion. 

How can your home resonate with and support your authentic self as you rediscover it in older age? Perhaps it involves transforming your home into a hub for community connections—reimagining the kitchen to make entertaining easier or adding LED lights to stairs to accommodate visitors’ different comfort levels. Alternatively, modifications could revolve around nurturing a love for nature by investing in your garden as a laboratory for experimenting with plant propagation. The goal is not perfection but rather a thoughtful approach that reflects care for both your home and yourself.

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Many of us live in our homes for a long time. We want or need to keep living there for as long as possible. How can we turn our home into a friend instead of an obstacle course, as we grow older–without breaking the bank?

 I am seeing things around my house with new eyes. I am asking each thing: ‘How are you serving me?’  I am asking myself: ‘How can I shift things, so they can serve me as I grow older?’

These few simple questions by a participant in one of our recent Aging 360 workshops can serve as a guide to home improvements that work with what you have, are free or cost very little, but can make a big difference in your ability to safely age in your home with delight. 

1. See things around your house with new eyes.

Furniture bought for good reason years ago can become immobilized, locked in place, even though it no longer serves us. A chair, for example, placed in the dining room, becomes storage space for magazines rather than a place to sit. Perhaps now it might work better in the bedroom, as a place to dress and undress. Or we might not use it anymore because the seat is hard, and it’s uncomfortable to sit on for long periods. 

The same holds true for everyday tools or our collections. If it hurts our back every time we bend over to reach our pots and pans, why not move them from the lower kitchen cabinets? Not using that family heirloom? What’s the best place for grandma’s water pitcher, so you can enjoy it every day?

These are just a few of the questions you can ask yourself. It takes courage to acknowledge lifestyle changes—that our bodies and minds aren’t the same and will continue to change. The world around us, starting with our home, can help us adapt and adjust to some of these changes. 

2. Ask each thing: ‘How are you serving me?’  

This question changes up how we’re used to doing things, adapting to our environments–-from counter heights to light levels—conditioned to the way we (or somebody else in our household) might have set things up years ago. 

For example (and for fun), ask the following long-term fixtures: ‘How are you serving me?’

Chair: 

• Are you in the right place for what I am using you for?

• Is it easy for me to sit down and get up? 

• Can I sit on you for a long time without getting a backache?

Bathroom light fixture:

• Why are you casting a shadow on my face?

• Can I easily reach you when I have to clean you?

Kitchen counter:

• Are you at the right height for preparing my food?

• Easy to clean?

• Close to my stove?

Window:

• Can I open you without much effort?

• Do you produce glare at certain times of the day?

Take some time, walk around your home, starting with the areas essential to your daily life and well-being. While you’re at it, ask this question along the way and take note. 

3. How can I shift things so they can serve me better as I grow older?

This question is key in making change. Dig deep, experimenting and exploring different ways to improve the function, safety, and delight of various things and areas of your home. Reflect on how a shift impacts you. Keep experimenting, and take your time. 

Here are some examples of problems and solutions from participants in our Aging 360 workshops:

• Living room: “I spend a lot of time in my living room and have let items accumulate there over time until I really don't notice them. I created game shelves for visiting children seven years ago; they have been joined by flashlights, sunglasses, and the VCR tapes I could not part with after a purge.”  

Solution:  For each area, either get rid of objects, find a place to store them out of sight, or display favorite objects with intent for enjoyment. Just keep at it until the job is done.  

• Basement stairs: “The stairs are narrow, dark, and feel dangerous.” 

Solution: Remove the old stair runner, paint the treads and risers in contrasting colors, and install an LED light strip along it. 

• Small bathroom: “The space under the pedestal sink which is used for much needed storage reduces the floor space in the bathroom and my ability to maneuver around.” 

Solution: I’m going to clear the space under the sink and use hanging storage on the door. 

Tips to get started to remove obstacles to your health and well-being: 

• Take photos of a room. A photo can offer a more neutral perspective; you may notice things you might not otherwise. 

• Show the photos to some friends and family members. Let them describe what they see: New eyes see new things!

• Identify things you’d like to change.

• Start to experiment.

• Note how these shifts change the way you 

  1. ) feel about your home

  2. ) use your home.

• Check in with yourself, occasionally; see what you can do to make it easier to do daily tasks, remove barriers to enjoying your home, hold on to something for better balance. 

• If you’d like to explore this process deeper with others, check out the Aging 360 workshop. 

November 2023 Tips

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Sometimes I wish the acronym ADU stood for Assistive Dwelling Unit, not Accessory Dwelling Unit. Its purpose would be much clearer—a home that assists, enables, and compensates for all the changes that come with the aging process and increases the capacity to live on one’s own terms for as long as possible. 

ADUs are second houses that people are allowed to build in their backyards. They can be up to 1, 200 square feet, depending on which state you live in. They’ve become synonymous with age-friendly homes and aging in place; but many are simply shrunken, standard homes and miss the mark in becoming lifelong dwellings. 

So, what makes ADUs a good candidate for aging in place? Since they’re jointly located with another house on a property, they naturally create proximity and encourage occupants to tap into an established neighborhood—a big plus for many older adults, who often become more isolated and lonely—a documented health risk. They’re also smaller than most standard homes, which makes them easier and more affordable to maintain (and to build). For many older adults, managing a standard home becomes too much, leading to its disrepair or worse.

The standard ADU toolkit should include basic accessibility features that support shifts in mobility, such as a step-free entry, a curbless shower with a safety bar, and minimum 32-inch- wide doorways. Incentivizing such features by lowering building permit fees and providing informational resources at the permit counter for architects, builders, and homeowners would be an easy and inexpensive way for cities to create much needed life-span homes. 

But there’s much more to creating an age-friendly home and fortunately, this is not expensive. For example, a simple kitchen design that avoids the standard upper cabinets can prevent falls that often result from using a step stool as well as encourage cooking for oneself and others because everything needed, is in easy reach.

An age-friendly home also should invite connection to the world beyond. In addition to a no-step entry, generous windows with a low sill height offer a connection to the outside whether from a bed, chair, or sofa; lever handles, instead of door knobs allow someone with arthritis to easily open a door.

Additionally, It should enable connection to one’s history and identity. Downsizing to a smaller footprint doesn’t have to mean giving up all of one’s prized possessions. A smaller home should entail well-thought-out, easy-to-access storage throughout as well as opportunities for displaying one’s collections. So, instead of upper kitchen cabinets, built-in shelves or a vitrine can hold cherished items. Rediscovering and thus using a favorite item more often can bring a simple pleasure. 

Delight is one of those overlooked but key principles in age-friendly design. It can come from a purely decorative item but also from something practical. 

For example, a red toilet seat is not only fun and bold, but since the color red has a long wavelength it is also more visible to someone with poor vision. Red acts as a signal color for people living with dementia; a crimson toilet seat clearly sets it apart from other bathroom fixtures. 

Designing an ADU can offer a fresh slate to create an ideal home as we age. By acknowledging and embracing the full range of our future lives, they can support us in the ongoing process of being at home with growing older. 

AGE-FRIENDLY ACCESSORY DWELLING UNITS /ADUs:

Standard accessibility features (does not cost more if you start from scratch - do your best if you adapt an existing cottage)

• No-step entry

• Wider doorways—at least 32 inches

• Curb-less shower with safety bar

• Lever handles for doors

Age-friendly features:

Safety/Comfort:

• Avoid upper cabinets in the kitchen 

• Drawers in lower cabinets

• Outlets at 18 inches

• Electric appliances

• Heat pump

• Wall framing to accommodate railings in future 

• Wall-hung sink (instead of vanity) for more maneuvering space

• Comfortable chair in bathroom/ Shower stool

Connection:

• Windows: easy to access, easy to open

• Storage:optimize use,easily accessible, and specific throughout the home

Delight: 

• “Functional” colors (i.e.: red toilet seat, )

• Built-in wall shelves to display collections, photos, books, etc.

• Hand-held shower head—weight, spray, grip

I believe in choice: Make sure the ADU design supports your passions. Whether it’s gardening, reading, or crafting, you can have it all—even in a compact space. 

Tips Age Friendly Accessory Dwelling Unit

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Home is not only our four walls. Many of us have homes away from home, places where we feel safe, where we can be ourselves, somewhere that offers solace. It could be anything—a sidewalk bench, a neighborhood cafe, a view you enjoy—even a smell that conjures a memory. How can we be at home with growing older, not only in our immediate environments but also in these extended spaces which are so vital to our well-being?  

My home away from home is the mountains and there, nights in my tent. Whenever I start packing my backpack, pulling out my beloved 38-year-old tent and inspecting my hiking boots, I kick into a different mode. I feel empowered when I connect to my hiking body and thus, to an ageless self. Out there on the trail, I come across people of all ages. There’s no ageism on the trail—out there, you’re treated like a fellow hiker—your speed or agility doesn’t matter. 

Of course that means you have to be able to be out there and over time, the nature of being out there changes. On a recent road trip, I stayed at a beautiful, primitive campground set along a river stocked with fish. On my evening walk, I spotted an elderly man gingerly stepping down a precarious slope to the river’s edge to fish; probably something he had done repeatedly throughout his lifetime. Though perhaps risky at his age, he was in his element and unafraid, which gave him confidence. 

I’ve been taking annual hiking trips with a group of women around my age for many years. Now in our mid-60s to early 70s, we’ve made some age-friendly adjustments. Instead of backpacking and carrying 30-pound backpacks, we have horses pack our gear into a base camp and do day hikes. The trade offs are that we don’t venture as far into the mountains as we used to, and our trips cost more, but going as a group makes it more affordable. 

We’ve also taken age-friendly hiking tips from the ultralight backpacking movement. Thanks to a thriving industry outfitting this movement, there are many equipment options and new materials (not always cheap) that significantly reduce the weight you carry. Recently, I ran into an old backpacking friend, who’s embraced this trend. Starting with a very light backpack and tent, he takes freeze-dried food (adding water when he cooks), a water filter to reduce the amount of water he carries, and brings fewer, light-weight clothes. 

Because they improve performance and safety, hikers of all ages and abilities have adopted various accommodations. Trekking poles, for example, now are ubiquitous. This summer we also crossed paths with long distance hikers, using hands-free umbrellas to protect them from the sun. I’ve often compared the process of adapting to an aging body and mind to practicing an extreme sport. We could all look to the well-tested gear long distance hikers or other athletes use, as we aspire to healthy aging.  

As we learn to adapt and find the right tools to maintain healthy habits, our extended homes, from sidewalks to parks also need to adapt to accommodate users of all ages and abilities.

Grover Hot Springs for example, an expansive  California State Park and campground  on the eastern side of the Sierras has recently completed a beautifully laid out and designed board walk with benches spaced at intervals  to enjoy the views of its magnificent meadow. It gave me great comfort that this is one place I could continue to visit over many years to come. 

In urban environments, it is often uneven sidewalks that cause stumbles and falls and may prevent people from venturing out and staying mobile and socially connected. In many cities, deferred maintenance has made the task of repairs so insurmountable that it would be worth looking into low cost, imperfect fixes instead of doing nothing. What if cities provided homeowners and business owners with inexpensive, adhesive, brightly colored safety strips that would visually mark level changes in sidewalks in front of their property? 

Our extended homes are as vital as our immediate environments for a healthy aging experience. What can you do to improve the use of or access to your home away from home? What can you do to advocate for more age-friendly environments? Here are a few practical tips from my home away from home. I’d love to hear about some of yours. 

Resources for those whose age-friendly refuge is the mountains:

Lightweight gear:

• Understanding tents: https://coolofthewild.com/parts-of-a-tent/

• Lightweight backpacks: Ultralight backpacks weigh below 3lbs, Zpacks or Exped are respected suppliers. 

• Water filters: How to choose a backpacking water filter. Pay attention to the effort needed to operate the water filter. 

Accessories:

• Trekking poles: I use lightweight poles by Komperdell, an Austrian manufacturer. 

• Umbrella hats: I have no experience with umbrella hats, but here is a link to a website to start your exploration.

• Supportive footwear: Foot wear is very personal. I go between heavy duty hiking boots and trail running shoes. Many through hikers (long distance hikers) wear trail running shoes.

Age Friendly Tips For The Mountains

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A few simple inexpensive accessories can increase our sense of connection, safety, comfort, and delight—key principles for feeling welcome in one’s home in later life. 

A recent Aging 360 workshop, led by At Home With Growing Older for the Curry Senior Center at the Cadillac Hotel in San Francisco, demonstrated this beautifully. The Cadillac is one of the oldest residential hotels (or SROs, single-room occupancy) in the city’s Tenderloin District. SROs originated in the mid-1900s to accommodate transient workers; and over time, they’ve become an important resource for housing very low-income residents or those experiencing homelessness. 

SROs were not designed to be long-term housing, but at the Cadillac Hotel, you can stay as long as you like. Naturally occurring retirement communities (or NORCs), a term originally coined for apartment buildings with a majority of aging residents in New York City, have become a reality for some SROs. So, it’s important to consider how residents can age comfortably in a room meant for short-term occupancy. 

This Aging 360 workshop for SRO residents offered an opportunity to explore how simple adaptations to a small space can improve health and wellbeing as well as instill confidence in participants that such adjustments are doable and make a difference in their quality of life. We selected items from the Aging 360 toolbox that wouldn’t permanently modify the room, fit into the building’s regulations, and were very inexpensive—especially when ordered in larger lots. 

The accessories participants received during the workshop provide a great start for anyone interested in aging in place with confidence and delight. Here are examples of how they chose to use them.

• A seat pad, for comfort and safety

• A hanging glass planter, for delight and connection

• Two adhesive hooks, for safety and delight 

• Two battery-powered LED stick-on puck lights, for safety and connection

• A tray, for connection and delight

• A resistance band, for comfort and well-being

A seat pad can travel with you. Anna hung hers on the handle of her walker and used it to cushion the hard, plastic seat of her chair in class, so she could sit longer and focus. Somebody else placed it behind their back to shorten the seat depth. To some, it felt good to hug the pad, while others were delighted by its color. 

Serving as a special container for a few cherished objects and sparkling in the sunlight, the glass planter brought delight to residents and offered a simple way to connect with the time of day and the outside world. 

It takes one third more time and a third more room to get around in a wheelchair, according to a participant from another workshop. It also requires more room to move around with assistive devices, more room to exercise to keep oneself mobile, and more organization to locate misplaced items in a crowded room. Hooks offer a handy way to create space and order. They get things off the floor and separate them by use. They also can be mounted at a level and in a location that fits our various body types and habits. 

We thought that most people would use the stick-on LED puck light as a night light or else over the sink in their room, but one participant used it as a beacon on the table near her door to call attention to the things she needs when leaving her room. Older eyes require more time to adjust between different light levels. Higher light levels and color intensity help improve visibility, as well.

A tray plays many roles in age-friendly living. Because it acts like a mini table, it makes meal times special and helps bring more attention to what we eat. It also encourages connection, and makes it easier to carry a meal somewhere else, which invites us to sit with others or enjoy a view. At the Cadillac, some residents used a tray to carry their plate from the microwave into the community room. They used it as a miniature table in bed and as a placemat to keep their multi-purpose table clean. 

What exercises can you do in a limited space? One option are resistance bands. They come in different colors and strengths; and as you progress, you can share them with others. Though you may go for the strong one right off the bat because it comes in your favorite color—fuchsia, a color that challenges you and brings you delight. 

Feeling welcome in one’s home, whatever its size, especially in older age, requires a space that fits one’s unique needs. Making our home more age-friendly is a win-win not only because it’s more enjoyable for us; it also makes it easier to invite others in and to stay connected with the world outside. It does not need a major renovation or a handyman to get a start on this!

INEXPENSIVE AGE-FRIENDLY ACCESSORIES:

Chair Pads: 

• Look for a firm, solid color chair pad about 1.5 inch to 2 inch high. We got ours from Homegoods.com on sale for $3/pad but there are many other sellers.

Hanging Glass Planter:

• They are versatile in use and ideal for a small space. We got ours donated but it seems that they start at about $8/piece and are often packaged in pairs.

Hooks with adhesive backing:

• The most common brand are 3M Command Hooks. They is a choice of different weight ratings. They come in packages of (2) at about $12.

LED battery powered stick-on puck lights:

• LED puck lights come either rechargeable or with batteries. We chose batteries because there are only one or two electrical outlets in many old SRO rooms. There are many brands. We chose a six pack from VICOX at $12.79

Serving Tray:

• We chose the Lyellfe 8 Pack Fast Food Serving Tray, 15 by 10-Inch, because it had a smooth surface, the right size, came in nice colors and was affordable. The pack of eight sells for $22.49

Resistance Bands:

• They are offered by many different retailers and come in packs of four to five bands in different strength that have different colors. The most important thing is to put them in a visible spot - for example at the door handle to the bathroom so there is always an invitation to use them.

Tips: 

• Most of these items are sold in multiples. This could be a good opportunity to team up with others to order them to benefit from a lower per unit cost.

Age Friendly Accessories

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I’m an older trail runner in the dog-friendly Oakland hills, which is amongst redwoods and oaks and habitat to many animal species. I run early in the morning with Luke, my Australian Cattle Dog. 

There are fewer humans between 6:45 and 7:00 am, when I start—mostly, older folks like me. There’s Missy with her two, white Golden Retrievers and an older gentleman with his cute, little white dog (maybe a terrier mix). Our paths cross, and over time, we’ve exchanged words beyond a ‘hello’.

The other day I noticed the little white dog with another older gentleman. I asked where his regular companion was, and the man told me that Ed (that’s when I learned his name) had fallen; and this was his neighbor, who had offered to take NImo for a walk. The neighbor added Ed had gone to the ER and hopefully, would improve soon. 

Later, I spotted Ed back on the trail with Nimo. I introduced myself and my dog, and we chatted about his recent health incident. Previously, I had also seen Ed make friends with two crows, Jekyll and Hekyll (as he calls them), who wait for him every morning to feed them after his walk with Nimo. Having created such a network of friends on his walks, it was no wonder he was anxious to be out there again, only a day after his visit to the ER, while still unstable on his feet.  

Especially in older age, as well as for those of us who live alone or work from home, an animal companion can play a key role in our daily lives. They get us out of bed in the morning, establish a routine, are our canine exercise coaches, let us mollycoddle them and, perhaps most importantly, connect us with other humans. 

Various studies confirm that a bond with an animal contributes to our health in many ways. The “pet-health effect” as I call it is real and those who have pets feel it. In a survey conducted by the National Poll on Aging in 2018, a majority of respondents confirmed that pets positively contributed to their health and well-being—from reducing stress and providing purpose to connecting with others and keeping them physically active—and—one out of four respondents put their pets’ needs over their own. 

Indeed, Ed might have delayed his visit to the hospital because of Nimo. When I ran into her on the trail this morning, Missy told me that she needs a knee replacement but is delaying the surgery because of her two dogs. 

How could we make sure that those who benefit from the “pet-health effect” can easily access it at any age? 

What if there was a question about pet ownership on medical intake forms or if it was part of your annual medical check up ? What if your doctor could discuss the possibilities of adopting a pet as part of a health and wellness plan because your Medicare Advantage plan also covered a vet check up and the Advanced Care Directive included a plan for your pet in the event of your death?  Imagine the health benefits if an older pet owner could get a procedure done or see their doctor without worrying about their pet because an animal daycare was part of a medical center.

The results of a recent study by Jessica Bibbo, a scientist at the Center for Research and Education at the Benjamin Rose Institute on Aging, provide empirical evidence that pets do impact the health and healthcare decisions of older adults and make a strong case for including pet ownership in conversations about senior housing, caregiving, transportation, and more.

From a physical design perspective It does not take much for age-friendly homes and housing to be pet inclusive. Pet-friendly adaptations are also age-friendly adaptations. A floor that is easy to maintain, a hand-held shower in the bathroom, and safe access to the outdoors benefit both older humans and their animal companions.  City governments, social and healthcare systems need to recognize and integrate the human-animal bond as an effective, non-medical contributor to healthy aging in their planning and programs.

To join the conversation on the vital link between animals and human health, come to Creature Comforts, our 4th annual agein on June 17 in San Francisco. For more information or to register, visit At Home with Growing Older. 

Practical tips and resources:

(Most resources are in the San Francisco Bay Area but look for similar programs in your area.)

Relationship with animals: 

• Muttville: Senior dog adoption agency in San Francisco. They match senior canines with senior humans and also have a drop in cuddle club, for those who cannot or do not want to adopt.

• Thulani: Senior German Dog Rescue Agency.

• San Francisco SPCA’s Sido Pet Protection Program: When pets outlive their guardians, cats and dogs enrolled in Sido are taken into the SF SPCA’s Adoption Program. They receive exceptional care and attention while the SF SPCA works to place them in a loving home.

Studies about the health benefits of pet ownership for older adults: 

• Pet ownership and Aging (Jessica Bibbo)

• Caregiving for an Aging Pet Owner (Jessica Bibbo)

• At Home, On Air, ‘Pet Ownership is ‘Medicine’. Listen to the conversation with Jessica Bibbo from April 27, 2023.

• ‘How pets contribute to healthy aging’, National Poll On Aging Report

Organizations that help defray the cost of pet ownership: 

• Pets are Wonderful Support : PAWS

• Paws as Loving Support:  PALS

Tips for making a home pet-friendly:

• Floors: 

  • Linoleum or Marmoleum: Environmentally-friendly flooring that comes in a wide variety of colors and is either sold in roles (sheet flooring) or tiles.

  • Wood or cork flooring with high-strength traffic coating. 

  • Luxury Vinyl Flooring  (LVT): Often comes in wood patterns.

• Hand showers:  If you decide to bathe your pet at home, you need a handshower. You can replace a wall-mounted shower head with a hand shower mounted on a bar. This is relatively easy since plumbing connections are standardized. One of my favorite hand showers is this one with a hand hold by Moen. 

• Stairs: Safe indoor and outdoor stairs are especially important with a dog, who can divert your attention or pull on the leash. Note that stairs are also a challenge for many larger senior dogs. 

• Housekeeping: Your furry friends shed hair and may have an occasional accident. Make sure that you take this into account not only in terms of flooring materials but also your cleaning protocol and tools (such as handheld vacuum cleaners).

• Food Area: Elevated food bowls may be more comfortable for you and your animal companion and also reduce trip hazards. They come in many styles, sizes and prices. 

Tips And Resources Pets In Healthy Aging

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It’s tax season and I’m continuing the tradition of meeting with my longtime tax consultant. We both have enjoyed catching up in our tax meetings over the years and watching each other's hair getting grayer and grayer. Through our conversations (as well as documented through my modest taxable income), my tax consultant knows that I run a nonprofit, At Home With Growing Older. At our recent meeting, the conversation landed on how to make her home more age-friendly. She lamented that she might need to install a grab bar in her bathroom. Even though she didn’t need it yet, she felt it was a good idea but dreaded that installing a grab bar in her bathroom signaled her entry into old age, aka weakness and decline. She also said that she was more ready to do it than her husband. Their perception of grab bars as more medical device than bathroom accessory kept them from using their bathroom with confidence and ease. Clearly, she was worried. 

This was, of course, the perfect opening  for me to make my argument that grab bars (or safety bars as I refer to them) should be featured in every bathroom, an accessory as standard as a soap dish or mirror. Holding onto a safety bar is not a sign of frailty but smart, as it allows you to do what you need or like to do with greater stability. We all can benefit from being able to grip something steadying—at any age. It’s similar to a climber relying on a climbing hold or steel rope, installed to ensure safer access to a treacherous passage, like at Half Dome in Yosemite National Park. 

I passionately described my favorite safety bars, pointing out how in your own home you can use whatever material you prefer—from a beautiful piece of driftwood (like the one in my shower, found at Limantour Beach in Pt. Reyes) to a custom railing made from a kind of wood that holds up well with moisture, such as teak or mahogany. 

Luckily, I had my laptop in tow and could show her some examples of safety bars and holds from the Aging 360 workshop, a program our nonprofit offers for people who are interested in aging in place. We talked about how aging is like an extreme sport; you have to manage your risks, practice, and both require the right accessories and gear. Inspired by the sport of climbing, you might even consider installing a climbing hold in addition to a safety bar. It’s fun, comes in different shapes, and communicates a sense of strength rather than decline. 

Last week when I sent in my authorization to file my taxes, she responded and thanked me for our conversation, adding that she had ordered the Choreograph Barre from Kohler, one of the options I had shown her. She also said that she planned to sign up for the next Aging 360 workshop to learn more about other age-friendly design solutions for her home. 

Because of the “acrobatic” movements involved when using a bathroom—stepping into, over; getting up and sitting down; reaching over and up—and often on slippery and hard surfaces, the bathroom is the most common area for falls, according to many studies, including this one by Stanford Medicine. Just imagine a climber having to navigate wet rock! Installing a safety bar in the shower and/or alongside the toilet not only mitigates the risk of falling, it’s smart. 

Practical Tips: SAFETY BARS

 Standards:

• General: Thanks to the American with Disabilities Act(ADA) and building code requirements for public spaces there are very precise standards for the installation of safety bars around toilets and bathtubs/showers. This is a good place to start since these standards have evolved over many years. Here is the link to a government website that explains ADA requirements with diagrams. Most of us though may only install one safety bar at the long side of the shower/bathtub and one along the toilet plus maybe a shorter vertical grip or hold for getting in and out of the shower/bathtub. 

• Length: Typical length for safety bars in showers/bathtubs and along a toilet are 48”.

• Height: Typical height is between 33” and 36: to the center of the bar.

• Diameter: Typical diameter is between 1.25 and 2”. This is a comfortable circumference to grip. 

• Distance from wall: The typical distance from the wall is 1.5”. That gives enough space for your hand between the bar and the wall without scraping your knuckles. 

• Mounting: It is best to mount the grab bar into studs or plywood that spans between studs (what builders call blocking) behind the finished wall. This is the right thing to do when remodeling a bathroom and you can prepare for it before installing wallboard and tile. For an existing bathroom with a tile wall, there are installation videos on youtube that show how to secure a safety bar to a wall assembly of tile and sheetrock rather than a blocking. Here is an example and another one  

I believe in choice:

• If you have a beautiful piece of driftwood that is long enough, use it and mount it with stainless handrail brackets. It is an additional stimulant and delight to feel the texture or quality of a natural material.  

• There are many safety/grab bars on the market, two of my favorite ones are the ‘barre’ from the Kohler Choreograph series and the Latitude by Gatco.

Tips:

• Even though there are standards that are a great guide for what works for many people, we are all different so it is worth checking to make sure what height feels best for you for a safety bar. Every inch makes a difference. 

• A short, vertically mounted safety bar or grip such as a climbing hold is often useful for balance when stepping in or out of a bathtub

• A bathtub handle that clamps on to the rim of the tub is also helpful as support for the tricky action of stepping in and out of the bathtub. 

Some other thoughts:

• A safety bar is a useful bathroom accessory at any age and should be in every bathroom. 

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Tips For Safety Bars

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