Courtesy CityView

Henry Cisneros is a former HUD Secretary, has served four terms as mayor of San Antonio, and is executive chairman of CityView, an investment firm specializing in urban development. Cisneros is also co-editor of a new book, Independent for Life: Homes and Neighborhoods for an Aging America, which offers realistic design solutions for the country’s rapidly aging population. Last week at Designing Homes and Neighborhoods for an Aging Population, a symposium hosted by the National Building Museum, Cisneros sat down with Builder to talk about the oncoming crisis—and how the building industry could actually be energized by it.

BUILDER: We know that by 2050, the population of Americans aged 65 or older will be 88.5 million—more than double what it is now. Americans aged 85 years or older will number 19 million—triple what it is now. What does this mean for builders?

Henry Cisneros: All builders need to be aware of the basic physical realities that an aging population implies. Right now, there’s a mismatch between the physical capabilities of people as they age and some of the built environment that we’ve created. Entrances with stairways, cabinets that are high, bathroom fixtures at the wrong height, number of stairs within the house. We have to think hard about retrofitting existing housing—there’s going to be a lively industry of retrofitting and renovation. As new homes are built, they need to be with the elderly in mind. That’s different from the approach we’ve used in the past: communities exclusively for aging, with a limited number of houses for aging persons.

BUILDER: What’s the approach we need to take?

HC: Housing will have to be built for the general populace, with the assumption that they’re going to live in those places for a long time. The housing will have to be smaller-scale, one-story, and accessorized in a thoughtful way. It will have to be walkable—closer in to amenities like grocery stores, pharmacies, doctors’ offices, and village centers. It will have to be transit-accessible. The best way to do this—at least I have found—is to ask older people what concerns them when they think about housing. In the book, we have a list of what people have told us. They’re concerned about isolation because they can’t drive. They’re worried about wandering off into neighborhoods where the traffic moves too fast. They’re worried that they won’t have the money to maintain the house when it deteriorates. They’re concerned about appliances that are dangerous and might be hard to operate.

BUILDER: Is conventional design the biggest barrier to aging in place right now in America?

HC: The biggest barrier to aging in place today is financial. People are really worried about being able to stay in the house because they haven’t paid it off or can’t pay the taxes, [and] they can’t afford a new house or apartment. Beyond that, yes, we have to think about the physical dimensions of this. This kind of design doesn’t have to be thought of as an impediment; done correctly, it can be an asset. We can actually help older people stay healthy longer and live independently longer if they don’t fall, if they can wake up at night and get around the house easily. We need to see this in terms of the positive environment we can create.

BUILDER: From a development perspective, this seems like a space problem—so much of flexible, universal design is about living on one story.

HC: It’s true that more square footage may be involved in one-story building, but the overall scale is going to be smaller. If we’re building age-appropriate housing, we don’t need as much space.

BUILDER: You mean we won’t need a house with as big a footprint?

HC: Right. But here’s what else is interesting. My brother is an architect in Houston, and it’s amazing to me the number of groupings of elderly people who are coming to him and asking him to design for two and three people. And they want very creative designs of bedrooms so there’s not only separate space and privacy, but also common space.

BUILDER: This isn’t just families, is it?

HC: No, this is friends. This is widows. This is three or four women who have pooled their money and figured out what they can afford together. It’s not a flash in the pan. It’s a real thing.

BUILDER:Is this the new commune?

HC: (Laughs) I think this is "Girls Gone Wild," only they’re in their 80s!

BUILDER: Isn’t this also about community? So many assisted living places are in the middle of nowhere or in undesirable neighborhoods, rather than near school communities. It’s often grandma who takes care of the kids after school.

HC: No question. Where we locate new communities is crucial. Two contributors to the book, Ellen Dunham-Jones and June Williamson, wrote one of the more important chapters, which takes off on a book they wrote that focuses on retrofitting the suburbs. The suburbs were appropriate when everyone could drive. The layout—cul de sacs, regional shopping centers—is oriented to the car. When we start thinking about village centers, we need a different model. Taking out strip malls and big-box stores and replacing them with housing is a real option.

BUILDER: So it's an opportunity for the exurbs, too.

HC: Absolutely. I’ve seen this in my own work; my company, CityView, did it in Pomona, California. [It’s] taking out an unsuccessful commercial center and replacing it—not being wedded to the current use that’s on the site. Space is at a premium so we’re looking at places close to transit.

BUILDER: What’s your best advice about how builders and developers can play a bigger role?

HC: Be attentive to the reality of the market and how to respond to it. I’ve watched companies succeed because they’ve put their own traditional experiences aside and allowed themselves to be open-minded and thought about how to respond to real societal needs.

BUILDER: What would builders be most surprised to learn about designing and building for aging in place?

HC: How much of it is going to be needed! The scale of this is massive. In the next 40 years, we’ll go from the present 40 million people who are 65 years of age and older to 88.5 million. The number of people who are over 85 will triple in that time frame. Now, 40 years sounds like a long time, but that’s the same amount of time between 1972 and now; it’s well within the planning horizon of a community. The scale is going to be huge, and it will be different qualitatively. What does it mean for a society to have 19 million people who are 85 years of age or older, a good number of whom are strong enough, healthy enough, fit enough, self-reliant enough to live on their own? We’re not even close to providing the kind of housing that can address that. It’s a big number.

Learn more about markets featured in this article: Houston, TX.