Aging in Place

Jenny Nixon Author

12/06/2024 Added

2 Plays

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Leacey Brown with South Dakota State University Extension discusses aging in place.

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[00:00:00.000]So this morning I'm going to go ahead and have each of you introduce yourself quickly because I have a guest speaker on today. We have Lisey Brown, who is with University of, let me get this right, South Dakota State University.
[00:00:19.880]She's out of Rapid City and I had a chance to go and visit my good friend Peggy there a couple weeks ago and she introduced me to Lisey and we had a great conversation about housing and, you know, aging in place and how housing should be constructed to be more available to more people and she has some great ideas and I really thought this would be a great place to share that.
[00:00:47.380]So if you guys could each give just.
[00:00:49.500]A little bit of an introduction.
[00:00:51.120]We are and where you from or what, where you're coming from, that would be really helpful probably for her.
[00:00:58.020]And I'm actually going to just call on you because we have so many and there's still more people coming in.
[00:01:05.480]Chelsea.
[00:01:07.540]Chelsea here in Boxview Development Corporation and Alliance and Hemingford.
[00:01:14.320]Mylon.
[00:01:16.120]I'm Mylon.
[00:01:18.180]Well, I'm with the Heartland Center.
[00:01:19.480]I'm with the Heartland Center for Leadership Development.
[00:01:20.740]Our office is in Lincoln.
[00:01:22.360]Brianna.
[00:01:24.140]Hi, I'm Brianna Worth.
[00:01:28.840]I'm with the Ballantyne Economic Development Board and I'm the coordinator here.
[00:01:34.280]Daniel.
[00:01:36.420]Hi, I'm Daniel Bennett.
[00:01:40.640]I'm with Civic Nebraska and I'm in Scotts Bluff.
[00:01:43.020]Emily.
[00:01:44.980]I'm Emily Shook.
[00:01:47.920]I am the Economic Development Board.
[00:01:49.460]I'm the Economic Development Director for the city of Bassett, Nebraska.
[00:01:51.680]Julia.
[00:01:53.580]I'm Julia and I'm with PAD in Scotts Bluff.
[00:02:01.460]Paula.
[00:02:04.360]Good morning.
[00:02:06.460]My name is Paula Abbott.
[00:02:07.880]I'm with Western Nebraska Community College and a new role.
[00:02:11.560]I'm now the Campus Director for both Alliance and Sydney.
[00:02:15.340]Shauna.
[00:02:18.280]Hi, I'm Shauna.
[00:02:20.680]I'm with Chapel Community Development.
[00:02:23.620]And sorry, my computer I'm on doesn't have a camera.
[00:02:29.580]So I'm black today.
[00:02:31.780]Sean.
[00:02:34.320]Hi, everyone.
[00:02:37.020]I'm Sean Kasky.
[00:02:37.960]And like Jenny, I'm an RPN educator serving several counties in central Nebraska.
[00:02:41.820]Susan.
[00:02:44.000]Susan Unzicker, Alliance Chamber Director.
[00:02:47.860]Awesome.
[00:02:48.380]And I'm Jenny Nixon.
[00:02:52.320]I'm an RPN educator in the northwest corner of the state.
[00:02:55.900]So without further ado, let's go ahead and get started.
[00:02:59.300]Lisey, tell us what you've got up your sleeve there when you're thinking so passionately
[00:03:04.580]about housing as it relates to diverse populations.
[00:03:10.440]Absolutely.
[00:03:11.960]So a little bit about my professional background before I kind of get into the housing.
[00:03:16.260]I'm a gerontologist by training, so my expertise is aging in older adults.
[00:03:21.020]I literally went to college to learn about aging.
[00:03:23.580]And the areas that I focus on when it comes to applying the gerontological knowledge is
[00:03:29.580]adult technology use, aging well, fall prevention, and aging in place.
[00:03:35.680]So I'm here today to really talk to you about aging in place.
[00:03:39.620]Now, before I get into the nitty gritty details of why this topic matters, I want to introduce
[00:03:46.040]you.
[00:03:46.240]I want to introduce you to this concept of an adaptable home certification.
[00:03:50.100]An adaptable home certification has four key structural features.
[00:03:55.200]That's it.
[00:03:55.880]Nothing else.
[00:03:56.980]Four key structural features.
[00:03:58.320]We're talking one on-grade entry into the house, a room or a bedroom that could be used
[00:04:08.080]for sleeping on the same level as the on-grade entry, a bathroom that measures nine by six
[00:04:16.220]and includes approach space for wheelchair users for accessing the toilet and the shower.
[00:04:23.600]And the final feature is wide hallways and doors.
[00:04:28.340]So I want you to think of this as an adaptable home certification concept.
[00:04:33.540]So I'm sure you have all heard that our population is aging.
[00:04:40.840]The baby boom, the silver tsunami, all those scary,
[00:04:46.160]scary words that they like to use when the media is talking about aging.
[00:04:51.300]And I prefer to think of it differently.
[00:04:53.700]I prefer to us to think of this as a time for innovation.
[00:04:57.240]And those of us in the Midwest,
[00:04:59.480]we have the opportunity to innovate better than anyone else because our
[00:05:03.960]population is smaller.
[00:05:05.160]You have people like Jenny walk into my office and just start talking to me.
[00:05:08.820]As you can see, you get me talking.
[00:05:11.180]I won't stop talking,
[00:05:12.460]especially when it comes to housing and older adults and aging and
[00:05:16.140]workplace.
[00:05:16.480]Because what we know is that adults age 15 older want to stay in their
[00:05:22.360]home and community. As they get older, the data is there.
[00:05:26.120]The data has been there for 30 years. That's what's frustrating.
[00:05:29.580]As we've known this for a while, this is a new, but what we also know,
[00:05:34.240]those four features I described to you at the beginning,
[00:05:36.580]they're not in most housing.
[00:05:38.500]Most houses have steps to get in. The halls are narrow.
[00:05:43.820]The doors are narrow.
[00:05:46.600]The bathrooms are tiny.
[00:05:48.400]The bathroom is in most houses are not,
[00:05:52.480]is not a space where you could hire in an elder care agency to come in and
[00:05:58.320]provide assistance with toileting or bathing.
[00:06:00.400]That's the reality of our housing.
[00:06:03.060]Yet we've got all these adults telling us they want to stay at home.
[00:06:07.160]And here's another thing that I really think is important to drive home.
[00:06:12.900]You know, when we think about aging in place,
[00:06:16.100]older adults, disability,
[00:06:17.440]we tend to focus on the groups who currently have a disability and people
[00:06:24.920]want me to tell them, well, how many units do I need? How much,
[00:06:28.720]how many people in our population have a disability? It's about 12%.
[00:06:32.900]But what I want to tell you is that making 12% of the units accessible does
[00:06:38.240]not solve the problem. Here's why.
[00:06:41.000]Throughout our whole lifespan, we will enter phases of disability.
[00:06:46.080]Disability, whether it's pregnancy, an injury,
[00:06:50.480]when we're out on the farm using a tractor, recovery from surgery.
[00:06:54.960]So disability is not an end course.
[00:06:59.020]It's just something that we experience.
[00:07:01.000]So these four features really are about making sure that a space has the
[00:07:06.920]structural bones for a person who needs help because of the space.
[00:07:16.060]One other thing I want to touch on,
[00:07:17.660]and then I'm going to let you guys kind of just give me your initial
[00:07:20.120]thoughts.
[00:07:20.620]It's really important that I distinguish between housing and housing with
[00:07:26.900]services.
[00:07:27.440]Housing with services, that is your assisted living,
[00:07:31.380]that is your nursing home.
[00:07:32.840]The cost of those units includes stuff like chore assistance,
[00:07:38.440]laundry, med management, medical care,
[00:07:41.880]and a whole wide menu of services.
[00:07:46.040]That is housing with services.
[00:07:47.420]That is what an assisted living is.
[00:07:49.340]That is what is a nursing home is.
[00:07:50.840]Housing is where we all live.
[00:07:53.820]The thing about that elder care that comes with older age,
[00:07:59.680]there are options to receive it in the home.
[00:08:02.560]But what I hope, you know,
[00:08:04.760]we leave this conversation understanding today is that design of the home
[00:08:09.640]can be a barrier to hiring elder care for the people you love in your
[00:08:14.500]family.
[00:08:16.020]So I'm going to stop there and see if anybody has some initial thoughts or
[00:08:20.560]questions.
[00:08:21.340]The floor is open.
[00:08:30.780]I guess my initial thoughts,
[00:08:36.380]I got really excited when I saw this one because I have like a tendency to
[00:08:41.120]just tell people I love old people. And I mean,
[00:08:45.680]while I,
[00:08:46.000]I love hanging out with them and like nursing homes and all that I've done
[00:08:48.740]like the CNA thing.
[00:08:50.000]I just think that like they deserve so much and we often don't plan for them.
[00:08:55.140]We just assume we can put them in a home and like whatever.
[00:08:57.680]And most of the time those homes are kind of depressing because we don't
[00:08:59.860]plan them well. So when I was in like a studio, my senior year,
[00:09:03.740]it was amazing.
[00:09:04.780]Like the architects and interior designers were all worried about all the
[00:09:07.180]fancy things. I was like, yeah, but in all reality,
[00:09:11.100]like how well is this plan for anyone with any type of like disability or
[00:09:15.680]handicap?
[00:09:15.980]And I guess I was raised in a house. We built our house.
[00:09:19.460]My parents were like, Nope,
[00:09:20.640]we're building a handicap accessible in case we ever have to take anyone in
[00:09:23.640]or if somebody else buys it.
[00:09:24.740]So I've just been surrounded by like the universal design.
[00:09:27.780]I think it's like the utmost important thing, like wall color is great,
[00:09:31.720]but like, can we make a three foot hallway?
[00:09:34.080]Yes.
[00:09:35.700]Thank you for being here, Julia.
[00:09:39.400]So what can we do as economic development folks to
[00:09:45.960]really try and, and get those four features to occur in our communities?
[00:09:50.540]That's the question that really struck me.
[00:09:52.880]Definitely. So I want to
[00:09:56.000]just looking at some of my notes.
[00:10:00.000]So let me touch on a couple other barriers.
[00:10:02.140]Cause I feel like if I don't touch on these barriers and we,
[00:10:04.720]then we forget really important pieces of the puzzle when it comes to aging
[00:10:08.200]in place. I mean, home design is really important.
[00:10:11.480]It sets the stage where all the action can happen,
[00:10:14.500]but there's some other players.
[00:10:15.940]There's some other players that need to be part of this whole big drama we're
[00:10:19.220]trying to put together. So services,
[00:10:21.480]there is a need for service providers. Some communities,
[00:10:25.420]particularly our rural communities may not have home care,
[00:10:29.560]home health, nursing home, or assisted living.
[00:10:33.400]So that could be a genuine challenge for an older adult to remain in their
[00:10:37.600]home is if they need a high level of care and that service is not available.
[00:10:42.740]There's also the risk of isolation. Part of the risk of isolation is
[00:10:45.920]that is related to the fact that we have homes that have so many steps to get
[00:10:49.600]in. So people can't even get out once they start having mobility limitations,
[00:10:52.780]but there is a risk of isolation for a person to remain alone in a home by
[00:10:59.120]themselves for an extended period of time.
[00:11:01.300]There's also community design issues. You know,
[00:11:05.200]do the sidewalks have curb cuts are goods and services with it?
[00:11:09.440]Are they walkable or they can you get to them with alternative means of
[00:11:12.500]transportation? Because most people before the end of their life,
[00:11:15.920]we'll lose their license, you know,
[00:11:17.840]so how can they still interact and engage with their community?
[00:11:20.740]And the last thing is I'm sure many of you've seen this,
[00:11:24.800]but it's families simply not planning. And Julia touched on that families,
[00:11:30.060]you know, they say they want to stay in their home.
[00:11:32.660]They invest absolutely nothing in home renovations, you know,
[00:11:37.800]so there's that pre-planning issue. And just for references,
[00:11:42.780]I pulled these numbers for you guys.
[00:11:44.540]So you'd have a sense of how much,
[00:11:45.880]how much elder care calls cost in Nebraska.
[00:11:48.980]These are state averages.
[00:11:51.280]There will be variations depending on where you are located,
[00:11:54.360]but the state averages. So for homemaker services, homemaker services,
[00:11:58.620]that's the chores, laundry. That's, that's non-medical stuff.
[00:12:03.860]That's homemaker service.
[00:12:05.580]Home care is the medical or home healthcare is the medical.
[00:12:09.120]That's about $26 an hour for both of those in Nebraska.
[00:12:13.840]And adults,
[00:12:15.860]adult day center. These tend to be pretty rare in the Midwest,
[00:12:18.940]but it's, it's a place where you bring an adult during the day so that you
[00:12:23.260]can go work, go run errands, what have you.
[00:12:26.740]That service is about $1,500,
[00:12:30.360]$1,560 a month for that service.
[00:12:34.120]For adult, excuse me, for an assisted living.
[00:12:38.060]So an assisted living is kind of one step up from an independent apartment.
[00:12:41.700]They help with laundry. They might help with meds, yada, yada, yada.
[00:12:45.840]They help with, you know, some tasks.
[00:12:47.280]The monthly rate on that is $4,200.
[00:12:50.020]And now for nursing homes, there's private rooms and then there's shared room.
[00:12:56.620]If you want to have a room all by yourself, you're looking at $7,900 a month.
[00:13:03.600]If you want to share a room, you're looking at $7,190.
[00:13:09.740]So yes, housing with services is different from housing,
[00:13:15.820]but what I'm sharing is that you can bring those services to your house
[00:13:20.240]because most people, when they start needing help,
[00:13:22.500]they're not needing 25, 30 hours a month.
[00:13:27.020]They need five hours.
[00:13:29.100]So five hours at $26 an hour a week or something like that.
[00:13:33.520]So I hope that connection is coming through to the group.
[00:13:37.800]Okay, so there's a couple things I want to mention because,
[00:13:45.800]our existing housing does not largely have these features.
[00:13:49.240]We have some people like Julia's family who put them in because they were thinking ahead.
[00:13:53.020]But by and large, most houses do not have these structural features.
[00:13:57.860]Therefore, they need to be modified.
[00:13:59.920]The challenge with that is, by the time most people need their residential setting modified,
[00:14:05.560]they're living on a fixed income and can't afford it, or they completely resist the modification.
[00:14:14.380]Anybody?
[00:14:15.780]Anybody on the call got experience with a family elder refusing a ramp?
[00:14:20.160]Anybody got experience with that?
[00:14:21.480]Somebody on mic, unmute, talk about what that was like.
[00:14:26.840]My grandma didn't even want us to put handrails on her front steps.
[00:14:39.220]She can still walk, but she's very unsteady, so we really worry about her because she lives
[00:14:45.760]out on the ranch by herself, and usually an uncle goes and checks on her once or twice a day, but
[00:14:53.160]just trying to put some of those things in place so she's safer on her own has been difficult.
[00:14:59.540]Yeah, absolutely, and that is actually a very, very, very common problem,
[00:15:04.280]is that once an adult becomes an elder and they're getting close to potentially end of life,
[00:15:10.720]or just becoming more frail because that's what happens as we get older, you know, they don't
[00:15:15.740]want those signs in their environment that they are disabled, you know, and that's what I'm talking
[00:15:23.980]about with this adaptable home certification. Let's get these features in first, so they're
[00:15:29.560]there from the beginning, so when grandma reaches 90 years old, that no-step entrance is already
[00:15:36.440]there, and you don't have to wrestle with her emotionally about putting in this ramp that's
[00:15:45.720]there. So there's a very important relationship with home that has to be understood in this topic,
[00:15:55.080]especially when you're dealing with older adults who have reached the end of their life,
[00:15:59.320]they know this, and suddenly we want to make their home look like a hospital.
[00:16:04.180]I want to stop doing that. I really, really want to stop doing that.
[00:16:08.540]So I want to talk a little bit more about those hallways and doors. We're looking for 42-inch
[00:16:15.700]wide hallways. We're looking for 36-inch wide doors. Those are the dimensions we're looking for.
[00:16:21.060]Another bonus feature that would be really good to put into new builds is a 42-inch wide stairs.
[00:16:31.100]What that does is it allows you to put a chair glider in the stairs. If you have it wired for
[00:16:39.640]the electricity already, so there's an outlet there, so you can just jump right into that outlet.
[00:16:45.680]Now, for a house to be appropriate for aging in place, it doesn't have to be one level.
[00:16:50.620]You just take a couple extra steps. You make the stairs wider. You make the halls wider. You make
[00:16:58.020]the doors wider. Here are some limitations of these four features, five if you add the stairs.
[00:17:04.940]Doing tasks like cooking, the kitchen will not be accessible. The kitchen will not be set up so that
[00:17:15.660]uses a wheelchair can cook their own meals. That is a limitation, but they can go to the bathroom.
[00:17:22.200]That's number one. Another issue is the laundry in the basement. If the laundry is still in the
[00:17:29.740]basement, then that's really, you know, there's a limitation. That means somebody eventually will
[00:17:34.100]have to come be the laundry, do the laundry. But here's some optional features that just say
[00:17:40.360]we're talking about a theoretical, hypothetical,
[00:17:45.640]certification for an adaptable home. Just say that you got really excited. Julia's like on this.
[00:17:51.360]She's going to start advocating for this. She's going to start like rallying for this.
[00:17:55.160]Maybe you have a three, a level of adaptable home. Maybe the level two has two master suites,
[00:18:03.080]you know, maybe level three adds the laundry on the main level. Can, so see where I'm going with
[00:18:11.440]this? Okay. So I wanted to get those extra little pieces in there.
[00:18:15.620]Um, to talk about what an adaptable home could be. I'm talking about the basic structure. Those
[00:18:23.140]four features, really what that does is it gives us the bones. It gives us the structure. Um,
[00:18:29.460]Julia mentioned, mentioned universal design with the bones that we're talking about.
[00:18:33.560]That house could be made into universal design or that house could be made into accessible design.
[00:18:39.080]It would work either way because it's got the framework it needs for either space.
[00:18:45.600]Okay. So before we talk about the how-to, because I do have some discussion questions,
[00:18:49.700]I want to talk about some of the benefits that, um, these features add to the housing beyond
[00:18:58.680]creating an environment that an older adult can remain in until the end of life. You know, so
[00:19:05.320]first of all, I mentioned earlier, we ebb and flow through different phases of disability
[00:19:11.700]throughout our whole life. By having these features in homes,
[00:19:15.580]we always know that we can remain in our home no matter what health issues or whatever we're
[00:19:21.420]facing. Another benefit is you can welcome guests who have disabilities. You know, so Julia could
[00:19:27.420]bring her grandmother in and let her come stay and she could stay the night and she could use
[00:19:31.820]the bathroom and take a shower. That's important. It enhances your opportunity to receive in-home
[00:19:37.940]care. I have been told more than once that in-home providers will decline.
[00:19:45.560]to provide services if the bathroom is a safe place for their employees.
[00:19:51.880]So it enhances your capacity to receive in-home care.
[00:19:56.160]It reduces the number, if we could get this into new bills, so say in your community,
[00:20:02.060]you could get this into a percentage of new bills, maybe 25%, you know, you can get that
[00:20:07.360]into your new bills. It reduces the number of units that are incapable of, incapable of,
[00:20:15.540]incapable of being renovated. So you think about split foyer, there is no renovating that for a
[00:20:20.920]no-step entrance. It's just not going to happen. You know, so if we can start moving our housing
[00:20:25.720]stock to include these features, over time, we reduce the number of in our unmodifiable units.
[00:20:33.440]Reduce injury, risk of injury while moving furniture in and out of homes.
[00:20:39.980]I mean, we don't think about how many people are hurt trying to wiggle,
[00:20:45.520]like how much through a narrow doorway.
[00:20:47.380]So that helps in that front.
[00:20:49.020]Emergency service professionals are able to move a gurney in residential settings
[00:20:56.420]and render assistance to occupants in need.
[00:20:59.460]So it's another benefit.
[00:21:00.840]So if you're looking for partners to really rally for this, emergency services,
[00:21:06.220]because they need this as well so that they can do their job
[00:21:09.980]when people have emergencies in the home.
[00:21:15.500]Jamie said the reduced risk of complications that happens
[00:21:18.640]when older adults resist home modifications.
[00:21:21.080]Home modifications work best when we implement them early in the disability process.
[00:21:27.380]But as Jamie shared, that has not been an easy process to do.
[00:21:33.920]And there's also who pays.
[00:21:38.080]Many of the adults who need home modifications are living on a fixed income and too much
[00:21:45.480]So to my knowledge, it's mostly nonprofits and government agencies that are doing these
[00:21:49.560]home modifications.
[00:21:50.300]There's not very many people that are low income private paying and the low income folks
[00:21:55.880]are the ones who need the modifications the most.
[00:21:57.580]So the final benefit of these four features is just the reduced cost of home modifications
[00:22:05.840]overall.
[00:22:06.380]If I'm not having to rip out a wall to make a hallway wider, that's going to save a lot
[00:22:12.940]of money.
[00:22:13.700]So that's it.
[00:22:15.460]That's super important, particularly in the bathroom, because the bathroom is arguably
[00:22:19.940]the most important room when it comes to aging in place.
[00:22:22.640]And if that room has to be completely gutted, you've got to take walls down to get your
[00:22:28.040]dimensions, that's outside of most folks' budget.
[00:22:31.540]It just is, you know.
[00:22:32.980]So now, financial facts.
[00:22:36.640]I want to get this stuff out front, because I would be dishonest if I didn't say it costs
[00:22:43.600]more, because it does.
[00:22:45.440]To say this doesn't cost more is not, it's just dishonest.
[00:22:48.400]It's not being realistic about what does it actually take.
[00:22:51.100]So I'm going to describe some of the costs that I can think of right off the top of my
[00:22:55.280]head.
[00:22:55.640]The doors.
[00:22:57.380]Those doors are a little bit more costly.
[00:22:59.600]It's about $4 per door, but that's for $4 per door that has to be increased to the cost.
[00:23:06.400]There's a cost with upstating all the building plans.
[00:23:10.320]The builders would literally have to redo every single building plan they have to in
[00:23:15.420]incorporate the structure, because I'm talking about structural features.
[00:23:19.260]I'm not talking about a different color vanity.
[00:23:21.920]So they have to update all that, and there's costs associated with that.
[00:23:26.280]There's also costs associated with training the contractors to build the new plans.
[00:23:31.540]And it's not just the time.
[00:23:33.460]It's also they could potentially need a translator to communicate with the contractors,
[00:23:39.220]because they could be Spanish-speaking or some other foreign language.
[00:23:42.880]So there's that potential cost.
[00:23:46.280]There's the cost of the landscape architect and the dirt work that's required to get your no-step entrance,
[00:23:52.360]because you're really going to probably have to work with a landscape architect,
[00:23:55.120]use some retaining walls, whatever.
[00:23:57.880]They'll have to figure it out on the space.
[00:23:59.820]But there are costs associated with putting in that no-step entrance.
[00:24:04.660]So that's important.
[00:24:06.340]And I think we have to, as passionate as I am about it, I think we have to really lay out the costs.
[00:24:12.180]And there's probably other costs that I may not be aware of.
[00:24:15.380]So how are the discussions about affordable housing?
[00:24:20.240]Tell me about how those are going in your neck of the woods.
[00:24:23.180]Do you need affordable housing?
[00:24:31.660]That would be true.
[00:24:34.260]Mike, you've kind of done some things recently with housing.
[00:24:37.540]Tell us what's going on in Ballantyne.
[00:24:39.760]Affordable housing is a matter of opinion.
[00:24:46.120]Because if you look at quality affordable housing,
[00:24:49.980]and our housing market is high compared to other communities our size.
[00:24:55.020]So what you could buy in a town 60 miles away for $100,000
[00:25:01.340]would maybe cost you $200,000 in Ballantyne.
[00:25:04.740]And it's difficult to find that price range that your wages allow you
[00:25:12.520]to buy a $200,000 house.
[00:25:15.340]I mean, there's multiple things on housing.
[00:25:17.540]We did get a grant for Nebraska Affordable Housing.
[00:25:20.480]We've got some NYFA funds.
[00:25:22.080]We have some rural workforce housing funds that we're trying to do some things with
[00:25:26.460]and try to keep that into a first-time homebuyer type category.
[00:25:31.840]But one thing that we're finding out is also some of the younger folks
[00:25:36.200]that are getting out and getting started, they're in their 25, 35 range or something,
[00:25:40.340]and they want that house that mom and dad have been working for 30 years.
[00:25:45.320]Or more to afford.
[00:25:47.140]And that's the kind of house they want to start with.
[00:25:49.640]And so they don't really want this fixer-upper house and then live in it for 10 years
[00:25:56.720]and then move up or whatever it is.
[00:25:58.560]So I don't know.
[00:25:59.680]Housing is definitely an issue.
[00:26:03.020]And I think it's just one bite at a time type thing.
[00:26:05.300]But I mean, it's good information that Lacey's put out here,
[00:26:08.140]or Lacey that's put out about when we're building these kind of things.
[00:26:12.320]Think down the road, because we do have a...
[00:26:15.300]Our demographics are showing 30-somethings moving here and early retirees.
[00:26:19.400]So some of our housing down the road is going to need those 42-inch hallways, 36-inch doors.
[00:26:25.320]It needs to be taken into consideration when we're thinking in the next few years.
[00:26:33.720]Definitely.
[00:26:34.600]I mean, my dream, they all would have it, but I know that's not practical.
[00:26:38.320]But if we could get a percentage of them with at least...
[00:26:41.640]It would get us in the right thing.
[00:26:42.880]But you brought up a good point.
[00:26:45.280]Quality, affordable housing.
[00:26:47.120]And the conversations that I've heard, you can hear the developers and the builders,
[00:26:52.320]and I get it, they're trying to save money.
[00:26:53.560]They're looking for shortcuts.
[00:26:54.740]They want to take off some of the quality of life amenities, the lights, the sidewalks,
[00:26:59.820]the yada, yada, yada to save money.
[00:27:01.740]And it's complicated.
[00:27:03.780]I mean, it truly is complicated.
[00:27:05.940]But one thing that I like to lift up and remind folks of when we're talking about workforce
[00:27:12.620]housing is everybody's looking at workforce housing.
[00:27:15.260]And I've been talking about the prospect disability and really trying to change our
[00:27:19.900]understanding that disability is just something we kind of come in and out of throughout our
[00:27:25.000]whole life.
[00:27:25.580]It's not an, oh, you've reached your disability point, you're disabled for the rest of your
[00:27:29.920]life.
[00:27:30.180]It's a, oh, Lisey was popping popcorn, decided to bounce from foot to foot and broke her
[00:27:35.680]ankle because it rolled.
[00:27:38.000]You know, that's, we've got to update that understanding.
[00:27:42.340]So when you think about workforce housing, who's living in workforce?
[00:27:45.240]Housing type it or unmute who lives in workforce housing.
[00:27:49.340]People that are working, hopefully.
[00:27:54.780]What kind of occupations there?
[00:27:57.900]What kind of occupations do people in workforce housing have?
[00:28:01.140]Well, that's part of our thing is, is our wage scale seems low for the price of housings.
[00:28:07.940]If you, if you're say the average wage is 17, $18 an hour, $16 an hour, whatever it
[00:28:15.140]is.
[00:28:15.240]Well, you can't afford a $250,000 house, you know, on, on wages like that.
[00:28:20.740]So, you know, we, we need to build houses that are going to accommodate that kind of
[00:28:26.540]a wage.
[00:28:27.040]And unfortunately, recently, anyway, the price of materials to build a house is way, way
[00:28:36.640]out of line.
[00:28:37.020]You can't do it.
[00:28:37.680]It doesn't, it doesn't.
[00:28:38.600]I appreciate you talking about the wages, but I want to focus on the occupation.
[00:28:44.800]are they doing for work they're working uh fast food places they're working as a store clerk
[00:28:53.740]they're you know um some of those kind of things um maybe they're a retail person
[00:28:58.700]they're working as a server at a steakhouse what about our police officers our nurses
[00:29:07.320]they're living in that housing too right those those are jobs that are high risk of developing
[00:29:14.080]a disability before older age true so that's what i'm getting so when we're talking about
[00:29:21.640]workforce housing people are like oh no that you know disabled people need different housing it's
[00:29:25.780]like no our workforce are in occupations that put them at high risk of developing a disability
[00:29:32.420]earlier in life you know so that's the what i'm kind of lifting up here so yes workforce
[00:29:38.700]housing is important but we have to understand those occupants
[00:29:43.360]some of them have a high risk of developing a disability at a young age
[00:29:46.840]because of the nature of the work that they do so that's an important point so i've got
[00:29:52.800]some discussion questions for you um so before i throw my questions out does anybody want to
[00:30:00.540]add to the conversation um ask a specific question share a personal experience with
[00:30:07.600]um an older loved one and aging in place like anything that the group
[00:30:12.640]wants to share based on kind of everything that i've thrown at you which i know is a lot
[00:30:16.400]this is don and i guess i have a question about if you can hear me all right yes
[00:30:30.720]okay i have a question about uh where small communities like that
[00:30:37.920]the harrisons or the harrisburgs or the militaires
[00:30:43.360]um where do they fit in this discussion in terms of can we attract folks to
[00:30:51.520]stay there and to come back there as they age and be part of the community
[00:30:56.080]i think that small communities in some ways have more flexibility because you know each other um
[00:31:06.240]you don't have the challenges like rapid city does where we have you know dream design
[00:31:10.240]international that just comes in and kind of
[00:31:12.400]of dominates all the housing that's getting constructed you know but a small community you
[00:31:18.320]know imagine like you really rallied your community community dawn like you started
[00:31:24.800]hosting meetings like started really bringing everyone together saying we really want to see
[00:31:29.360]this happening and our new builds we want to see this happening we want to retrofit everything
[00:31:34.160]that's possible because some units can be retrofitted um and then maybe once you get
[00:31:39.680]the community all organized you have this adaptability
[00:31:42.320]home certification and you market it and you say you can tell your retirees come back we
[00:31:47.480]got housing for you you know that might be one way maybe i'm a little pollyanna and optimistic
[00:31:53.600]but that might be one way is to really rally the community and implement an adaptable home
[00:32:00.100]certification so on all your sales paperwork with your house the house says adaptable home
[00:32:05.420]and that way the buyer knows because i firmly believe that there are
[00:32:12.220]no adaptable homes that are not going to be able to be used in the future
[00:32:12.300]and i firmly believe that there are no adaptable homes that are not going to be used in the
[00:32:12.300]future and i firmly believe that there are no adaptable homes that are not going to be used
[00:32:12.300]in the future and i firmly believe that there are no adaptable homes that are not going to be used
[00:32:12.300]in the future and i firmly believe that there are no adaptable homes that are not going to be used
[00:32:12.300]enough people who want to stay in their home that if we start finding a marketing outlet and we
[00:32:19.860]market this and we say okay this is an adaptable unit that they'll move i mean in rapid city
[00:32:25.460]properties are going 10 to 15 percent above asking right now you know and i have a feeling that if we
[00:32:31.780]could market a whole development i mean i wish i could find the developer that was bold enough to
[00:32:35.960]do it just put in a whole bunch of these houses and see how quick they sell because
[00:32:42.280]if they sold quicker than anything else in rapid city that would tell us something
[00:32:46.680]and i think that they would the cost will be a little bit more will be you know but when you're
[00:32:54.340]dealing with adults who are actually thinking about where they want to be when they're old
[00:32:59.400]they may be willing to invest in that so
[00:33:04.120]yeah this is daniel um i'm thinking that maybe there are you know the opportunities
[00:33:12.260]if there's some kind of a community sponsored build or if there's like a community investment
[00:33:17.240]group or community development organization that has a part to play in um some kind of a
[00:33:24.240]like a new build that it would make sense to put uh some of these features as um like to consider
[00:33:36.420]as real requirements for that just to make that housing as flexible as possible um
[00:33:42.240]but on the you know on the adaptive side like retrofitting things that seems like it would be
[00:33:49.940]it would be more of uh um kind of a case-by-case basis as far as what's feasible and what you're
[00:33:56.900]able to do and i'm wondering if there's um are there like architects who specialize in this kind
[00:34:06.380]of thing or do they need some kind of a certification or i mean how could we how could we make the
[00:34:12.220]that step lower to know that if somebody wants to adapt something in their home like go to this
[00:34:17.660]person they can help you and to have that capacity locally that can be faster and cheaper so daniel
[00:34:23.500]that's um i don't know architects in your area that would be there may be so i'm going to
[00:34:30.900]describe a project in south dakota it's actually a bi-state with north dakota um but one of the
[00:34:36.140]outputs is what you're describing daniel once people learn about this topic where
[00:34:42.200]can they go because like you said 100 retrofitting a house that's an existing unit that's case by
[00:34:48.120]case you know you have to have someone in here who can come and even then it may be very limited
[00:34:54.100]it may be the entrance and maybe there's just a room in the bathroom and the rest of the house
[00:34:58.600]is just the way it was but you have those those key features um so part of this housing
[00:35:06.700]so we in south dakota north dakota we are creating a communications kit to talk about
[00:35:12.180]home modification and the role that home plays or home design plays in aging in place
[00:35:18.600]part of the um resources we're going to compile are professionals who might do
[00:35:24.760]the um plans you know i don't know that they would do it for free you know you know because
[00:35:31.180]there's just yeah um but that's one of our plans and that could be something worth like if you find
[00:35:36.700]somebody that's interested in this maybe pulling together a similar group because we actually are
[00:35:42.160]planning to do videos and written testimonials from people in north dakota and south dakota who
[00:35:48.440]have kind of had the home modification challenges or successes what have you and our real we want
[00:35:55.720]to do a big like uh promotional push with all these materials to really try to raise awareness
[00:36:01.780]because we did a study a couple years ago and one of the things that we found is that there's just
[00:36:07.180]general a lack of knowledge about what it takes to make a home appropriate for people
[00:36:12.140]of all ages and abilities there is this mindset that you have to make special units for people
[00:36:18.900]with disabilities and that they're different from the units with everybody else and with this
[00:36:24.160]adaptable home concept it's like no if we can get the bones the rest is negotiable
[00:36:29.280]so the questions so it's a couple questions that i wrote down so um for the bigger communities
[00:36:37.560]granted i think smaller communities have access to tis but i don't i don't know a lot about tax
[00:36:42.120]increment financing but i do know in south dakota one of our barriers to a municipality saying okay
[00:36:50.400]hey if you want to use tiffs to put up housing you have to include these four features
[00:36:55.940]right now we can't do that they can't say you have to include these features
[00:37:02.140]but if we could get the state legislature to update the tiff laws so that say rapid city
[00:37:08.220]could say okay we want twenty four five percent of the units in this development
[00:37:12.100]to have these four features that would be a potential tool because like i said there's
[00:37:18.300]no denying there's some additional cost you know um so other question i had is what tools might be
[00:37:28.460]able available in your own personal community like what resources if you're really interested
[00:37:33.040]and you're like man we really should try to like start talking about like doing this and figuring
[00:37:37.720]out how to make something like this happen in the housing um what tools might be available in your
[00:37:42.080]community where you live or what groups what non-profits is there anybody working in housing
[00:37:47.020]right now oh there's lots of people working in housing that was a silly question
[00:37:54.280]we have several contractors in valentine and and they always a lot of them are you know
[00:38:02.340]expansion projects some are complete build projects and stuff so there's
[00:38:06.640]there's a workforce to do that kind of stuff um
[00:38:12.060]and we do have like i said we have some rural workforce housing funds and the city is willing
[00:38:19.680]to put some pretty good money next year i think we're going to do some infrastructure to a new
[00:38:24.200]build area to a new development area because we figure we need 40 to 60 new units in the next
[00:38:30.680]couple years and so and and we did have the university of nebraska school of architecture
[00:38:37.320]students come up and they planned out a development in that area that kind of gave
[00:38:42.040]us a mix of multi-family and and single family dwellings but i we never did really touch on the
[00:38:47.420]the subject of the you know the modifications and retrofitting anything or you know making them
[00:38:53.200]looking at the future of those kind of things that we we didn't think about that i guess and
[00:38:58.060]we didn't get down to planning what types of houses they would actually be but the ones we're
[00:39:02.800]doing right now are a couple of 1250 1300 square foot spec houses and stuff that are um i think
[00:39:12.020]uh most of those are going to be on a slab
[00:39:14.640]so but we have um i know that we'd be willing to put in about 350 000 out of our lba 40 money
[00:39:27.100]into housing here in the next couple of years and i've got a private business that is looking at a
[00:39:33.080]huge expansion and they were they were talking about putting a million dollars into some housing
[00:39:42.000]we'd have to do some type of a private and public partnership to meet the housing needs
[00:39:51.060]that we're going to need and i'd like to retrofit a few houses on some infill housing and that kind
[00:39:57.500]of stuff so awesome but yeah using i think public private public partnerships i think could be super
[00:40:03.360]helpful for doing stuff like this um it's just imagining figuring out like who's dealing who's
[00:40:09.160]putting up the housing in your community you know
[00:40:11.980]you know can you advocate to them to make say 25 of the units you know i mean it's just a matter
[00:40:18.720]of figuring it out and if you're offering the adaptable home certification then maybe you can
[00:40:24.380]say okay if you do these 15 i just used your 60 number these 15 units as adaptable they get a
[00:40:30.160]little stamp you know i mean there's it's it's not easy it'll take work um but it provides a
[00:40:37.480]communication tool and that's what i like about this concept of trying to really promote an adaptable
[00:40:41.960]it provides a tool that allows us to communicate about housing with as real estate agents as
[00:40:48.360]consumers it helps us be able to describe what we're looking for because i know people here that
[00:40:54.220]have looked for a house that's appropriate for someone who has parkinson's disease and that was
[00:40:58.580]practically impossible to find um you know so definitely um other ideas about tools or strategies
[00:41:06.540]in your community that you would try if you were really interested and wanted to maybe start the
[00:41:11.940]work that you would want to do in your community that you would want to do in your community
[00:41:16.320]jenny if you give me screen share i'll show some ramps because you should have the ability okay
[00:41:29.400]cool i'll get the pictures up because typically i would guess that when folks are thinking about
[00:41:37.760]ramps they're thinking about that ugly wood
[00:41:41.920]ramp that sticks off the end of a house um
[00:41:46.800]and it's just a nice one but what i was just going to show you an example of is this is a ramp
[00:41:55.740]um any thoughts i mean i know expensive is probably thought number one but any
[00:42:02.220]thoughts just at first glance about this ramp and how it ties into the exterior of this house
[00:42:07.520]i think that looks awesome but yeah
[00:42:11.900]price was the first thing that popped in my head but i love the aesthetics of it
[00:42:17.160]as when you think about that remember eight thousand bucks for a nursing home
[00:42:21.560]so are there i'm sorry i missed a little bit of the the beginning here um
[00:42:30.120]at least but let's is there money available to do some of these kind of things like some ada money
[00:42:36.280]or something if a contractor was wanting to put a ramp like that in can they apply for some money
[00:42:41.880]to help make those kind of adjustments so if you are dealing with an older adult um you would need
[00:42:48.880]to have them contact your adrc hang on age
[00:42:55.260]source connection there and it's going to be i don't know for nebraska what there is
[00:43:03.320]um i just know this one just because i know um this is standard across all states um so this
[00:43:11.860]would be so if you have an older adult or a person with a disability this is who i would direct them
[00:43:19.180]to contact um it's the aging and disability resource center most states do have medicaid
[00:43:25.840]funds to pay for home modifications the only challenge is um finding contractors who actually
[00:43:34.360]accept the medicaid dollars and they will not be putting in a ramp like this this is the this is a
[00:43:41.840]who's thinking ahead and who's investing in it um as another option of a ramp
[00:43:48.280]and i'm showing yes they're costly but i want you to know that they don't have to be
[00:43:55.800]um that wood eyesore so this one is done beautifully with steps still included but
[00:44:04.760]that's got the ramp you know so ramps can be done differently yes they are costly but i
[00:44:11.820]you know but they the goal if the goal is to not go into an assisted living on a nursing home
[00:44:18.940]then the investment in the ramp and especially a ramp that's going to add aesthetic appeal
[00:44:24.440]is probably worth it as opposed to just retrofitting a wood ramp that you're going
[00:44:30.640]to rip off eventually so i'm going to show those because not many people have seen
[00:44:35.840]uh ramps that are attractive and there is also just doing
[00:44:41.800]a no-step entrance so um other comments and we're getting close to the end in terms of cost
[00:44:50.480]for something like that you're talking uh you can do a lot of renovations for what two months cost
[00:44:57.120]at eight thousand dollars a month that's yeah and the happiness that the i don't know how you
[00:45:05.180]factor that into to an elderly person's life but it's big yeah and just in your own home
[00:45:11.780]because what the meaning of home is important especially when you're talking about the elders
[00:45:16.000]in your family particularly if they have been in that home for 50 years they raise their children
[00:45:22.740]maybe it's their parents home that they inherited you know and that's why like yeah you're like you
[00:45:29.760]said for two months of what it costs to go into a nursing home you can do that ramp it's gonna look
[00:45:35.060]beautiful that your loved one can stay there and that that's a mindset change because people
[00:45:41.760]friend right now he just got a piece of property there is just a two foot um lip between the door
[00:45:49.080]jam and a little wood deck and he's talking about replacing the whole deck and i'm like dude just
[00:45:53.380]make it a no step but no but he won't do that i'm like seriously if you just made it a no step right
[00:45:59.180]now it would be done but whatever so i just shut up in color but yes and then that's what you know
[00:46:08.480]i try to like really that's why i bring in the cost of service
[00:46:11.740]you know because you can pay for 26 bucks an hour you know maybe you need to you know two 10 hours a
[00:46:18.420]week you know so it's 260 a week that's a thousand a month compared to 8 000 for a nursing home and
[00:46:25.680]here's the other thing most care to elder elders is done by family members it's not done in housing
[00:46:34.640]with services it's done at home by family so that's why it's so imperative to have a space
[00:46:41.720]where if your grandmother needs help walking down the hallway you can stand beside her and help her
[00:46:47.820]that's the benefit of those wide halls so jamie writes my grandma designed her home
[00:46:53.540]and had it built 60 years ago i bet now she wish she had thought of some of these
[00:46:57.320]adaptations absolutely and that's what i see happen to people is you don't realize how big
[00:47:03.520]a deal those three are to get into your house until you hurt me or you sprain your ankle and
[00:47:11.700]ankle popping popcorn and i'm not kidding it rolled i had a vertical crack i was living on
[00:47:16.580]the third floor of a building with no elevator climbing on crutches climbing stairs in the
[00:47:21.180]winter time you know it's like when you have those personal experiences with having a disability like
[00:47:26.920]it was temporary you know i'm better my ankle's not broken anymore but it happened and it can
[00:47:31.940]happen at any time especially in the midwest where we make our bread and butter with agriculture
[00:47:37.600]we're doing hard work you know other
[00:47:41.680]comments questions they say one of the things that you said to me earlier was that even if we
[00:47:48.560]just think about putting the handholds in the showers this is the thing that always gets me
[00:47:53.240]i'm always doesn't matter where i am wishing there was a handhold in the shower and and we don't have
[00:48:00.740]to make them ugly no we don't and truthfully you know another cost that i forgot to mention i had
[00:48:06.280]it wrote it written down but i forgot to mention um there is the cost of putting so when you put
[00:48:11.660]put in that bathroom that's got that six by nine it's got the approach for the shower and the
[00:48:16.380]toilet the best thing to do is to put plywood on every wall behind the drywall why this is good
[00:48:25.560]is because grab bars can then be placed wherever they're needed because a man who is six foot
[00:48:32.700]five need grab bars at a different height than a woman who's five foot three so and i
[00:48:41.640]personally would like to have grab bars in all bathrooms at least like you know one in the
[00:48:45.100]shower one by the toilet just in case because that's a dangerous room and i'm sure the folks
[00:48:51.100]with kiddos understand because kiddos are slipping and sliding everywhere and having those grab bars
[00:48:56.860]would be nice for your kiddos you know when they're a little bit clumsy so but i i would
[00:49:01.580]i would put grab bars everywhere in the bathroom who else has got comments or questions
[00:49:11.620]is is this something that the aging office can help us with
[00:49:19.900]as far as you know they have a lot of contact with seniors
[00:49:25.040]uh getting them to plan ahead maybe given some the challenge with the aging office that's people
[00:49:32.240]who already need services right so those folks generally if they are calling that aging and
[00:49:39.120]disability resource connection they're all they're all going to be calling that aging
[00:49:41.600]their income is fixed they don't have money to do renovations um so but could we convince them
[00:49:49.560]could we visit with them and try and help them you know look look further out and and maybe deal
[00:49:56.520]with some folks that are 50 or 55 that might still be able to do these sort of
[00:50:00.940]just informational don i don't i missed uh where you're located but i know at least in the pan
[00:50:10.020]handle i've worked
[00:50:11.080]i've worked pretty closely with our aging office and then i know
[00:50:15.780]the aging office and the public health district are both really interested in
[00:50:20.820]in adaptations and in housing that's safe for older adults and would be i think open to looking
[00:50:30.920]down the road it's in all of their benefit to do that so i think they'd be open to that
[00:50:36.100]conversation and at least being able to provide insight on what
[00:50:40.560]the people they see need well and there might be benefits to mobilizing a group because it
[00:50:45.640]you're probably in the same boat like we are i mean we need people to make the investment
[00:50:50.100]in home modifications before they exit the workforce that honestly needs to happen across
[00:50:56.160]the board however people aren't even investing in retirement let alone home mods so they're really
[00:51:04.860]there's you're right there we there needs to be some work that targets
[00:51:10.040]um 40 year olds 50 year olds and get some thinking about this because and i would say 40 because
[00:51:17.360]you know depending on the nature of your home you could need some major renovation renovations it
[00:51:22.740]could be you know a hundred thousand dollar reno job well that's expensive and that could take a
[00:51:30.040]while to pay off because you know most people don't have a hundred thousand dollars sitting
[00:51:33.280]in their bank accounts to go do home rentals they're going to do a have to do a home equity
[00:51:38.140]loan or something like that
[00:51:39.520]so I do agree and that's part of what we're trying to do in South Dakota with our communications
[00:51:45.460]toolkit is really get people really just raise awareness because a lot of I mean there is
[00:51:51.400]misunderstanding that you know okay people are old we just pop them in the nursing home and we
[00:51:56.180]move on and that's not what older adults want that's not what I want for myself when I become
[00:52:03.900]an older adult and that's what I think I would really drive that one home every solution
[00:52:09.000]that you are proposing for an older adult you are proposing that same solution for your future
[00:52:16.020]older self so if you're excited about living in a nursing home by all means keep promoting them
[00:52:22.100]keep on that's where you're going yeah pre-covid that was not such a frightening experience post
[00:52:28.440]covid it's much more frightening well in my I mean I have always felt that nursing homes were
[00:52:33.980]broken um I don't see benefits in congregating people in frail
[00:52:38.480]health together it's not good emotionally it's it's just it's like I don't remember who talked
[00:52:44.640]about just how depressing kind of the nursing home environment can be they are making moves
[00:52:48.920]to make them better but at the end of the day I really feel covid has shown us why nursing homes
[00:52:55.600]and assisted living may not be a really good idea because what are we doing congregating
[00:53:02.340]vulnerable people into a single location and then allowing
[00:53:07.960]essential personnel to come in and out
[00:53:10.420]I mean that's a lot of the deaths happened in adults over the age of 50
[00:53:16.700]and I don't know how many of those were nursing home residents but I would not be surprised if
[00:53:21.480]it were high because you congregate people with chronic conditions and chronic conditions are
[00:53:26.580]one of the leading risk factors for complications due to covid 19 is having a being obese for
[00:53:31.860]having diabetes leading risk factors for complications along with older age
[00:53:37.440]so I think that if we were to start getting more homes like this then we could reduce the number of
[00:53:45.140]nursing homes we could reduce the cost associated with elder care because most people cannot afford
[00:53:52.600]to pay that 8 000 a month out of their own personal pocket who's the number one payer for
[00:53:59.420]nursing homes and long-term care number one payer who do you think it is anybody guess medicare
[00:54:06.920]second one second one medicare so every adult age 65 and older gets medicare medicare is just
[00:54:16.080]like the health insurance that's provided through your employer employer it's just health insurance
[00:54:21.360]doesn't do anything else so it doesn't cover nursing home stays unless it's for a very short
[00:54:28.160]rehabilitation so but if we work on this housing you can keep your elders at home you have
[00:54:36.400]better control who's coming in and out you know so there's just a lot yeah after COVID I think we
[00:54:42.500]learned a lot about nursing homes and assisted livings I know too many people who lost loved
[00:54:47.560]ones and weren't able to see them before they got left or transitioned so
[00:54:51.100]well thank you Lisi for bringing such thoughtful
[00:54:58.660]conversation about housing and all of us are thinking about that all the time and I just
[00:55:05.880]thought it was a great opportunity to to be able to broaden a little bit what we're looking at in
[00:55:11.140]housing stocks so I'll tell you it has taken years to really pull together this work group
[00:55:17.360]that we have between North Dakota and South Dakota but we've got architect interior designer
[00:55:23.680]gerontologist some businesses that do home renovations you know and I think finding a
[00:55:30.560]group like that could be beneficial because then you have more people who are working on it
[00:55:35.360]you know and you can learn from them and figure out what's going to make sense because I think
[00:55:39.280]every community is going to have to do it a little bit different if this is something they
[00:55:42.980]feel is important but when you think about saving those Medicaid dollars the longer we can if we can
[00:55:49.420]provide care in home we save Medicaid dollars because as you saw that nursing home was about
[00:55:56.060]eight thousand dollars a month compared to say maybe a thousand dollars a month worth of in-home
[00:56:02.740]care depending on how many hours
[00:56:04.840]you use there is that variation so so as you and and North Dakota and South Dakota get this
[00:56:11.780]project underway presenting at national conferences would be awesome and actually
[00:56:18.740]doing it at an economic development conference would be awesome as well so just yeah I think it
[00:56:26.640]would because I really think that most people can see how this is an economic development issue
[00:56:32.860]because housing
[00:56:34.320]is just the center of so many of people's lives you know and if that house can't support them
[00:56:44.160]if they develop a disability when I mean really when they develop a disability
[00:56:49.160]that then it just it has a bad a negative impact on their quality of life
[00:56:53.840]awesome any last thoughts or comments before we take off for the next two weeks
[00:57:03.800]if not we will be back in two weeks at this very location
[00:57:10.140]if you guys didn't already know Valentine was selected to host NIDA in May 2022
[00:57:16.720]awesome awesome good thanks everybody and Lacey thank you have a great day thank you thanks
[00:57:27.100]Thanks.
[00:57:27.600]Amen.

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Aging in Place

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