HOUSING POLICIES AND CARE FACILITIES FOR OLDER ADULTS IN THE UNITED STATES: AN ANALYSIS OF THEIR APPLICABILITY TO TÜRKİYE

Öz

The aging population worldwide, coupled with urbanisation dynamics and social sustainability goals, necessitates the development of new-generation housing policies. This study examines housing policies and care services designed for individuals above a certain age in the United States and evaluates the applicability of various models to Türkiye’s housing policy framework. Adopting a qualitative research approach, the study employs document analysis and comparative assessment methods. In the first phase of the research, age-restricted communities, assisted living facilities, and continuing care models implemented in the U.S. were comprehensively analysed. These models were evaluated in terms of their advantages in terms of the diversity of social services, facility management structures, financing mechanisms, and legal regulations. Key findings include the significance of user-oriented services, structures that enhance social participation, and the development of sustainable management systems. In contrast, it was observed that current practices in Türkiye largely remain fragmented, that age-sensitive housing models are limited, and that there is a lack of specialisation in facility management. In the final phase, the comparative analysis yielded several recommendations for Türkiye: strengthening the legal framework to support age-friendly housing policies, initiating pilot projects through public-private partnerships, enhancing the role of local governments in expanding social support networks, and fostering age-specific expertise in facility management. Furthermore, it is emphasised that culturally adaptive and participatory policies should be promoted through model projects in regions with a high concentration of elderly migrants, ensuring a broader focus on social justice and inclusivity. In this regard, the study aims to contribute to the development of age-sensitive, sustainable, and socially integrative housing policies and care services in Türkiye, offering an original perspective on the literature through its holistic approach, which incorporates the dimension of facility management.

Anahtar Kelimeler

• Elderly housing
• facility management
• housing policies
• elderly care services
• senior living facilities

AMERİKA BİRLEŞİK DEVLETLERİ’NDE BELİRLİ YAŞIN ÜZERİNDEKİ BİREYLER İÇİN KONUT POLİTİKALARI VE BAKIM TESİSLERİ: TÜRKİYE’YE UYGULANABİLİRLİĞİNE YÖNELİK BİR İNCELEME

Öz

Dünya genelinde yaşlanan nüfus, kentleşme dinamikleri ve sosyal sürdürülebilirlik hedefleri doğrultusunda yeni nesil konut politikalarının geliştirilmesini zorunlu kılmaktadır. Bu çalışma, Amerika Birleşik Devletleri’nde belirli yaşın üzerindeki bireyler için geliştirilen konut politikalarını ve bakım hizmetlerini incelemekte ve farklı modellerin Türkiye’deki konut politikalarına entegrasyonuna ilişkin uygulanabilirliğini değerlendirmeyi amaçlamaktadır. Nitel araştırma yaklaşımıyla yürütülen çalışmada, doküman incelemesi ve karşılaştırmalı çözümleme yöntemleri birlikte kullanılmıştır. Araştırmanın ilk aşamasında, ABD’de uygulanan yaş sınırlamalı topluluklar, destekli yaşam tesisleri ve kademeli bakım hizmeti sunan modeller kapsamlı biçimde analiz edilmiştir. Bu modellerin sosyal hizmet çeşitliliği, tesis yönetimi yapıları, finansman mekanizmaları ve yasal düzenlemeler açısından sunduğu avantajlar değerlendirilmiş; kullanıcı profiline özgü hizmetler, sosyal katılımı artırıcı yapıların önemi ve sürdürülebilir yönetim sistemleri öne çıkan bulgular arasında yer almıştır. Türkiye’de ise mevcut uygulamaların büyük ölçüde parçalı yapıda olduğu, yaşa duyarlı konut modellerinin sınırlı kaldığı ve tesis yönetimi alanında uzmanlaşmanın yetersiz olduğu saptanmıştır. Son aşamada gerçekleştirilen karşılaştırmalı analiz sonucunda, Türkiye için yaş dostu konut politikalarının yasal altyapı ile desteklenmesi, kamu-özel sektör iş birliğiyle pilot projelerin hayata geçirilmesi, yerel yönetimlerin aktif rol üstlendiği sosyal destek ağlarının güçlendirilmesi ve tesis yönetiminde yaşa özgü uzmanlığın geliştirilmesi gibi öneriler sunulmaktadır. Ayrıca, yaşlı göçü alan bölgelerde örnek projelerle kültürel uyumun ve yerel katılımın artırılması, sosyal adalet ve kapsayıcılığı esas alan politikaların yaygınlaştırılması gerektiği vurgulanmaktadır. Bu yönüyle çalışma, Türkiye’de yaşa duyarlı, sürdürülebilir ve sosyal bütünleşmeyi destekleyen konut politikaları ve bakım hizmetlerinin geliştirilmesine katkı sağlamayı hedeflemekte; tesis yönetimi boyutunu da içeren bütüncül yaklaşımıyla literatüre özgün bir perspektif sunmaktadır.

Anahtar Kelimeler

• Yaşlı konutları
• tesis yönetimi
• konut politikaları
• yaşlı bakım hizmetleri
• yaşlı yaşam tesisleri

Destekleyen Kurum

Yazarlar çalışmanın herhangi bir fon almadığını beyan eder.

Etik Beyan

“Amerika Birleşik Devletleri’nde Belirli Yaşın Üzerindeki Bireyler İçin Konut Politikaları ve Türkiye’ye Uygulanabilirliği” başlıklı çalışmanın yazılması ve yayınlanması süreçlerinde Araştırma ve Yayın Etiği kurallarına riayet edilmiş ve çalışma için elde edilen verilerde herhangi bir tahrifat yapılmamıştır. Çalışma için etik kurul izni gerekmemektedir.

Teşekkür

Yapıcı eleştiri ve önerileriyle çalışmanın gelişimine katkı sağlayan saygıdeğer hakemlere ve süreci titizlikle yürüten dergi editörlerine destekleri için teşekkür ederiz.

Kaynakça

1. Abdel‐Ghany, M. ve Sharpe, D. L. (1997). Consumption Patterns Among The Young‐Old and Old‐Old. Journal of Consumer Affairs, 31(1), 90-112.
2. Aile ve Sosyal Hizmetler Bakanlığı. (2022). 2022 Faaliyet Raporu. Ankara: T.C. Aile ve Sosyal Hizmetler Bakanlığı. https://www.aile.gov.tr/media/129482/ashb_2022-idare-faaliyet-raporu.pdf, (11.04.2025).
3. Allen, M. (1997). Measuring the Effects of “Adults Only” Age Restrictions on Condominium Prices. Journal of Real Estate Research, 14(3), 339-346.
4. Anttonen, A. ve Karsio, O. (2016). Eldercare Service Redesign in Finland: Deinstitutionalization of Long-Term Care. Journal of Social Service Research, 42(2), 151-166.
5. Ardahan, M. (2010). Yaşlılık ve huzurevi. Sosyal Politika Çalışmaları Dergisi, 20(20), 25-32.
6. Bekhet, A. K. ve Zauszniewski, J. A. (2012). Mental Health of Elders in Retirement Communities: Is Loneliness A Key Factor? Archives of Psychiatric Nursing, 26(3), 214-224.
7. Berg-Warman, A. ve Brodsky, J. (2006). The Supportive Community: A New Concept For Enhancing The Quality of Life of Elderly Living in The Community. Journal of Aging and Social Policy, 2006(18), 69–83.
8. Bian, X. ve Lin, Z. (2022). Housing Debt and Elderly Housing Tenure Choices. Real Estate Economics, 50(5), 1360-1397.

9. Bosman, C. (2016). Boomer Housing Preferences: Active Adult Lifestyle Communities Versus Aging in Place. Housing in 21st-Century Australia içinde (ss. 105-120). London: Routledge.
10. Buffel, T., Phillipson, C. ve Scharf, T. (2012). Ageing in Urban Environments: Developing ‘Age-Friendly’cities. Critical Social Policy, 32(4), 597-617.
11. Campbell, N. (2015). Designing For Social Needs to Support Aging in Place Within Continuing Care Retirement Communities. Journal of Housing and the Built Environment, 30, 645-665.
12. Caplan, Z. ve Rabe, M. (2023). The Older Population: 2020. US Census.
13. Castle, N. G. ve Ferguson, J. C. (2010). What is Nursing Home Quality and How is it Measured?. The Gerontologist, 50(4), 426-442.
14. Clark, A. (2025). Senior Living Industry Statistics in 2025. https://www.theseniorlist.com/senior- housing/statistics/, (02.05.2025).
15. Cohen, B. ve Menken, J. (2006). Aging in Sub-Saharan Africa. Recommendations for Furthering Research. National Academies Press, Washington DC.
16. Cushman and Wakefield. (2024). Market Trends and Investor Survey Senior Living and Care. https://assets.cushmanwakefield.com/-/media/cw/americas/united-states/insights/research-report- pdfs/2024/cw_senior-living-trends-h1-2024_final-2.pdf? rev=9f632b59010e43dd8038dd7d5e412759andhash=6B99736CB5867C1C554E7742443C401D, (11.04.2025).
17. Cutchin, M. P. (2003). The Process of Mediated Aging-in-place: A Theoretically and Empirically Based Model. Social Science and Medicine, 57(6), 1077-1090.
18. Cutchin, M. P. (2004). Using Deweyan Philosophy To Rename and Reframe Adaptation to the Environment. The American Journal of Occupational Therapy, 58(3), 303-312.
19. Danış, M. Z. (2009). Türkiye’de Yaşlı Nüfusun Yalnızlık ve Yoksulluk Durumları ve Sosyal Hizmet Uygulamaları Açısından Bazı Çıkarımlar. Toplum ve Sosyal Hizmet, 20(1), 67-84.
20. Denizli, F. (2023). Yaşlı ve Engelli Bakım Turizm Potansiyelinin Değerlendirilmesi “Fırsatlar ve Tehditler”: Kayseri İli Örneği. Süleyman Demirel Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, (46), 59-75.
21. Dobbs, D., Meng, H., Hyer, K. ve Volicer, L. (2012). The Influence of Hospice Use on Nursing Home and Hospital Use in Assisted Living Among Dual-Eligible Enrollees. Journal of the American Medical Directors Association, 13(2), 189-e9-e13.
22. Flynn, T. E. ve Boenau, A. E. (2007). Trip Generation Characteristics of Age-Restricted Housing. ITE Journal, 77(2), 30.
23. Fontaine, S. (2013). Innovations in Housing and Assistive Services To Support Aging in Place. Online Journal of International Case Analysis, 4(2).
24. Golant, S. M. (2008). Commentary: Irrational Exuberance For The Aging in Place of Vulnerable Low-Income Older Homeowners. Journal of Aging and Social Policy, 20(4), 379-397.
25. Golant, S. M. (2015). Aging in The Right Place. HPP, Health Professions Press.
26. Gonyea, J. G., Curley, A., Melekis, K., Levine, N. ve Lee, Y. (2018). Loneliness and Depression Among Older Adults in Urban Subsidized Housing. Journal of Aging and Health, 30(3), 458–474.
27. Greco, A. J. (1987). Linking Dimensions of The Elderly Market to Market Planning. Journal of Consumer Marketing, 4(2), 47-55.
28. Greenfield, E. A. (2012). Using Ecological Frameworks to Advance a Field of Research, Practice, and Policy on Aging-in-place Initiatives. The Gerontologist, 52(1), 1-12.
29. Groger, L. ve Kinney, J. (2007). CCRC Here We Come! Reasons for Moving to a Continuing Care Retirement Community. Journal of Housing for the Elderly, 20(4), 79-101.
30. Gürer, A., Çırpan, F. K. ve Özlen, N. A. (2019). Yaşlı Bakım Hizmetleri. Sağlık Hizmetleri ve Eğitimi Dergisi, 3(1), 1-6.
31. He, W., Gao, W. ve Jia, S. (2024). A Review on American Senior Housing and Financing Decisions. International Journal of Housing Markets and Analysis, 1-22.
32. Heisler, E., Evans, G. W. ve Moen, P. (2003). Health and Social Outcomes of Moving to a Continuing Care Retirement Community. Journal of Housing for the Elderly, 18(1), 5-23.
33. HUD (U.S. Department of Housing and Urban Development). (2013). Housing for Older Persons Act (HOPA) Guidelines.
34. Hudson, R. B. (2014). The Federal Commission on Long-Term Care: Setting an Agenda and Moving It Forward. Public Policy and Aging Report, 24(2), 35-36.
35. James, R. N. (2008). Residential Satisfaction of Elderly Tenants in Apartment Housing. Social Indicators Research, 89, 421-437.
36. JLL. (2025). Seniors Housing and Care Investor Survey and Trends. https://www.jll.com/en- us/insights/market-perspectives/seniors-housing-care-investor-survey-and-trend-outlook, (14.03.2025).
37. Jolanki, O. H. (2021). Senior Housing as a Living Environment That Supports Well-Being in Old Age. Frontiers in Public Health, 8, 589371.
38. Jones, M. and Clem, M. (2025). Senior-Living Industry Statistics. https://www.seniorliving.org/companies/statistics/, (01.04.2025).
39. Kemeny, J. (2006). Corporatism and Housing Regimes. Housing, Theory and Society, 23(01), 1-18.
40. Kim, S. H., Kim, H. B. ve Gon Kim, W. (2003). Impacts of Senior Citizens’ Lifestyle on Their Choices of Elderly Housing. Journal of Consumer Marketing, 20(3), 210-226.
41. Kröger, T., Yeandle, S. ve Yeandle, S. (Ed.). (2013). Combining Paid Work and Family Care. Policy Press.
42. Kylén, M., Löfqvist, C., Haak, M. ve Iwarsson, S. (2019). Meaning of Home and Health Dynamics Among Younger Older People in Sweden. European Journal of Ageing, 16(3), 305–31.
43. Lawrence, R. J. (2004). Housing and Health: From İnterdisciplinary Principles to Transdisciplinary Research and Practice. Futures, 36(4), 487-502.
44. Lazer, W. (1986). Dimensions of The Mature Market. Journal of Consumer Marketing, 3(3), 23-34.
45. Lloyd-Sherlock, P. (2000). Population Ageing in Developed and Developing Regions: Implications For Health Policy. Social Science and Medicine, 51(6), 887-895.
46. Lynn, D. ve Wang, T. (2008). The US Senior Housing Opportunity: Investment Strategies. Real Estate Issues, 33(2), 33-51.
47. Organisation for Economic Co-operation and Development [OECD]. (2019). Aging in Place: Growing Older at Home. OECD Publishing. https://www.oecd.org/els/health-systems/ageing-in-place.htm, (07.03.2025).
48. Peace, S., Holland, C. ve Kellaher, L. (2011). ‘Option Recognition’in Later Life: Variations in Ageing in Place. Ageing and Society, 31(5), 734-757.
49. Perkins, M. M., Ball, M. M., Whittington, F. J. and Hollingsworth, C. (2012). Relational Autonomy in Assisted Living: A Focus on Diverse Care Settings for Older Adults. Journal of Aging Studies, 26(2), 214-225.
50. Phillipson, C. (2007). The ‘Elected’and The ‘Excluded’: Sociological Perspectives on The Experience of Place and Community in Old Age. Ageing and Society, 27(3), 321-342.
51. Pynoos, J., Caraviello, R. ve Cicero, C. (2009). Lifelong Housing: The Anchor in Aging-friendly Communities. Generations, 33(2), 26-32.
52. Redfoot, D. L. ve Kochera, A. (2005). Targeting Services To Those Most At Risk: Characteristics of Residents in Federally Subsidized Housing. Journal of Housing for the Elderly, 18(3-4),137-163.
53. Rioux, L. ve Werner, C. (2011). Residential Satisfaction Among Aging People Living in Place. Journal of Environmental Psychology, 31(2), 158–169
54. Salamon, L. M. (Ed.). (2004). The State of Nonprofit America. USA: Brookings Institution Press.
55. Scanlon, K., Whitehead, C. ve Arrigoitia, M. F. (2015). Social Housing in Europe. Stephens, D. ve Perry, A. E. (Ed.), Social Housing and Regeneration: Rebuilding the city içinde (ss. 22–39). Wiley Blackwell.
56. Schneider, T. ve Till, J. (2007). Flexible Housing. Elsevier.
57. Sherman, E. ve Forman, A. (1988). The Elderly Consumer–What Do They Want and How Do They Select Health Care Services. Sanchez P. Marketing is Everybody’s Business. American Marketing Association: Chicago, IL, 48- 52.
58. Shoemaker, S. (2000). Segmenting the Mature Market: 10 Years Later. Journal of Travel Research, 39(1), 11-26.
59. Sixsmith, A. and Sixsmith, J. (2008). Ageing in Place in the United Kingdom. Ageing International, 32(3), 219– 235.
60. Şenol, D. ve Erdem, S. (2017). Yaşlılık ve Yaşlı Kadınlarda Huzurevi Algısı: Nitel Bir Çalışma. Kırıkkale Üniversitesi Sosyal Bilimler Dergisi, 7(2), 31-50.
61. Taylor, H. O., Wang, Y. and Morrow-Howell, N. (2018). Loneliness in Senior Housing Communities. Journal of Gerontological Social Work, 61(6), 623-639.
62. The US Census. (2020). Population Survey. https://www.census.gov/programs-surveys/cps.html, (11.03.2025).
63. Torgersen, U. (1987). Housing: The Wobbly Pillar Under The Welfare State. In B. Turner, J. Kemeny, ve L. J. Lundqvist (Eds.), Between state and market: Housing in the post-industrial era (pp. 116–126). Almqvist and Wiksell.
64. Trolander, J. A. (2011). Age 55 or Better: Active Adult Communities and City Planning. Journal of urban history, 37(6), 952-974.
65. Türkiye İstatistik Kurumu (TÜİK). (2025). İstatistiklerle Yaşlılar, 2024. https://data.tuik.gov.tr/Bulten/Index? p=Istatistiklerle-Yaslilar-2024-54079, (21.01.2025).
66. Wiles, J. L., Leibing, A., Guberman, N., Reeve, J. ve Allen, R. E. (2012). The Meaning of “Aging in Place” to Older People. The Gerontologist, 52(3), 357-366.
67. World Bank. (2024). Population Ages 65 and Above, Total - United States. https://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS, (10.01.2025).
68. World Health Organization (WHO). (2015). World Report on Ageing and Health. https://www.who.int/publications/i/item/9789241565042, (09.04.2025).
69. World Health Organization (WHO). (2020). Decade of Healthy Ageing: Plan of Action. www.who. int/publications/m/item/decade-of-healthy-ageing-plan-of-action, (21.01.2025).
70. Wyndham-West, C. M. ve Dunn, J. R. (2024). Housing Instability and Policy Considerations for Equitable Aging in Place in Canada. Canadian Journal on Aging/La Revue canadienne du vieillissement, 43(4), 588-598.
71. Yang, H-Y ve Stark, SL. (2010). The Role of Environmental Features in Social Engagement Among Residents Living in Assisted Living Facilities. Journal of Housing for The Elderly, 2010(24), 28–43