I came across a really thoughtful piece from HousingWire where Dr. Anthony Zizza, a geriatric medicine expert and chief medical officer at Element Care, talks about something I see affecting my clients every day. He makes a strong point that aging in place isn't just a housing question. It's really about weaving together healthcare, planning, and services in a way that lets seniors stay safely in their homes as they get older. Too many families he sees end up making major decisions about moving to assisted living or nursing homes after a crisis like a fall or hospitalization, when everybody's stressed and time is short. He believes we'd all be better off thinking about this earlier, before emergencies force our hand.
According to HousingWire, Dr. Zizza runs a PACE program, which stands for Program of All-Inclusive Care for the Elderly. The way it works is pretty comprehensive. The program pulls together medical care, therapy, transportation, meals, and home assessments all in one coordinated effort so that eligible seniors can stay in their own communities as long as it's safe. What I appreciate about his approach is that he sees the person as a participant with a voice in their own care, not just a case to manage. When someone needs physical therapy or a ride to a specialist or home modifications to function safely, the program coordinates all of that together.
Dr. Zizza gives homeowners some practical advice about what to look at right now. He encourages people to walk through their homes with family members and really think about the daily activities that matter. Can someone get in and out safely? How about using the bathroom or moving around after dark? He particularly focuses on fall risks because a single fall can be life-changing for an older person. Stairs, bathrooms, and dark hallways need real attention. Grab bars, handrails, nonslip surfaces, and removing tripping hazards like loose rugs can make a real difference. But he also reminds us that fixing hazards is only part of the equation if someone is also dealing with weakness or dizziness from other causes. Heat is something he emphasizes too, especially for older adults with chronic conditions who can be really vulnerable during hot weather.
What HousingWire reported is that the PACE model brings everyone together as one team around the same person and the same goals. The primary care provider, nurses, therapists, social workers, and others all develop a care plan with the participant and family. Transportation makes it possible to get to appointments, meals and nutritional support help when shopping or cooking gets hard, and daily activities at home can be supported. Dr. Zizza shared an example that really illustrates how this coordination works. One participant with chronic lung disease kept getting hospitalized in the summer, sometimes needing a ventilator. The team looked at the pattern and realized heat in his home was probably triggering the flare-ups. They got him an air conditioner, and the hospitalizations stopped. A federal analysis from March 2026 showed lower hospital and emergency use among PACE participants compared to similar people in other Medicare Advantage plans, which supports what he sees happening in practice.
What I'm seeing locally here in the Bay Area is that families are increasingly interested in aging in place but often don't know where to start. We have a lot of homes that people love and want to stay in, but we also need to think honestly about whether those homes can work as people's needs change. The rising cost of assisted living and memory care facilities makes aging in place more attractive financially, but it requires real planning now, not panic decisions later. Whether someone's staying in Fremont, Oakland, or anywhere in the East Bay, the principle is the same. We need to help our clients think through home safety, access to services, and what modifications might be needed before a health crisis pushes them into a corner.
