Something happens when a person living with dementia walks into Rosener House in Menlo Park. They get noticed, greeted. And people know them.
Siobhan Cohee of Peninsula Volunteers Inc. described the contrast for us. Out in the wider world, a person with dementia may walk into a store and find that nobody quite knows how to respond. People look away, or keep their distance. At Rosener House, she said, “they’re rock stars.”
It’s a small thing to notice, and it sits underneath a much bigger question facing families across the Bay Area. What does it take to grow older without losing your independence, your connections, or your say in what happens next? For Peninsula Volunteers Inc., better known as PVI, the answer takes more than just keeping someone inside the family home.
Quick Answer: What Does Aging in Place Really Require?
Aging in place means more than staying in the same house. For many Bay Area seniors, staying independent requires safe housing, transportation, nutritious food, social connection, caregiver support and sometimes adult day services. Organizations such as Peninsula Volunteers Inc. bring those supports together so older adults keep their choices as their needs change.
- 19.4% of San Mateo County residents are 65 or older, and the county’s median owner-occupied home is worth about $1.56 million. Home equity is not monthly income.
- Only about 1% of U.S. homes have five basic accessibility features at once, and 43% of older adults say they will need to make their homes more accessible.
- Adult day programs like Rosener House fill the gap between living independently at home and moving into assisted living or memory care.
- 75% of adults 50 and older want to stay in their current homes. 44% still expect a move is inevitable. Both can be true.
What Aging in Place Actually Means
Aging in place is the ability to remain safely and independently in your home as you grow older, supported by loved ones and senior care services that will provide the means to stay in put at home, such as appropriate housing, on-call transportation, healthy food delivery, healthcare and caregiving services.
In practice that can mean occasional visits from a caregiver, a free ride to the doctor driven by a volunteer, or a healthy lunch arriving daily at the door. It includes enjoying a bridge game with old friends on Wednesdays, a fall-safe home, or someone coordinating care when your children live hundreds of miles away.
Aging in place can also look like the Rosener House, where a person living with dementia can spend the whole day among professional caregivers and still be able to come home to family at night.
That is aging in place too.
An Aging Population and a Support System Still Catching Up
PVI has been working on these questions for a long time. Beth Kuechler founded the organization in 1947 with a group of women from around the Peninsula. Little House opened in Menlo Park in 1949, and PVI describes it as the first suburban senior center in the United States. The adult day program that became Rosener House started in 1978, for older adults who couldn’t easily use Little House on their own. After the 1989 Loma Prieta earthquake damaged its home in the old Fremont School building, PVI ran a capital campaign for the 12,000-square-foot building it uses today.
Nearly 80 years on, the demographics have shifted underneath all of it. Children still outnumber adults 65 and older nationally, 73.1 million to 61.2 million as of July 2024, but the gap has narrowed from more than 20 million in 2020 to just under 12 million. Eleven states and nearly 45% of U.S. counties already have more older adults than children. San Mateo County is part of that shift: 19.4% of residents are now 65 or older.
Funding hasn’t kept pace. Peter Olson, PVI’s CEO, raised this during our interview, and his exact percentages vary depending on which philanthropic dataset you use. The underlying concern is documented. Writing for Next Avenue and citing Candid, Paul Hogan reported that less than 1% of the most significant grants from America’s largest foundations go to causes related to aging.
Public money is tight too. On its own About Us page, PVI says that “continuing cutbacks in governmental support have increased the need for PVI fundraising to cover funding shortfalls” in its Meals on Wheels program.
And the need isn’t always where people assume it is.
The Bay Area Paradox: House Rich, Cash Poor
Consider Atherton. The name suggests wealth. So do San Carlos, Menlo Park, Palo Alto, Woodside and plenty of other Peninsula communities where houses bought decades ago are now worth millions.
A valuable address doesn’t tell you how much money someone has each month.
San Mateo County’s median owner-occupied home value is roughly $1.56 million, according to Census Bureau estimates. But equity isn’t income. Harvard’s Joint Center for Housing Studies found that only 14% of single adults 75 and older could afford daily visits from a paid caregiver, and 13% could afford assisted living. Nationally, 11.2 million older adults were cost burdened in 2021, spending more than 30% of their income on housing.
Peter sees it firsthand. Some PVI clients live in extremely valuable homes they purchased decades ago. Their resources are tied up almost entirely in the house. The property needs maintenance. Monthly income is limited. Food, transportation and care are still hard to pay for.
He described occasions when Meals on Wheels funding has been harder to secure for people in affluent communities because of assumptions attached to a ZIP code.
His question is a fair one. Are we judging wealth, or are we judging need?
PVI’s position isn’t that everyone should receive everything free. People who can afford services should pay for them, so donated and subsidized dollars stretch further for people who can’t. But need shouldn’t be dismissed because someone happens to live in Atherton rather than East Palo Alto.
In the Bay Area especially, a home’s market value often says more about how long someone has owned it than about what they can spend today.
Your House May Be Worth Millions. Is It Ready for an 85-Year-Old?
There is another irony hiding inside all that housing wealth. A house can be worth a fortune and still be a bad place to grow old.
Peter acknowledged that many of the homes PVI encounters weren’t designed around the physical realities of aging. Stairs, narrow hallways, bathrooms, entrances, a missing handrail. Ordinary routines slowly turn into obstacles.
This isn’t only a Peninsula problem. AARP’s 2024 Home and Community Preferences Survey found that 43% of older adults say they will need to make their homes more accessible as they age, with grab bars and entryway changes at the top of the list. An earlier AARP Public Policy Institute analysis found that only about 1% of U.S. homes have five important accessibility features at once: no-step entry, all living space on one floor, switches and outlets at reachable heights, wide hallways and doors, and lever door handles and faucets.
This is where universal design becomes useful. It isn’t the same thing as making a private home “ADA compliant.” It means designing spaces that work well for people across different ages and abilities.
For a family thinking ahead, that could mean:
- creating a step-free entrance
- adding secure handrails
- improving lighting
- replacing slippery flooring
- installing a curbless or low-threshold shower
- planning for grab bars before they’re urgently needed
- using lever-style door handles
- making commonly used storage easier to reach
- creating a bedroom and full bathroom on the main level when possible
The point isn’t to turn a house you love into something that feels institutional. It is closer to the opposite. Good aging-in-place design lets the house fade into the background so the person can get on with their life.
Aging in Place Shouldn’t Mean Aging Alone
A perfectly renovated house still doesn’t solve everything. You have to be able to leave it.
Peter described giving up the car keys as one of those deceptively small moments that can change an older person’s independence in a hurry. Suddenly the grocery store, the doctor, lunch with friends and the exercise class all become somebody else’s problem.
PVI built RIDE PVI partly for people who find smartphone rideshare apps difficult or off-putting. A registered rider calls. PVI arranges the trip through drivers it has partnered with, knows who is driving and monitors the ride. The organization puts it plainly on its own site: “Whenever you need a Lyft, give us a call. We’ve partnered with drivers in the area to get you anywhere you need to go, all without a cell phone.” In our interview, the team said subsidies may be available for certain trips, including medical appointments, grocery shopping and visits to activity centers.
Food presents a similar challenge. PVI’s Meals on Wheels program delivers more than 3,000 meals a week to homebound seniors and adults with disabilities across San Mateo and Santa Clara counties.
The value of a meal often exceeds what’s inside the container. For someone living alone, the person arriving at the door may be one of the few people who would notice that something seems wrong.
Then there is Little House, PVI’s activity center in Menlo Park. When we suggested that people might start going there as they become “less independent,” Peter pushed back, gently.
That’s not why most of them are there. They’re playing bridge and Mahjong. They’re exercising, taking ceramics, meeting friends for lunch. They’re building new circles as old ones inevitably change.
Getting older isn’t the same thing as losing independence. Accepting some support is often what preserves it.
The Missing Middle Between Independence and Memory Care
Most families understand the two ends of the spectrum. Mom is living independently at home, or Mom needs assisted living or memory care. What families tend to know very little about is everything in between.
That’s where Rosener House can enter the picture. PVI’s Adult Day Services supports people living with Alzheimer’s, dementia, Parkinson’s, stroke and other chronic conditions. The program runs Monday through Friday, 8:30 a.m. to 5:00 p.m., with a scheduled activity program from 9:30 to 2:30: exercise, music therapy, art, current events and games, plus occupational therapy on Tuesdays, brain games on Thursdays and a baking group on Fridays.
During our interview, PVI staff described adult day services as a middle option. A participant still lives at home but spends two, three or even five days a week in a structured environment, with staff on hand for social engagement and help with everyday needs. That time also gives the person’s spouse or adult child something equally important: a chance to work, shop, handle appointments or simply rest.
Caregiving can be an act of love and still be exhausting. Both things are true at once.
“But My Mother Will Never Agree to Go”
This may be the hardest part of the conversation for families dealing with dementia. You can see that Mom needs more support. Mom disagrees.
Siobhan used the phrase “transition trauma” to describe the distress that can accompany a change of environment for someone experiencing cognitive decline. PVI staff told us they work with families gradually, using tours, shorter introductory visits, consistency and redirection rather than confrontation. During early visits, families may be asked to stay reachable in case their loved one is simply not settling in.
The goal isn’t to force someone into participating. It’s to give them enough time and support to find out whether the place can become familiar.
Rosener House also isn’t right for every person at every stage. Because it is a group setting, someone who needs extensive one-on-one care may eventually need a different level of support. PVI’s team emphasized that fit is considered individually.
Veterans Should Ask About Benefits
Families often miss this one. PVI told us it works with the Veterans Administration to support eligible veterans attending Rosener House.
The VA says all enrolled veterans are eligible for Adult Day Health Care if they meet the clinical need for the service and it’s available in their area. Fees can apply depending on disability status and financial circumstances. The VA directs families to a VA social worker or case manager, who can complete the Application for Extended Care Benefits (VA Form 10-10EC) and explain what a copay would be. It is worth asking rather than assuming either that the service is free or that you wouldn’t qualify.
Staying Home Isn’t the Only Successful Outcome
There is one thing we wanted to push on during our conversation with PVI. Is staying home always better?
We have watched older adults move into senior communities and do well. Suddenly there are people around at dinner. Activities are down the hall. Somebody else worries about the roof, the garden and what’s for lunch.
Peter agreed. The question, he said, is choice.
AARP found that 75% of adults 50 and older want to stay in their current homes as they age. The same survey found that 44% think a move is inevitable. Those two numbers aren’t in conflict. People can love their homes and still see that life changes.
Successful aging isn’t defined by never moving. For one person it means modifying the family home and bringing in support. For someone else it means downsizing to a smaller place nearby, or moving closer to children, or discovering that a senior living community offers more freedom and company than staying home alone ever did.
What matters isn’t the address. It’s reaching the decision yourself, while you still have enough information and support to make it a real one.
An Entire Network Behind One Front Door
That helps explain why PVI’s services fit together the way they do. Little House provides social connection and activity. RIDE PVI helps someone keep moving through the community. Meals on Wheels helps when shopping or cooking becomes difficult. Quiescence helps families coordinate care and the practical details that pile up when someone ages at home. Rosener House provides a supportive daytime community when cognitive or physical needs become more complicated.
The scale is modest by Bay Area standards. The Almanac reported in 2022 that PVI runs on roughly a $6 million annual budget with about 300 volunteers. PVI’s own figures include more than 160,000 locally sourced meals a year, 13,000-plus rides and 3,500-plus classes and events.
No single one of those things guarantees that someone can remain at home. Together, they make the possibility more realistic.
And perhaps that is what we get wrong when we talk about aging in place. We picture a house. PVI pictures the network around the person who lives inside it.
Back at Rosener House, none of this looks particularly theoretical. Someone walks through the door with a diagnosis that has changed the way much of the world responds to them. A familiar face looks up. Someone says hello. They’re expected. They’re known.
For a few hours, they’re a rock star again.
Whether a community is ready to grow old shows up in small things like that. Somebody looks up. Somebody knows your name.
Learn More: Peninsula Volunteers Inc.
PVI serves older adults and caregivers across San Mateo County through five programs:
- Adult Day Services at Rosener House — 500 Arbor Road, Menlo Park, (650) 322-0126. Monday through Friday, 8:30 a.m. to 5:00 p.m.
- Little House — the activity center in Menlo Park: fitness, arts, education and travel.
- RIDE PVI — phone-based rides, no smartphone required.
- Nutrition Services / Meals on Wheels — more than 3,000 meals a week in San Mateo and Santa Clara counties.
- Quiescence — non-medical support and care coordination for family caregivers.
Start at 1pvi.org. Families who are beginning to see changes in an older loved one’s needs usually benefit from learning what is available before a crisis makes the decisions for them.
This article is for general educational purposes and is not medical, legal, financial or caregiving advice. Program availability, eligibility, pricing and benefits can change. Contact the relevant provider or agency for guidance specific to your situation.
Frequently Asked Questions
Can someone be house rich but cash poor?
Yes. An older homeowner may have substantial home equity but limited retirement income or liquid savings, which makes everyday expenses and caregiving hard to fund. Harvard’s Joint Center for Housing Studies found that only 14% of single adults 75 and older could afford daily visits from a paid caregiver.
What is universal design?
Universal design creates homes that are easier for people of different ages and abilities to use, with features such as step-free entrances, wider hallways and doorways, accessible bathrooms and lever-style handles that are easy to operate.
What is an adult day program?
Adult day programs provide supervised daytime activities, social connection and varying levels of support while allowing participants to continue living at home. Rosener House in Menlo Park provides adult day services for people living with dementia, Parkinson’s, stroke and other chronic conditions.
What if a parent refuses adult day care?
PVI recommends approaching the transition gradually. Staff described using tours, shorter introductory visits, consistent routine and redirection rather than forcing participation, and asking families to stay reachable during the first visits.
Can veterans get help paying for adult day services?
The VA says all enrolled veterans are eligible for Adult Day Health Care if they meet the clinical need and the service is available in their area. Fees can apply depending on disability status and finances, so families should ask a VA social worker or case manager about the Application for Extended Care Benefits, VA Form 10-10EC.
Does aging in place mean you should never move?
No. Aging in place is about independence and choice. AARP found that 75% of adults 50 and older want to stay in their current homes, while 44% expect that a move is inevitable. Moving to a smaller home, closer to family or into a senior community is the better outcome for some people.
Sources
- U.S. Census Bureau — QuickFacts: San Mateo County, California (19.4% age 65+; median owner-occupied home value $1,559,600), ACS 2020–2024 estimates
- U.S. Census Bureau — Older Adults Outnumber Children in 11 States and Nearly Half of U.S. Counties, June 26, 2025
- AARP — Older Adults Want to Stay in Their Homes and Communities (2024 Home and Community Preferences Survey), December 2024
- AARP Public Policy Institute — Building for the Future: Creating Homes and Communities for Aging Well, Joanne Binette and Fanni Farago, December 2024
- AARP Public Policy Institute — Expanding Implementation of Universal Design and Visitability Features in the Housing Stock, Shannon Guzman, Janet Viveiros and Emily Salomon, July 2017
- Harvard Joint Center for Housing Studies — Housing America’s Older Adults 2023, November 30, 2023
- Next Avenue / Forbes — Why It’s Time For More Big Foundations To Fund Aging, Paul Hogan, September 11, 2019
- Peninsula Volunteers Inc. — About Us (1947 founding; Little House 1949; Meals on Wheels funding shortfalls)
- Peninsula Volunteers Inc. — History of Rosener House (1978 program start; 1989 earthquake; 12,000-square-foot facility)
- Peninsula Volunteers Inc. — Rosener House Adult Day Services (conditions served, hours, activity schedule)
- Peninsula Volunteers Inc. — Our Services (RIDE PVI, Little House, Quiescence)
- Peninsula Volunteers Inc. — Nutrition Services (3,000+ meals weekly, San Mateo and Santa Clara counties)
- U.S. Department of Veterans Affairs — Adult Day Health Care fact sheet (eligibility, copays, VA Form 10-10EC)
- The Almanac — Peninsula Volunteers marks 75 years of programs, activities for seniors, Chris Kenrick, September 7, 2022
