Older women with a low pension, living in Sweden: Strategies to age in place and thoughts about future housing

ABSTRACT

Financial security influences good quality housing, health, and longevity, but few recent studies of the financial aspects of aging in place have been published. We explored strategies used to age in place and thoughts about future housing among women aged 65 and older living with a low pension in Sweden. We conducted semi-structured qualitative interviews with 13 women aged 65 and older with a low pension, followed by thematic analysis. Three themes were generated. “Adjusting to a low pension” explains that most participants needed to supplement their pension with savings or earnings to afford housing and living costs. “The home as a home – and an asset” explains that relocating or renting out the property were common strategies that could raise money to supplement their pension. “Thoughts about the future (home)” explains that most participants preferred to age in place, but pragmatic considerations about potential housing costs, housing type, housing locality, safety, and security were expressed. In addition to the need for further research on this topic, our findings have implications for community planning and can be used to inform pension and housing policies in Sweden and countries with similar welfare systems.

KEYWORDS:

• Older adults
• retirement
• low pension
• housing
• residential reasoning

Introduction

In Sweden, as in many other Western countries, aging policies support older adults to age in place. The policies revolve around the idea that living in familiar homes and neighborhoods positively impacts older adults’ ability to live independently and increases well-being (Pani-Harreman et al., 2021; Roy et al., 2018). Accordingly, several studies found that aging in place is also what many older adults wish for (Lewis & Buffel, 2020; Wiles et al., 2012). In later years, the demographic shift in Western countries and cutbacks on funding have reduced the number of residential care facilities. Altogether, aging in place seems to be a widely shared value and a pragmatic solution. In Sweden, four percent of adults 65 years and older live in residential care facilities (i.e., tax-funded residential care with 24/7 availability of care and support granted after municipal needs assessment) (Statistics Sweden, 2022), which is close to the corresponding proportion (4.5%) in the U.S (Administration for Community Living, 2021). Thus, the vast majority of older adults in Western countries age in place. In Sweden, approximately 50% of older adults aging in place are homeowners, and 50% rent their dwellings from a public or private housing company (Abramsson & Hagberg, 2019; Statistics Sweden, 2022). In the U.S., the proportion of renter-occupied housing units is approximately 36% (Lee et al., 2019).

Taking a theoretical stance on aging in place and residential mobility in later life, Golant’s (2018) Theory of Residential Normalcy explains how moving behavior depends on older adults’ experiences of residential normalcy. In residential comfort and mastery zones, older adults experience housing satisfaction, competence, and control, which leads to well-being. Age-related health changes, life events, or environmental changes may threaten residential normalcy. Coping strategies to adjust to such changes involve assimilation or accommodation to regain residential normalcy and live life as usual. Relocation can be one such strategy if a) other coping strategies do not work, b) moving seems like a viable option, c) a future move is likely to enhance residential comfort, and d) the act of moving is considered manageable. In a longitudinal study from Sweden, Nygren and Iwarsson (2009) found that health decline could cause a turning point where the home environment no longer fits the individual’s needs, triggering relocation. Likely financial changes could cause similar reactions, particularly for low-income older adults. However, research concerning relocation patterns and socioeconomic resources is still scarce (Roy et al., 2018). Lee et al. (2019) qualitative study of 25 low-income older renters identified their challenges to age in place from factors concerning housing affordability, adjustments to the home environment to support autonomy, and resources for formal and informal support systems. In a recent scoping review, Pani-Harreman et al. (2021) found that aging in place requires personal resilience and physical and mental strategies to be used in daily life to manage health, housing, finances, information, social activities, transportation, and safety. Resilience has been found to include protective factors and utilize personal agency and goal direction to proactively sustain aging in place in late life in a qualitative study from the U.S (Stafford & Gulwadi, 2020).

Due to generational differences in health and financial status, younger older adults are expected to relocate more than previous generations over the life course, making it possible to access accumulated wealth generated from home ownership (Beer et al., 2011). When transitioning into retirement, downsizing to a smaller home can be caused by a wish to adjust to changing housing needs, but it is also a way of making financial resources available (Beer et al., 2011). Abramsson and Hagberg’s (2019) survey on previous moves and future housing plans among people aged 80 and over living in semi-urban areas in Sweden found that 27% had relocated at least once in the last ten years. Recent literature on rural gerontology (Berry, 2020) describes an increasing trend of older adults relocating to rural areas due to the desire for closeness to nature and affordability. However, living in rural areas may lead to challenges accessing services and sustaining social relations, with increased risk of exclusion and reduced housing satisfaction potentially leading to poorer health and socioeconomic challenges in later life (Abramsson & Hagberg, 2019; Berry, 2020; Kingstone et al., 2020).

Roy et al. (2018) literature review of housing decision-making found that the home reflects older adults’ identity and experiences. The home is central to day-to-day life and provides physical and psychological security that contributes to familiarity and attachment. Decisions to move are caused by numerous interacting factors relating to the home, health, and socioeconomic resources. Reasoning regarding housing preferences and decision-making, that is, residential reasoning (Granbom et al., 2014), is an ongoing reflective process of thoughts and feelings related to housing. Assimilative and accommodative coping strategies influence residential reasoning and changes in health, and day-to-day life challenges may lead to relocation considerations. According to Koss and Ekerdt (2017), the residential reasoning process influences older adults’ views about the future, considerations, and preparations for care and support needs. Thus, the residential reasoning process may involve preemptive or contingent reflections. Preemptive reflections refer to resisting thoughts about relocation, while contingent reflections refer to detailed thoughts about relocation, including preferred housing locality, suitability, price, safety, security, and care. In addition, residential reasoning is influenced by push and pull factors. Push factors may reflect negative thoughts about the home environment and be caused by changes in health or lack of money. Pull factors are thoughts based on attractions or desires and are positive reasons why a new dwelling might be preferable to the existing one (Koss & Ekerdt, 2017). Severinsen et al. (2015) found that some older adults want to age in place despite living in “unsuitable places” because of strong emotional bonds. In a similar vein, Nygren and Iwarsson (2009) and, Löfqvist et al. (2013) found that emotional attachment to the home could cause ambivalence in older adults’ residential reasoning.

The individual’s ability to age in place and move when wanted is strongly influenced by socioeconomic resources (Abramsson & Hagberg, 2019; Lee et al., 2019). Granbom et al. (2020) explored residential reasoning among low-income older adults in Baltimore, U.S. They found that the desire to age in place could become the realization of being stuck in place, as personal finances limited relocation options. Coping strategies such as family members moving into relatives’ homes to share housing costs, being a homeowner, housing locality, and home attachment influenced residential reasoning. Power’s (2020) study from Australia found that 60% of low-income older adult women who rented a dwelling in the private housing sector stated that increased housing costs and never-ending expenses forced relocation and caused housing insecurity. Studies from Australia (Jenkins Morales & Robert, 2020) and the U.S (Stone, 2018). found that homeownership in old age could secure tenure and reduce housing costs; however, a mortgage may increase the housing cost burden. Other studies (Coleman et al., 2016; Fausset et al., 2011; Kelly et al., 2014) found that while assets from homeownership were tied to the home, simple maintenance and gardening costs could be impossible to afford. The lack of financial means led to poor-quality housing and psychosocial stress. Research has found that women, more often than men, age in single households, have low pensions and less accumulated wealth, and experience financial distress (Butrica et al., 2007; Finch, 2013). In Sweden, more than 16% of adults 65 years and older, mainly women, have a pension below the European Union (EU) relative poverty line (i.e., 60% or less of the national median income), which is a higher proportion than in other Nordic countries (European Anti Poverty Network, 2019). How older adults with limited financial means (such as a low pension) reason about aging in place and their housing preferences is still an underexplored topic. Accordingly, this study aimed to explore strategies used to age in place and thoughts about future housing preferences among older women having a low pension living in Sweden.

Materials and methods

Based on a qualitative methodological approach, we collected data using semi-structured in-depth interviews followed by a thematic analysis (Braun et al., 2017). The Swedish Ethical Review Authority approved the study (Ref. no. 2019–02870).

Inclusion criteria

We included women aged 65 and older aging in place with a low pension in Sweden because compared to men, women more often live alone and have a low pension. The EU defined a low pension as a monthly net pension below the EU relative poverty line of less than 60% of the national median income (Dvorak, 2015; Eurostat, 2018). At the time of the interviews, official Eurostat data of the relative poverty line in Sweden referred to figures from 2018, which was approximately 1,190 USD for people living alone. We excluded participants not fluent in Swedish.

Recruitment

We aimed for a diverse sample concerning age, health status, urban or rural location, housing type, and financial situation. We used purposeful sampling in the recruitment process and approached potential participants in several ways. First, two members of the User Board of our research center, representing a local branch of a national senior citizen organization, volunteered to distribute information about the study to members. Interested members gave us contact information via the representative. Twenty members contacted us for participation. However, only one person met the pension level inclusion criterion. Second, we posted information about our study in six Facebook groups related to four towns and villages in the south of Sweden to reach older adults in urban, semi-urban, and rural areas or interest groups specifically addressing retirement-related issues. Interested group members were informed how to contact us. For integrity reasons, we muted the commenting option on the Facebook posts. Twenty-two persons responded to the advertisement. Twelve met all the inclusion criteria and were included in the study. In total, 13 participants were included in the study.

Sample characteristics

Sample characteristics are presented in Table 1. Briefly, the women who participated were relatively young older adults (mean age = 70 years; SD = 4). They lived in urban, semi-urban, and rural areas in the South of Sweden. They all lived in single households, even though some participants rented out owned property connected to their homes. All participants but one were born in Sweden. More than half of them had a university education, and all had been working before retirement. Four participants were still working part-time, mainly in creative or artistic jobs. Several participants had had long periods of part-time or full-time absence from paid work due to illnesses, family situations, staying home with children, education, or unemployment. Several participants had health issues such as arthritis, heart problems, digestive problems, or pain. Several participants had been diagnosed with depression, stress-related symptoms, or cancer earlier in life, and, to some extent, they still needed to adapt their daily life to the long-term consequences of those disorders. However, they all managed independently and did not receive home care services.

Table 1. Description of the study sample (N = 13).

Pseudo-nym	Age	Living status	Type of dwelling	Location	Education^a	Net pension $^b	Years in current home	Health issues^c
Anna	65	Alone	Owned house	Rural	PNU	<1,022	6–10	Stress-related disorder
Bodil	67	Alone	Owned house	Rural	U	1,022–1,224	1–5	Stress-related disorder, back pain
Cecilia	66	Alone	Owned house	Rural	PNU	<1,022	1–5	Depression
Dagny	74	Alone	Owned house	Rural	U	<1,022	15+	Depression, arthritis, limited mobility
Edith	68	Alone	Owned house	Rural	U	<1,022	15+	—^d
Filippa	74	Alone	Rented apartment	Semi-urban	U	1,022–1,224	11–15	—
Gunilla	65	Alone	Owned apartment	Urban	S	1,022–1,224	11–15	Digestive problems, dysfunctional liver, pain
Helen	67	Alone	Owned house	Semi-urban	PNU	1,022–1,224	6–10	Stress-related disorder, arthritis, digestive problems
Ingrid	74	Alone	Owned house	Rural	U	1,022–1,224	11–15	Rheumatism and arthritis
Jane	68	Alone	Owned house	Rural	PNU	<1,022	15+	Stress-related disorder, cancer survivor
Karla	74	Alone	Rented apartment	Semi-urban	S	1,022–1,224	1–5	Rheumatism, tiredness, history of falls
Lena	75	Alone	Rented apartment	Urban	U	1,022–1,224	1–5	—
Marianne	68	Alone	Rented house	Rural	U	<1,022	1–5	Arthritis

NOTE: ^aEducation; S = secondary school (9–12 years); PNU = post-secondary, non-university education; U = University education.

^b1 EURO ≈ 1.2 US Dollars.

^cHealth issues; Physical and psychological issues adding to decrease in functionality and well-being.

^dNo health issues.

Interview guide

We developed a semi-structured interview guide based on the study aim. The questionnaire explored residential reasoning, thus promoting participants to speak about past, present, and future housing. Using open-ended questions allowed asking follow-up questions to further explore responses and the topic of interest. In particular, participants were asked about previous moves, wishes to age in place, future housing preferences, and whether or not their income level influenced their current housing situation and future housing plans. We tested the interview guide by interviewing a woman who fulfilled the inclusion criteria but was not part of the study. Minor revisions were made, for example, to include additional follow-up questions.

Data collection

Data were collected from September 2019 to April 2020 by the second author and a research assistant experienced in interviewing older adults in their homes. We interviewed each participant once. When the COVID-19 pandemic broke out in March 2020, three participants were interviewed over the phone or in online meetings. According to Chiumento et al. (2018), physical separation is a known methodological challenge of online interviewing. However, during COVID-19, phone or online meetings provided flexibility in gathering data despite social distancing restrictions. While the online meetings allowed gaining an impression of the participants and their homes, this mode provided less interaction compared to in-home interviewing. However, the disadvantage of not having a physical meeting and observing the home and neighborhood was not entirely reduced by online meetings. Making every effort to counteract study limitations we tested the technical equipment to minimize data limitations, and avoid webcam feeds, time lag, and potential data loss. We arranged with the participants to voice problematic issues to ensure verbal, non-verbal, and visual contact. After completing the interview, the participants received two lottery tickets each (valued at approximately 6 USD).

Data analysis

A professional transcriber transcribed the interviews verbatim. The first and second authors entered the transcripts into NVivo 11 Pro software to support a thematic analysis using Braun et al. (2017). First, we familiarized ourselves with the data material by listening to the audio recordings several times and reading the transcripts and field notes line by line. We sorted data by collating general related topics identified from the abstractions of participants’ experiences and expressions about coping strategies, housing, aging in place, relocation, and personal finances. We began assigning preliminary codes and searched for potential themes and subthemes. We compared and discussed the codes and started a recursive abstraction of collating codes under potential themes and subthemes. The iterative process included identifying repeated topics by looking for data nuances, similarities, or differences across the different interviews. The first and second authors had regular meetings during this process to reflect on the analysis process and validate the codes, themes, and subthemes. The third author provided critical input, followed by optimization at the stage where themes were generated to strengthen the validity of the findings.

Findings

The findings elucidate three themes describing how the participants already had or were adjusting to a low pension (see Figure 1). Some participants were used to living with limited financial means while working. However, the low pension further limited and impacted the daily lives of most participants. For some participants, the adjustment process toward living with a low pension had been ongoing for many years. For others, it was something they seemed to be actively working on at the time of the interview, and for yet others, it had to be dealt with later. In “The home as a home – and an asset” theme, the findings describe how the participants, to some extent, could compensate for the low pension by turning their home into an asset by selling it or renting it out. The adjustment process also had a future perspective. As expressed in the theme “Thoughts about the future (home),” the findings describe that although most participants preferred to stay in their current homes, thoughts about relocation and attractive housing options were present.

Figure 1. Overview of themes and subthemes.

Adjusting to a low pension

Some women had been used to living with limited financial means. However, for most, it was during retirement that they felt financially restricted for the first time. The theme “Adjusting to a low pension” included two subthemes (see Figure 1). The subtheme “cutting down on expenditure” describes the constant balance between limiting expenditure and enjoying life. Housing-related expenditure were the toughest part to cut down on. Nevertheless, as elucidated by the second subtheme, the participants had the capability of “maintaining a positive mind-set – almost always.”

Cutting down on expenditure

Most participants considered cutting down on expenditure, which was perceived as the most immediate and important strategy to make ends meet. Some participants were used to that after a working life with a low salary, long periods of not working, or being raised by parents to be thrifty and exhibit financial responsibility.

“I have always managed my money carefully. I have never had a high income” (Filippa).

Housing-related expenditure seemed to be the toughest part to limit. Utility bills for water and electricity could not be reduced, and sudden repairs were usually costly and urgent when they arose. Several participants who owned their homes had plans for more or less urgent renovations and improvements, such as replacing the roof, installing a new kitchen, renewing the gutter, or building a guesthouse. Most projects had to be postponed or at least carefully planned. One participant had a leaking roof and not enough money to fix it. She had not asked the bank for a second mortgage; it was no use, she thought.

“ … and since I have reached this age, it’s worrying, right? I won´t get any loan to fix the leak in the ceiling, so what the heck am I supposed to do?” (Dagny).

Several participants also acknowledged that house maintenance and garden upkeep became increasingly hard to manage independently with increasing age. If approved by the bank, some participants cut down expenditure by paying only interest on their mortgage even though they realized they would never be able to pay it off.

I have chosen not to pay the mortgage … after the last renovation, I do not have a chance to zero anything… so… it is about liquidity (Anna).

Owning and driving a car was necessary for several participants to remain in their current homes, and car costs were a substantial part of monthly expenditures. It was hard to reduce the costs, but they tried to drive as little as possible, sometimes stopping them from meeting family and friends. One woman who needed to drive to continue working used her credit card to pay for gas.

Every month when I pay my bills, I have to force myself to sit down. I get a stomachache in case something happens … that the money won’t cover everything. What do I do then? (Dagny).

Some participants had savings they could use during months when the pension did not cover all regular expenditure. Other participants needed to cut back on necessities such as food and could not afford to buy new glasses or go to the dentist. Some participants could afford necessities but cut back on the “luxury of daily life”, such as traveling or participating in social and leisure activities.

“Last week I met some former co-workers in Malmö to dine out… it cost gas back and forth, parking, eating… I spent sixty dollars. I had to use my savings … So, I do not go out… only on really special occasions” (Cecilia).

The strategy to cut down on expenditure resulted in isolation. With great sadness, some participants felt prevented from visiting family members and grandchildren. Nevertheless, most participants did not want to discuss their financial situation with their children – they wanted to feel that they remained financially independent:

They know nothing about my finances. I have not needed help yet, so there is no reason to tell them (Lena).

Maintaining a positive mind-set – almost always

Most participants had a positive view of life, even if some were worried about their financial situation, and some participants were annoyed that they did not receive a higher pension. Some participants were grateful and satisfied with the choices they had made earlier in life, even if it meant they now had a small pension:

“I am incredibly grateful. I do not feel bitter about my low pension” (Bodil).

For some participants, maintaining a positive mind-set was a conscious strategy. After having experienced disease, loss, divorces, abuse, and unemployment, they had learned that nothing constructive came from worrying. After living with constant worries about themselves and family members, they concluded that constant worrying did not solve problems. “No, I do not worry because it’s no use” (Karla).

In addition, some participants expressed how the place they lived in made them feel relaxed and happy. Two participants moved to the countryside after an entire life working in the city. They moved because it was easier to find an affordable home in the countryside. In addition, being close to nice scenery made them feel relaxed, positively impacting the long-term consequences of earlier stress disorders. They and several others stated that as long as their health was okay, they would find a way to live on a low pension. “As long as I’m healthy, there’s no reason to worry … ” (Cecilia).

The home as a home – and an asset

The participants were aware that, as homeowners, they possessed a potential asset. Two subthemes were generated in “The home as a home – and an asset” theme (see Figure 1). As described by a first subtheme, some participants “gained access to money by selling” and had moved to a less expensive house or apartment. Other participants realized that they could “add to the pension by renting out” and thereby stay where they lived. Further elaborated on in a second subtheme, the participants explained considerations before such decisions were made, including how they felt about the outcome.

Gained access to money by selling

Three participants described how they, in the last ten years, reached a point where they realized that they needed money for monthly spending, and selling their house or apartment and moving into rented accommodation would be a good solution. At the age of 70, Lena had suffered a dramatic cut in her pension (almost 33%) and did not mind moving. She had moved many times throughout her life and was pragmatic. She wanted to stay in the city where her grandchildren lived and did not want to leave the community.

“I had a much larger home, and yes, it was very nice, the apartment … but it was financially necessary for me … and I wanted to stay in this community…” (Lena).

Filippa, who had been a widow since her forties, decided to sell the house she and her spouse had built together. She moved to an apartment on the ground floor and understood that it was a practical place for aging. Additionally, the home sale resulted in extra money on top of her monthly pension. She received help from the financial adviser at her local bank to budget her savings until her 80th birthday, making her feel financially secure. In contrast to Filippa, Marianne (who moved four years ago) had no savings left over from her home sale. However, she was very pleased with her new apartment, and the rent was affordable on her low pension.

Two more participants had moved from the city to the countryside. With lower house prices, they could buy a small house with the profit from their city condominiums. They preferred to leave the city, enjoy nice scenery, and be close to nature. Moving into a house as a pensioner was somewhat of a dream come true. Financially, it also meant they still had a potential asset in their new home, if needed someday.

Add to the pension by renting out

Several participants saw renting out their owned property as a good option to increase their monthly income. At the time of the interview, three participants rented out their owned property regularly. By having short-term renters over a weekend or the summer, the participants received a monthly increase in income or the possibility to carry out renovations when needed. They all lived in the countryside or semi-urban areas and had additional buildings they could rent out on their plot. At the age of 55, Anna explained that she decided to take a mortgage on her house to renovate a small cottage on her property to rent it out and generate an extra income. For one of the participants, renting out owned property and having two long-term tenants was an absolute necessity for remaining in the house.

Other participants had considered renting out owned property but did not currently. Usually, renting out their property would require preparations and renovations to avoid sharing a bathroom with the tenants. Renovations were expensive, but renting out the owned property was seen as a good backup, if needed.

“I have been thinking about the small cottage over there (referring to a small cottage in her garden)… there is no water installed, but it has electricity … I am considering connecting the water to make it habitable and rent it out” (Cecilia).

A positive side effect of renting out was the social benefit with worldwide personal contacts and recurring guests, which to some extent provided new connections and a sense of competence in hosting guests and sustaining their finances to age in place.

Thoughts about the future (home)

There was great variety in participants’ reasoning about their future and future homes, as described in the theme “Thoughts about the future (home.)” This was elucidated in four subthemes (see Figure 1) that seemed to be connected to what the participants had already done about their living situations. The first subtheme describes that most participants considered “staying put as the best option” and had already prepared to age in place by moving to their current home, renting out their owned property, earning an income, or adapting the home to becoming older and in need of care. The second subtheme describes that some were reluctant and “avoiding thinking about the future” The third subtheme describes that some participants expressed that “moving is a likely option” even if put hypothetically. Regardless of moving intentions, all participants had opinions about “attractive housing options”, which was generated as the fourth subtheme.

Staying put as the best option

Some participants considered staying put to be the best option. These participants had already executed strategies to generate more money by moving to their current home, renting out, or living in a home that enabled them to continue working part-time. Helen, for example, could continue her small business designing, making, and mending clothes in her home. These participants had also considered the home’s functionality and how to adapt it or receive help when health deterioration later on might make them dependent on help. They mentioned they could move their bedroom to the ground floor, remove the bathtub and install an accessible shower. They also made preparations on how to get help, if needed. One participant created an informal text message network among some of the neighbors in the village, leading to local arrangements with neighbors’ texting each other every morning for security and support. Such community arrangements would help organize shopping, borrow a car, let in a neighbor’s cat, water plants, or provide safety, security, and care during periods of illness and acute need.

Should I fall and break my leg, I have … one, two … three, four, five, six, seven, eight, nine … probably ten houses I can call … And that’s a difference, compared to not having any (Anna).

Avoiding thinking about the future

In accordance with not wanting to worry and keeping a positive mind-set, some participants did not want to overthink the future or prepare for potential future financial or health-related problems. Other housing options, such as assisted living facilities, were considered too expensive, so exploring those options further was no use. Further, some of the participants expressed that it would not be realistic to think that the home would be manageable if health deterioration continued, and they possibly had mobility problems but dismissed the thought with “I will deal with that when that day comes.” For example, for several participants living in the countryside, being able to live the way they did depended on their ability to drive and afford a car, a topic they avoided talking about.

Moving is a likely option

Most participants preferred to stay in their current homes. However, relocating was an option considered, at least hypothetically. Some participants had signed up for housing waiting lists to keep themselves open for potential offers. However, the offer had to be better than the one they already had, and the queues were long.

I have been in that queue since I moved here in 2015, and I have not yet received an offer. I have not gotten any invitations to look at any (apartments). There have been some vacancies, you know, but I am too far back in line (Karla).

One participant was informed that when she signed up at the age of 74, the expected time to get an offer was 14 years.

Dagny felt forced to consider relocation due to health deterioration and financial problems. However, she was ambivalent about changing home as she felt a sense of coherence with her current neighborhood and all the friends and social activities she engaged in regularly. She still had dreams about her garden, and the nature surrounding her was essential to her well-being.

I still have my dreams about the garden! It’s been seventeen years since I started dreaming … I thrive here and take great pleasure from nature… and need … I need nature! (Dagny).

Attractive housing options

Besides affordability, housing preferences varied vastly among the participants. Some participants wanted to live in urban areas with shops, family, friends, transportation, parks, and cultural venues nearby. Other participants preferred the countryside, being close to nature, having nice scenery, and taking walks in the woods or along the coast. Some thought that living in an apartment was the most attractive option, while others preferred the space and garden a house could offer.

Several participants expressed an interest in co-housing to live independently in an apartment but share communal space with other tenants. The participants described co-housing in various ways, for example, as places built explicitly for artists, inter-generational, or with an approach similar to a hotel. Co-housing was considered a safe and secure way to live when aging. It would make it easier to keep active, interact socially, and get support if needed.

I could live in a hotel for the rest of my life! Old-age hotels!… There would be someone who cleans for you and… you could go down and dine if you wanted to … Yes, if the hotels go bankrupt … they can be rented to older people who do not want to do everything themselves and who do not mind having a little of their furniture around them. I’m there! (Lena).

Anna started a Facebook group on co-housing, mainly for herself, to connect with others interested in starting such a project; indeed, this group had grown. Some members were about to realize their dream of living in co-housing, but Anna chose not to join. Anna herself dreamed of developing co-housing for artistic people.

There should be a room with a sewing machine and an ironing board. There should be a room for a carpenter’s bench, and tools and, and then a dining room and kitchen (Anna).

Discussion

Aiming to explore strategies used to age in place and thoughts about future housing in women aged 65 and over with a low pension, the present study adds to the knowledge of residential reasoning among older women living in Sweden, a group in the population that is rarely studied. Our findings explain that although most participants prefer to continue living in their current home, several had experienced recent relocation or had elaborated ideas about future relocation. Overall, the home and thoughts about aging in place and living well seem to contribute to the adjustment process of living and managing daily life on a low pension. Most of the women interviewed supplemented their low pension by raising additional means. Some did so by allocating money through selling a previous house or apartment and relocating, renting out, or working. Cutting down on regular housing costs comes with difficulty, and participants had to cut down on other necessities instead. If future relocation would be needed, several participants thought positively about co-housing options.

Our findings elucidate that the participants, whose mean age was 70 years, were in the middle of their residential reasoning process. Some had already acted on housing decisions pre-retirement, and others were making plans and considerations about the future. In our findings, preemptive reasoning (Koss & Ekerdt, 2017) included thoughts about the home allowing home adaptations to their future needs and becoming a homeowner pre-retirement. From a financial perspective, important push and pull factors were the potential “value for money” by relocating to a new dwelling in terms of finances, space, and access to a garden. The Swedish universal welfare system includes financial support for home adaptations. In a study from the U.S (Lee et al., 2019), affording home adaptations for low-income renters came with difficulties, reducing their autonomy and mastery capacity of coping in their homes and thus successful aging in place. In Koss and Ekerdt’s (2017) study in the U.S., the participants reasoned about and visualized future health problems and care needs. Family members and friends were important in the reasoning and decision-making process. Partly similar and partly, in contrast, among our participants, the driving force for making residential decisions also seemed to be influenced by their future health needs and relations with friends, children, and grandchildren. However, considering the heterogeneity of the sample, and the fact that it did not include very old women or those with high care needs, the findings should be interpreted with these limitations in mind.

In our findings, the pension level below the EU relative poverty threshold (Eurostat, 2018) influenced the participants’ daily lives to varying degrees. Despite the fact that our participants all received a low pension, the type of dwelling and corresponding housing cost burden varied according to their personal circumstances and financial means; pension, mortgages, savings, and income. Accordingly, with this study, we cannot conclude whether a low pension implies a risk of poverty, nor that women with a low pension have more financial difficulty or fewer future housing options because such matters depend on their eligibility for potential welfare grants. Thus, a sample of women living solely on a low pension have different financial situations and housing-related challenges. In addition, it should be kept in mind that the data collection for this study was made a few years ago, and the women’s financial situation is likely different in today’s situation of financial strain because of the current world situation.

Notably, regular costs for housing, transportation, and planned renovations accounted for a large part of the pension and savings spending for our participants. Maintaining the home and garden with needed repairs and improvements was difficult to afford, and the low pension also excluded some participants from increasing existing mortgages or using tax-deductible repair and maintenance services. This made the struggle to maintain the house standard harder for the participants. Poor-quality housing is a well-known threat when aging in place that potentially has negative consequences for health and well-being (Coleman et al., 2016; Fausset et al., 2011; Kelly et al., 2014).

The low pension and the costs related to housing created a need to work and earn a wage to make ends meet and stay in the preferred home. Hess et al. (2020) found that older adults’ job motives and satisfaction in retirement were determined by the necessity to earn a wage to make ends meet. Working post-retirement was more satisfactory for older adults working for joy and interest than for those who continued working due to the lack of financial means. In our study, work mainly consisted of part-time jobs and was considered meaningful and manageable. However, one participant had to consider relocation because she no longer managed to work as she used to, which was a cause of financial stress and worry. This example relates to Finch’s (2013) and Phillipson’s (2020) research, which highlighted the negative impact on physical and mental health, well-being, and longevity among older adults needing to work for financial reasons.

The home-owning participants possessed a potential asset when considering relocation in old age, which was obvious from their narratives about how they reasoned regarding the economy and housing issues. Whereas participants in our study did not appear to experience housing insecurity, several of them seemed to be in vulnerable situations. For example, housing insecurity might occur with increased age and further health deterioration if renting out or continuing working would no longer be possible. Our findings are similar to studies from Australia and the U.S (Beer et al., 2011; Jenkins Morales & Robert, 2020; Stone, 2018). that found that homeownership could provide financial security in old age. However, our findings differ from a similar study, including urban-living low-income older adults in Baltimore, U.S., where relocation options were unavailable (Granbom et al., 2020). Instead, participants managed by arranging for their younger family members to relocate into their homes to share housing costs and receive help (Granbom et al., 2020). There are likely differences among settings and populations, not least due to societal and cultural influences, and more research is needed to shed light on such circumstances.

The facet of the findings describing that participants had to budget regular costs and cut down on costs related to daily life to make ends meet are concordant with the findings of a Danish study exploring financial scarcity in old age (Brünner, 2018). As one of few studies on a similar topic in a country close to Sweden geographically and in terms of welfare regime, it is interesting to note that participants did not consider themselves poor (Brünner, 2018), which was the impression in our study as well. However, like in our study in Sweden, needing to cut expenditures led to unmet desires, limited visits with family and friends, travel, and leisure activities. In the Danish study (Brünner, 2018), family members sometimes supported the participants financially. In our study, participants preferred not to share their financial concerns with their children, and they had a strong will to remain autonomous and manage independently for as long as possible.

Several participants in our study were experienced movers who had relocated several times during their lives, and five of them had relocated recently. In Sweden overall, very low proportions of older adults relocate. According to public statistics, the annual incidence of moves in the population aged 65+ is one to two percent, but it has been suggested that future generations of older adults will relocate at a higher rate than previous generations (Beer et al., 2011; Oswald & Rowles, 2006). The findings from this non-representative, qualitative study imply that relocation might be more frequent among low-income older adults than more affluent older adults – an implication that deserves further attention.

Literature suggests (Berry, 2020) that relocating to rural areas in old age may symbolize life coming inwards and maintaining the meaning of life. According to the findings, several participants chose to leave the city and move to the countryside for financial and health reasons, emotional recovery, closeness to nature, and remaining physically active. Several studies (Abramsson & Hagberg, 2019; Berry, 2020; Kingstone et al., 2020) found that living rurally in late life may be associated with poorer health. In our study, relocation to rural areas was related to the desire to change living environments and develop new relationships and the possibility of starting a new chapter in life. However, this may be due to the fact that our study participants were younger. Although living in rural areas brought new challenges, such as relying on access to transportation, our participants were willing and capable of adjusting to such demands. Nevertheless, old age and health decline were associated with increased vulnerability risks. Moreover, some participants had lived their whole life rurally. For them, it was a lifestyle they never wanted to exchange. Reasonably, such older adults are more familiar with the rural lifestyle and more rooted in their neighborhoods and environments.

In our study, participants aged in place independently despite living with chronic illnesses. Hatcher et al. (2019) identified older adults’ processes and strategies when aging in place. In a study in Australia (Hatcher et al., 2019), participants reacted to age changes and adjusted to them over time by learning and finding support from family and friends, which helped them maintain health, independence, safety, and security. Participants in our study needed to rest more due to chronic illnesses, but they prioritized pleasurable activities in nature and having positive social relations at work and with family and neighbors. Our study describes that living with a low pension and aging with chronic illness require changes in daily life, and some participants found that maintaining health became a higher priority than having more money.

Conclusion

This study contributes to filling the knowledge gap about residential reasoning and strategies used by women aging in place with a low pension in Sweden. Based on qualitative data, the findings shed light on currently unknown strategies used to age in place while recognizing aging and health changes and adapting to those. Living with a low pension leads to cutting down spending, using savings, earning a wage post-retirement, and renting out or selling the estate to manage financially. Alternative housing options for the future were kept open but mainly reflected on rather than realized. Our study has implications for further research on the complex topic of housing and personal finances during retirement. Importantly, to shed light on other types of life situations, future studies should include men as well as couples aging with a low pension. Based on participants’ perspectives, we found that important and even drastic housing choices are made in old age. Affordable housing is needed in all types of municipalities in Sweden – urban, semi-urban, or rural – our findings have implications for community planning. In addition, the findings can be used to inform pension and housing policies in Sweden and countries with similar welfare systems.

Author contributions

The second author designed the study, obtained ethical approval, and collected the data aided by a research assistant. The first and second authors drafted the manuscript, designed the analysis, and analyzed the data. Providing critical input and text optimization, the last author contributed to the iterative revision of the manuscript. All authors contributed to and approved the final version of the manuscript.

Ethics

The Swedish Ethical Review Authority approved the study (Ref. no. 2019–02870). Written informed consent was given before the data collection started.

Acknowledgments

We thank professor Håkan Jönson, Lund University, for supervising Ph.D. student A. Yadav (first author). Thanks also to the research assistant, Ph.D. Lizette Norin, for contributing to the data collection.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was conducted within the context of the Centre for Ageing and Supportive Environments (CASE) context, Lund University. The study was supported by the Swedish Research Council for Sustainable Development (FORMAS) under the grant (RF: 942-2015-403), the Swedish Research Council for Health, Working Life and Welfare (Forte) under the grant (RF: 2018-01793), and the Ribbingska Foundation in Lund, Sweden.

Notes on contributors

Agata Yadav

Agata Yadav is a Registered Occupational Therapist and Nurse. Since January 2020 working as a Ph.D.- student at the Active and Healthy Ageing research group at Lund University, Department of Health Sciences, Faculty of Medicine.

Marianne Granbom

Marianne Granbom is a Senior assistant researcher. Registered Occupational Therapist at Lund University, Department of Health Sciences, Faculty of Medicine.

Susanne Iwarsson

Susanne Iwarsson is a Professor. Registered Occupational Therapist. Head of the Active and Healthy Ageing research group at Lund University, Department of Health Sciences, Faculty of Medicine.