Sarah Susanka ran through the researchers' numbers, then added one of her own.

Currently, 46 million American are over age 65, and by the year 2045 it'll be 84 million--one in five citizens. In addition, while 89% of people want to age in place in their own home, 53% don't think they'll be able to and 26% say their greatest fear is losing their independence.

Sarah Susanka: "We have on our hands a real issue."
Sarah Susanka: "We have on our hands a real issue."

Those are huge issues, said Susanka, the architect best known for her Not So Big House series of books. And to remedy that, she put up another number: 1,000.

That's roughly the population of the village in England where she grew up before moving to Los Angeles around age 14. It's also her idea of the kind of community size--small enough to be cozy, big enough to provide support and independence simultaneously--that she believes can be a model for helping people age gracefully in places where they want to live rather than in an institution.

Most people have a clear idea of what they want to do when older, but when they get there, it may be too late, Susanka said in Los Angeles Sept. 29 to participants at Hanley Wood's HIVE Conference. "How do we shift this picture so we can create communities and houses to look after us for the long haul?" she asked. "It's important that we take action now."

Promoting communities that are intimate and supportive also was a common theme expressed by a panel of experts who joined Susanka on stage for a group discussion after her talk. We naturally get together in small groups, said Ross Chapin, architect, author of the book Pocket Neighborhoods. "We need to look not at housing, but at community ... places that foster and augment our deep connection with humanity. ... We have embedded in the hardware of our society isolation and loneliness. That leads to life-threatening illnesses. ... this is life and death. While we argue about housing we are solving dysfunctional problems. The real problem is the structure of our entire environment."

This issue is personal with Susanka; her grandmother died just four months after the local authority in England took away the bus service that ran in front of her home. That bus was her lifeline, Susanka said.

Hailing from Rockville, Md., developer Ryan Frederick talked about a housing complex he created called The Stories, in which people in their late 90s live side by side with newborns and, lots of inter-generational exchanges occur.

Architect Matthias Hollwich is seeking to promotes housing units that hold roughly 1,000 people. Of those, he expects roughly 150 will be over 65 and five will need heightened level of care. "If you create a good community, the other 995 can provide informal care," he said, "And there's a great business opportunity in which service providers can promote those elements of community and ways to help people stay where they are."

Susanka cited the Village Network movement, in which a largely volunteer force in an area helps and serves the community's elderly by doing things such as making small repairs. There are roughly 200 of these villages nationwide, with 100 more in the works, she said. The designer also noted that advances in tele-medicine will help make it easier for people to stay in their homes because care providers can monitor them from miles away.

As with other sessions at HIVE, flexible design was a touchstone. In 2012, Susanka designed a show house in Libertyville, Ill. in which a room on the main level could be converted into a bathroom. Now she's working on a similar project at a development in Lake Zurich, Ill.

"We have on our hands a real issue," she said. "It's a huge opportunity. The innovation I believe we need is something that will rethink our entire community/town/city structure, and rethink how we design houses."