Retiring to Your Home

Judy and Michael Spock wanted to age in place in the home where they have lived for 25 years in Chicago’s Lincoln Park neighborhood, but weren’t sure they could manage it. In their late 70s, they had health issues and were slowing down. Michael has had two heart attacks and a stroke. Judy has had a heart attack, two mini strokes and needs knee surgery.

“We looked into retirement communities,” Judy said. “We found them sort of reassuring, but also sort of chilling. What we really wanted was to live in our house and stay in our house a while longer.”

Partnering with two other couples in the neighborhood, the Spocks decided to create a non-profit community called Lincoln Park Village to provide services and support to members who wanted to age in place in their own homes, but already needed, or soon would, some level of assistance to make it work.

AARP polls show that a large majority of elder Americans want to age in place in their own homes.

Under the village concept, members pay annual dues— with reduced rates for lower-income members — in return for free services provided either by volunteers or “concierge” services by vetted providers such as plumbers and electricians. Services villages provide to members include transportation, meals, home repairs, yard work, computer training, health care and financial advice, exercise, informational programs and social gatherings.

“You call the village, and we’re going to help you no matter what it is,” said Jane Curry, a member of the Lincoln Park Village Board of Directors. “You call, we will always have a volunteer first if we can do it. If we don’t have a volunteer, we will find that person you need and provide that person.”

There are as many ways of providing volunteer and paid services to members as there are villages. “If you’ve seen one village, you’ve only seen one village,” said Candace Baldwin, an adviser to elders who are starting villages.

Initiated by Beacon Hill Village in Boston in 2001,aging in place villages are growing rapidly all over the country, serving communities in at least 19 states and Washington, D.C.

“We know of 50 villages that are actually open and operating and serving their members,” Baldwin said. “About 100 others are in various stages of development.”

Baldwin is a senior policy adviser at NCB Capital Impact, a nonprofit community development organization based in Arlington, Va. NCB has partnered with Beacon Hill Village to develop the Village to Village Network, which advises developing villages and helps them manage their affairs more efficiently.

Individual memberships at Beacon Hill Village cost $660 a year and household memberships are $850, about the same range as other villages. Most also offer membership-plus options to lower-income residents of the neighborhood, charging about $100 for individuals and $150 for households.

The threshold for membership in a village is usually either 50 or 60 years old. Membership typically ranges from a few dozen to several hundred. Beacon Hill Village has about 450 members.

The volunteers who provide free services to village members are either members themselves or members of the larger community. Many are active seniors, but high school and college students also serve villages as volunteers.

Sonia Crow, executive director of the Palisades Village in northwest Washington, D.C., joked that it has some four-year-old volunteers. They are pupils at a neighborhood school who have befriended a 96-year-old member known as Miss Betty.

Crow said the kids visited Miss Betty before Christmas, singing Christmas carols and the Dreidel Song, and were rewarded with milk and cookies. The children have returned on several occasions, including St. Patrick’s Day and an egg hunt at Easter.

The Spocks said they were surprised at how often they have taken advantage of Lincoln Park Village services, including transportation, wellness programs, financial advice, home maintenance and health care. A consultant provided by the village is developing a master plan for maintenance and modifications on their home, built in 1891.

Judy Spock participates in three village exercise programs a week, t’ai chi, nia (non-impact aerobics) and swimming.

Some villages connect their members to geriatric physicians, if that’s what they want. Lincoln Park Village has a partnership with the geriatric program at the Rush University Medical Center in Chicago, and the Spocks were seeing a doctor there until she took another job. Beacon Hill Village has a partnership with the geriatric program at Massachusetts General Hospital and also connects members to home health care and personal care providers.

Village officials say the No. 1 service they provide to members is transportation, typically rides to the doctor’s office, pharmacy or grocery store.

“When they get in the car with a member it’s not like Driving Miss Daisy, it’s a conversation between two people that enriches both of their lives,” said Gail Kohn, executive director of the Capitol Hill Village in Washington, D.C.

Volunteers transporting members typically drive their own cars, but Beacon Hill Village also pays some of its drivers $20 an hour and asks members to help defray the cost of gasoline.

Palisades Village has a different model. “There’s no compensation, no tips, nothing,” Crow said. “They do it because they feel it’s the right thing to do. They’re helping others, and one day other people will be helping them.”

Safety and security are important considerations for village members who need some assistance, and members want assurance that the volunteers and service providers are reliable. Village officials stress that they protect members by carefully vetting both service providers and volunteers. The Beacon Hill vetting process checks criminal records, driving records, insurance coverage, bonding if applicable and references, Willett said.

“In addition, we get them [village members] a 10- to 50-percent discount [from the service providers],” she said. “Most of the discounts are around 20 percent.”

While most villages depend on dues and volunteers to pay expenses and provide services, there are other models. Partners in Care, based in Anne Arundel County, Md., and serving members in four Maryland communities, including Baltimore, is free for its 2,600 members— no dues whatsoever.

Partners in Care keeps track of the amount of time its members spend on volunteer projects, a concept known as time-banking.

“It’s the concept that you help others for a couple of hours, you’ll get help back when you need it,” said Anne Myers, marketing director for Partners in Care. Members who receive services are expected but not required to provide services to other members.

“We will say to you that our concept is reciprocity, and we hope that there will be a time and way that you will give back,” Myers said.

Partners in Care and Community Without Walls in Princeton, N. J., were developed by seniors seeking aging in place options before the village model originated in Boston.

Dating to 1992, Community Without Walls emphasizes social and educational programs and encourages its members to care for and assist each other. The community is organized into six houses with 60 to 90 members each. The houses charge dues ranging from $25 to $35 a year and decide what programs they want to offer members.

“We intended it as a sort of mutual support organization,” said Vicky Bergman, the community’s first president. “We do not have volunteers. We have personal connections. We do lots of things with each other.”

 “It’s building that level of support and trust that enables us to reach out to somebody else and also to be more receiving ourselves,” she said. “It’s sort of awkward if somebody you don’t know shows up at your door and says, ‘I’m here to feed you your lunch.’”

At Community Without Walls, friends feed lunch to friends.

Following a series of forums on improving its services to members, Community Without Walls contracted with Jewish Family and Children’s Services of Greater Mercer County to develop a fee-for-services program called Secure@Home, providing a variety of aging in place services to community members. After one year, the program was opened to the Princeton area community at large.

Village officials say member dues typically cover 50 to 60 percent of their operating expenses, making fundraising from outside sources critical to their success.

“There’s not one village right now getting any money from government for operating expenses,” Baldwin said. “These are very strong opinionated individuals. They’ve already realized that the public sector doesn’t help them, so they’re going to go out and do it on their own.”

Some villages have received government grants, but they are few and far between. Midtown Village in Lincoln, Neb., was awarded $60,000 in stimulus funds to pay for energy efficiency improvements to the homes of members. Capitol Hill Village received a $50,000 grant from the city of Washington to support lower-income memberships.

Andrew Mollison, a charter member of Palisades Village, said foundations are helpful but are not the solution to the ongoing need to raise funds to pay a large share of the cost of village operations.

“We know very well that the foundation money will all be spent in the first couple of years, and we’ll never get any more after that,” he said. “We have to depend on our dues and neighborhood contributions for the vast majority of our revenue.

“I think the biggest issue is whether the villages will be sustainable,” said Michael Spock. “At some level there is going to have to be government support in making it possible for villages to be able to pull this off.”

Government Must Engage for Communities to Age in Place

With the country facing a huge increase in its senior population, smart growth principles and local governments will play vital roles in determining whether older Americans can age in place in dignity and security in their own homes.

The first baby boomers turn 65 this year, soon to be followed by millions more as the country experiences an unprecedented surge in its senior population. The number of Americans 65 and older is projected to double to 71.5 million in just a couple of decades.

New and redeveloped communities that rely on smart growth principles, including compact, mixed-used neighborhoods featuring a variety of housing styles and prices and smart transportation options, will provide the physical amenities that seniors who live there need to age in place. That may be a relatively small portion of the overall senior population, however.

“By adopting smart growth principles, communities can design places that increase mobility and improve our quality of life,” the U.S. Environmental Protection Agency said on its Web site linking smart growth to its Aging in Place Initiative. “Neighborhoods that integrate homes with shops, services, and parks and recreational facilities allow residents — especially older adults — to pursue an interesting and active life without depending on a car.”

Much of the responsibility for designing and re-designing communities to meet smart growth principles, however, falls on local governments. It’s largely up to cities and counties to adopt the policies, design the programs and provide the services that seniors need to age in place in their own homes and communities.

But a 2005 survey, issued as a report in 2006 by the National Association of Area Agencies for the Aging (n4a) in partnership with the associations representing cities, counties, city/county managers and Partners for Livable Communities found local governments are far from ready to meet the needs of a rapidly aging population. The Metlife Foundation supported the original study and is supporting the follow up.

“Only 46 percent of American communities have begun to address the needs of the rapidly increasing aging population,” the study said.

The n4a plans to conduct another survey this year to see how much progress has been made since 2007.

“Some preliminary steps have been taken, but they are not really enough,” said Jo Reed, senor program manager at n4a. “Part of what our survey is about is calling attention to the good things being done and to provide actual tools for communities to use in going forward.”

The EPA’s initiative, www.epa.gov/aging, focuses on things seniors should do to make aging in place in their homes work for them and also spotlights best practices in communities around the country. The n4a’s Aging in Place initiative, www.aginginplaceinitiative.org focuses primarily on things cities and counties should do to support seniors who want to grow old in their own homes.

“Every part of government and every sector of the community has a role to play in building livable communities for all ages,” n4a said in its manual ‘A Blueprint for Action: Developing a Livable Community for All Ages.’

“Certainly, community-wide initiatives focused on aging in place can be initiated by civic leaders, community activists, and nonprofit organizations. At some point, whether at the beginning of the process or somewhat later, local government leadership is critical to sustaining such initiatives and engaging the entire community.”