B'nai B'rith International - The Global Voice of the Jewish Community

Staying 'Home': Aging in Place Trend Matures
By Alison Goldstein

With the knowledge that 1.2 million people will be over the age of 65 in the year 2030, baby boomers are embracing a growing phenomenon that will allow them to maintain quality-of-life without excessive aid from others. The concept is known as "Aging in Place."

The National Aging in Place Council (NAIPC) defines the term as "the ability to continue to live in one's home safely, independently, and comfortably-regardless of age, income, or ability level."

And you can "age in place" anywhere you choose to live. "Aging in place is not about where you choose to be sick," but where you plan to spend your golden years, says Rachel Goldberg, B'nai B'rith International's (BBI's) director of senior services.

With a much more dynamic definition than commonly perceived, and a consistently increasing demand for services, aging in place communities have popped up all over the country. The communities are anchored by the common principle that the first wave of baby boomers-now approaching their senior years-doesn't want to be institutionalized in nursing homes.

"Baby boomers saw what their parents did [in retirement] and they didn't like it, so they looked ahead and made things happen," says Gail Kohn, executive director of Capitol Hill Village (CHV), a newly formed community in Washington, D.C., where members have incorporated everyday services to ease the challenges associated with getting older while remaining at home.

Planning Ahead

Boomers are proving their planning aptitude as they look forward to various retirement options.

Peter Bell, president of NAIPC and a 54-year old boomer himself, says that his generation's penchant for prep just makes sense. "As we deal with our parents aging while we are in our 50s and 60s, it raises our consciousness about our futures, so we're embracing the change and planning for ourselves as well."

With life expectancy higher than it has ever been, "Boomers expect to age healthy, they expect an active retirement, and they demand to stay in their homes," adds Goldberg.

CHV gives its members the tools to do just that. It's located in the Capitol Hill/ Eastern Market neighborhood of Washington, D.C., recently named one of the nation's 10 great neighborhoods by the American Planning Association, and the average age of a member is about 50.

Capitol Hill Village didn't have to be built-the homes, and their residents, were already there. "This is [a] motivated group of people who just want to stay in their homes. They had the energy and the drive to take this process a long way, and they created this out of a dream," says Kohn, the only professional employee associated with the nonprofit organization.

For $500 dollars per person per year, and $750 per year per household, the group's 82 members, all of whom live within a 2.5-square-mile range of CHV, have access to services provided by volunteers, running the gamut from garden maintenance and pet-feeding to transportation to doctors' appointments.

If a volunteer is not available to perform the service, CHV has relationships with local vendors who can step in, which also helps to bolster Capitol Hill/ Eastern Market commerce.

With nearly half of CHV's members doubling as volunteers, the recipe for success in this community is simple: Be a neighbor. Help out. It is ideal to need and be needed.

"Social engagement is an essential tenet of healthy aging in place, but the opportunities and the infrastructure, such as transportation, have to be there," says Bell.

CHV activities are crafted by the organization with the neighborhood in mind, notes Harriet Rogers, a CHV charter member and volunteer, as well as a longtime resident of the Capitol Hill neighborhood. CHV offered six events during the month of October that were locally based, focused on arts and culture in the neighborhood, and free of charge to members. On October 19, for instance, Mike Canning, a movie critic for a local paper called the Hill Rag, spoke at a member's home.

If members want to attend activities and do not have transportation, they need only request a ride in advance-that's part of their yearly dues.

The basis of CHV is built on tapping into resources in the community. "The entire idea behind Capitol Hill Village is neighbors helping neighbors. We encourage every member, regardless of their abilities, or how busy they are, to do things for one another," says Kohn.

Civic engagement within Capitol Hill Village is also natural because CHV's members are connected to the Capitol Hill community. Kohn hypothesizes, "these people are linked together by their neighborhood, and they want it to succeed. When Eastern Market [the neighborhood's iconic public market] burned, all of these people contributed to revive and rebuild a place that they love. That, in and of itself, is civic engagement."

According to Kohn, CHV is one of 16 such communities in the Washington, D.C., area, many of which are modeled on Beacon Hill Village, an award-winning, over-50 community in the Boston area.

BBI Creates Place Called 'Home'

While tapping into an established, naturally aging community to incorporate services is a current trend, it is most certainly not the only way for older Americans to stay in their homes.

A residential facility designed specifically for older Americans that has a deep sense of community is the B'nai B'rith Homecrest House in Silver Spring, Md. Goldberg asserts that one of BBI's goals is for people to call a place "home" while retaining social and cultural ties.

Oftentimes, those who have reached the age of retirement no longer feel comfortable in homes they've been in for decades. "Older Americans may begin to feel isolated, depressed, worried about their kids, or unsafe in their neighborhoods. Staying put is not for everyone," says BBI Associate Executive Vice President Mark Olshan.

Money can also be a concern that comes with retirement, which is why BBI's senior housing is subsidized, targeting those with low-to-moderate incomes.

When seniors enter a community like Homecrest House, "their definition of 'home' changes," Olshan points out. The fears that were prohibiting their enjoyment of daily activities wane over time, and the newly minted citizens become engaged in the activities uniquely associated with these communities, such as communal meals.

Safety Key

Regardless of whether older Americans remain in original residences or relocate, there is one principle of "home" that is a non-negotiable-safety.

B'nai B'rith's Center for Senior Services is traveling the country with its "Solving the Aging in Place Puzzle" program, which provides health and safety ideas from local and regional experts for prolonging independent living.

The program encourages the tenets of the universal-design movement, which means that a home is designed incorporating the needs of the disabled-even if no one is disabled in the home. "There are parts of [such a] home that are very inconvenient, such as step-up showers, and it is possible to build without them," says Morgan Gable, BBI's director of grassroots advocacy.

The key is to be proactive, so that a precipitating or tragic incident doesn't warrant the update.

"Universal design targets the sandwich generation, who may be building new homes, adding onto existing homes for the future, or helping their parents make their houses feel safer," Gable notes. Modifications include grab bars in showers, more lights, and easier-to-turn doorknobs-changes that are neither expensive nor difficult to commission.

"The overall goal is to create an environment at home that is conducive to wellness, because there is a direct correlation between the comfort of your home and your health. It is important for boomers to educate themselves on universal design to anticipate needs for the future," says NAIPC's Bell.

Majd Alwan, director of the Center for Aging Services Technologies (CAST), supports the same proactive approach to home safety. CAST is a coalition of 400 companies and university researchers who share the belief that technologies can solve the aging crisis by reducing caregiver burden, and allowing older Americans to age in a dignified manner at home.

With ideas like incorporating healthcare records into a nationwide repository, CAST seeks to eliminate incidents that can lead to healthcare problems before they surface.

Alwan notes: "Seniors and any other group are receptive to technology if it answers a need, is easy to use, and has proven valuable."

Innovations CAST evaluates include everything from a "smart pillbox" that alerts users with an alarm when it is time to take medicine, to motion detectors that evaluate lack or frequency of activity in seniors' homes.

The technologies creating the most buzz are what Alwan dubs "therapeu-tainment," or devices that combine functional/cognitive stimulation with entertainment, such as Nintendo's Wii. The devices maintain mind fitness and help keep seniors on their toes.

But for someone aging alone in his or her home, seeking out these tools-whether they're essential or for entertainment-can be tough.

The issue, as Bell sees it, is that there just aren't enough resources for the ballooning population of older Americans. That is why NAIPC's goal is to create a number of networks where there is "one-stop shopping" for products and services associated with geriatric care.

"With so many people approaching the age where they need aging in place services, there are huge entrepreneurial opportunities in the market. If we rely on philanthropy alone, it will be hard to fulfill the needs of so many older Americans," he says.

Bell makes the point that services providing geriatric care are quite interrelated. NAIPC wants to incorporate these services so that businesses follow an accountability system, with a common ethics policy for treating seniors with dignity and respect. "This would be good for business and good for older Americans," he says.