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Villages: Helping People Age in Place

More than a neighborhood, a village gives older people a better chance to stay in their own home longer

On a bitterly cold morning a few years ago, Eleanor McQueen awoke to what sounded like artillery fire: the ice-covered branches of trees cracking in the wind. A winter storm had knocked out the power in the rural New Hampshire home that Eleanor shared with her husband, Jim. "No heat, no water. Nada," Eleanor recalls.

The Real Social Network

Illustration by Headcase Design

<b>Village People:</b> Villages allow more older people to stay in their home.

See also: Home and community preferences of the 45+ population.

The outage lasted for nine days; the couple, both 82 at the time, weathered the ordeal in isolation with the help of a camp stove. Their three grown kids were spread out in three different states, and the McQueens weren't very close to their immediate neighbors. "We needed someone to see if we were dead or alive," Eleanor says.

But the McQueens were alone, and it scared them. Maybe, they admitted, it was time to think about leaving their home of 40 years.

Luckily, last year the McQueens found a way to stay. They joined Monadnock at Home, a membership organization for older residents of several small towns near Mount Monadnock, New Hampshire. The group is part of the so-called village movement, which links neighbors together to help one another remain in the homes they love as they grow older.

The concept began in Boston's Beacon Hill neighborhood in 2001, when a group of residents founded a nonprofit called Beacon Hill Village to ease access to the services that often force older Americans to give up their homes and move to a retirement community. More than 56 villages now exist in the United States, with another 120 or so in development, according to the Village to Village (VtV) Network, a group launched in 2010 that provides assistance to new villages and tracks their growth nationwide.

It works like this: Members pay an annual fee (the average is about $600) in return for services such as transportation, yard work, and bookkeeping. The village itself usually has only one or two paid employees, and most do not provide services directly. Instead, the village serves as a liaison — some even use the word concierge. The help comes from other able-bodied village members, younger neighbors, or youth groups doing community service. Villages also provide lists of approved home-maintenance contractors, many of whom offer discounts to members. By relying on this mix of paid and volunteer help, members hope to cobble together a menu of assistance similar to what they would receive at a retirement community, but without uprooting their household.

The earliest villages, like Beacon Hill, were founded in relatively affluent urban areas, though new villages are now sprouting in suburbs and smaller rural communities, and organizers are adapting Beacon Hill's model to fit economically and ethnically diverse communities. Each is united by a common goal: a determination to age in place. A recent AARP survey found 86 percent of respondents 45 and older plan to stay in their current residence as long as possible. "And as people get older, that percentage increases," says Elinor Ginzler, AARP expert on livable communities. (Read the full AARP survey "Home and Community Preferences of the 45+ Population")

Next: Avoiding the "old-age ghettos." >>

In its own quiet way, the village movement represents a radical rejection of the postwar American ideal of aging, in which retirees discard homes and careers for lives of leisure amid people their own age. That's the life Eleanor and Jim McQueen turned their backs on when they joined Monadnock at Home.

"To dump 40 years of building a home to move into a condominium doesn't appeal to me at all," Jim says. "The idea of Monadnock at Home is, I won't have to."

You could call it the lightbulb moment — literally: A bulb burns out in that hard-to-reach spot at the top of the stairs, and that's when you realize you're dependent on others for the simplest of household chores. "It's horrible," says Candace Baldwin, codirector of the VtV Network. "I've heard so many stories from people who say they can't get on a ladder and change a lightbulb, so they have to move to a nursing home. A lightbulb can be a disaster."

Especially when the homeowner won't ask for help. Joining a village can ease the resistance, says Christabel Cheung, director of the San Francisco Village. Many members are drawn by the opportunity to give aid as well as receive it."A lot of people initially get involved because they're active and want to do something," she says. "Then they feel better about asking for help when they need it."

Last winter Blanche and Rudy Hirsch needed that help. The couple, 80 and 82, live in a three-story brick town house in Washington, D.C.; they pay $800 per year in dues to Capitol Hill Village (CHV). During the blizzard-filled February of 2010, Rudy was in the hospital for hip surgery and Blanche stayed with nearby friends as the snow piled up. On the day Rudy came home, Blanche recalls, the driver warned that if their walkways weren't clear "he'd turn around and go back to the hospital." She called CHV executive director Gail Kohn, who summoned the village's volunteer snow brigade. A pair of young architects who lived nearby were quickly dispatched with shovels.

The Hirsches have discussed moving; they've postponed the decision by installing lifts so Rudy can get up and down the stairs. Remembering her visits to a family member who lived in a retirement home, Blanche shudders: "Everyone was so old. It's depressing."

Avoiding "old-age ghettos," says Kohn, is a major draw for villagers. She touts the intergenerational quality of Capitol Hill, full of "people in their 20s and people in their 80s," and CHV organizes a handful of events geared toward people of different ages. One program brings high school freshmen and village members together in the neighborhood's public library, where the kids offer informal computer tutoring to the older folks.

Such social-network building is a natural outgrowth of village life. Indeed, Beacon Hill Village was founded on the idea of forging stronger bonds among members. "There was a program committee in existence before the village even opened its doors," says Stephen Roop, president of the Beacon Hill Village board. "Most of my friends on Beacon Hill I know through the village."

Next: Creating social capital. >>

One fall evening in Chicago, Lincoln Park Village members gathered at a neighborhood church for a potluck supper. A group of about 80 — village members and college students who volunteer as community service — nibbled sushi and sipped Malbec wine as they chatted with Robert Falls, artistic director of Chicago's Goodman Theatre.

Lincoln Park Village's executive director, Dianne Campbell, 61, doesn't have a background in social work or gerontology; her experience is in fund-raising for charter schools and museums, and she lives in Lincoln Park. To village member Warner Saunders, 76, that's a big plus. "She doesn't see us as elderly clients who need her help," says Saunders, a longtime news anchor for Chicago's NBC affiliate, WMAQ-TV. "I see Dianne as a friend. If she were a social worker, and I viewed my relationship with her as that of a patient, I would probably resent that."

For Saunders, Lincoln Park Village makes his quality of life a lot better. He recently had knee and hip surgeries, and his family — he lives with his wife and sister-in-law — relies on the village for transportation and help in finding contractors. "I'd call the village the best bargain in town," he says.

Others, however, might balk at annual dues that can approach $1,000 for services that might not be needed yet. To expand membership, many villages offer discounts for low-income households.

At 93, Elvina Moen is Lincoln Park Village's oldest, as well as its first "member-plus," or subsidized, resident. She lives in a one-room apartment in an 11-story Chicago Housing Authority building within Lincoln Park. The handful of member-plus residents pay annual dues of $100 and in return receive $200 in credit each year for discounted services from the village's list of vetted providers. Since joining, Moen has enlisted the village to help paint her apartment and install ceiling fans.

But beyond home improvements, Moen doesn't ask a lot from the village yet — she's already created her own village, of a sort. When she cracked her pelvis three years ago, members of her church brought her meals until she got back on her feet; she pays a neighbor to help clean her apartment. Her community-aided self-reliance proves that inter  generational ties and strong social networks help everyone, not just the privileged, age with dignity.

Social scientists call this social capital, and many argue that we don't have enough of it. What the village movement offers is a new way to engineer an old-fashioned kind of connection. "As recently as 100 years ago most everyone lived in a village setting," says Jay Walljasper, author of All That We Share: A Field Guide to the Commons, a book about how cooperative movements foster a more livable society. "If you take a few steps back and ask what a village is, you'll realize it's a place where you have face-to-face encounters." He compares the village movement to the local-food movement, which also started with affluent urbanites. Think of a village as a kind of "artisanal retirement," a modern reinterpretation of an older, more enlightened way of life. And just as there's nothing quite like homegrown tomatoes, "there's no replacement for the direct connection with people who live near you," Walljasper says.

Next: Offering wellness services. >>

Strong, intergenerational communities — just like healthy meals — are good for everyone. Bernice Hutchinson is director of Dupont Circle Village in Washington, D.C., which serves a diverse neighborhood. Many members are well-off; some are getting by on Medicaid. "But at the end of the day," says Hutchinson, "what everyone wants is connectedness."

Connectedness alone, of course, can't ensure healthy aging. What happens next — when villagers' needs grow beyond help with grocery shopping or the name of a reliable plumber?

To meet the growing health demands of members, villages boast a range of wellness services, and many have affiliations with health care institutions. Capitol Hill Village, for example, has a partnership with Washington Hospital Center's Medical House Call Program, which provides at-home primary care visits for elderly patients.

A new village — Pennsylvania's Crozer-Keystone Village — flips the grassroots Beacon Hill model: It's the first village to originate in a health care institution. Barbara Alexis Looby, who oversees the village, works for Keystone, which has five hospitals in the southeastern part of the state. A monthly fee gives members access to a "village navigator," who schedules medical appointments and day-to-day logistics like errands. Members also get discounts on Keystone's health services. Because the village and the hospital system are aligned, says Looby, "the boundaries are flexible. You care for people when they come to the hospital, and you are in a position to coordinate their care when they leave." Keystone hopes this integration will lead to fewer ER visits and hospital readmissions.

How long can a village keep you safe at home? It depends. But Candace Baldwin, of VtV, says the the trust factor between members and the village can help family members and caregivers make choices and find services.

Michal Brown lives about 30 miles outside Chicago, where her 89-year-old mother, Mary Haughey, has lived in a Lincoln Park apartment for more than 20 years. She worries about her mom, who has symptoms of dementia. Brown saw a flyer about Lincoln Park Village in a pharmacy and immediately signed her mother up. Through the village, Brown enrolled her mom in tai chi classes and asked a village member to accompany her as a buddy.

Just before Christmas, Haughey became dizzy at her tai chi class. With her buddy's help, she made it to the hospital, where doctors discovered a blood clot in her lung. Without the village, Brown is convinced, her mother might not have survived.

Through the village, Brown has also learned about counseling services at a local hospital to help plan her mother's next steps. "We can add services bit by bit, whether it's medication management or home health care. The village knows how to get those services."

Nobody knows what Mary Haughey's future holds, but the village has given her options. And it has given her daughter hope that she can delay moving her mother to a nursing home. For now, it helps knowing that her mother is safe, and still in her own apartment, in her own neighborhood.

Martha Thomas is a Baltimore-based freelance writer.