Aging in Community

As a recent lunchtime stroll taught me, we have much to learn about planning communities that work for all ages and abilities!

Aside from the obvious issue of getting the utility guys to talk to the concrete guys, we must acknowledge our own mortality and stop creating Peter Pan communities where no one ever grows old.

How do we do this? Let’s start by a creating a non-medical discourse about aging. (Note: This blog started out as a column for the NY Times Op-Ed page. It didn’t “make the cut” as you see.) The Times’ New Old Age blog, while well researched and beautifully written, is almost totally devoted to medical issues and, appearing only in Tuesday’s Science Times, reinforces the notion that science is going to solve the “problem” of aging.  Why not place the Times New Old Age blog in the Arts section? Can the arts not provide a proper framework and discourse for this issue – the art of aging?

If, as I believe, aging is about community and not about individual bodies, we have some challenges ahead. As we have fragmented the individual body into pieces with associated specialties, so have we fragmented communities into silos that separate housing  from working, schools and shopping from neighborhoods, and, as a consequence, old from young. Face it… we live in an age-segregated society, and people with disabilities, as well, continue to find themselves on the margins, barely visible to the mainstream community.

We have created this disaggregated society because our model of aging sees old people only wanting to be around other old people, old people as needing to be cared for,chronological age as an accurate marker of needs and interests, and old people as consumers, not producers.

As a consequence we produce environments that are: age-segregated, clinical in character, risk managed, and commodified,  therefore expensive, with consumable goods and services that we used to be able to access by virtue of our own labor.

Creating livable places for all ages and abilities should be the guiding mantra as we enter an era of rebuilding our infrastructure. Small towns and cities all across the country are struggling to find their future identity and are rightly worried that new investments will favor old patterns of urban sprawl. Yet, these communities often retain significant community fabric, with main street infrastructure and wonderful core neighborhoods that echo the former, pre-suburban character of walkability, mixed-use, density, and architectural richness.

A savvy media would turn its attention away from glitzy sunbaked, often gated  “active aging” communities to where the real action is. Linton, Indiana is  a blue-collar (former) mining community of 5,000 in rural southern Indiana. Here’s a “naturally occurring retirement community” (a NORC) where a hard-working committee of older citizens organized to retrofit an aging neighborhood by modifying 19 homes for safety, independence and mobility. A progressive Mayor and City Council added its support with the approval of a golf cart ordinance that provides new cost-saving mobility options for the nearly 100 residents who purchased licenses in the first few weeks. Now, the owner of the local pharmacy has put his personal economic livelihood at risk to restore and develop two entire blocks of Main Street as affordable senior and family housing, converting the old Ciné movie theater and creating new street-level space for retail and service.

For an urban example, look at Amsterdam Towers, a NORC in New York City, where the acronym originated. This post-war high-rise complex of 13 public housing buildings is called home by close to 600 mostly African American and Hispanic elders who have raised their families and aged in place successfully. The 60-year-old Lincoln Square Neighborhood Center, serving the Towers and surrounding neighborhood, engaged the seniors’ advisory council in a partnership with the Visiting Nurse Service of New York AdvantAge Initiative. The Initiative surveyed elders in the community and the Neighborhood Center community organizers put seniors in touch with local public officials across the spectrum of housing, transportation, local government, hospital care, police, fire and even the US Postal Service. Enabling the seniors to speak firsthand to their experiences and needs with influential people was all it took to foster rapid response that resulted in new on-site mental health services, an enhanced food program, increased police security, and even a new, closer mail box. All this community building work is a testament to the power of good data put to use with enthusiastic community organizing.

In the next ten years, we will see these examples replicated a thousandfold; this, not the gated village, is the future of senior living. It’s a future based on the notion that aging is about place, not body, and about relationship, not the individual quest for eternal youth. As Wendell Berry writes, “community is the smallest unit of health.”

Making Aging Sexy

by impure_with_memory, Lublin, Poland

It’s a very exciting time to be involved with the field of aging studies, but then I’ve been fascinated with the subject for over 35 years. When I started this work, people would often express curiosity or find it humorous, even depressing, that anyone would be interested in such things. I am amused, at times, when aging celebrity authors “discover” the topic, as if they were the first to encounter the experience and, by virtue of personal reflection, have some premium on knowledge of the subject. That’s ok. After all, aging is certainly a personal learning experience, a process of discovery no doubt, as is life in general, no?

What I find particularly exciting, however, is that we are finally reconsidering aging beyond the narrow confines of its definition as a personal, individual journey. Moreover, we are expanding our definition of aging beyond its focus on the body alone, despite the commodification of aging through every imaginable product that Madison Avenue can hype. Finally, we are giving serious attention to the notion that aging and disability find their manifestation not in the body but in the relationship between the body and its surrounding environment. Necessarily, this politicizes the issues of aging and disability and transforms aging from a personal challenge to a community responsibility.

Through the lens of community, we can now re-envision the study of aging as a “place-based” endeavor. Aging activists (and disability advocates) can now align with the environmental movement in the new emphasis on livability and sustainable communities. A focus on supportive environments now joins the traditional aging-network emphasis on supportive services. Perhaps this new theoretical base for the discipline will attract the youthful attention that the field has always lacked. Yet, some clever marketing of our own might be in order, as our field continues to occupy the dark corners of academia.

Throughout the country, an aging-in-community movement is taking shape. Often, I observe, the impetus is provided by groups of women approaching late life, sharing concerns about their future, and sometimes driven by harsh realities of caregiving for elderly parents within a less than adequate system of care and support. Planning models are emerging and aging activists are indeed becoming educated about municipal planning, zoning, and the critical relationships among mobility, housing and land use decision making.

The AdvantAge Initiative (AI) planning model, including a new, online version of the AI community survey is being tested in three diverse settings: very rural Sonora, California; Georgetown, Texas, a rapidly growing retirement destination; and Clinton/Chelsea/Hell’s Kitchen neighborhoods in the thick of the Manhattan performing arts districts. Despite significant differences in the character of these communities, I am amazed at the degree of enthusiasm that people have for getting to the urgent work of planning community futures. Similarly, here in Indiana, my recent workshop on Livable Communities for Aging in Place filled the 35 participant slots within about a week of its advertisement. Something is clearly going on here. There is a pent-up demand for communities to face the future and a growing realization that change may occur at the local level long before the contentious federal debate about Social Security is ever resolved.

Redefining Prosperity

 

Vulcan salute

If I were to fulfill Mr. Spock’s blessing to “live long and prosper”, I guess I would die a rich old man.

Somehow, however, that dream feels a little hollow. Yet, it’s at the core of the American economy, right? We are told that we depend on people getting rich to create the jobs that fuel increased consumption and continued economic growth. And staying young forever is, of course, the desired state of every baby boomer consumer, according to Madison Avenue.

I have a growing suspicion that the prospects for every American to enjoy riches are as dim as the prospect that we can all live to 120. Acknowledging the reality of one’s own mortality is the first step to understanding what it means to age well. Acknowledging the reality of our economic limits can be the first step to a new definition of prosperity.

As this year’s fabulous Community Matters ’10 conference was held in Denver, I had an opportunity to meet planners, government officials, and resident activists from multiple small towns in the Mountain West and High Plains. Many of these communities are struggling economically, often due to the decline of traditional  industries (mining, logging, ranching and farming) in the face of worldwide competition. One common consequence of this trend is the departure of young people from their home communities and the subsequent increase in older age-density, creating what Dace Kramer has referred to as “naturally occurring retirement regions” (NORR’s). This has been accompanied by an influx of new retirees seeking amenities not typically provided by sunbelt retirement communities – incredible natural beauty, skiing, hiking, recreational ranching, etc. As one might guess, local economies are shifting to a “service” base as the population ages, due to both aging in place and in-migration.

While recognizing aging is a major driver of population and economic change in the New West, I have come to realize that, with respect to local economy, it’s impossible, better said, impractical, to discuss aging without reference to youth, and vice versa. If people are to age well in the New West, they need robust youth to provide services of all kinds. If communities are to provide opportunities for youth that enable them to stay put, they need the monetary investment of elders.

Seems like a simple dollars and cents issue. But it goes deeper. In the practical sense, attachment to place requires dollars and cents. For a young person, it equates to a job. For an elder, it often equates to cost of living. The converse applies to both. In a deeper sense, attachment to place is not a monetary issue. We are attached to a place because we feel we belong there. We know the place and it knows us. We nurture the place and it nurtures us.

When we reach the right place, we don’t need more because we have enough. We have loving relationships. We have the sense of fulfillment that comes from the beauty of the quiet order around us balanced by the sense of delight that comes from the unpredictable and creative spirit of nature and of youth. To appreciate what we have means we must regularly view our place from the outside, which can simply involve embracing those strangers who are our future neighbors, friends and family.

When we reach the right place, we are prosperous. Yet, we may very well be spending less, not more, which in the current scheme is anathema to our American economy. We are told that, without wealth-creation, America will become a “second-class economy.” The “new normal” means a lower standard of living. If that’s true, is this bad? These days, both young people and elders are the new pioneers in the so-called lower standard of living. Should we not notice that they are discovering the difference between standard of living and quality of life? Should we not be listening to elders who can teach us how they survived hard times and to youth who can teach us how to live more lightly on the planet?

Addendum:

Through the generous support of the Orton Family Foundation, and others, the participants in the Community Matters ’10 conference came together to explore and develop a new “heart and soul” approach to community planning. This approach is based on the belief that a slavish adherence to growth in every direction threatens the heart and soul of our communities – the things that, in the end, attach us to place and define who we are. Economic growth and quality of life are not necessarily antithetical. But a corporation is not a person (despite the Supreme Court decision) and capital is, too often, not attached to place. Planning that reveals and promotes the heart and soul of a place is essential and, indeed, many local companies are loyal to their communities and help define heart and soul. Storytelling and story sharing are critical tools for “heart and soul” practitioners. For a wealth of connections to this growing and exciting area of community planning and activism, visit the Orton website at: http://www.orton.org

Spend some time with the site and be sure to look for the Heart and Soul Community Planning Principles.

It’s not a vision. It’s a memory.

I had the privilege this week of observing a planning forum for Fifth Ward seniors, held at the JW Peavey Senior Center in central Houston. Programming for the predominantly African-American neighborhood is provided by the venerable Neighborhood Centers, Inc., an outstanding non-profit serving Houston for over 100 years.

Using the facilitation method known as Appreciative Inquiry, over 100 elders spent three hours reflecting on the strengths, not the weaknesses of the neighborhood. From small table workgroups they produced creative and powerful images of the kind of neighborhood that would enable individuals to remain in place as they age, typically focusing on an infrastructure that would enable people to move about with safety and security, accessing vital services and relationships with friends and family.

Though produced as a vision for the future, my friend Jane Bavineau wisely observed that the group was merely wanting to get back to the way it was, before drugs, prostitution, crime and disinvestment changed their stable, strong neighborhood.

So it’s not a vision. It’s a memory.

While it’s common, and usually a good thing, we “facilitators” of the world often engage groups in envisioning exercises to help create a template for actions that can lead to a better future. Perhaps we need to spend more time with memory. Unlike a dream, memory is based in a reality, albeit sometimes rose-colored by nostalgia. Being reality-based, moreover, the examination of memory can lead us to consider the real forces, political and economic, that led to negative (and positive) change… that led us away from home, so to speak. Asking how we arrived at this point is a worthwhile premise for discussing how we move forward. For how can we move forward without targeting the fundamental forces and power structures that keep us where we are?

This group at JW Peavey is indeed politically aware. They vote. They call their elected officials, en masse. They see that their efforts to create a good place to grow old means that everyone, all ages, will benefit.

Children have dreams. Elders have memories. How interesting that they produce a common image. How powerful  it would be to mobilize the energy of children’s dreams and the wisdom of elders’ memory to transform our communities “back to the future”.

Don’t leave yet… speaking of community planning, I want to draw your attention to several new tools recently published to our www.agingindiana.org website. With support from the Daniels Fund of Denver, Colorado, we engaged several national experts to produce tools organized around the Indiana state planning process we are coming to call Communities for a Lifetime. As access to mental health services emerged as a key issue in the Indiana AdvantAge Initiative survey, we have produced a community guidebook to enable citizens groups to learn the basics and mobilize around evidence-based solutions to improve the mental health of elders in their communities. Likewise, as many communities in Indiana are addressing home modification needs, we have produced “How to Develop a Home Modification Coalition.”  In addition, as communities begin to formulate social marketing campaigns to raise awareness about key issues, they can now take advantage of a Communications Guidebook, organized specifically around the AdvantAge Initiative’s 33 indicators of an elder-friendly community.

You might also find interesting, in the research reports, a new table illustrating similarities and differences in our survey results across urban to rural areas. And to top it off, this growing and rich resource of data for Indiana now includes GIS-producted visual images of variation across Indiana planning and service areas around some very interesting indicators – obesity, diabetes, awareness of services, etc. Check it out!

While you’re at it, visit our “founding” home page at the Center on Aging and Community, Indiana Institute on Disability and Community, Indiana University, to join the Facebook group, follow tweets, and link to other Center projects and websites. See http://www.iidc.indiana.edu/index.php?pageId=31.

Walking as a Narrative Activity

In response to an earlier blog (March 15), friend Lyman Orton, founder of the Vermont Country Store, picked up on my comment about remembering old ladies and their small grocery carts coming home from the Jewel Tea store in my neighborhood. “Are these things still for sale somewhere?”, I asked.  Well, indeed they are, and it’s no surprise that the Vermont Country Store is the place to find them, visit the catalogue here and voila’ . 

The Vermont Country Store is the source for much of the “good” from the good old days. While nostalgia is fun, the store sells more than nostalgia. Simpler toys,simpler appliances, simpler (and often organic) products are the store’s stock in trade. For Lyman, and his family, the Vermont Store has come to represent an attitude towards life and an attitude towards community that values local activism, livability, and philanthropy. Indeed, the Orton Family Foundation has heavily invested in citizen participation planning initiatives that tap what Lyman calls the “heart and soul” of the community. (See Orton Family Foundation) Not just for the sake of pitching clothes lines in his catalogue, Lyman is also at the front of the “right to dry” campaign, which fights against covenants and ordinances banning clothes lines from backyards. In light of our national energy/environmental crisis, it’s hard to imagine that anyone could wish away the sight and smell and fresh air experience of hanging clothes in the springtime breeze. I should mention, I suppose, that you can also find those great old wooden clothespins in the catalogue, you know… the ones with the metal spring (which, as a kid, we reversed to create neat matchstick guns). You can even order pins printed with the “right to dry” slogan!

Now those little grocery carts don’t work too well if there are no good sidewalks. How is it that sidewalks came to be seen as “amenities” rather than part of the essential community infrastructure. Nowadays, we have to incentivize developers to include sidewalks on both sides of the street. I guess that’s a step (backward) in the right direction, but it galls me that we have to reward behavior that should be expected.

But a sidewalk is, after all, a means to an end, a conveyance. We should also consider, as we think about the quality of our communities, whether the sidewalk leads to valued destinations and, perhaps more importantly for people with time (elders and children) the sidewalk provides the journey. Walking, and maybe I should say strolling, whether on foot or in a chair can be a rich narrative experience. As we walk, the surrounding environment, built and natural, becomes part of our sensuous world. Being physically open to the world, we see, we smell, we hear, we feel, we belong in a way not experienced in the automobile. The time it takes to move through the environment enables us to reflect, remember, retell the story of the neighborhood to ourselves. Over the years, I’ve watched that root gradually lift the pavement; I remember that old lady in the bonnet who used to live there and tend to her flowers; I recall with pain the cinders that would grind into your knees when you fell off your bike in the alley; I react  with fear at the house where my friend’s mean Dad was taken away in the police car, his mother on the porch bruised and sobbing.

Years ago, I came across an essay by Michel de Certeau called “Walking in the City.” (In the Practice of Everyday Life, 1984) He noted that people in positions of power (city authorities, planners, developers) tend to be enamored of the “birdseye” view of the city. Their grand maps, looking from above, are a testament to their control, to their ascension. Yet, the meaning of the city, the story (text) of the city, the life of the city  is produced by people walking. This is how the city is truly inhabited. As William H. Whyte said, “the meaning of a place is a product of the users, not the planners.” As I see it, the first step in planning and creating good places to grow old (and grow up) is a literal one – a step along the sidewalk.

Awhile back we invited kids in the local public housing complex to “walk the neighborhood” with us. Before we started, we had the kids draw maps of their neighborhood and, typically, we saw “elevation” maps – as if you were standing on the street and looking out. After walking the neighborhood, the kids began relating to the birdseye view. They were “ascending” to power, if you will, and beginning to see the larger context of connections among the parts. This is a good thing, where citizens understand that “maps have teeth”,  in the words of geographer Doug Aberley, and take back the human cartographic impulse  from the professional mapmakers, who haven’t done such a good job designing our towns lately.

From Linton to LaGrange, and New York City along the way

The Clearview Gardens Housing Coop in Queens could fit the entire population of LaGrange, Indiana within its complex, with room to spare. LaGrange, Indiana (pop. about 3,000), Linton, Indiana (pop. about 5,000) and Clearview Gardens (pop. about 4,500) are worlds apart along the rural-urban continuum, but next-door neighbors when it comes to their desire to enable elders to age in place. April travels to all three sites proved to me that there are some basic commonalities driving the aging in community movement. The vast majority of seniors do want to stay put, no matter where they live; the built environment provides major challenges; grass roots creativity may be the road to the future.

In Linton, Indiana, older citizens are taking to the streets in golf carts, saving lots of money and challenging traditional notions of transportation. Our on- line survey of mobility issues in Linton barely made it in time to help inform Mayor Tom Jone’s decision to sign a new ordinance supporting but regulating the use of golf carts in town. The survey results suggested a majority of citizens approve of the growing trend, while being very much in favor of regulations around public safety. Among 239 respondents to the on-line survey, 48 were current users of golf carts to get around. Another 109 respondents agreed they will consider using a golf cart in the next ten years. Wisely, the city of Linton is getting ready! Visit www.agingindiana.org  for the survey results. 

Linton, Indiana on-line survey prize winners, Mayor Tom Jones, NORC leaders (Daily World, T. Ferree photo)

In LaGrange, Indiana, grass roots creativity found its expression in a local group of citizens concerned about elders being stuck in their homes due to mobility limitations. With the leadership of local contractor Dave Clark, a small group of folks rounded up money and supplies to establish a “ramps program” enabling 19 older and disabled citizens to get in and out of their homes with ease. In a smart twist on the usual approach, this group decided to build the ramps in sections that could be easily dismantled and reassembled as needed.

LaGrange Aging in Place Committee members ready to greet summit participants

The Clearview Gardens Cooperative Housing project dates to 1949, when the first buildings were thrown up for returning veterans, who paid $50 a room to own their units – units that now have a price tag in the $250K range! Over the decades, continued building resulted in a project that covers 88 acres and houses nearly 4,500 individuals. With aging in place, naturally, there are over 1,200 seniors living in the community. This concentration of elders was the reason that three community leaders, several years ago, sought and received designation and funding to create a formal NORC – naturally occuring retirement community. NORC funding has enable the seniors to carve out valuable community space on the site and contract with the local YMCA for a NORC supportive services program. The wonderfully talented and dedicated staff of the program (two social workers and a nurse, primarily) work closely with residents to identify and respond to individual needs as well as create a broad array of communityprograms such as screenings, cultural offerings, and healthy aging activities. Their current grant through the Administration on Aging Community Innovations for Aging in Place project, administered in the city by the Dept. of  Aging, will enable the provision of evidence-based chronic disease self-management programs.

Despite the resilience and experience of the residents and the creativity of the staff, some pretty major challenges loom ahead – there is no internal transporation on the site and every single building is fronted by several stairs. Half of the units on the site are second story. I asked one lovely lady what she would do when (oops…if) she should develop a problem with … Not letting me finish my sentence, she asserted “That won’t happen!”  While I admire her grit, I have to wonder how realistic she is about the future. And even if her assertion comes true, as I certainly wish, the basic inaccessibility of the entire project is like the elephant in the room. Some creative thinking will have to come forth, along with some big bucks, I imagine. But, like the Linton seniors taking personal transportation into their own hands, I suspect the Clearview elders will figure it out.

Here's my fellow traveler Duane Etienne, CEO Emeritus of CICOA Aging and In Home Services, at the entrace to Clearview Gardens.

Announcing Elderburbia: Aging with a Sense of Place in America

Now available: Elderburbia: Aging with a Sense of Place in America, by Philip B. Stafford, Ph.D., Praeger Press.

The work is a labor of love, reaching back to memorable encounters with amazing elders over thirty years. It argues that a deep understanding of the experience of home and place is an essential starting point for discussions about “aging in place”, which too often equate “place” with “house.”  It provides a nice introduction to the use of ethnography and participatory methods towards understanding the lifeworld of elders in Bloomington, where I live. It also provides the first book length treatment of the national movement towards elder-friendly communities. My hope is that this will provide the impetus for a serious critique of our current model of aging, which focuses primarily on the individual aging body and not on the experience of aging in community. It suggests that aging is not IN the body, but in the RELATIONSHIP between the body and its environment – which is an environment replete with meaning and memory.

Oh… and about that title:  did you know that more elders live in suburbs than in cities and towns combined?  Are suburbs very well designed for growing old?  Read the book and you’ll find out!

I hope you will find the book stimulating. If so, add a comment and let’s have a discussion !