Aging in place: a little help can go a long way
VERONA, N.J.—Retirement communities may have their perks, but Beryl O'Connor says it would be tough to match the birthday surprise she got in her own backyard when she turned 80 this year.
She was tending her garden when two little girls from next door -- "my buddies," she calls them -- brought her a strawberry shortcake. It underscored why she wants to stay put in the house that she and her husband, who died 18 years ago, purchased in the late 1970s.
"I couldn't just be around old people -- that's not my lifestyle," she said. "I'd go out of my mind."
Physically spry and socially active, O'Connor in many respects is the embodiment of "aging in place," growing old in one's own longtime home and remaining engaged in the community rather than moving to a retirement facility.
According to surveys, aging in place is the overwhelming preference of Americans over 50. But doing it successfully requires both good fortune and support services -- things that O'Connor's pleasant hometown of Verona has become increasingly capable of providing.
About 10 miles northwest of Newark, Verona has roughly 13,300 residents nestled into less than 3 square miles. There's a transportation network that takes older people on shopping trips and to medical appointments, and the town is benefiting from a $100,000 federal grant to put in place an aging-in-place program called Verona LIVE.
Administrated by United Jewish Communities of MetroWest New Jersey, the program strives to educate older people about available services to help them address problems and stay active in the community. Its partners include the health and police departments, the rescue squad, the public and public schools, and religious groups.
Among the support services are a home maintenance program with free safety checks and minor home repairs, access to a social worker and job counselor, a walking club and other social activities. In one program, a group of middle-school girls provided one-on-one computer training to about 20 older adults.
Social worker Connie Pifher, Verona's health coordinator, said a crucial part of the overall initiative is educating older people to plan ahead realistically and constantly reassess their prospects for successfully aging in place.
"There are some people who just can do it, especially if they have family support," said Pifher, "And then you run into people who think they can do it, yet really can't. You need to start educating people before a crisis hits."
There's no question that aging in place has broad appeal. According to an Associated Press-LifeGoesStrong.com poll conducted in October, 52 percent of baby boomers said they were unlikely to move someplace new in retirement. In a 2005 survey by AARP, 89 percent of people age 50 and older said they would prefer to remain in their home indefinitely as they age.
That yearning, coupled with a widespread dread of going to a nursing home, has led to a nationwide surge of programs aimed at helping people stay in their neighborhoods longer.
Verona LIVE is a version of one such concept: the Naturally Occurring Retirement Community, or NORC. That can be either a specific housing complex or a larger neighborhood in which many of the residents have aged in place over a long period of time and need a range of support services in order to continue living in their homes.
Verona is an apt setting. Roughly 20 percent of its residents are over 65, compared with 13 percent for New Jersey as a whole.
Another notable initiative is the "village" concept. Members of these nonprofit entities can access specialized programs and services, such as transportation to stores, home health care, or help with household chores, as well as a network of social activities with other members.
About 65 village organizations have formed in the U.S. in recent years, offering varying services and charging membership fees that generally range between $500 and $700 a year.
One of the potential problems for people hoping to age in place is that their homes may not be senior-friendly
"It becomes a challenge because we live in Peter Pan houses, designed for people who never grow old," said Susan Bosak, a social scientist who is overseeing a program to boost intergenerational engagement in Tulsa, Okla.
Many older people live in homes that are 40 or more years old, abounding with narrow interior doorways, hard-to-reach kitchen cupboards and potentially hazardous bathroom fixtures.
"If you're a boomer person, with money to remodel, think about making your house more user-friendly, not just more beautiful, for when you have your knee replacement or a chronic condition," said Nancy Thompson of AARP. "We're talking smart, convenient. It doesn't have to look institutional or utilitarian."
To promote this outlook, AARP has teamed up with the National Association of Home Builders to create a designation for certified aging in place specialists trained in designing and modifying residences for the elderly. Several thousand builders, contractors, remodelers and architects have been certified. Building or remodeling homes can include such details as touchless faucets, trim kitchen drawers instead of cupboards, grab bars and nonslip floors in the bathrooms.
Arizona's Pima County, along with a few other local governments, has gone a step further, passing an ordinance requiring that all new homes in the unincorporated areas around Tucson offer a basic level of accessibility. They must have at least one entrance with no steps. Minimum heights and widths are set so that light switches can be easily reached and doorways are passable in a wheelchair.
For now, Beryl O'Connor's two-story, four-bedroom Cape Cod house, built in the 1940s, poses no physical challenges for her. Her own bedroom is on the ground floor, and she recently had a safety bar installed in her bathtub, so she thinks prospects are good for staying put over the long term.
Plus, she's got company at home -- a 26-year-old granddaughter lives upstairs and commutes to a job in New York -- and many friends around town, where she has a busy schedule of club meetings, group lunches, card games and occasional bus trips to casinos.
"You've got to socialize," she says. "There are things out there to do -- you've got to look for them."
Ira and Roseanne Bornstein, who live a few blocks from O'Connor, also think their longtime home can accommodate them suitably for many years to come. There's a room on the ground floor they could convert to a bedroom, and space upstairs to house a live-in aide if one were needed.
"It's a modest home, but it's always worked for us," said Rosanne Bornstein, 63, who was a school counselor and teacher for 25 years. "We're very strong in wanting to stay here."
Her 69-year-old husband, a retired pharmacist, said they worry that the economics of relocating might result in a smaller residence, and crimp their ability to entertain and host out-of-town guests.
"People are younger and healthier when they retire," he said. "If you plan right, you can have a lot of time to enjoy it."
Connie Pifher, the town social worker, engages with aging-in-place issues as part of her job, and also on a personal level as she nears retirement at 64.
Divorced, with two grown sons, she used to be determined to stay on in her four-bedroom house as a retiree. Now she's planning to move out, to a co-op or townhouse. She said the ordeal of a recent three-day power outage after a surprise snowstorm hammered home the point that "it's time to move out of Dodge."
"Do I want to worry about the sump pump or getting the car out of the garage when the door doesn't work?" she asked.
One former option, moving to an upscale retirement community, is off the table for financial reasons. She said the value of her house has dropped too far for her to afford that switch.
That's a relatively common problem, with many continuing-care retirement communities charging entry fees of several hundred thousand dollars, followed by ongoing monthly fees.
In several states, there's debate about whether to promote aging in place by shifting more Medicaid dollars to community-based programs and away from traditional nursing facilities. But budget problems may complicate such efforts as some financially struggling states cut back on home health services that help keep some elderly people out of nursing homes.
Susan Bosak, the social scientist who is advising Tulsa on its Across the Generations initiative, says building positive intergenerational relations throughout a community is vital to enhancing life for its elderly.
"Aging in place fosters the illusion we can do it by ourselves, but we can't," she said. "A high quality of life requires support from the entire community."
It's worth the effort, she says, if it means that more older people are aging where they feel most comfortable.
"Home is more than just meeting our need for shelter," she said. "It's in our memories. It's where we can be ourselves."
Verona senior programs: http://www.veronanj.org/seniors.php
AARP fact sheet: http://tinyurl.com/3jxoso3
National Association of Home Builders: http://tinyurl.com/6cwbdn