Tuesday, June 17, 2014

Virtual Retirement Villages: Supporting Aging in Community

Older adults searching for meaningful lifestyles as they retire are finding a
sense of community and belonging in the rapidly growing Village movement.


What do you do with a generation of social innovators who marched for civil rights, stood up for equal rights for women, defended our country in multiple wars and conflicts, and developed the entire technological infrastructure on which we communicate as a world today? The answer: Find a new movement. The Village movement sweeping the nation for the last ten years has become a place where baby boomers can influence social norm and create a vision for aging in community. The Village to Village Network is a national peer-to-peer network supporting communities and leaders to innovate the Village models in their community to support older adults to remain in the community as they age.

Dorothy Weinstein is a good example of how the Village can help. For sixty years, she ran a boarding house for medical students in Boston. Understandably, as she got older, it became more difficult for her to do the work on her own. At age one hundred, Dorothy finally decided she needed help making beds and cooking for the students. Her son, who worried for her health and safety, thought that it might be time for her to move to a retirement community. But for Dorothy, it would never be time to move. 

Dorothy’s story might be unique in that she was able to run an in-home business—and a labor-intensive one at that—for so many years, but her spirit and will to live independently is nothing if not normal. In fact, according to a variety of market research data, older adults today overwhelmingly prefer to age in place and are increasingly seeking options that allow them to continue to live in their own homes and communities (MetLife Mature Market Institute 2010).

Consequently, many older adults purposefully seek out supportive communities reminiscent of a time when neighbors were a significant part of each other’s lives and provided a helping hand with no expectation of reciprocation. Today, the experience of aging could be viewed as a constellation—one that is multi-dimensional and interrelated as a result of recent health care policy trends and the realization that the “one size” approach to service delivery does not fit all.

Older adults—especially baby boomers who have experienced their own parents’ aging—are searching for meaningful lifestyles as they retire and alternatives to nursing homes, assisted living, or continuing-care retirement communities, which are increasingly perceived as lacking a sense of community. It’s been proven that aging in a community-based setting improves the quality of one’s life and health (Kaye et al. 2009). In response, new models are beginning to emerge to support aging in the community that provide “one-stop shopping” through a single point of entry. Over the past ten years, one of the innovative models to emerge is the Village model, which creates a wide array of support services and facilitates social connections so that older adults can enjoy a rich, independent, and healthy quality of life.

The Village Model

When Dorothy Weinstein realized she needed help, she contacted Beacon Hill Village, a community-based membership organization in Boston that empowers older adults to remain active and engaged in their communities as they age. She told the Village staff how she was having trouble navigating the stairs at home. It’s understandable why her son thought she should move to a retirement community, but Dorothy hoped there was another way.

There was. The Beacon Hill Village was able to coordinate neighborhood volunteers to provide Dorothy with companionship, light cleaning for the boarders, rides, home care services, and delivered meals and groceries—including pizza on some Fridays. On days Dorothy felt well, she joined lunch groups and lectures organized by the Village. This support meant that Dorothy was able to age in her own home, still actively engaged in the world around her. “At age one hundred-and-two, my mom died in her own bed, in her own home, with her family at her side,” said Dorothy’s son. “If it weren’t for the Village, this might never have happened.”

At the heart of the Village model is the focus on the individual as the core of the community. In this model, older adults are active members in the service delivery process and provide essential assistance in the planning and implementation of a wide range of programming offered. Villages offer members a network of resources, services, programs, and activities that revolve around social, cultural, and educational programs; ongoing health and wellness activities; a trusted referral source for local businesses; and member-to-member volunteer support.

Built on cooperative principles, Villages facilitate access to community support services and connection to ongoing civic engagement. Most Villages are nonprofit organizations governed by their members. Since the first Village, Beacon Hill Village in Boston, opened in 2002, one hundred and twenty Villages have opened across the country, providing full-service programs to nearly thirty thousand older adults. Membership levels range from 100-800 people, with an average membership of two hundred. Currently, at least one hundred and twenty communities are in the development phase, which could result in an implementation of at least seventy-five new Villages within the next two years (Greenfield et al. 2012).

Villages share the following hallmark principles: 
  • They are self-governing, self-supporting, grassroots membership-based organizations.
  • They consolidate and coordinate services to members.
  • They create innovative strategic partnerships that leverage existing community resources and do not duplicate existing services.
  • They are holistic, person-centered, and consumer-driven. 
  • They promote volunteerism, civic engagement, and intergenerational connections.
Furthermore, Villages focus on expanding choice and access to their members. They create social networks within the community, and provide assistance to secure long-term services and supports. Villages currently derive their revenue from member fees, corporate and foundation investment, and individual donations. Without reliance on public funds, Villages are able to work with their members to create a system of supports that can adapt to their needs based on level of care, financial circumstances, informal care network, and preference of the member.

Research shows that the most damaging threat to well-being in later life is not fear of absolute destitution or poor health, but loss of life purpose and boredom (Moody, undated). Villages address directly what recent research has documented as health-related problems caused by social isolation, including depression, increased risk of morbidity, mortality, cardiovascular disease, dementia, and Alzheimer’s disease (Holt-Lunstad 2010). Real-life social networks decrease isolation, the likelihood of institutionalization, and mortality, and increase longevity. The Villages’ emphasis on volunteering provides not only manpower for Village programs, but more importantly, provides an organized way to engage members in their community and improve their morale by making a difference in their lives. Villages provide a model for aging in the community with a keen focus on four core tenants. 

1. Villages keep people healthier. In a recent survey, 40 percent of Village members report feeling healthier than they used to. Forty percent of members are more likely get access to the medical care they need through their Village membership, and 45 percent agree they have an easier time taking care of themselves and their homes since joining the Village. Forty percent of members think health services are most important to supporting aging in community (Scharlach and Graham 2013). Villages offer a variety of services and supports that provide access to transportation, care transition support, and offer activities that enhance health and wellness such as exercise classes, yoga, and tai chi. 

2. Villages help people retain a higher quality of life. They build and provide an outlet to social networks within the community. Villages help people retain a higher quality of life (QOL) with 52 percent of members in agreement that their QOL has improved; 34 percent of Village members report feeling happier than they used to, and 40 percent leave their home more often to engage with peers (Scharlach and Graham 2013). 

3. Villages allow people to remain financially in control. The same survey found that 75 percent agree they are more likely to age in their homes because of their Village membership, and 47 percent are less worried about preserving their wealth and finances, which mitigates one fear—becoming destitute or “spending down” assets in order to access public long-term care supports (Scharlach and Graham 2013). Villages provide members with the tools they need for long-term life planning and access to a preferred provider network that coordinates group purchasing benefits. This allows them access to critical discounted services (e.g. home health care, home maintenance, transportation). Villages mobilize volunteers within the community to offer a helping hand and access
to free services as part of the membership, thus providing cost savings to members. 

4. Villages keep older adults civically engaged. Members report feeling more connected to their communities and less lonely because of Village services and activities offered through membership. Thirty-six percent agree they use community services more often as a result of more access and awareness through Village membership. Not only is this a benefit to members, but communities are able to rely upon this volunteer labor force as a resource and reduce reliance on existing public services. Fifty-three percent of members also volunteer back to their village providing an informed, active group of civically engaged members who are providing the “manpower” behind the local Village (Scharlach and Graham 2013). This “neighbor helping neighbor” focus provides opportunities for intergenerational connections, further strengthening the demographic fabric of the community. Additionally, Villages provide encore career and leadership opportunities for older adults to give back and remain valued and relevant in the community.

Recent changes to public health policies through the Affordable Care Act have highlighted the value of comprehensive, person-centered care plans that combine health interventions with social supports, leading to better health outcomes and efficiencies in local health and aging service systems. Additionally, implementation of readmission penalties and an increased focus on wellness and prevention through this new policy provides a greater opportunity for solutions to connect health and medical community. This has created a new space for innovative models, like the Village model, to support cost effective and person-centered delivery systems that build upon the best assets and resources the community has to offer.

Villages are poised to provide a new systems coordination model to integrate innovative solutions and services to link both medical and social supports. Research has shown that integrating services to address social factors can reduce health care use and costs and improve patient outcomes (Shier et al. 2013). Villages are mindful not to replicate or replace services and supports that already exist in the community, thus providing many opportunities to build strong local and regional partnerships. Each local Village crafts its member services and programs based upon the community’s unique needs. 

The Village movement is growing but not every community has an active Village. The Village to Village Network is the national hub for the Village movement. This membership-based organization provides a platform for shared knowledge exchange, innovative discovery, and research on health and social impacts of the Village model. For more information on how to connect with or start a Village in your community, visit the Village to Village Network at www.vtvnetwork.org or call 617-299-9638. CSA


The author, Candace Baldwin, is Director of Strategy for Aging in Community for NCB Capital Impact and the Village to Village Network, LLC. She is on the board of the National Family Caregiver Association, and is certified as an Economic Development Finance Professional by the National Development Council. She can be contacted at candace@vtvnetwork.org. 

Virtual Retirement Villages: Supporting Aging in Community was recently published in the Spring 2014 edition of the CSA Journal. 
 
Blog posting provided by Society of Certified Senior Advisors 
www.csa.us