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When the Boston Duck Boats pass through upper Beacon Hill, you can hear from the loudspeaker, “And if you look to your right you will see where John F. Kennedy lived on the third floor before moving to the White House.” Reflecting on the past, Beacon Hill’s cobblestone streets have been home to presidents, painters, novelists, and architects. However, today the area is making history through its Aging-in-Place community for city dwellers. Created 10 years ago, the Beacon Hill Villages (BHV) model is being replicated across the country.
As the nation celebrates Elder Americans Month, the Gerontological Society of America is reminding us of vital on-going research and the need for developing healthy aging alternatives to institutionalization.
We have all read of the problems with many nursing homes and assisted living communities through the work of Charles Ornstein of ProPublica, a Pulitzer Prize awarded group. Their "Nursing Home Inspect" is a tool to help people evaluate the safety of nursing homes. Despite high marks of some assisted living and nursing home communities, we all know of places where the elderly are simply assigned to a room with two or three strangers and expected to get along.
Atul Gawande, M.D., M.P.H, at Brigham and Women’s Hospital in Boston, and staff writer at the New Yorker, is author of the 2014 book “Being Mortal: Medicine and What Matters.” He reminds us of how often the elderly are “left with a controlled and supervised institutional existence, a medically designed answer to unfixable problems, a life designed to be safe but empty of anything they are about.” (1)
Aging-in-Place
With the Villages model, people can stay in their homes and receive services to help them age in place. According to Boston University's Judith G. Gonyea, Ph.D, School of Social Work, and Robert B. Hudson, Ph. D., Professor and Chair, Department of Social Policy, while most Home and Community-Based Services are focused on low-income consumers, some of the more affluent have created their own city villages.
Source: Wiki commons“The Village movement began when neighbors in the Beacon Hill area of Boston formed a self-governing collaborative to which they paid dues and from which they obtained services to wrap around any Medicare or insurance benefits. The Village movement has spread nationally and abounds with practical examples, for example, hiring a handyman to do miscellaneous tasks like changing light bulbs. The media reports a rare but notable phenomenon of persons with financial means joining together to purchase property and arrange their own services for the group—for example, a nurse who is offered an apartment on the 'campus.'” (2)
Fees are discounted for people on limited incomes (BeaconHillVillage.org). More than just a program, BHV assists the elderly with services from trips to the local Massachusetts General Hospital to help within the home. Additionally, there is the vital socialization component.
The socialization factor
Robert Cole, MHSA, is Chief Operating Officer at the Connecticut Mental Health Center (CMHC), a State-owned facility operated in partnership with Yale. He acknowledges the importance of socialization for all aging populations and pointed out how it can take place though a virtual network.
“One former trustee of CMHC's supporting foundation arranged for a program in three New Haven area neighborhoods which is helping residents to remain vibrant. They put on plays, have parties, run exercise classes, and even recently held a document shredding party,” he said.
Also lecturer in psychiatry at the Yale School of Medicine, Cole was referring to Frances T. "Bitsie" Clark, executive director of the virtually connected HomeHaven in New Haven, Connecticut (eastrockvillage.org). HomeHaven belongs to the nationwide Village to Village Network.
Anyone who has read the “Island Where People Forget to Die” knows of Ikerian, a region of Sardinia’s Nuoro province called home for the highest concentration of male centenarians in the world. Researchers attribute long life on the island to diet, gardening, dancing, wine, tea, sex and gossip – in essence hard work and socialization. (3)
When I moved back to Beacon Hill recently and walked along Charles Street, I felt as if I had never left. There are some new trendy places to gather, however, the flavor of the community remains intact. With many of the shop-keepers, you can pick up the conversation where you left off some 10 years ago. It is this type of socialization that is so often missing in nursing homes and assisted living centers. Good neighborhood gossip is a lively aging-in-place benefit. And at least one reason to stay alive and well is to be certain that you do not miss the next chapter of: "Wait until I tell you!"
Rita Watson, M.P.H., Yale, writes on issues concerning the elderly as a former recipient of the Met Life Journalist in Aging Award of the Gerontological Society of America and New America Media. Public Policy and Aging Report is a publication of the National Academy on an Aging Society, the policy branch of the GSA.
Copyright 2015 Rita Watson
REFERENCES
1. Atul Gawande, Being Mortal: Illness, Medicine and What Matters in the End, Profile Books, Ltd, London, 2015, p.109
2. Judith G. Gonyea and Robert B. Hudson, Emerging Models of Age-Friendly Communities: A Framework for Understanding Inclusion, Public Policy Aging Report (2015) 25 (1): 9-14 doi:10.1093/ppar/pru056 http://gerontologist.oxfordjournals.org/content/55/2.toc
3. New York Times: The Island Where People Forget to Die, Oct. 24, 2012
