Maryland Aging in Community

Blog

A Growing Old Story

 We have another post from our blog contributor, Jack Matthews, from HomePorts Village program in Chestertown, Maryland. His reflections on using technology give me hope and inspiration. Also the importance of family nearby.  The capacity to keep a positive attitude and be realistic about planning for a future when additional support might be needed, shows us how to be responsible for lifelong planning, and mindful of the importance. So remain open to learn new things and interact happily with younger generations!


This story is being typed on a Bluetooth keyboard on a tv table, but the print is on an iPad on our dining room table nearby. It will be printed on a wireless printer at the other end of the table. This is what makes growing old exciting to me, in my 90th year.

   I enjoy every day, look forward to every tomorrow. I have eliminated TV and the home phone, but I do have a Jitterbug cell phone, an iPad, and a laptop. The latter two provide unlimited news, information and communication. When I get older I may get a smart phone so our great granddaughter can show me how to use it. Then I think I will be unstoppable … if I can just get started.

   My life is not complete because in early January,’14 my wife moved to an Assisted Living Home in Rock Hall, 12 miles away. Diagnosed with Alzheimer’s three years ago, our two children and I finally realized I could not continue providing the day and night care she required. She knows us, converses, but has no short-term memory, so it’s limited. She is content, eats well, sleeps well, and has excellent care. I plan to join her when I can’t take care of myself.

   We visit her as often as possible, but I gave up driving a year ago, when my arthritic knees, hips and back were telling me they could not handle an instant emergency, such as a deer, dog, or child, so my rollator and I have to be taxied. Other-wise, I live by myself, eat a careful, healthy diet, get some exercise every day, and sleep well.

   I could not do this without a great family: our daughter lives 8 blocks away, shops for me. Our son is Director of Athletics at Washington College, 4 blocks away, visits me at least once a week, and both take me to see their mother when their schedule permits. Most Sunday mornings finds them on our porch, to catch up on our comings and goings from the week, with me. We stay in touch by texting, email or phone.

   Aging forces us to evaluate our minds, bodies and energies. If we accept this and plan accordingly, this stage of life can be rewarding. There is still time to dream, to learn, to see, and to do. Each of us is a story, and whatever stage we are in, we should act as if we are the person we want to be. We create our feelings by the thoughts we select.

   There are times when I would like to still be driving a vehicle, but I feel fortunate to be living in Kent County where we have an organization that is established to provide services to assist us, 55 and older, to live in our homes as long as possible. HomePorts is a non-profit membership structure that has volunteers for some services, and provides referrals to reliable providers for numerous additional services.

   This “village” concept is growing rapidly in Maryland and the U.S., and promises to provide assistance to members who wish to age in their community.

   I have called for advice or assistance a number of times and was pleased with the response each time. This also means I have a great resource without calling on our adult children.

   For additional information, www.homeports.org or 443.480.0940.

Village Movement to be featured this Sunday (October 19) on CBS Sunday Morning

Hello Village Friends,

Back in the Spring we made an announcement that the Village Movement would be highlighted on CBS Sunday Morning.  We have been patiently waiting for the segment to air and that time has finally come, it will air THIS SUNDAY!  Please share this information with your Village members.  We also recommend reaching out to your local CBS affiliates and offer to provide them more information on your Village and possibly even a follow-up story. See the full episode description below.

As we all know, an aging population, fewer family caregivers, increasingly limited personal financial resources, and growing strains on government and family budgets will create an unsustainable demand for long-term care.  Furthermore, policy makers have failed to reach consensus on how to finance and deliver long-term services and supports.  On this weekend’s CBS Sunday Morning, (check your local TV listings), senior news correspondent Rita Braver reports on the challenging picture of caring for older adults through interviews with a woman caring for her aging step father, former Senator Tom Daschle who leads the new Bipartisan Policy Center’s Long-Term Care Initiative, and New Yorker Magazine cartoonist and author Roz Chast (“Can’t We Talk About Something More Pleasant” – a memoir about caring for her aging parents).   It then highlights Beacon Hill Village and the Village model as a solution to the crisis.

If you are unable to catch the show live on Sunday, it will be available on http://www.cbsnews.com/sunday-morning/, as well as vtvnetwork.org.

Thank you,
Village to Village Network

Caregiver Wisdom: Mindful in the Midst of a Tender Process

Boats x rainbowsI strongly believe it is in sharing our stories that we build community, our stories can help guide others through rough waters. Families and loved ones face many lessons providing care, it is profoundly deep heart work. Caregiving is a critical part of aging in community. Noelle a colleague from Montgomery county who led the Commission on Aging study on Caregiving this summer  agreed to share a personal story about her caregiving with her parents who are aging in community.

He donated the sailboat. He did not sell it. He donated it to the local fire department.

 He loved that boat. WE, all my siblings, our spouses, our kids, our friends—we LOVED that boat with him as the Captain. So many amazing memories tied up (no pun intended) in that 22 foot vessel. He asked each of us if we wanted the boat. Some of us thought he was joking around. Others simply were not able to take on the responsibility of a boat 12 hours and 14 states north. Nothing more was said. He just donated the boat.

 Always the student, an avid reader and traveller he spent years reading about historic figures traveling the seas, venturing to new and never before seen lands experiencing exotic peoples, plants and spices. When he retired he decided it was his turn for (more) adventure. Learning to sail became his newest passion.

 Sailing lessons became a year ‘round activity on the Bay, on the river, in harbors and finally on the ocean. Certified by the U.S. Coast Guard as an official “sailor” he purchased his sailboat and christened it “Andiamo”, Italian for “Let’s go!!!”— his modus operandi. He was always on the move.

 An avid outdoorsman, he knew how to navigate by the stars on land. Navigating by the stars on a sailboat required focus and skill. He spent years learning the night sky from a new place on the planet and tested himself and any one around him until we all knew the constellations from up north. Then came the nautical maps—learning about the unseen world beneath the boat: the craters, boulders, ledges, bouys. The deep water in front of the house was always a glorious gorgeous source of solace and pleasure. Learning a new landscape without actually seeing it, using new tools to safely navigate, avoiding potential danger (and lobster pots) became a new challenge.

Boats I will never forget my first time out with him, the maps and the depth finder. The day was gloriously clear with moderate winds and we tacked our way out to the ocean. On the way back we came around a small island surprisingly populated by 30-40 sunning seals. They took our breath away. We watched, we listened, we didn’t move. But the boat kept moving. At the tiller, I refocused after a minute or so. I saw birds on or in the water a few hundred feet ahead sitting in a straight line. Not moving. “DAD—those birds, they’re in a line. They’re standing on a ledge!!!” I won’t share the choice language and chaos of the next 90 seconds. Let’s just say we learned a lot about rapid-fire navigation and piloting a sailboat in short order.

 We all learned how to tie nautical knots (“each has its own purpose”). Pieces of rope were in baskets wherever he happened to be. He would spend hours practicing tying those knots. Some were so beautiful one could forget their strength and purpose. He found the process meditative and relaxing. Over and over he practiced. He can tie any knot in his sleep. So can we.

The big adventure of the season was sailing to a neighboring harbor, tying up and heading into town for an ice cream cone or lunch with the Captain leading the charge. Always leading, always teaching, always in charge.

N HouseThey planned a marvelous adventure for the family in celebration of their 50th wedding anniversary. The entire extended family gathered at a summer camp at one of those ubiquitous small New England towns not far from their home. A family reunion, a wonderful gift of an entire week together swimming, sailing, eating, running, golfing and playing charades late into the evenings. Unbeknown to us he had spent a year carving small wooden clocks out of gorgeous walnut, cherry and zebra wood for each of us (and we are many). He wrote a poem about the wonder of life, how it brought the two of them together and to this place surrounded by their children and grandchildren.   A magical week made more poignant because he was scheduled to begin treatment for a sarcoma (bone cancer) in his neck identified by accident during a physical exam—an amazing piece of good luck, if you can call it that.

Surgery, radiation, painful recovery made easier for him by thoughts of times spent on that sailboat, the nautical maps, the knots.

I was caring for my youngest daughter who was pregnant and, at that time hospitalized with a devastating illness. I left her in the good care of the doctors. I left my husband to his own devices. I left my work, but was glued to my blackberry and phone in between crises that followed.

She doesn’t drive. Her eyes do not cooperate and, without the benefit of formal driving lessons, driving frightens her. She would not leave his side   I arranged for and stayed with her in the hotel and brought her back and forth to the hospital where she spent the days in a chair facing his bed, worrying for him and about him. “He’s falling apart”, she said. “Bit by bit he’s falling apart” she said, her eyes wide with panic and recognition of unwanted change. I spent the days in a chair in a waiting room so they could have their privacy.

They relied on me to navigate the healthcare system and conversations with the various doctors, nurses and technicians. I advocated for pain meds, clean sheets, food, a bath, milk of magnesia, physical therapy. I got him out of bed for a walk after the doctor said he had to move. He leaned on me. He leaned on me and we walked round and round the nurses’ station. They relied on me for discharge and transition planning and all related communications, for groceries, for medications, visiting nurses, physical therapy.

 I did not let them see my fear, my worry, my stress. I did not tell them about my daughter, their granddaughter. I did not share the overwhelming weight of worry, the crushing sense of responsibility, the agony of fear or, the craziness at work with my husband. I did what I needed to do when I needed to do it.

The thought of asking for help never occurred to me. I do help others navigate similar nightmares for a living. Somehow, when it happened to me everything was different. The thought that I might need help worried me. If I felt so overwhelmed, exhausted and fearful I must be doing something wrong I am strong, organized, capable, reliable, trustworthy. I am the oldest daughter of an immigrant family. I am chosen. I am responsible. I will do what I have to do.

N parents I took a basket of ropes to the hospital. He started tying knots. They began talking about next steps: radiation, transportation. They were stronger, more confident. They worked the details out between them. They did not need me to drive them to the medical center for treatments. They needed my presence every day so they could report in and check to make sure they were on the right path. They needed me to present options and advice when asked. They needed me to step back and let them walk together toward whatever the future held.

 In the intervening years they took turns, as they say. She has an incurable lung disease. The medications used to tamp down the infection cause hearing loss and blindness, both of which are evident. He now has lung cancer and survived a nasty battle with a bone eating bacteria in his spine. They are more confident in their ability to address each issue as it presents itself.

 Their color is good, their eyes are bright. They choose to deal with their challenges through humor. They get out for coffee every day and sometimes they head out to dim sum for lunch. They are living and enjoying every second of their lives as best they can. They “have things in order”, as they say. Everything: finances, burial, anything and everything is organized and ready for when the time comes. And we talk openly about that time, death, dying. We are lucky to trust each other to engage and participate in such rich though emotionally challenging conversations—another topic for another day.

 He’s still tying knots. And I understand now why he donated the boat.

Guest Blog Interview: Bob Coen of Carroll County

OLYMPUS DIGITAL CAMERARecently I interviewed one of our CoP members who is from Carroll County, Bob Coen. Bob shared some of his work experience on aging in place and disability issues and shared some of his insights with me. I knew Bob had a long history of examining issues related to disability access and had insights based on his work and his personal experiences. Bob worked 36 years for the federal government, at the Aberdeen Proving Ground, has been a contractor for the Marine Corps and more recently with the Commission for Aging and Disabilities (COAD) in Carroll County.

Bob was involved with a disability awareness team at the Edgewood Area of Aberdeen Proving Ground, as he had experience from coping with his own Multiple Sclerosis and he also started working with Volunteers for Medical Engineering (VME). See http://www.v-linc.org/. Working with VME was fascinating because engineers helped to invent all sorts of resources to help individuals with disabilities live more independently. Projects ranged from the mundane to very complex. For example, VME designed and built an attaching mechanism to allow a carpenter who had lost his hand in an industrial accident to use a drill and other devices to continue to work.

As his experience expanded Bob also met individuals working on similar issues up in Harford County and started involvement with the County Commission on Disabilities there. He was responsible for updating their web page by providing web addresses for helping organizations for the disabled in the Harford County area.

After a home accident, Bob and his wife chose to relocate from Harford County to Carroll county to live closer to their daughter and family. He and his wife were looking to find a place that was easier to take care of their large home and property. While looking for options-it was important that the new home location was accessible. Finding this type of site was difficult. Bob finds swimming to be an ideal exercise for his MS so finding a place with a pool was a real benefit. Ultimately he and his wife chose a CCRC, Carroll Lutheran Village in Westminster because it offered accessibility and the pool, and has 50 home as well as apartment style residences. When we are seeking maximum independence and support it is critical to carefully examine all angles to make sure all our needs and wishes for our new community can be met.

Once he relocated to Carroll County, he volunteered and was appointed a Commissioner on the Carroll County Commission on Aging and disabilities (COAD). As a result, he volunteered to work on an Aging in Place initiative in the county. This led to meeting with resource people at McDaniel College. He met with Dr. Martin, the Director of the Center for the Study of Aging and works as a member of what they call the Gang of Five and they are both also collaborating with leaders in Carroll County to expand Aging in Place to a potential Village or Aging in Community Model for the County. The gang has developed a mission statement, a list of values and a needs assessment to be distrusted to the over 65 community in the county so that we can focus on what this population really needs. We are working with a local artist to develop a logo for our efforts. On October 13, a forum will be held at McDaniel College Center to introduce the County to our efforts.

See:

https://calendar.mcdaniel.edu/event/carroll_farmstead_a_carroll_county_aging_in_place_initiative

Building Community & Careful Communication: What can we learn about accessibility from thought leaders on disability access?

We all have insights, opinions, preferences, something to say about how we wish to be treated by others and how we live our daily and hourly lives. Considering the personal story from Bob Coen, part of our Community of Practice Leaders who live in Carroll County, I found his insights very useful. Our stories and insights can guide us to deeper reflection about how we plan to age in community.

Living in our community, in our neighborhoods, in our interactions with groups we find that our social connections can offer support or create stress or frustration. Sometimes it is wonderful, easy, effortless, to be part of a social group and sometimes more challenging. Sometimes communication style, personality and behavior influence this greatly.   Often the successful connections arise with careful communication, our use of words or language that either invite or push away others. I often think about how to make my language more inclusive.

Our social interactions are pivotal because social connection helps us feel a sense of belonging and is often essential to our care, as we have increased times of vulnerability. The tricky thing about aging is that our bodies change and our needs shift. How do we adapt to these changes, what is our self-perception and our flexibility? Our need for help and helpers can change in an instant. Just a little fall, perhaps a stroke, and suddenly we are more vulnerable, and need to navigate with more assistance. Sometimes we need help from those who are our family and friends as our unpaid helpers and also from people who are very different than us.

Anyone who has been a caregiver or managed increased care for themselves recognizes the effectiveness of your care plan is dependent on multiple social interactions, on good and skillful communication and a careful plan to keep things running smoothly.   Whether we live alone in our home without a “Village support “ and rely only on family and neighbors, or whether we live in a more structured group setting, assisted living or a CCRC-how we fare is often about our connections and communications with those around us.

How do we plan to manage living in the manner we wish to live, with maximum independence? Sometimes connecting to social interactions requires literal access into doorways and rooms. Disability access is important to understand as we approach aging in community.

I spent ten years of my work life working in two states for government programs managing rehabilitation programs working closely with amazing advocates for disability rights efforts. I listened and learned and since those years many more improvements have been made to make living independently better for individuals coping with various disabling situations.  Some individuals avoid the term “disability” others use it.   We need to understand what happens if you have had a life long disability and then grow older and decide to “age in place/age in community”? And what happens if you have not experienced a disability situation until you are already older and living in the independent refuge you have created in your own home in your wonderful village community?

In the Journal of Health and Social Behavior, I found one article about self-perception of disability, When Do Older Adults Become “Disabled”? Social and Health Antecedents of Perceived Disability in a Panel Study of the Oldest Old.

In the study, researchers examined how and when individuals determine the health decline they experience creates an identity of being “disabled.” Individuals used social and health criteria to subjectively rate their own disability status. Cessation of driving and receipt of home health care influenced older adults’ perceptions of their own disability. However, having a strong social network seemed to slow the rate of this self-labeling. Another positive plug for building our social connections our networks of caring.

These insights into our self-perception and our social connections can help us as we work together to design lives where we have meaning and social support and adequate personal control over our later-life, adequate access to the world around us. The more we understand about the impact of our communication, about how important our social relations can be, the more prepared we are to promote the dignity of all so that all may thrive within our communities. Hopefully we can find a way to use our language to support all of us as we age in our community and avoid any attitudes or phrases that might further stigmatize and marginalize people who, by virtue of their disabilities might need to make choices and find accommodations that appear to be a bit different than we consider aging well in community.

Thank goodness it is possible to grow, change and learn throughout the lifespan!

CITE: Journal of Health and Social Behavior, June 2006; vol. 47, 2: pp. 126-141.                                                                                     When Do Older Adults Become “Disabled”? Social and Health Antecedents of Perceived Disability in a Panel Study of the Oldest Old Jessica A. Kelley-Moore, John G. Schumacher, Eva Kahana, and Boaz Kahana

A Bump in the Road

There will be bumps in the road for all of us.  I use the phrase “bumps in the road” to indicate those learning opportunities , or challenges that are part of the process of being human and growing older. Maybe my personal situation will illustrate this idea.

20140816_122419My 91 year old mother fell on May 1, 2014 cooking her dinner of fish, salad, and green beans. She somehow managed to call me on her cell phone as she lay on the floor. When we discussed her safety previously, she promised to carry that cell phone on her person at all times. It probably saved her life. Plus the fact that she did not knock herself out on the way down and was conscious. Some of you may be familiar with the following scenario: a broken hip, surgery to wire the femur together and insert a rod down the leg, a heart attack on the operating table, a trip to CCU, discharge to rehab for 6 weeks, and eventually back home with 24/7 care.

A bump in the road often shows up when other things are also happening in your life. Like planning a wedding , to happen at your home! Three days before this incident, my son and girlfriend had excitedly called to say that they were having a baby and were going to get married.  I offered to host the wedding and reception at our home where we have celebrated other family milestones. Oh and the wedding would be in four weeks on May 24th! In the middle of the hip rehab process my mother was able to attend the wedding and sit in the front row in our backyard and watch her oldest grandson get married.

 We can’t stop the bumps in the road, so  how can WE make good decisions in our lives so that the bumps are not so exaggerated? The village that I belong to has been looking at this “thinking” and decision making” process for over 7 years. We have come up with some ground truth learned the hard way from other members as well as ourselves.

1.  The most important element is to MAKE A PLAN for yourself that reflects your wishes and desires for optimum living. Make sure that the PLAN is able to be executed by yourself or someone who will respect and have the authority and energy and skill set to put your plan in action.

2.  DO NOT WAIT FOR AN EMERGENCY (BUMP) to make that plan. Your options and choices in crisis might be diminished or there may in fact be no good choices.

Education is your best defense against a bad ending in life. Just like a financial plan, the more you know and put into the plan, the better decisions you will make and the more likely you are to find advocates and friends and family to help you implement your plan.  We always hear, “I don’t want to worry my children” and so don’t let them know that there is a plan. This causes unnecessary worry for many.

Never assume that children or family will automatically do the “right thing by you.” Members at At Home Chesapeake have been surprised several times and in unfortunate ways by our naiveté about family dynamics. There are no perfect families just like none of us are perfect.

Learn from your Experiences! On August 31, the live-in caregiver  that our family had hired to care for my mom called me to say something strange was going on with mom. The first trip to the ER by ambulance diagnosed a UTI (brain and heart checked first with a scan). She was sent home. She continued to deteriorate and we could not move her. The second trip to the ER resulted in admission and diagnosed stroke on her right side. Mom was stabilized and was sent home with 2  more caregivers for  24/7 support.

photo-8My mother is one lucky lady for many reasons.  I have been in the field of aging for 25 years. Not just the field of aging but a loud proponent of “aging in community.” When mom wouldn’t move closer to us and stubbornly wanted to live in her 4 bedroom 2 ½ bath house (no bedroom or full bath on first floor), daughter monitored quietly and thoroughly every day to listen and watch for changes.  The “bump” was coming, just didn’t know exactly when it would be.

I could call on my colleagues and friends to help secure the best of the best for mom’s rehab and resources. Mom was coddled from beginning to the present with loving care. The resources included a colleague and caring geriatrician in the rehab center, long time association with professionals at the Respite Program at the Department of Aging, plus the care of my supportive and talented husband, friends with special listening and professional skills and fellow members of my village At Home Chesapeake in Anne Arundel County.

What does good support look like when an older adult is in a very vulnerable condition? Today’s scenario:  when I arrived at mom’s house, mom had just been bathed with lavender and wildflower body wash, her special foot cream carefully massaged into every toe, and had eaten steamed and pureed spinach butternut squash soup with a  banana blueberry smoothie with protein powder. She was lying in her bed peacefully and calmly. Her one medication is a baby aspirin crushed into her food. Mom has lived a natural life without excessive medications and our goal is to help her live out her life naturally.

What can we learn from mom’s story so far?  Of course, number one, make a plan! Do have FUN with the plan. Learn from your peers and from all sources you trust.  In our Coffee/Discussion in At Home Chesapeake, we take hard questions and subjects and attack the material from all viewpoints. This peer to peer approach builds resilience and trust among us so that we are able to dig deep into our own insecurities about life’s uncertainties.

Caregiving is not for sissies and it is hard work and requires real time and labor. My mom’s choices are limited at this point. I do wish she had not “worried” me for so many years. Worry does take a toll on us adult- children.  I do wish my mom  had been more proactive with her decision process.  My biggest wish is that more of us become “consumers” of living a good and well thought out life. We WILL have bumps but we may be able to ride more smoothly over them with education and planning and resources. This approach will change aging for us and the generations to follow.

Getting there is half the fun…..A Pilot Transportation Solution

DSCF0689Mike Greenhut of Olney Home for Life told me about a new transportation pilot study and I interviewed Elinor Ginzler of the Jewish Council on Aging.

Today I interviewed Ellie about something new helping Village members in Montgomery County.   Two years ago several Village leaders, County leaders and the Jewish Council for Aging (JCA) started to meet together and dream about ways to collaborate that would help local Villages thrive.   All the Villages agreed that their number one “ask” was for rides. JCA and The Senior Connection, a non-profit community based organization with a 20 year history of volunteer driver services, decided to apply for federal funds from the FTA, available through the Metro Washington COG. The project was approved for a two year funding period and Village Rides was born in the fall of 2013.

The goal is basically to give more rides to more seniors more quickly! Sounds like an abundant plan! The pilot project includes five participating Montgomery County Villages: OHFL-Olney Home for Life

NAN-Neighbors Assisting Neighbors

BTV-Burning Tree Village

TPV -Takoma Park Village

SSV-Silver Spring Village

They hope participation will create a “buzz” across the Village community in Montgomery County and lead eventually to large scale implementation. The funding means that the participating Villages have expanded transportation resources, including a new, user-friendly web-based software, a call center, background checks for drivers and assistance in recruiting new ride users and new volunteer drivers.

Across the country and here in Maryland, participants in villages and other Aging in Place programs identify transportation needs as paramount to maintaining an independent lifestyle. This is even more pronounced in suburban or rural locations. Often loss of driving capacity is what creates a barrier to remaining in one’s home, unless there are resources such as this to make independence possible. Many people find it more comfortable to rely on a system like this rather than on the kindness of friends alone. So far it appears that this project has been a win-win solution for all involved.

Thanks for the information on this story Mike!

Further questions for reflection:

How has your area or Village solved the transportation dilemma?

Have you had any situations dealing with a neighbor who is reluctant to stop driving even though they show signs of being dangerous on the road?

We’d love to hear what solutions have been created in your community!

Or give us a lead on some newsworthy happening in your area!

Elder Friendly Communities What is in a Name? Diversity among Village Models in Maryland

IMG_3058In recent decades a cultural shift has been building in response to the ever-burgeoning population of older adults. The work of thought leaders in aging organizations like Leading Age, AARP, and The American Society on Aging, along with the voices of writers like BiIl Thomas, and the efforts of the World Health Organizations on Elder Friendly Communities/ Age-Friendly Communities and of Met Life and Generations United on Livable Communities has supported the development of truly intergenerational communities of residents that have ample opportunity to share their expertise and support each other and their community. All this fine work is moving to build a world where individuals can survive and thrive with adequate resources for housing, transportation, health care and other supportive services and social connectedness. Some of the shift is an outgrowth of decades of work on home and community based services movement. Other perspectives that have helped to light the path have emerged from creative innovations of thought leaders like Bolton Anthony of Second Journey, Zalman Schacter Shalomi, and other efforts like the Center for Conscious Eldering, or Fierce with Age an Online Digest for Boomers.

We are fortunate in Maryland to have had a long history of programs that support Aging in Place. The first effort grew out of a Naturally Occurring Retirement Community Model, (a NORC), and was developed in the City of Greenbelt. The program, Greenbelt Assistance in Independent Living (GAIL) was established in 2001 the same year as the initial “Senior Village” Beacon Hill was set up in Boston.

One of the reasons the Community of Practice talks about “Aging in Community” is because using that language allows us to embrace those programs that are a ViIlage-style program but not considered a Village, and larger models like “Livable Communities” and “ Elder Friendly Communities”. In addition there are other models for Aging in Place that support affordable housing communities and are not part of the Village movement, but we can all learn from each other about how to foster leadership and empowerment for Aging in Community. The common thread of the models that helped our Maryland Village programs to emerge is the theme of consumer empowerment, or participant-directed programming. The work of each of the programs in Maryland has helped older adults join together to expand the options for aging in place so that individuals can live and thrive in local communities throughout their lifespan.

In terms of the history of these types of programs in Maryland, soon after the GAIL program developed in Greenbelt, news about the Beacon Hill effort was picked up by AARP and the popular media.   The first early forming VIllages emerged in Maryland. They were Burning Tree Village and Bannockburn’s Neighbors Assisting Neighbors, both in Montgomery County and Home Ports in Chestertown, in Kent County. Even these initial programs reveal the critical importance of how Village style programs are tailored to the needs of the local community and are developed in part, by the creativity, wisdom and backgrounds of those who are the founders. The decisions made about the program operations are guided by those who step forward into leadership roles as founders and early Board members. Although they may be strongly influenced by reviewing other resources about other VIllages we found from listening to Village leaders in Maryland that the heart of the development process for an individual Village group is relational. Which implies that the personalities, backgrounds and vision of the early formers plays a strong role in determining how the program is instituted.

The current Villages already operating or those under development  in Maryland, represent a very wide array of models. Some are covering entire counties, some are representing small neighborhoods of 400-500 individuals others cover towns or townships. The models include those that have developed with close support from county agencies or non-profit organizations and others that have been created around a kitchen table among friends. There is no single or “right” or “wrong”way. Some of the programs look like expansion of a social service model, while others are innovations that look more like a neighborhood or community change models.

As Villages continued to develop in Maryland we found that the backgrounds of the leaders was very diverse. Some founders included Board members who had extensive professional backgrounds working with vulnerable seniors and other individuals who had a deep personal understanding of serving as a caregiver to a spouse or parent with a disabling condition associated with aging. Other founders had less experience in the aging services field but a fierce sense of the need for personal independence and a profound desire to remain at home. More recently a handful of leaders in Maryland are also looking at ways to explore the accessibility that can be obtained living in a CCRC environment with additional VIllage-style resources provided to maximize freedom and independence. Sometimes this sort of creative adaptation can provide maximum lifelong independence to someone with a mobility impairment. It is so important to think creatively.  Each Village leader we meet has revealed a passion for thriving in the community, boldly asks questions of the status quo,  has a desire to share wisdom earned over decades, and voices a commitment to living among all generations. We think this is a dynamic and creative approach and wish to support all leaders who are promoting these innovations!

Making a Safe and Welcoming Home

The following Guest Blog Writer shares some of the home modification and other preparations made by his family.

As a member of HomePorts, a Village in Chestertown Maryland, he says, “I am sharing my plans in the hopes it will help other seniors.”

HOW  I  AM  PLANNING  TO  GROW  OLD

IMG_0471Seven years ago I saw a quote that impressed me, “People do not plan to fail, they fail to plan.” That year my wife and I started planning for our future. We moved from a ten room house that needed work, six miles from town, to a six room one story house in town. A great house in which to grow old, but after a careful check we made a number of changes before moving in.

There were two high steps to the entrance into the kitchen from a carport, so we had a deck built over them with a bench and two easier steps, plus a railing. It was planned so that we can have a ramp built over the steps at some time in the future. The bench has proven to be most helpful for delivery drivers and the mail man to leave their packages.  Even though there was a front door, this became our main entrance.

The washer and dryer were in the basement, but though I was only 82 and my wife three years younger, we decided that carrying the laundry up and down would be an accident waiting to happen. Everything in the bathroom needed to be updated, so the bathtub was replaced by a shower and an over/under washer and dryer.  A modern toilet and sink were installed and several grab bars were placed in strategic spots in the bathroom and shower, and they have saved me from a fall several times.

Three years after moving, my wife was diagnosed with Alzheimer’s. With support from our two children living fairly close, and some assistance from home health aides, I was able to care for her at home for three years.

However, after I developed health problems the children and I, with advice from a Geriatric Case Manager, decided that her best option was to move to an Assisted Living Home in Rock Hall. Fortunately, to prepare for this possibility, I had visited several AL Homes a year earlier and there was an opening in one. Although she does not remember where she is she still knows us and enjoys our regular visits. We are pleased knowing that she is well cared for in a home atmosphere. When I cannot take care of myself, I hope to join her.

Thoughtful questions for our readers:

What we have heard among leaders of Maryland Villages as the motivation for founding a new Village program arises from several needs. Often they express a strong connection to a beloved town, a specific neighborhood full of friends, or being near a part of nature like the Chesapeake Bay. Gardeners in particular are loathe to leave their plot of heaven-and many treasure the intergenerational connections and friendship they have in neighbors. Some who are founders of Villages started with the idea of freedom and independence for all seniors in their area so there would be an alternative choice to relocation to a typical one level living two bedroom condo in a seniors-only assisted living location.

Whatever the initial motivation for making a plan to age in community intrepid Village joiners have been creative about exploring options. As leaders begin the process of learning as much as they can there is a dramatic increase in awareness about resources for older adults. Most wise Village members learn that proper planning is critical, and also soon realize that there is a great deal of variation about how prepared friends and neighbors might be for their own aging. For many people it is the process of joining a Village that initiates a deeper level of contemplation and planning. Once you determine that you wish to find an option for living with a great deal of freedom, then slowly you begin to address what might come next as you face other aspects and complications of aging.     Then you bemoan the fact there is no full bath on your main living level! For other individuals the need to plan for more support comes suddenly -is a reaction to personal health crisis or a caregiving need of one’s spouse when a hospital bed is placed in your dining room.

What does “home “ mean to you?

How attached are you to the place where you live now?

For some, home is the perfect house, perhaps designed and built by you. For others a house and large lawn might be something you would be glad to be finished maintaining!     The actual “meaning of home” can be quite tender for each of us. As adults we make our home in many ways, some move often with jobs requiring frequent relocation, so strong feelings for a house or yard maybe has less attachment, then a friend who has had the same residence for 30 years when retirement nears.

Most of us have images, scents and tastes that conjure up what “home” means to us from our childhood and from various parts of our life. My childhood home had a beautiful maple tree resplendent in autumn, and a red rose bush that wound around the fence next to the front walkway, as an adult I still miss the home I lost with a fireplace. But can a place still be a home if it is inaccessible to you once you have mobility impairments?

Many never consider the changes that might emerge in the next phase or stage of life. Some of us are natural planners, others live in a more spontaneous manner.   However at some point folks who lean towards being prepared, we older girl scouts and boy scouts, and those who have worked in gerontology know it is time to get more organized for what comes next. For many leaders of Villages we have met the awareness that planning is an important task-shows up when one takes on responsibility for caregiving an older parent with serious health concerns. Suddenly an adult child has to address these decisions for a vulnerable parent and begins to wonder how they might become better prepared. Then the idea of ones “heart home” and the possibility of leaving it or adapting it arises.

Most of the Maryland Village programs offer frequent educational discussions and lectures or referrals to meet with a planning professional that help can help foster this planning. Finances play a part, what can you afford to do to make your current home suitable for advanced age? Do you have resources to hire paid helpers? Does your town have one level living options that are affordable and near to you? Much is learned around the informal coffee klatches or through the kitchen table wisdom and knowledge exchanged among trusted friends, other information is gathered form reading, websites, paid professional advice.

MIght you have insights to share? What have you learned that might be useful to others in Maryland who are passionate about aging in place? How have you prepared for potential age-related changes in your mobility or health that might necessitate a change in your home? Have you already made similar structural home modifications? What did you find useful in this process of examining home modifications? In additions to changes in the household have you discussed other care alternatives that might emerge in terms of behavioral or health concerns like memory loss? If you consider resources like relocation to Assisted living have you taken steps to visit some programs near to you?

We would love to hear your thoughts.

Leaders who Listen Build Stronger Relationships

IMG_4264I like listening to the opinions of what ordinary people who are doing extraordinary things so I can learn from what they say. In discussions with builders of Villages they often reveal that engaging neighbors and other community members to donate time and resources is a whole other tactic from supervising a paid workforce.   Sometimes they note that they are using skills they might have applied in a prior professional life-but almost always indicate they have to acquire a few new leadership techniques, new leader skills more suited to managing volunteers. Volunteers are not only the programmatic ones recruited to provide support but all the unpaid leaders who work without pay-especially those doing the early the early planning of the Village.

When everything is working well, when leadership is strong and members are active and committed there is so much joy and hope. You feel connected to a group of like-minded others and capable of navigating whatever comes. There is a wonderful enthusiasm for the choices made to stay in one’s neighborhood, to be part of a group.  It’s as if life is a bowl of cherries.

Things work well when communication and teamwork happen even among individuals with varying backgrounds. People come together to build a new model with a great variety of professional backgrounds and hope. Just like you can not predict who your next door neighbor might be it is impossible to predict who will volunteer to help establish a program. Often there are those who have worked in non-profits, some nurses, psychotherapists and social workers, teachers, and usually business leaders, scientists and lawyers, or others who have been on advisory boards. The beauty of such a team is their wide and diverse skill set.

Good communication is the center for creating the social glue that is essential for a highly functioning Village. Experienced and insightful leaders know that they must learn to listen to excel as a communicator. Like any organization-some leaders are much better at listening and engaging a large group-while others have trouble allowing shared leadership. Of course in a Village there are multiple leaders so it is important to observe how the group learns to listen and how cooperation is fostered. For some this aspect of leadership is more difficult than for others especially if most of their work experience did not include teamwork or volunteer management. Some of our Village CoP members have shared situations that were challenging with a less than ideal leader or have struggled with some personality characteristics that made group process and team committee work quite difficult.

In listening to the discussions of what those building local Villages are thinking, all of them understand that typically one does not build and maintain a Village alone.   Rarely a Village is created by a solo individual-but not usually. The programs that have emerged in Maryland are developed by groups of consumers, practicing self-direction, careful group decision-making and lots of hard work.

To summarize leaders can help their Village thrive if they listen deeply and to support the opportunities that will building connections between members. This is critical in organizations where much of the work conducted is done by volunteers. What we know about volunteers is that they need to feel connected For most programs to thrive there must be relationships of shared commitment, shared values, there must be a sense of trust that together you will stick with it until the Village comes to fruition. The importance of the capacity of the leaders to go beyond just offering guidance and direction and instead to lead in a way that invites cooperation and collaboration is important.

Later after incorporation when a program opens it’s doors for business trust must continue-among the group because you have made a commitment to each other for all the times when the potential challenges of aging show up. For many this level of social commitment is quite new. Some program leaders call this the social glue that makes a Village tick.

Questions for our readers:

What have you noticed about leadership in your Village?

How has your group learned to foster teamwork over a long period of time?

How have you benefitted from the diverse array of backgrounds on your advisory Boards?

Have you rotated leadership roles?

What have you identified as unique for managing volunteers as compared to a paid work team?

What resource guides, books, tools have been most helpful?

%d bloggers like this: