Jan. 30, 2013 — Instead of either leaving older Americans to fend for themselves as they become less mobile and more isolated, or stowing them away in nursing homes and other facilities, an old idea in secular garb — a community of mutual assistance — has begun to find life in virtual villages scattered throughout the United States.
While it seems to be improving the lives of its members, the “Village model,” as it is known, has limitations, including a strong tendency to replicate the racial and economic homogeneity of the places where Villages arise.
Moreover, Village administrators we spoke with were unable to articulate a broad political or philosophical vision of mutual assistance as an alternative to the far more dominant social practice that might be characterized as “ignore or transplant.” But Villages do appear to provide rudimentary aspects of genuine community that are worth further evaluation.
Over the last decade or so, some 90 Villages have cropped up across the country, with an average of about 250 members each.
Villages offer members services including transportation, assistance with grocery shopping and home maintenance, friendly visitors, exercise programs, cultural excursions, and classes.
Villages, which operate as nonprofits, are funded primarily through yearly dues paid by members, which average about $500, as well as by private donations. Some Villages may fairly be seen as something like concierge services, referring members to approved paid providers who will help for a fee, but others emphasize members directly helping each other.
The little things aren’t so little
In Newton, Massachusetts, a suburb of Boston, aging residents founded “Newton at Home” in 2011. It is a Village that prides itself on serving its members predominantly through mutual assistance.
Recently, a member (we’ll call her Mrs. Smith) was in Boston running errands. While she was out, Maureen Grannan, executive director of Newton at Home, recounted, she fell and badly broke her ankle. Mrs. Smith was taken by ambulance to the hospital and sent in for surgery. As soon as she could, Mrs. Smith called the Village office and asked for help. (Most Villages have one full-time paid staff member who takes calls and coordinates services.)
“So we scrambled and we got a couple of volunteers to go over to Cambridge, near Harvard Square, pick up her car, [and] drive it back,” explained Grannan. Once Mrs. Smith was moved to a rehabilitation facility, the Village sent a volunteer to her apartment to gather clothing for her stay. “And we’ll be helping her out when she comes home,” Grannan said. “What we’ll probably be doing is grocery shopping, picking up prescriptions for her, whatever she needs.” These services will be provided by other members and volunteers — free of charge.
Villages claim that help like this is crucial in allowing older people to stay at home.
“As people grow older they lose muscle mass, strength, [and] the ability to do things around the house that they used to be able to do,” Grannan explained. Simple tasks like changing a light bulb, getting trash barrels to the curb, fixing a door that won’t close, or a broken window can seem insurmountable. “They can’t keep up with home maintenance,” Grannan said.
Similarly, if older people can no longer see well enough to drive, they won’t be able to keep up with doctor visits, grocery shopping, housekeeping, and cooking, and they can begin to feel overwhelmed. They might stop venturing out to see friends, which can lead to isolation-related depression. They, or their family members, might then begin to feel that they should leave their home because they can no longer fully care for themselves and their quality of life has declined.
“It’s a compilation of a lot of little things that make people leave and say, ‘I can’t do this anymore,’” Grannan said.
According to a 2010 AARP survey, almost 90 percent of people over the age of 65 say they want to “stay in their residence as long as possible.” In other words, they don’t want to go to retirement communities, assisted living, or nursing homes.
“The place people really fear is nursing homes,” said Jon Pynoos, professor of gerontology, policy, and planning at the University of Southern California. Pynoos said that people’s fear of leaving home centers around a “loss of control and power over their lives.” Many people imbue their homes with symbolic meaning. “They might have raised their children there,” he said. “It’s decorated in a way that’s a statement about who they are. And when you’re in your place, you’re the king or the queen.”
Kathryn E. McDonough is the executive director of Capitol Hill Village in Washington, D.C., the Village that pioneered the volunteer-centered approach when it launched in 2007. According to her, the most recent generation reaching retirement age — the one establishing Villages — doesn’t want to live in housing for the elderly. These are people, McDonough said, afraid of not being able to have what they want to eat, not being able to see the people they’ve known all their lives, and not being able to do activities that they like. They know this can happen, she said, because they watched their parents go through the experience. From this they also know how expensive care facilities can be.
Restoring a more robust life at home
But staying at home (according to the most recent census data, the vast majority of the elderly do — only 1 percent of those aged 65 to 74 lived in a nursing home, while 18 percent of those aged over 85 did) does not necessarily mean that the life being lived at home is fulfilling. Older people, not infrequently, suffer from isolation and depression as they lose contact with other people. Friends and spouses die, and getting out of the house becomes more physically challenging.
“Villages provide a way to bring together older adults who otherwise might be more isolated from one another,” explained Andrew Scharlach, a professor and director of the Center for Advanced Study of Aging Services at the University of California, Berkeley. Villages keep older people “more active, more engaged, more involved — to create more of a sense of community,” he said.
In addition to providing help with chores and errands, Capitol Hill Village is among the subset of Villages that offers a wide array of social activities. It has frequent discussion groups on cinema, literature, and politics (which some younger residents of the neighborhood also attend), outings to theatrical productions and sports events, dinners and potlucks, a walking club, and Qigong (breathing and body movement) classes. Its volunteers and members will even visit other members simply to offer company. According McDonough, almost all of the organization’s social programs and services are provided by member volunteers. The weekly Qigong class, for example, is led by a member who is in her 70s and has multiple sclerosis, and McDonough said, “she has a following of 15 members.”
Giving and getting
As currently constituted, Villages are a self-selecting group: they are populated by those who have decided it’s a good idea to come together to help each other as they age. But even in this context, those in need of help are sometimes reticent.
Some people don’t want to give up the privacy required to let a volunteer they may not know (or even someone they know) into their home to help with cleaning and laundry, for instance. If someone is not accustomed to asking for help from peers and neighbors, then it can be a challenging prospect. It requires trust and allowing others to see vulnerability, and entails a more personal connection than when paying a third party for help.
At Ashby Village, in Berkeley, California, Andy Gaines, its executive director, said that when the organization started two-and-a-half years ago, many of its members were people who already understood the culture of mutual aid (if not necessarily its mechanics). But the task of acquainting more people with the idea and experience of mutual aid, a fundamental precept of Ashby Village, and with the trust it requires — over 80 percent of its services are provided by volunteers — is a constant process.
“It’s always coming up in different ways,” Gaines said. “We address it on the pragmatic level by building people’s comfort and confidence that they can ask for something.”
From the outset the organization had challenges soliciting requests from members; only a few calls came in each month. “People just didn’t want to ask,” he said. “Either they didn’t perceive themselves as needing [help], or they didn’t necessarily feel the sense of confidence yet in the safety, the value, the skill they would get,” Gaines explained. To address this, the Village “had a pretty active marketing campaign” to encourage people to request help. As was true from the beginning, Ashby Village has had no shortage of assistance. Today there are 130 volunteers to help its 250 members.
The service most frequently requested and provided by Ashby Village is transportation, which is true at the majority of Villages across the country. But, as was pointed out in an Ashby Village newsletter, there can be a variety of other needs, including some which may not immediately occur to members: “help arranging a veggie platter for wedding centerpiece,” “learning to sew on a sewing machine,” “help studying for driver’s license renewal,” and “taking 14 bags of books to the bookstore.”
A way to organize ad hoc local assistance
Capitol Hill Village has about 370 members and about 275 volunteers (a group comprising, like most other Villages, both members and nonmembers). “It creates something that’s very different from a concierge service,” McDonough said.
There is neither a minimum commitment of volunteer time, nor a cap on the amount of help members can request at any of the Villages with which Remapping Debate spoke. “People come to volunteer because they want to,” not because they have to, said Grannan of Newton at Home, which has 160 members and 85 volunteers. About Ashby Village’s volunteer policies, Gaines said, “We’re not interested in creating an economy of giving, but rather really promoting this idea that at different times in life we’re all going to need [help].”
McDonough said Capitol Hill Village acts as a galvanizing force. “We’re creating a way for people to come together…an entire group of people relying on one another,” she said. “It’s almost like a sense of family.”
McDonough added that using the Village organization to coordinate volunteers with jobs is an effective way of managing mutual aid. “Instead of having to call your neighbor every time you fall down, or having to call your neighbor every time you need something fixed in your house…you can call the Village,” she explained. With the Village serving as the middleman, “the volunteer is empowered to say ‘no’ or to say ‘yes’…and the member is empowered to ask for help and not feel guilty about it,” McDonough said.
Ashby Village’s Gaines agreed that providing referrals to paid services has its place when connecting members with trusted vendors for bigger jobs, such as a roof replacement. But offering services for free and embracing the model of “members helping members” has been central to making Ashby Village work. “What really makes the Village model particularly powerful is that we’re getting people to engage in mutual giving,” he said.
Is it a movement?
Although they practice it, none of the three Village directors we spoke with, McDonough, Gaines, or Grannan, seemed to see mutual aid as a model for transforming the way our larger society treats the aging.
When Remapping Debate asked Grannan why her organization relied on mutual aid, she simply said, “We live in a community that believes in volunteering.”
One of the founders and a current board member of Newton at Home, Dr. Cynthia Pill, said that their choice to be volunteer-centered “made more sense to us” because it was “a warmer human way.” When Remapping Debate asked whether Newton at Home had a philosophy about how our society should treat older people, Pill offered a generic response: “Respectfully.”
In similarly broad terms, Gaines said Ashby Village’s philosophy is implicit through how its staff, members, and volunteers engage with one another. When asked why not make this more explicit, Gaines said, “It would be interesting to work on creating a statement about that,” adding that maybe the Village would do so.
None of these Villages have had deliberate internal discussions about the potential for their work to lead to a larger movement to transform aging in the U.S. “I don’t think Villages are going to change society,” McDonough said. “I’m really focused on making sure this organization is going to define itself and be able to figure out [what] it is and who it’s going to serve.”
David Spataro is a doctoral candidate at City University of New York who has studied mutual aid as it is expressed both as a response to crisis and as an ongoing component of permanent community. Spataro said that the interdependence that exists in the volunteer-centered Villages sounds like the kind of mutual aid a family would have — in other words, a form of interdependence that is exclusive. These organizations are rejecting the ways older people have been treated in our society, but Spataro said their work doesn’t seem to reflect a grappling with “the larger structural issues.” He said Village members’ practices make growing older meaningful for them but not in a way that transforms American society’s broader notions of aging and how we treat each other.
Spataro categorized what Village members are doing as “smaller-scale projects based in mutual aid and cooperation. But they’re not focused on transforming life.” Their function thus far, he said, has been being “engaged in maximizing cooperation to help their own lives.”