A return to helping one another?

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.