Village Model for Aging in Place
The Village Model is a membership-driven grassroots organization that underlines the provision of supportive services such as transportation, home maintenance, and companionship (Greenfield et al. 2012). It is an innovative consumer-driven approach that aims to promote aging in place through a combination of member supports, service referrals, and consumer engagement (Scharlach et al. 2011).
“Aging in place” is defined as the preference of an older adult to live in the residence of their choice as they age and being able to have necessary support system and service as their needs change with the age.
Policymakers have long supported and focused on several concepts and initiatives regarding aging in place, livable communities, and long-term care services. The Administration on Aging (AOA), Center for Disability (CFD), and Center for Aging and Community have combined to become the advocates for community living. “Aging in place” promotes the ability of older adults to remain in their homes and neighborhoods even in the face of functional decline. An increase in the disability-free life expectancy has enhanced the desire of elders to remain in their own homes and community for as long as possible rather than living in residential care (Crimmins et al. 2009). The Village Model emerged as an approach to aging in place with goals of encouraging and allowing older adults to become empowered, active, and engaged in their communities (Scharlach et al. 2011; AARP 2011). The Village Model offers community-based initiatives that have addressed the longing of elders to age in place.
The Village Model is an organized grassroots community approach to helping older adults remain in their own homes in the face of frailty or disability (Scharlach et al. 2011; AARP 2011). Member supports, service referrals, and consumer engagement (Scharlach et al. 2011) are key factors of the Village Model. Villages are created and administered by the people of the community where the volunteers and paid staff manage the services. This community effort is a critical aspect of making aging in place an effective possibility and eventual success. The Village concept of community preparedness for an aging population provides support systems, companionship, and educational and recreational opportunities that enable senior people to age at home with dignity (Scharlach 2012) and has the potential to reduce unnecessary institutionalization of elders (Thomas and Blanchard 2009).
The Village Model concept emerged in 2001 with the establishment of Beacon Hill Village (BHV). The BHV was started by a group of seniors living in the Beacon Hill neighborhood of Boston, MA, in search of a way of helping each other to stay in the neighborhood for as long as possible (Greenfield et al. 2012). The Village Model concept captured the attention of policymakers, community developers, and the people located on the periphery very quickly. By 2012, there were about 180 Village Models nationwide out of which approximately 50 were in their developmental phase (Village-to-Village Network, 2013). Currently 231 Village Models are operating in the United States, and 86 are in their developmental phase (Village-to-Village Network, 2018). The national Village-to-Village Network is an online system that supports and updates the development of Village Models. Most of the Village Models are in bigger cities such as Boston, MA; Los Angeles, CA; and Washington, DC. The studies on aging preferences and available resources to aging have offered the feasibility of the Village Model.
Village Model Initiation in Oxford, Ohio
In the small college town of Oxford, Ohio, almost 6% of the population of 21,371 is 65 and older (US census, 2010); the population skews young because of the presence of the university. Efforts to enhance aging in place took place in Oxford because of the strong desire of elders to maintain independence for as long as they could and to avoid institutionalization. Some entities that were concerned about “aging in place” for the City of Oxford were the Ohio Department of Aging (ODA), area Senior Centers, the Council on Aging of Southwestern Ohio, Inc. (an Area Agency on Aging), local providers of health and social services, housing entities, community development organizations, and others. The City of Oxford is a relatively small town seasonally dominated by a 20+ age cohort which made the city very challenging regarding its development as a retirement community. However, many people expressed their preference to live in Oxford in their older age either due to retiring from positions within Miami University or because of the well-established resources at the University. Resources from Miami University such as the Institute for Learning in Retirement (ILR), the fitness and recreation center, transportation services, and libraries were ideal to community-dwelling older adults.
In the process of taking steps toward making Oxford a more comfortable place to grow old and a more attractive place to retire, Oxford Senior Citizens, Inc. (OSC) initiated the idea of establishing a Village Model in 2013. OSC collaborated with the City of Oxford and multiple community groups to explore The Village Model. The concept of aging in place played a vital role in the Village Model project because its goal was to allow individuals to stay in their home as long as possible by creating a network of resources. The finding from the exploratory study conducted by the OSC suggested that the elders from Oxford enjoy the intergenerational and diverse community in which they were living and yearn for the continuity of such a society.
The Oxford Village Model envisioned a network of service providers and activities that would flex and grow with the members’ needs. This network is made available through telecommunication, and virtual means and members can access services such as transportation, home repairs, social and educational activities, and other day-to-day concerns on an “as needed” basis. Telecommunication has been a significant part of life for younger generations, but its use and significance are not limited to one age category because it is ubiquitous (Vanderheiden 2006). Although advanced technology is not typically user-friendly to older generations, the enthusiasm of many older adults to learn advanced technology has encouraged organizations to rely on virtual and telecommunication options.
Aging in Place
In the United States, people over the age of 65 constitute almost 13% of the entire population (US census, 2010). This figure is expected to increase to 20% by the year 2030 (Applebaum et al. 2009). Meanwhile, in the trend of aging in place, a network of support systems to an aging individual has arisen to support older adults in their desire to remain in comfort of their own home regardless of potential disability (Gardner 2011). As baby boomers begin to retire in large number, they will have different expectations than those of their parents and grandparents. Many of these changes have to do with the fact that today’s retirees expect to live much longer than their parents or grandparents (Fowels and Greenberg 2011).
Aging in place is a social network which helps older adults in maintaining well-being and quality of life (Gardner 2011). It is also defined as remaining in the community, either in their family homes or in supported accommodations with some level of independence, rather than having to move into residential care (Davey, Nana, de Joux, and Arcus 2004). Aging in place is getting popular in recent years, and much of this shift is due to the general increase in home and community-based services. The availability of support systems such as transportation, meal programs, and home repairs, social and educational activities strengthens the ability to retain independence and fulfills the need to grow old gracefully. Aging in place embraces much broader concepts than just being able to live at home at an older age because it is related to a sense of identity both through independence and autonomy and through caring relationships and roles within the places people live (Davey, Nana, de Joux, and Arcus 2004).“It is the ability to continue to live in one’s home safely, independently, and comfortably, regardless of age, income, or ability level” (http://www.ageinginplace.org). Aging in place represents a “fit” between individuals and their social and physical environments (Greenfield et al. 2012). Therefore, policymakers are seeking better opportunities to increase services and to reach a broader population of older adults and assist them in remaining independent and healthy in the comfort of their homes for as long as possible.
Most of the studies on aging in place have concluded that land use, transportation, and housing policies all contribute to the livability of a community. For example, land use policies may include the establishment of shopping centers or medical facilities within walking distance of residential areas. Transportation policies could involve improving traffic laws that protect pedestrians and establishing affordable public transportation services. Housing policies may promote the building of accessible and age-friendly housing. Such changes and efforts can help older adults achieve their desired goal to remain independent and in their own homes as they age.
Disability and Aging in Place
While physical health declines with age, it does not necessarily mean that getting older means being incapacitated or severely disabled. Disability in older age is commonly measured by the ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs) (Crimmins et al. 2009). Aging in place could be a practical and appealing alternative to people with physical limitations or disabilities with some adaptations to the physical environment and support systems that facilitate activities of daily living. These include age-friendly/handicapped accessible houses, efficient public transportation for disabled, pedestrian accessibility, and home health-care services (Ball 2010). Moreover, the creation of a network of community-based services and supports that focus on individuals’ needs, values, and preferences can enhance the ability of elders to age in place.
The reports of declining rates of disabilities among the aging population (AARP 2011) have not only reinforced the preference of people with disabilities to age in place but also have led to optimism in refining and defining the policies on aging for elders. Despite experiencing a late-life disability, most elders feel they are successfully aging when they mature at home (Romo et al. 2012). However, mobility disability is one of the most feared impairments among older adults because this disability limits a person’s movement from one place to another, which in turn becomes an obstacle for independent aging.
The institutional bias of long-term care has placed a massive burden on state budgets. The trend of taking care of older citizens is shifting toward a more preventive and proactive perspective. “The institutionalization to cope with the needs of frail older people is gradually being seen as morally unacceptable” (Thomas and Blanchard 2009, P.16). Therefore, aging in place with the help of The Village Model has grown as a feasible notion.
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