BY PROFESSOR CINNAMON DORNSIFE
Aging in Cities—Longevity is Opportunity
Over the next three decades, the percentage of urban residents who are elderly will rise to 20 percent, from 13 percent in 2010. The public policy challenges of addressing the needs and priorities of the elderly and their families will be huge. Approaches will vary, depending on the setting and context.
The Village Movement—Neighbors Helping Neighbors
Today, I am encouraged by the breadth of opportunities and new ideas. Among the most promising, and increasingly widespread, is the village movement, prominent in North America, Europe and Australia, where seniors are supported as they “age in community” with a range of services offered by one neighbor to another neighbor. Services include transportation (to the grocery store, a medical appointment, a place of worship), shopping (for groceries, medicines, or other necessities), light housework, yard work or home repairs (raking leaves, shoveling snow, changing a light bulb in a hard to reach ceiling fixture). Also included are services aimed at companionship, such as drop-in visits for a cup of tea, sharing a meal, or community outings to museums or other cultural events. Reading to the sight impaired, singing or playing music in a home setting also allows house-bound seniors increased opportunities to “age with joy.” The business model of the village is a membership fee for service. The membership fees are modest, ranging from $300 to $500 annually for a full membership, with fee reductions available for those on reduced incomes. Services to those who need them are provided by neighbors of various ages who volunteer their time, and who pay lower membership fees that are partially tax deductible. In addition to these services offered neighbor-to-neighbor, there is a big push for building or customizing homes to allow seniors to successfully “age in place.”.
Communities Act—Governments Pay Attention
As people age, the prevalence of dread diseases—like cancer, diabetes, and dementia—rises. By age 65, around two thirds of seniors have at least one chronic disease. What is available for these seniors? Communities around the world have taken initiatives based on their own cultural traditions.
One of the most interesting I know about is the Kintun concept from Santiago, Chile. Kintun is roughly translated as searching. Their vision is to search for awareness and connection, but also for treatment. At Kintun, a facility tailored to the needs of those diagnosed with dementia is embedded within an adult day care center, which is embedded within a community center, which is itself embedded within a community. This approach has the benefit of de-stigmatizing those diagnosed with dementia (Alzheimer’s is by far the most common form of dementia, but not the only one). The seniors’ quality of life is increased because of the opportunity to interact with others—research shows that both the quality and the length of life are shortened with isolation. I recently learned that the Chilean government has become intrigued with this concept, and has made funding available for twelve more centers based on this model to be opened throughout the country.
In Singapore, the Tsao Foundation, whose vision is “longevity is opportunity,” has designed and funded a center located at a subway stop, offering a range of medical and social services that are easily accessible for seniors from the entire city via public transportation. Their mission is to enhance the quality of life of older people by empowering them with informed choice, self-care and autonomy. The government was so impressed with the effectiveness of this model that the self-care training developed by this community-based effort has been widely replicated and expanded.
What about aging in cities in the developing world, where relative material well-being is substantially less than that of Singapore or Chile? Widening inequality and exclusion, including lack of equal access to basic services and a lack of voice are all social problems that are exacerbated for the elderly. This is a substantial challenge for government, community and family, but I am encouraged by the imaginative ideas of social entrepreneurs around the world, such as India’s Aravind Eye Hospital and Jaipur Foot, which provide cataract surgeries and prosthetics at substantially reduced price points for those at the base of the pyramid, including the elderly.