WHEN THE LONGEVITY REVOLUTION HITS YOUR TOWN
7 January 2009 
Stella Gerson rides a Whistlestop shuttle
to a senior center in San Rafael, Calif.
BY CECILY O’CONNOR
It’s no problem for Stella Gerson to walk down to the bus stop. Getting home is the hard part.
“I have to go up a hill to my house,” said the 89-year-old San Anselmo, Calif., resident, who suffers from macular degeneration, a disease that blurs her vision.
In Northern California where Gerson lives, transportation is one of several pressing needs for a rapidly graying population. Age-friendly housing, affordable healthcare, walkable neighborhoods, crime-free streets and social activities are others.
As they age, many residents think about these needs by asking themselves, “Is my community a great place to grow old?”
That question is becoming more urgent as 78 million US boomers race toward retirement like a “silver tsunami” that, by its sheer size and market power, will change the way we think about aging. The answer will likely redefine retirement, not only for boomers but for the generations that follow.
“We have a wonderful challenge ahead,” said Christine Kennedy, chief executive officer of the Leading Age Institute, which helps communities launch “age-friendly” programs. Boomers are “coming at the infrastructure of cities at a rapid pace, and if we don’t prepare for it, we’re in trouble.”
While the problem is national, solutions must be tailored to specific needs of each city and county. Five diverse Northern California cities - San Francisco, San Rafael, Santa Rosa, Sacramento and Vallejo - reflect the range of challenges that face communities across the United States.
Based on dozens of interviews conducted over the course of three months, we examine why it’s important for a city to become age friendly; the challenges raised by the graying population; and shortcomings that towns need to address. We also examine initiatives by individuals who are leveraging community resources to fill needs that cities can’t address.
Changes in cities over the next two decades will be driven by the “longevity revolution” as the ranks of US adults over 60 soar and many more lifespans stretch past the century mark. While these changes present challenges to cities that are ill-equipped or unprepared, they also serve as a wake-up call to tap into the skill and expertise of older adults. These elders represent a key to the solutions, whether it’s through volunteer work, sharing professional experience or helping families with childcare.
As cities consider the entire life-spans of their residents - children, working adults and the retired - officials are forced to rethink services that define age-friendly living. Those include housing, transportation, healthcare, civic participation, safety and employment.
Addressing that list requires that residents:
– are close to health services; have access to stores;
– can engage in social and cultural activities;
– and live in tight-knit neighborhoods where residents care for one another.
Downtown centers often become hubs to these amenities. For example, Portland, Ore., and New York City are trying to meet many of these goals through their participation in the Age Friendly Cities Project started by the World Health Organization.
Outside of services, the “aging friendly” concept boils down to design, said Andrew Scharlach, professor of aging at the University of California, Berkeley. It’s “more about how we create communities that bring people into contact with one another and make it easier” to live.
One big challenge is addressing “intersecting interests” of aging populations and people with disabilities, added Patrick Fox, a sociologist and co-director of the Institute for Health & Aging at the University of California, San Francisco.
“There’s been this schism where ‘These are programs for older adults’ and ‘These are programs for younger adults,’ and not a lot of dialogue or thinking about how the needs of these population groups might be similar and dealt with in a holistic way at the community level,” Fox said.
‘Getting Worse’
Local governments nationwide are struggling as their cash flow plummets along with declining home values and sales tax revenue.
In California - which tends to set trends nationally - 24 percent has been cut from programs administered by the state Department of Aging, according to the California Association of Area Agencies on Aging. That includes funding for a long-term care ombudsman in each county who supports patients living in nursing homes and assisted living facilities.
Meanwhile, adults are trying to find their way through their own fiscal land-mines: rising healthcare costs, insufficient retirement savings and falling home equity. “Economic security for older adults is a problem that’s getting worse,” Fox said.
Most boomers want to age in place. They want to retire in the cities where they raised their families, started businesses and forged neighborhood ties. And younger residents worry about competing with the older generation for limited community resources.
“There are a lot of multiple and conflicting needs to address,” Fox said. “In these times, it’s difficult to sustain things that may have smaller funding base than they had in the past.”
The trend is likely to accelerate because local governments count heavily upon sales and property taxes that are falling along with consumer spending. The state of California, currently facing a deficit estimated at over $40 billion, is in no position to help.
“The safest thing to say is, with this large deficit, there are going to be service reductions in all areas, including senior services,” said Patricia Fruiht, assistant to the city manager of Santa Rosa, which is facing its own $20 million deficit
Conditions in Vallejo, which declared bankruptcy in May, are much worse. “Shoring up core services will precede new initiatives such as aging,” said Craig Whittom, assistant city manager. “It’s not something we’re happy about at all, but that’s our reality currently.”
Given cities’ tough position, members of the community are coming together in various ways - from social networks to fundraising - to address the entire generational continuum. Too often, solutions that could complement different age groups such as housing or day care are overlooked.
“We need to see these as multigenerational communities, and that’s the way we need to create the language,” said Barry Barkan, founder of the Elders’ Guild in Berkeley, Calif.
The message is just starting to get through as cities discover they need to evolve or be crushed by the longevity revolution.
As life spans lengthen, cities are trying to be all things to all age groups. But they’re just scratching the surface.
Committees, studies and action plans are baby steps on a long road toward coordinating services and resources before a crisis sets in. The down US economy is adding to the mess.
If you took a tour of Northern California, you’d see a microcosm of what’s happening elsewhere. Big cities like Sacramento are better prepared, thanks, in part, to a downtown ripe for redevelopment. Others like San Rafael, the county seat of the nation’s richest county, are watching new housing proposals dry up as the economy contracts. And not one city has figured out how services for different age groups can complement one another.
Planning prudently now can mean the difference between a highly livable multigenerational city that succeeds, or bankrupt communities struggling with poverty and street crime.
Dozens of interviews with officials, activists and residents in five Northern California cities showed that communities that choose to become age-friendly now are positioning themselves for further growth as 78 million baby boomers move into their retirement years over the next two decades.
Three main concerns - housing, transportation and health services - are equally pressing, and in many ways, go hand in hand.
Sacramento is one city that recognizes this. A big part of its long-term general plan centers on downtown development. It plans to make the city walk and bike friendly, to build housing in areas like the old rail yard, to emphasize cultural amenities, and to expand the existing light-rail system.
The “goal is to create a 24-hour destination where there are people who live and work downtown, so streets are enlivened by residents in the nighttime, not just workers in the daytime,” said Tom Pace, long-range planning manager. “That will make downtown safer and appeal to a certain segment of the older population.”
By comparison, Santa Rosa has much more planning ahead. Culturally speaking, it’s hard to beat. It’s nestled in the wine country and offers a charming downtown full of restaurants, making Santa Rosa attractive to both young and old. City officials are crafting goals to keep it that way.
“Now is the time to start,” said Shirlee Zane, chief executive officer of the local Council on Aging. Zane, recently elected to Sonoma County’s board of supervisors, created a mayor’s advisory committee several years ago to improve issues for seniors and the disabled.
Limited bus service, with routes that run until 8 p.m., is one improvement area, Zane said. “If you’re a senior and want to go to a movie or public meeting, you’re limited on the bus routes,” Zane said. “That’s an example of ways we need to start looking forward for how we’ll meet the needs of our aging population.”
Healthcare is another, although cities like Santa Rosa have a somewhat limited role because health is largely a county service. But local officials are mindful of the fact that affordability and access is a major issue residents of all ages face.
“Unless you belong to Kaiser, (it’s) really a problem to have access to specialists in Sonoma County,” said Zane, noting its Medicare physicians are reimbursed at a lesser rate than doctors in neighboring counties because Sonoma County is considered “rural.” The federal government believes things cost less in rural areas, even when it’s the nation’s premier wine region.
‘We Can Always Do More’
To the south, Marin County, the grayest and richest of all counties in California, recently took a step in the right direction by opening a health and wellness center in San Rafael. It situated the campus near a community center and school.
Still, San Rafael faces broad problems, many of which are mirrored in a recent report on the county. Due to a rapidly aging population, Marin needs to address shortages of in-home support services, cheaper health care, affordable housing and transportation, according to the nonprofit Marin Community Foundation. An action plan by the foundation and civic leaders is in the works to fill those gaps.
“I think we’re doing pretty well,” said Linda Jackson said, principal planner in San Rafael’s Community Development Department. “We can always do more, though. Looking ahead, I do worry about housing and accessibility…”
Older residents know first-hand where cracks in service are surfacing. That includes certain areas of San Rafael that aren’t near public bus routes, said Olivia Schultz, who lives in the Peacock Gap neighborhood. “We did have service, and no one took it,” she said. “But we were all young then.”
San Francisco also wrestles with the “age-friendliness” of its neighborhoods, said Ann Hinton, director of the Department of Aging and Adult Services. It’s tricky due to the city’s hilly composition, which results in stairs and tough access.
“We may have more services like transportation, but then you have issues of, ‘How do you get in and out?’” Hinton said. Stair lifts is one solution worth exploring, she said.
Huge Potential
San Rafael also is encouraging new design features that help residents age in place. One idea is second units that can be added to single-family home properties to lodge downsizing boomers, or a caregiver.
“When you think that we have around 9,000 single family homes in San Rafael that would qualify under our rules, there’s huge potential,” said Jackson, noting the city has conducted educational workshops over the past three years, and collaborated with other agencies to lower fees and ease the permit process.
At the same time, San Rafael could benefit from more affordable housing downtown. However, the city relies on private development, and proposals aren’t being made because builders are having a tough time securing financing.
San Rafael also supports the idea of co-housing, in which residents own their own homes and benefit from shared land, workshop areas and a community room for eating meals. But the high cost - and scarcity - of land is a challenge. “In Marin and in San Rafael, there’s little vacant land left,” Jackson said.
Of course, co-housing developments don’t have to be created from scratch. Many have formed organically in long-standing neighborhoods made up of condos or single-family homes. That includes one in Davis, Calif., about 11 miles west of Sacramento, and another in Berkeley, just across the Bay from San Rafael.
Boomers’ interest in these types of alternatives continues to build as people look to create stronger communities and deal with increasing economic pressures on cities and their residents.
‘Very Challenged’
Of all the cities on our tour, Vallejo residents face the most financial fallout, in the form of decreased service. That’s because the city is weighted by a $16 million deficit and declared bankruptcy last spring.
Vallejo “is very challenged to provide a basic level of services to our entire community,” said Craig Whittom, assistant city manager. “Our current effort is to emerge from bankruptcy in a manner where we have a breadth of service that provide basic municipal services (fire protection, police) to the community.”
Whittom said it’s uncertain how quickly Vallejo will be able to build upon the basic services. For example, he said he’s “not optimistic” Vallejo can fund the senior center “at a level that we would like to.” The city owns the Vallejo Senior Center facilities and leases it to a nonprofit that administers programs there.
Yet before Vallejo’s financial fiasco, housing was one area it had built up over the past 15 years, creating three affordable senior developments, Whittom said. Another high-end project called Belvedere is about three-quarters built. It was intended as a gated community for adults over 55, but that age restriction is being revisited to create a multi-family project, and eventually, sell more units.
San Francisco has worked on aging for a long time, but it faces big budget shortfalls. Yet long-term care is one area in need of funding, according to a proposal by the Long Term Care Coordinating Council (LTCCC). That proposal seeks to improve and expand the city’s network of home, community-based and institutional long-term care services between 2009 and 2013.
With one in eight boomers expected to develop Alzheimer’s, dementia is another public health issue in the spotlight. San Francisco is forming a task force that will recommend dementia care strategies and services in 2009, Hinton said, but so far, there’s no real plan.
Overall, the intentions of task forces in San Francisco and other cities are all good, but their ability to develop and carry out plans will depend upon coordinated efforts by city agencies and other groups - many of whom are often competing for the same grant dollars.
“The idea would be to find common program development areas and eliminate the geographic, this-is-my-territory mentality,” said Robert Trevorrow, executive director at the San Francisco Senior Center, and a LTCCC member.
Residents also bear responsibility in the creation and sustainability of age-friendly communities. They can not only call attention to problems, but lend a hand in crafting solutions.
For almost a year, boomer Tricia Webb has enjoyed an automatic door at the front entrance of her San Francisco apartment building.
She fought hard for that door. Webb, who sits in a wheelchair, lobbied her landlord for the door for five years, but her requests were denied due to cost.
The effort finally gained momentum over a year ago when she became part of the Community Living Campaign (CLC), a group that support seniors and adults with disabilities. The CLC-sponsored a bake-sale that was attended by district supervisors and other civic leaders.
The event “embarrassed (the landlord) so bad,” that he eventually green-lighted the door, Webb said.
And that automatic entry has not only made Webb’s life easier, but also helped her neighbors, including parents with strollers. “When we got the automatic door, it wasn’t about me anymore,” Webb said.
Webb’s experience illustrates how members of the community are raising awareness of increased aging and disability needs - many of which cities can’t address due to financial pressures and limited resources.
“Government is not really capable of meeting all the needs of our elders,” added Carolyn Rosenblatt, a registered nurse and attorney who counsels families on aging issues through Help With Elders in San Rafael, California. “It can fund certain essential things, like providing low-income housing, (but) in a very limited amount.”
That’s why the need for grassroots initiatives is critical, especially when it comes to helping people live in their own homes, establish relationships that prevent isolation, achieve financial security, embrace diversity and contribute to the well-being of others. Hearing that loud call, various groups nationwide are fundraising, building awareness and exploring creative ideas that support age-friendly living.
In parts of Northern California, some of the work centers on intergenerational collaboration. For example, retiring boomers have valuable skills in healthcare, education and other fields. These talents can be channeled through volunteer efforts, bolstering the ability of neighborhoods to offer health and daycare services - without turning to government for support. The younger generation can return the favor by helping elders with shopping, transportation or companionship.
“It’s not all about (providing) money or services,” said Marie Jobling, CLC project coordinator.
CLC is helping to test an online social and personal networking site called Tyze. In San Francisco, Tyze operates about about 14 social networks, made up of volunteers who rally around individuals like Webb and create a community of support. They do things like organize dinners and movie nights, even plan birthday parties.
“Before you know it, you have a whole group of people and you’re no longer isolated,” said Webb, 49. “They all come visit and they always bring me food.”
Outside of Tyze, there are several examples of groups aiming to integrate seniors and disabled individuals into day-to-day life. In Sacramento, the Caring Neighborhoods program pairs neighbors with older residents to help mow the lawn or run to the store. A similar program operates in San Francisco’s Chinatown, calling upon youth to deliver groceries.
Caregiver needs also aren’t overlooked. In San Rafael, Rosenblatt’s Help With Elders group has become a one-stop shop for families with aging parents, organizing low-costs drop-in workshops that include experts on psychology, housing, caregiving, health, hospice care, finance and more.
Senior Roundtable
The wisdom of elders is a big part of shaping community initiatives and involvement. Vallejo has a senior roundtable that meets monthly with various civic leaders to discuss current needs, and potential solutions.
Vallejo City Council member Tom Bartee, who facilitates the meetings, said he’s speaking with the mayor about fundraising to establish a community chest. The idea is still in preliminary stages, but it could disperse money to Vallejo’s senior center and other groups in need.
However, fundraising isn’t easy, especially in the current climate. As part of Seniors, Inc. some Santa Rosa residents have been at it since 2002, collecting about $7 million (including in-kind donations) so far to construct a new senior wing at the community center. Currently, the city’s only senior center is housed in an 80-year-old building, with the capacity to serve about 750 seniors a week. But more space is needed to accommodate Santa Rosa’s rising older adult population.
The Seniors group, which is about $3 million shy of its total goal, continues to hold frequent fundraisers.
“We’re just going to keep pushing along and we’re going to make it happen,” said Carolina Scence, director of community outreach. “The time frame may not be as quick as we’d like.”
Fundraising may not be the only challenge groups face if the economy continues to falter. Public service demands are bound to rise, too, directed at mental health, unemployment, housing or counseling, said Max Nyman, associate director and senior fellow at the California Public Policy Institute.
“In times of economic stress, some of (residents) difficulties become more intense,” Nyman said.
That’s one of the reasons why Santa’s Rosa’s Health Action Committee has come up with an early initiative that would pair residents with a clinic, nurse, or other health provider to ensure individuals have consistent records of care, said Shirlee Zane, chief executive officer of Santa Rosa’s Council on Aging.
“That’s going to be a challenging initiative, but there needs to be some real energy put into that,” Zane said.
What Would You Do?
It’s those kinds of out-of-box ideas that are critical right now to ensure vulnerable residents don’t slip through the cracks.
For anyone thinking about how to fill a need in their community, Rosenblatt offered some tips:
Look within, and ask, “What am I good at? What are my talents?”
Educate yourself about the boundless volunteer opportunities, and then volunteer.
Consider what you would want as an aging individual. Think about what you would do, if for example, you couldn’t drive. What would you like to have someone help you do?
Now is the time to ask these questions, before the longevity revolution hits.
Cecily O’Connor is a senior writer at RedwoodAge.com, a news site focused on issues that affect adults over 40. In addition to a decade of experience at MarketWatch, Crain Communications and other media organizations, O’Connor recently completed a fellowship at the National Press Foundation on retirement issues in the 21st century, adding to her well-honed perspective on aging in America.
This report is funded by Spot Us.
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