Saturday, October 21, 2006

Growing old together

Individually, the many aspects of the ElderSpirit Community aren't new. But as a whole, the community has become a testing ground for new concepts in aging.

ElderSpirit community

Gene Dalton | The Roanoke Times

Click for a slide show of the ElderSpirit Community.

ElderSpirit Community timeline

  • 1967: About 40 members leave the Glenmary Home Mission Sisters of America, a Catholic order, and form the nonprofit Federation of Communities in Service.
  • 1995: A FOCIS committee develops guiding principals for what will become ElderSpirit Community.
  • 1999: Members of FOCIS loan $1000 or more each to buy 4 acres in Abingdon for ElderSpirit.
  • 2002: Lenore Mularney dies in Abingdon. The care she received from five ElderSpirit founders became a prototype for dying in community.
  • 2003: "Mountain Sisters: From Convent to Community in Appalachia," a history of the Glenmary sisters and FOCIS, is published.
  • 2004: Construction of ElderSpirit begins
  • 2006: ElderSpirit opens

ElderSpirit Community by the numbers

  • Cost for ElderSpirit 1: $3.5 million
  • Low-income apartments: 16
  • Average rent: $386
  • Owner-occupied townhomes: 13
  • Average home price: $103,000
  • Estimated cost of ElderSpirit 2: $5 million
  • SOURCE: ElderSpirit Community

Related past stories

ABINGDON -- In the second half of their lives, Tom and Marianne Boyle want the excitement of a new way to grow old in America.

They want to commit to caring for their neighbors as they age and to being cared for in return.

They want the joy of a community that believes the spirit never ages, never dies.

But it takes sacrifice. So they're casting away two lifetimes' worth of possessions.

Things like the 2,500-square-foot house on Smith Mountain Lake.

The large deck with its deluxe gas grill. The fish pond and waterfall. The china cabinet.

They're exchanging it for a 956-square-foot town house in Abingdon's ElderSpirit Community.

"I don't think we would have considered a retirement community," Marianne Boyle said.

"But I'm interested to be on the ground floor of this kind of movement ... and be involved in its evolution."

A new way

It used to be that families lived and died in the same town, providing many caretakers for parents and grandparents.

But as families have dispersed over states and even continents, seniors are often left to struggle at home alone or enter institutions that focus more on illness than on living.

This cultural shift is not just unhealthy for elders, it's also costly for government.

A year in a traditional nursing home for one patient can cost a state's Medicaid program about $75,000, according to Scott Parkin of the National Council on Aging.

And those cumulative costs will only rise as the baby boom generation ages. Using U.S. census data, researchers estimate that every day this year, 7,900 people will celebrate their 60th birthday.

To find ways to cut costs, the federal government has recently funded pilot projects in several states to substitute home-based care for institutional care.

But providing medical services at home is not enough, said AARP scholar Dr. William Thomas.

The biggest problems facing elderly people are not heart disease and diabetes. "They are loneliness, helplessness and boredom," said Thomas, a former nursing home physician.

So the founders of ElderSpirit set out to find ways to heal those emotional diseases.

Each day the 30 or so residents are forming small groups to talk about their spiritual journeys, make sense of their life experiences and plan the community Halloween party.

They cooperate to settle disputes -- like how bright streetlights should be in their 4-acre complex in the Kings Mountain neighborhood.

Marianne Boyle calls it "the fabulous challenge of living in consensus," and she and other residents have gone through conflict resolution training to help them work better together.

But most importantly, ElderSpirit residents have formed a care committee that organizes neighbors to help one another as they struggle with illness and infirmity.

Through such assistance, Thomas believes, communities like ElderSpirit could "save America a trillion dollars" in long-term care costs.

'Just like family'

It was the first week of June, and Pat and Bob Wolfinger had just moved into their ElderSpirit apartment after a year's worth of construction delays.

Parts of the complex were still unfinished, including the common house, a feature of most cohousing communities, and the wide plaza that stretches between rows of owner-occupied town houses and low-income apartments.

Residents were tending small garden plots and waiting for grass to grow. Some were already gathering on the many couches and chairs of ElderSpirit director Dene Peterson's town house for snacks and conversation.

Monica Appleby, outreach coordinator for the community, was hosting luncheons in her home full of African artwork and family heirlooms.

That's when the Wolfingers faced a crisis. Bob Wolfinger, 70, went in the hospital for hip surgery, but suffered complications while he was there.

With help from his wife and home health care, he came home in mid-June. But he had to use a walker and was still speaking slowly.

The ElderSpirit mutual support system kicked in almost immediately.

"They're just like family here. Everyone's been coming to visit," Pat Wolfinger said. "It's a miracle, really."

"It's been a boost," Bob Wolfinger said, while sitting on his sunny patio munching fresh strawberries. "I feel like somebody cares."

Informal mutual support, the founding principle of ElderSpirit, was developed by Peterson and other co-founders when a friend, Lenore Mularney, lost her eyesight and mobility to illness.

"We didn't know we were doing the prototype of ElderSpirit at the time, but we realized it later," Peterson said. "Lenore showed us that with mutual support, people could die at home. And it wasn't a burden to anybody."

Mularney moved to Abingdon, and a care committee of five women involved in ElderSpirit looked after her. They took turns cooking, answering mail, paying bills, even sleeping nearby, for the last two years of Mularney's life.

Mutual care isn't for everyone, however. At the June 9 dedication, visitor Robert Vessey said he admires ElderSpirit, but he's not sure he'd want to move in.

"It's a great idea. But it's a big commitment. I'd have to think seriously about it. You wouldn't want to let people down," Vessey said.

And joining ElderSpirit won't keep everyone out of traditional nursing homes or assisted living facilities. Some will simply grow too sick or too frail to live at home, Parkin said.

Still, many groups around the country are watching ElderSpirit closely, as it has become a testing ground for much of the newest research into aging.

Many pieces, one innovation

Of the pieces that make up ElderSpirit -- mutual care, spirituality, human development, community service, affordable housing, cohousing -- none is new, Peterson said.

But combining them into one community is a milestone.

From the cohousing movement, ElderSpirit organizers learned to encourage neighborliness and environmental conservation by clustering smaller homes around common meeting areas.

From Dr. Drew Leder, a physician and philosophy professor at Loyola College in Maryland, ElderSpirit took the idea that spiritual or religious practice can ease the transition into old age. So every resident is asked to tend to spiritual matters and to respect all other religious and spiritual views.

Much of the ElderSpirit concept is based on a new theory that says old age is another phase of human development with distinct stages, similar to early childhood development.

Unlike children who need to run around and make noise, however, seniors need quiet time to reflect on their experiences, said Bernice Wilson, a retired hospice director who will oversee construction of a second ElderSpirit in Abingdon next year.

Elders also need to reach out to the community and serve others to build self-esteem, Peterson said.

The 74-year-old former Catholic nun has become an example of this principle, teaching herself over the past decade how to finance nonprofit housing developments.

But the biggest and hardest-won triumph of ElderSpirit has been its affordability.

More than half the residents qualify for public assistance, making it the first American cohousing group to fully integrate subsidized housing, said Betsy Morris, research director for the California-based Cohousing Association of the United States.

Another aspect of ElderSpirit has astonished Morris and others. Those who own their homes, like Marianne and Tom Boyle, agree that when they eventually sell their town houses, they will donate half of their profits to ElderSpirit.

Being part of this social experiment is a big attraction for some residents such as the Boyles.

"If this model works, the government can actually put a lot of people in a very comfortable situation," Tom Boyle said. "Then all they have to do is pay Social Security and be done with it."

About a half-dozen groups spread from Florida to Kansas aren't waiting for a final report on ElderSpirit. They're working now to develop their own variations on the theme.

And ElderSpirit resident Monica Appleby is heading up a grant-funded outreach project to advise them.

Meanwhile, all the spots in the first Abingdon community are taken.

And the number of people on the waiting list -- more than 30 -- is enough to fill the second ElderSpirit, which may open in Abingdon sometime in 2008.

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