Village Concept Promotes Aging in Place
By Donna Mae Mascarinas Scheib, MN, RN

Village living enables older adults to remain longer in their homes.

The baby boomer generation seeks retirement options to enhance their lifestyle choices. For many, it is highly desirable to retire in the home where they have resided for decades. Equally important, many wish to remain part of an intergenerational environment while living active, independent, and social lives in a familiar neighborhood. Within the past few years, villages have emerged within communities around the country, attempting to meet these needs. This article describes the purpose, function, and structure of such villages, reviews the structure of organizations that operate villages, and outlines reasons supporters believe the village living concept is a successful form of retirement.

In June 2009, the U.S. Census Bureau estimated that 8% of the world’s population is aged 65 and older. It projects that by 2030 this population will reach 12%; and 16% by 2050. There are now 39 million people aged 65 and older with this number projected to more than double to 89 million by 2050.

New Elder Options
Until the last decade, options for retirement living arrangements commonly required individuals to relocate from their homes. Residential choices included nursing homes, assisted-living facilities, adult family homes, or moving in with family members. For those who wanted to remain in their homes, the options for assistance included hiring a personal caregiver or having family members or friends either move in or visit regularly to manage care needs. While many people happily made such choices, emotional considerations often make the decision difficult. While older adults may recognize they are in need of some assistance, they hesitate to “burden” family and friends. And most elders find it incredibly difficult to leave the homes and neighborhoods where they have lived most of their adult lives. Some simply fear the loss of independence and control.

The National Aging in Place Council (NAIPC) was founded on the belief that “an overwhelming majority of older Americans want to remain in their homes for as long as possible but there is a lack of awareness of home and community-based services, which help make independent living possible.”  With the needs and motivations of the aging population to remain in homes and communities, older adults have found that the village living concept offers an alternative living arrangement. Members of such villages can continue to live in their homes while receiving assistance that supports independent lifestyles and helps with home maintenance. The arrangement provides help that bridges the gap for individuals with enough assistance from the village to remain in their homes.

In early 2010, an observational project compiled a list of 47 villages by name, location, contact person, and phone number from information available on the Beacon Hill Village website. Each village was given 24-point questionnaires requesting information on subjects such as membership fees, board of directors, volunteers, services provided, recreational programs, and geographical demographics. The results of the surveys and interviews from the 26 responding villages demonstrated that although the village living concept is a successful movement for aging in place, organizing and operating such a village takes perseverance and time.

A Boston-based group advocating aging in place was one of the first to organize a village program for an elder community. Founded by a group of long-time Beacon Hill residents as an alternative to moving from their homes to retirement or assisted-living communities, Beacon Hill Village formed in 2001. Since then, 48 other villages have surfaced around the country and more are expected to launch in the future.

Basic Operations
As nonprofit organizations, these villages are operated by board members or by volunteers. Some service specific geographic areas, providing members assistance with home maintenance, daily activities, and social gatherings to build neighborhood friendships. Based on the results of the questionnaires, village organizations are typically operated by boards of directors that design and administer daily operations. Most members pay annual dues, depending on the village structure. Villages offer specific services with the goal of making daily living more convenient and helping residents maintain healthy, happy, and social lives. When a member needs assistance beyond the capabilities of volunteers or neighbors, the village offers a concierge service for local businesses that is prescreened for security. Vendors sometimes offer lower rates for their services in exchange for the loyalty and repeat business derived from village residents. Volunteers and/or neighbors provide personal, wellness, technological, transportation, and household services along with home repairs. Tasks range from changing light bulbs or installing a DVD player or programs in a computer to housekeeping chores such as help with laundry, gardening, dog walking, grocery shopping, and transportation to medical appointments. 

San Francisco Village serves the entire city and offers more than 65 services to members through its conciergelike program. Included are veterinarian services, aging consultations, hairdressers, estate planning, long-term care insurance, meal preparations, roofers, gardeners, and transportation services. This unique program allows members to trade skills and experiences with each other for further support and education.

According to the NAIPC, in 2008, the average cost of a home health aide for a single person was $19 per hour. Assisted-living facilities fees were about $3,008 per month while nursing homes ranged from $169 to $192 per day. By comparison, village living costs range from free (all volunteer-based with no revenue) to around $1,000 per year. Annual membership fees and dues support most villages while some, like Gramatan Village in Bronxville, N.Y., receive funding from other sources, including community pledges, donations from its volunteer-based board of directors, and grants.

Membership fees vary from one village to another based on staff expenditures, insurance, marketing, and sources of funding. Not surprisingly, a village with a board of directors and paid staff has higher membership fees. For individuals with lower incomes, some villages have scholarships to help ease the financial burden. Lincoln Park Village in Chicago offers a “member-plus” program where dues and fees can be reduced based on income level.

Connecticut’s Community Caring in Bridgewater has no membership fee. John Flaxman, president and CEO, runs a program with seven volunteers who comprise the board of directors. They offer their time and handiwork to clients free of charge. If they are unable to meet their needs, services are outsourced to business providers at reduced rates. Since the community’s launch in 2007, Flaxman has partnered with New Milford Hospital and the New Milford Visiting Nurse Association. The village has access to the community senior center and owns a wheelchair-accessible van for client transport.

Village Viability
The recent economic downturn has had an impact on the perceived viability of the concept. Some active older adults find it difficult to justify spending up to $1,000 per year on services they may not fully utilize. On the other hand, interviews with prospective members of North East Seattle Together (NEST) opening in 2011, revealed that people are looking forward to services such as transportation assistance and social-networking possibilities. Tom Rasmussen, a Seattle council member and village-living supporter, says his mother is a candidate for village living. Dissatisfied with an assisted-living facility where only elders surrounded her, she sought a more active intergenerational environment. Hopeful that a village will develop in his mother’s community, Rasmussen says, “I do think that we need to strengthen a support system for seniors who want to stay in their own homes. NEST certainly is an option for that.”

Healthcare providers around the world have supported and become advocates for aging in place as a successful retirement arrangement and an alternative to traditional long-term care alternatives. Valerie VanBooven-Whitsell RN, BSN, PGCM, a professional geriatric care manager and author of The Senior Solution: A Family Guide to Keeping Seniors Home for Life,consulted with consumers and other professionals regarding the needs of the older adult population. “Set up properly, [many] senior[s] can stay in his or her home for their entire life. As long as care can be paid for, or provided by family members locally, and as long as the living situation is safe and comfortable, seniors stay at home,” she says.

Village executive and program directors agree that the village-living concept has aided elders who foresee the need for services or have found themselves aging alone following the passing of a spouse and friends. Jane Hawkes, program director for Vineyard Village at Home in Massachusetts, says “members are happy and grateful” because “they couldn’t continue living in their households if they didn’t have the village.”

Directors of villages agree a paradigm shift in aging and retirement-living arrangements exists, driving the demand for village living. The demand defines the village mission statement to support the continuation of aging in a home and community where people have lived most of their adult lives and remaining part of the intergenerational community’s society. 

With the short period over which the concept has existed, a literature review yields limited research on overall long-term health of members who participate in the village lifestyle. The most obvious advantage over traditional long-term care models is the continuation of the lifestyle older adults desire: remaining in their homes. The most significant proscription related to the village concept is its limited availability.

— Donna Mae M. Scheib, MN, RN, spent four years working in long-term care facilities and is preparing to take the adult and older adult nurse practitioner licensure exam. She received her graduate nursing education from the School of Nursing, University of Washington in Seattle.