Throughout history, elders served many societies worldwide by preserving tradition and bestowing the wisdom needed to foster regenerative and balanced communities. But in recent decades, our culture has shifted from venerating wisdom and experience to prioritizing youth and innovation. Likewise, our society has come to view elders as a liability rather than a vital resource.
However, as the boomer generation moves into elderhood, many are realizing what’s at stake when elders are lost from the social fabric. They’re aghast at the realities of our current model of care and are sparking a movement that seeks to redefine the later stages of life — not just for the benefit of elders but for the enrichment of all generations.
Lost in the dream
The 1950s saw the beginning of a post-World War II cultural tide, where economic prosperity lured young Americans away from their hometowns to follow the American dream. At the same time, medical advancements were dramatically increasing life expectancy. Combined, these two factors meant that, for the first time, mom and pop were growing old alone.
“Hospitals started becoming the place to go when the elders could not live at home,” explains Aditi Sethi-Brown, palliative-care physician at CarePartners’ Solace, an inpatient Hospice facility. She describes this pervasive cultural shift as “the medicalization of aging,” where growing old and dying changed from being seen as sacred, dignified and natural to diseases to be combated.
Sethi-Brown describes how the nursing home industry first developed in order to accommodate frail elders as hospitals could not continue as a longterm housing solution. In the ‘70s, around 13,000 of these facilities popped up throughout the country, establishing an infrastructure that has carried on through the present.
“The whole idea [in nursing homes] is to make sure people are safe, so they stick them in the hallway in a wheelchair so they don’t fall, and they end up staring at the walls,” says Rae Booth, who owns Griswold Home Care, a local provider of non-medical in home care for seniors. “Fear of being sued causes a lot of this. … Facilities are afraid to allow more vibrancy because vibrancy entails dynamism, and dynamism entails risk.”
Sethi-Brown and Booth are both members of The Council On Dying to Live, a local group of professionals who work to find solutions for the current systems of elder care, which they all agree is riddled with problems. Members say the root of the dysfunction stems from a cultural fear of death itself. If we reintegrate the premises of inevitability and dignity back into our understanding of death — if we face death bravely — then we would not end up sacrificing quality of life as we battle, deny and try to conquer that fate.
The current cultural mindset, they say, equates quality of life with material capability and consumption, and with that, our life’s purpose has slipped into the material realm as well — racing the clock and trying to achieve some permanence and meaning through how much we can experience and consume. Rather than ignoring and fearing our transition out of this world, members of CODTL ask that we view death as an inescapable reality that, when embraced, encourages us to live our lives to the fullest.
“We put elders in places we don’t want to visit,” says CODTL member Greg Lathrop, “rather than honoring what is left for them to share with us about wisdom and living.”
What’s more, in a world where doctors play God and youth equals power, Lathrop explains, many elders are simply afraid of voicing what they want.
“What do you want?” Lathrop recalls asking his grandmother, as the rest of the grandchildren deliberated putting her in a nursing home. “She said, ‘They tell me I have to go to a nursing home.’ And I said, ‘With respect, Grandma, that’s not what I asked you: What do you want?’ She said, ‘Well, … if I go to a nursing home, then I’m going to die.’”
Lathrop says he had to ask her three or four times before she was brave enough to say, “I want to go home.”
In fact, many families don’t want to choose a nursing home for their parents, but economic circumstances often press them to make that decision.
“In health care in America right now, it’s ultimately a question of, ‘What does your insurance pay for?’” Lathrop says. “You can’t stay home because Medicare and Medicaid will only pay for you to be in a facility. … It’s not working, and at some point, we have to enter into a more cooperative community model.”
Without the help of insurance, many adopt the role of caregiver themselves. “In our region, roughly one-third of the population are older adults, and when you count in the folks that are caregiving, you’re talking about over half the population,” says LeeAnne Tucker, director of Aging and Volunteer Services at Land of Sky Regional Council.
LOS’ Family Caregivers Support Program, run by Carol McLimans, offers $1,000 of annual assistance to families for professional care. Even at the lower-end rate of $20 an hour, McLimans says, the fund only affords families 50 hours of in-home care each year. The caregivers themselves are at risk, McLimans adds, “because they’re often only providing for the person they are caring for — forgetting about their own health and becoming extremely stressed.”
With salary and Social Security loss combined, McLimans says in the years caregivers spend looking after their loved ones they lose an average of $350,000 in potential income. And since caregivers often find themselves in that role quite suddenly, it’s not uncommon that they lose their jobs as well, she adds.
Often, people who find themselves providing care don’t identify as “caregivers,” which presents a problem when it comes to utilizing the resources available to them, explains Sandy Norbo of CarePartners Adult Day Center. “I always say that education is the biggest piece — right in the beginning,” she says.
The coming wave
A 2010 Pew Research Center study finds that baby boomers are turning 65 at a rate of 10,000 per day. North Carolina’s State Data Center projects that this trend means Buncombe County’s population over 60 will climb from about 60,000 to almost 100,000 over the next 20 years — and North Carolina’s population of individuals ages 75 to 84 will increase by 102 percent.
The current system is ill-prepared to handle this shift, and the boomer generation is not eager to have their elder years compromised by systems that they’ve had plenty of time to see fail.
The boomers are the first generation in the nation’s history to see their parents experience late old age in such huge numbers, and as they see themselves approach that phase of life, some are starting to brainstorm ways to create a more sustainable, enriching and affordable way to live.
“They’re going, ‘Oh my gosh, I don’t want to live in assisted living!’ But dealing with my own parents in their situations, I’m realizing that aging in place isn’t the whole answer either,” says Linda Kendall Fields, who heads the Culture Change in Aging Network of Buncombe County. “And so alternate concepts are emerging called ‘aging in community.’”
Fields highlights three models for aging in community that are starting to sprout up around the country. The first is shared housing, which she describes as the “‘Golden Girls’ model,” where seniors live together in communal property.
The second model, community-owned co-housing, spans generations. Of this model, which includes West Asheville’s Westwood, Fields says, “What’s happening is its members are aging, and the community is starting to ask questions like, ‘What happens when someone here has a stroke or starts to develop Alzheimer’s? How far does this community stretch, and how do we build in that kind of care?’”
The third example she describes is called Naturally Occurring Retirement Communities. NORCs can be any given neighborhood and don’t require communal ownership of property. A neighborhood can become a NORC if its residents do strength-based assessments on how they can help one another and set up barter and support systems to meet varying needs. “Generally, there needs to be some small, core group that’s committed to leading that,” Fields says, though she notes that there is software available that residents can utilize to support NORC development.
The CCAN holds public meetings the third Wednesday of every month to address the “Living Environments” criterion of Buncombe County’s Aging Plan, part of an effort to make sure all the county’s seniors have the support they need for healthy lives.
“We have people walking into their 60s, 70s, and 80s without the savings that their parents had,” Fields explains. “And they’re going to have to figure out how to do it without the government and without their pensions.”
Aging in community is about more than just a network of support to meet elders’ basic needs — it’s also about a network where elders themselves are needed. Seniors today don’t just face a difficult system when it comes to housing or care; but they also face the existential dilemma of finding purpose, usefulness, an intergenerational connection and meaningfulness in today’s world.
We generally take it as true that age brings wisdom, but with a generation of elders hanging onto their youth, we lose the value and importance of those with the greatest messages to share. “What is very foreign to American culture is the importance of elderhood as a distinct, developmental stage,” Fields says. “Instead, there’s this concept of never-ending adulthood.”
Sethi-Brown adds, “We pride the 80-year-olds who can run a marathon. We put billboards up about it … and so other people who can’t run marathons at 80 are not considered as successful.”
If current cultural norms push elders to achieve value through youthfulness, not only are they lost in a search for identity and purpose, but we lose them as a source for inherent and unique abilities like wisdom — because with today’s dependence on technology, society no longer relies on wisdom to survive. What was once sage advice may now be seen as irrelevant, outdated, overshadowed by innovation — causing fewer seniors to cultivate wisdom altogether.
Born in 2014 from discussion groups at UNC Asheville’s Osher Lifelong Learning Institute, the group Elders Fierce for Justice grew out of a sense of urgency to take action and rediscover the role that lies beyond adulthood and career.
“There’s an expression at OLLI that a large number of people there are PIPs: Previously Important People,” says Steve Kaagan, one of the founders of Elders Fierce for Justice. “[Without their careers], they don’t have a role anymore. All of us had decided to really change our narrative and that what we wanted to do was to reclaim the role of elder.”
The group kicked off its outreach with a series of op-eds in the Asheville Citizen-Times. The first letter, written by Mahan Siler, opens: “A new idea is rising to expression in our community. Persons over 65, officially retired from a variety of professions, are coming together and rediscovering the traditional role of elder in the service of a more just, healthy and compassionate community.” From the letters, more than 100 people signed on to attend an open forum at OLLI in early March 2015.
However, in the pursuit of this more traditional role, Elders Fierce for Justice, and boomers in general, may find that the role as it once existed is gone for good. Rather than reclaiming it from the past, they may need to redefine it in a way that meets modern needs.
The traditional elder fits perfectly into a society whose very survival depended on the renewal of customs and ethics that kept communities in balance. To achieve that balance, however, modern American culture is pressed to branch away from conventional ways of being and thinking, repeatedly eliminating the usefulness of “how it used to be.” As the elder role is redefined, it’s necessary to involve the many generations in discourse and decision-making, as one generation’s youth will become another generation’s elders.
“I think surviving in and of itself is a kind of wisdom,” says OLLI’s director, Catherine Frank. “You can say, ‘Here’s what we did.’ But as an older adult, I think you have to be open to the idea that there are other ways, and listening to younger people [and recognizing], ‘That’s not exactly the struggle we fought, but it’s part of the struggle. And here’s what we learned, and here’s what I can bring to the work that needs to be done.’ Even if that isn’t just wisdom — that kind of exchange is really important.”
If we’re looking for a way to engage with elders, the opportunity isn’t difficult to find, notes Wendy Marsh of Council on Aging of Buncombe County. In fact, aging services are always in need of volunteers. “There isn’t as much interest in helping older adults as there is in helping other groups of people,” Marsh says. “I think people have a hard time seeing their own futures.”