The Health Care M&A Monthly: ‘Aging in Community’ A Hit in Boston
Beacon Hill Village Helps Elders Stay in Their Own Homes
Back in the late 1990s, a group of friends and neighbors living in the Beacon Hill area of Boston were very leery of what they perceived to be their options as they approached retirement — all of which, essentially, meant moving out of their homes. And that seemed totally unacceptable. "Other than that, we had no other thought in our heads." says Susan McWhinney-Morse, one of the founders of Beacon Hill Village, its past president, and currently co-chairman — a rather unique organization that supports elderly people who choose to stay in their own homes in the neighborhood in which they’ve lived forever or at least for a significant period of time.
"The group concluded that what they needed to stay in their homes was right here," says Steve Roop, president. "All the things that they cared about — their neighbors, their friends, the emotional association with their home, business relationships that they had built up over the years, and so on." They also realized that all the services they were concerned about could be relatively easily arranged — services ranging from finding people to help move furniture or hang pictures to home care services if they became frail or suffered a serious illness.
"Why should there be a point – and no one can really define it – when suddenly we become old and are expected to pick up and change our lives," McWhinney-Morse wonders. "At any other time of life, you just move from one phase to the next. I really resent the concept that, at 65, you’re old because social security says so. Or if you break your hip, you’re old. No, you simply need a new hip. Most of the time when you need something, it’s a short-term problem or relatively easy to obtain if you just have someone who can help you obtain it."
Relatively quickly, the group decided not to own any real estate, as the mission, of course, was to keep people in their homes. They finally settled on a not-for-profit membership organization, with an annual fee that includes a number of services and programs — both free and paid.
So Beacon Hill Village was born in February 2001 and has turned out to be a phenomenal approach to simply making life easier for people in the neighborhood.
Beacon Hill Village is a creative example of the burgeoning "aging in community" model. "We have three components to what we offer," says Judy Willett, executive director. "We offer concierge services, referrals, and geriatric care management; assistance in living services, such as home care; and community-building programs and activities. Providing those three components all together is what makes us so unique and why this whole image and concept has become quite a movement across the United States and beyond. In its simplicity, this model is what 90 percent of elderly people say they want – which is to stay in their own homes."
The free services that members receive include, for example, transportation from a doctor’s office following a medical procedure and thrice-weekly shopping trips. The driver will provide assistance getting into the vehicle and, if the member wishes, help with the shopping and carry the purchases into the home. "It’s a very important service for elderly people," says Roop, "and it’s also a way to keep track of a subset of our members. If someone reliably shops every week but suddenly doesn’t schedule a next trip, we can call to make sure everything is okay. After all, our major concern beyond keeping our members in their homes is their well-being."
For the paid services, Beacon Hill Village has a very extensive Rolodex of vetted providers. Some services are provided on a matched basis — e.g., chores, maintenance, repairs. Other services — e.g., athletic clubs — are discounted. When services are rendered to a member, the staff follows up to make sure it was satisfactory. If not, Beacon Hill Village drops the vendor.
"We’re continuously auditing our programs and services to ensure that the basic membership package always offers things that are of value to members," says Roop. "At the same time, we’re not trying to ignore services such as Meals On Wheels. In fact, we try to work with those kinds of services as much as possible.
"This is a way of helping people keep their living circumstances under some kind of control," he continues, "whether they’re basic necessities or small things such as watering the plants if they’re sick, helping to pay the bills, or just visiting. These services may seem very homely, but they’re absolutely critical to a person’s well-being."
Volunteers are absolutely essential to the operation of the organization, but the core of the idea really does depend on a paid staff, according to Roop. And most of Beacon Hill Village’s paid staff are trained social workers.
"There are certain services that people simply are not willing to disclose to neighbors," says Roop, "or maybe they need a professional intervention and are more open to talking with a trained professional — someone who has heard it all before and is bound by professional ethics to keep the information confidential."
The literature on the relationship between people who are adequately stimulated and their survival is unmistakable, according to Roop. "People who have more to do live longer, happier, and healthier lives," he says. "Our founders understood that right from the beginning."
So along with twice-weekly exercise classes, members can sign up for an array of activities such as museum visits, art and architecture tours throughout New England, informal gatherings over lunch, even a singles group. Some activities require a fee. "Many of our members have affiliations or are trustees of important cultural institutions in Boston," says Roop, "so they’re able to help us arrange special trips, backstage visits, or specially docented tours of major exhibits."
One staff person works three days a week solely on attending to the needs of the program committee, whose job is to come up with a long list of activities each month.
The grass-roots aspect of this type of organization is crucial, but the basic principle — older people defining for themselves what they need and want to keep them happy in their homes — can probably work in any neighborhood.
"Our village resembles our community," says McWhinney-Morse. "It has in it all the things that we love. If you live in the country and get together a group of people with the same ideas and same vision, their village will look like what they love. It won’t look like our city village. Transportation would be a much larger component than in the city, the activities would be different, and the concept of community might take on different aspects. But it’s really universal," she adds. "It’s really just common sense."
In response to continuous inquiries from people wishing to start a similar village in their own communities, Beacon Hill Village published a manual, "The Village Concept: A Founder’s Manual" (available for purchase online at www.bhvillage.org) and, with MIT AgeLab and Massachusetts General Hospital, co-hosted a conference in early May called: The Building Blocks: How to Make Your Neighborhood Into a Village. "We had 250 attendees from all over the country," says Willett. "They included consumers interested in or in the midst of developing their own village, not-for-profit organizations, municipalities, CCRCs, home care providers, and a few nursing homes."
CCRCs have many reasons why they might partner with this type of village or develop one for themselves, according to Willett. For a CCRC with a wait list, the village helps people stay in their homes for a longer term. It provides another revenue stream, and it includes another group of people who might use the CCRCs health and/or recreation facilities through a partnership agreement.
Beacon Hill Village has built connections to many community resources and philanthropic organizations and has formed strategic partnerships with three organizations that, from the beginning, believed strongly in the group’s experimental vision.
Massachusetts General Hospital’s Senior Healthcare Practice, which is at the foot of Beacon Hill, considers the alliance community outreach. Rogerson Communities provides moderate- and low-income housing for the elderly in Boston, including two facilities on Beacon Hill, and offered the group a neighborhood office. And HouseWorks, which supplies home health care aides, gives members a 10 percent discount on services.
McWhinney-Morse sees a "huge, wonderful challenge" for creating different models if, for instance, a nearby retirement community said to residents of a locality, "Form a village, and we will provide any of our services that you need and offer our facilities in any way that we can." A member of the village might need a short-term stay or the village itself might needed administrative or consulting services. "It could be a very workable partnership," she says.