This is the last in a monthly, yearlong series called Age of Opportunity about Maine people, organizations, towns and businesses that are helping keep older residents safe, healthy and happy.
It has been one year since Mary Owen, Betty Carter and Margaret Staples welcomed us into their homes on the Blue Hill peninsula and spoke about the challenges of growing older. In their 80s and 90s, they were finding it harder to go about the tasks of daily living — buying groceries, lifting up a gallon of milk, driving to appointments.
They were hardly alone. Most people say they prefer to remain in the place they know and love, even as it becomes more difficult to be independent. But Owen, Carter and Staples had something many other older adults do not: a network of people ready to bring them to the grocery store or hairdresser, deliver their prescriptions, schedule regular in-home checkups from nurses, and organize social get-togethers.
That’s because a small group of residents on the peninsula set out to find a way to avoid the near inevitability of adults having to go into assisted living or senior housing, or move in with family, as they grow older.
After three years of planning and community organizing, At Home Downeast began operating in the winter of 2012 as a program of the nonprofit Washington Hancock Community Agency. We featured the group last January as the first piece in this series, and we end with a look back on its year today.
An effort that started in people’s livings rooms is significantly growing its membership base and expanding to other towns, offering hope to other rural Maine communities that there is a way to help aging neighbors live in their beloved homes longer. It requires hard work, coordination and vision on the part of local people who see — and often experience — the challenges directly.
These days, Owen, Carter and Staples — in addition to Dorothy Noble, who met us as she did her shopping at Tradewinds Marketplace in Blue Hill last December — are all still members of the program and able to live at home.
A year in review
It’s been a busy year for the fledgling group, which is the state’s first “village” of the Village to Village Network, a national nonprofit group that supports local programs to keep seniors safe in their homes. Surviving on in-kind contributions from volunteers, private donors, grant funding and membership fees based on a person’s ability to pay, At Home Downeast has been lauded by state leaders and advocates for the aging. It serves the peninsula’s nine towns of Surry, Blue Hill, Brooklin, Deer Isle, Stonington, Sedgwick, Brooksville, Penobscot and Castine.
Members are guaranteed four rides per month to medical appointments within a 50-mile radius, a check-in from a nurse twice a month, weekly grocery and prescription delivery from participating merchants, a safety assessment of their homes, and social gatherings. Volunteers — who have undergone a background check and must provide a local reference — can do most of the work. They also may help members with home repairs, call every so often to check in, provide companionship, make an occasional meal, assist with technology and sometimes take care of pets.
The model is proving scalable. To date, the group has nearly doubled the number of people it has helped, serving a total of 117 members, up from 60 a year ago. It now has 105 volunteers, up from 80. It has added more opportunities for socializing and events — such as bringing members to see “The Nutcracker” in Orono.
In November 2015, the program delivered 425 individual services, up from 339 in November 2014. The vast majority of members — 90 percent — sign up for another year. The number fluctuates if someone dies or enters a nursing home.
And it has expanded to another region. Last year, At Home Mount Desert Island began offering services to residents of the towns of Southwest Harbor, Tremont and Mount Desert, and it soon will offer them in Bar Harbor. The MDI program has 29 volunteers and nine members so far.
The work continues to evolve, especially to fine-tune the medical components, which are not found in every village model. The program expanded the number of nursing programs it contracts with to send nurses to check on members in their homes. It has reached out to more area medical centers and community members on surrounding islands to share what services it can provide patients when they return home. And it has aimed to better coordinate care with its members who might end up in the hospital.
Kara Janes, the part-time program manager and a social worker, said the work finds a way to bridge gaps in services.
“In the past it’s been ‘this agency does this’ and ‘that agency does that,’ and then there are these gaps. Who’s going to do the stuff in the middle for this aging community?” she said.
To help improve the ability of the community to care for older adults, the group partnered with the Island Nursing Home in Deer Isle to hold free training in November — and will hold another this spring — for direct care workers who play a vital role in keeping seniors at home. Direct care workers might be certified nursing assistants, people who provide personal care, or housekeepers. Or they might be family members. They don’t necessarily work with At Home Downeast, but they do help seniors in the community and could benefit from knowing basic techniques, such as how to best help a senior get up or down steps, or into a car.
“Because they’re so important to support people to stay in their home, I want to support them any way I can,” Janes said.
As the number of members and services has increased, so has the need for staff and funding. The budget has grown to $150,000 this year, up from about $100,000. The group hired a part-time volunteer coordinator and increased Janes’ hours.
“We want it to develop and grow and expand, but not lose quality,” Janes said. “It’s quality first. It’s quality to the members. It’s making sure the volunteers are supported and enjoying themselves.”
To that end, the group is figuring out ways to measure its impact. It was asked to be part of a national survey of select villages in the Village to Village Network by the University of California, Berkeley. Do members have to go to the emergency room less often? Do they fall less at home? The research will aim to answer questions relating to the return on people’s well-being.
The group also is partnering with the University of Maine Center on Aging to evaluate its programs and improve its ability to track the myriad services it provides, from making phone calls on a member’s behalf to giving rides to specific medical facilities.
Outreach plays a significant part in the group’s efforts, too. Janes, steering committee members and Joe Perkins, with the Washington Hancock Community Agency, have traveled from Portland to Bethel to discuss their model with interested residents. Other communities are planning their own villages, or have already launched. For instance, Awesome Seniors began operating in the Boothbay region this year. At Home Downeast can provide advice based on its own experience, though each village is unique.
The group makes a point to speak at conferences and is a member of the Tri-State Learning Collaborative on Aging, which shares information on successful strategies that help older adults thrive in their homes and communities across Maine, New Hampshire and Vermont. It has met with some Maine lawmakers as well to ensure they understand the model.
“We offer our experience with At Home as one solution — certainly not the only one — to serve elders in their cherished homes and beloved communities. Whether through helping to shape policy, offering to help draft legislation or generally advocating for the aging-in-place movement, we look forward to building on our relationship with our legislators,” Perkins said.
At some point, perhaps, the village model will spread to the point that it will gain financial support from the state. Meanwhile, At Home Downeast and At Home MDI are still looking for new ways to bridge gaps in care with other agencies and programs, and grow and strengthen their base of volunteers and members.
Last July, we asked our readers to rate promising efforts across the state that are helping improve Maine seniors’ quality of life. All the efforts got high marks, but one in particular earned more stars on the scale of importance than all the others. It was the idea that residents in communities across the state should organize to help older adults age in place. Essentially, they wanted to see more programs like the ones on the Blue Hill peninsula and Mount Desert Island.
If there’s any broad takeaway from this series, it’s that change doesn’t necessarily require government intervention or sweeping reforms. Often, what it takes is a group of willing and committed individuals who see a problem in their town and get together to figure out how to address it. At Home Downeast and At Home MDI illustrate a central theme that has emerged from our year of reporting on the issue: The ancient “neighbors helping neighbors” model is often the most effective way to change a community for the better.
We all hope to live a full and long life. The question is whether we will help one another along the way.
Erin Rhoda is editor of Maine Focus, a journalism and community engagement initiative by the Bangor Daily News.