Golden Years

Charlottesville’s population isn’t getting any younger, and the area’s reputation for a high quality of life is driving not only growth in general but also an influx of people over 60 from across the country. Indeed, 12.5 percent of the Charlottesville-Albemarle population in 2000 was 65 or older, compared to 9.7 percent in 1990.

 

Ned and Fran Morris, formerly of New Jersey, can describe exactly what propels that growth among senior citizens. When they were looking for a place to retire, Ned says, they knew they wanted to continue to live with four seasons.

"But we didn’t want to have to put up with the New York winters," Ned says. "And we knew we wanted a community with good medical facilities, hopefully with a college or university."

Advertisers know that Charlottesville fulfills the Morrises’ wishes almost perfectly. In the Fall 2002 issue of Virginia magazine, a publication of the UVA Alumni Association, for instance, there’s an ad placed by Westminster-Canterbury of the Blue Ridge, the retirement community where the Morrises have lived since 1990. The full-page ad beckons senior citizens to move into one of Westminster-Canterbury’s cottages or apartments. One selling point is the security of lifelong care, something every Westminster resident is guaranteed.

Yet the ad’s true focus is something else: the quality of life outside Westminster around Charlottesville itself. The marketing piece highlights opportunities that senior citizens have here for cultural activities and intellectual stimulation, which many other medium-sized towns cannot offer. The region shines in this ad as a mecca of learning, nestled in a spectacular natural setting.

"Charlottesville has become a real destination for retirees," says Kevin O’Halloran, development director at Westminster-Canterbury. The ad in Virginia magazine is just one of many targeting retirees around the country. It drops tantalizing names: summer Shakespeare at Barboursville, UVA football games, and—of course—Monticello.

Retirees coming to Charlottesville may indeed find an enjoyable new home awaiting them. Yet, for many other seniors, there is no guarantee of basic services, much less lifelong learning. A growing population and shrinking economy have people worried about the future of aging in Charlottesville.

 

 

Occupying a lofty perch on Pantops Mountain, Westminster-Canterbury’s main building could almost be an upscale hotel. "You think of a nursing home as a grim, sterile place. That isn’t the case here," O’Halloran says. Framed art—original drawings by the daughter of a resident—bedecks a hallway. Gracious common areas include a full-service dining room, complete with linen napkins at each place setting. Outside the building, residents have an eye-level view of Monticello.

Westminster is what’s known as a continuing care facility. Its 300 residents sign contracts guaranteeing them housing, food and medical care for life. Most arrive during what O’Halloran calls the "second phase of retirement." In other words, they’re ready to be done with the responsibilities of home ownership and they’re looking for a secure future. The average age of new residents is 75. At this stage, usually healthy, they live independently in cottages or apartments and drive their own cars. "They want to plan ahead and make sure everything is taken care of so that their children don’t have to," he says.

The Morrises, who moved first to Crozet from New Jersey in 1979 when Ned retired from a marketing career, say their Westminster cottage feels like home.

"The people are great, and it’s beautifully run. You can be busy every minute of the day, there’s so much going on," says Fran.

As residents age and begin to need help with basic activities like dressing and eating, they move into Westminster’s assisted living facility, which has nurses on each floor. Later, they may move again, into full-time nursing care or a specialized Alzheimer’s unit.

With Westminster providing various levels of care at a single site, it can accommodate couples whose needs vary. "We had been here about three years when I found out I had to have my hip operated on," Fran says. "I was over in the health center, and Ned didn’t have to go across town to a nursing home to see me when I was convalescing."

Westminster residents enjoy on-demand transportation around town. They can join bus tours to plays and lectures or take special classes for seniors taught by current and retired UVA faculty at the Jefferson Institute for Lifelong Learning. And their living quarters are hardly cramped: Many have two-bedroom cottages or apartments.

Naturally, all this costs quite a lot. Westminster is a non-profit organization affiliated with the Episcopalian and Presbyterian churches, and its revenue mostly comes from its residents. To move into an apartment here, a single person would pay an entrance fee of at least $180,000; couples wanting larger cottages shell out considerably more. On top of the entrance charge, monthly maintenance fees range from $2,000 to more than $4,000.

The Westminster Fellowship Fund can cover the entrance or monthly fee for people with limited means, and a few residents receive full assistance. The fund also provides a form of insurance for residents who have unexpected money troubles.

The Morrises have no doubt that for them, the cost has been more than worthwhile, and say that the monthly fee is comparable to the cost of living independently.

"I know it’s staggering to contemplate writing that first check for the entrance fee," Ned says. "But most people, by the time they reach the age to come in here, they own their home, and that money is usually more than is required for whatever unit they want to live in here. It’s upscale, but it’s not expensive."

 

 

Kathy Crosier, who handles community relations at the Jefferson Area Board for Aging, agrees that Charlottesville is a good place to grow old. She says the area offers a wealth of resources JABA can tap to help serve the elderly, and that a commitment to volunteerism is what mobilizes these resources. "We’re very fortunate in this area that there’s such an outreach from the community," she says.

She tells the story of a woman in JABA’s adult day care program who spoke only Japanese. "We were able to contact someone at UVA who found people who spoke Japanese, and they came and visited with her once a week," Crosier says. "If you were in an isolated area, you might not be able to tap into that. Even the most unusual thing, we can usually find someone to assist us."

With its broad mission covering a long roster of programs for the elderly, JABA needs to be adept at drawing assistance from whatever sources it can. A mostly publicly funded agency serving Charlottesville plus five surrounding counties (Greene, Louisa, Nelson, Fluvanna and Albemarle), JABA’s constituency includes all elderly people and their caregivers. "We serve people that may have means, and people that don’t," Crosier says. JABA’s mission is simple and far-reaching—to determine the needs of the elderly, and fulfill them.

Among the services JABA offers are health insurance counseling, home safety assistance (installing handrails in the shower, for example), meal delivery and in-home care. There are even volunteers available to help seniors decipher byzantine medical bills. Joyce Gentry, an information specialist at JABA, says "Some people look at a bill, and say ‘I don’t have a clue; it’s five pages long. What do I pay?’ We have someone who can help them look at that and determine, ‘This is what you pay.’ It gives them peace of mind." JABA is so well known as a go-to information source for seniors that, says Crosier, "People call Joyce for directions to the airport."

JABA also operates senior centers in each of the five counties it serves and is working to open adult day care facilities around the region. Walking through the day care center in JABA’s main office north of Charlottesville, Crosier says that in some ways day care is one of JABA’s most important programs.

"It’s all about creating that quality of life and making the elderly feel useful," she says. "You still participate in life, and you still give back and do things, even though you have physical limitations."

Clients in the day care program can become part of a hand bell choir, arrange flowers donated by Whole Foods Market or help make quilts, some of which hang on the walls of the Charlottesville center’s spacious great room. Outside, there’s a pleasant enclosed patio where clients grow vegetables, which they then cook in the center’s kitchen. Crosier greets a group of about 10 clients making cookies; an activities director handles the oven to help ensure safety.

The day care center has been in this location for five years, and the new building was designed to be more effective at meeting clients’ most pressing needs. A two-bed infirmary has exit doors opening directly to the outside.

"That keeps everybody in day care away from the situation, and they don’t all panic and get worried," Crosier says. "This is a state- of-the-art facility, and when they were planning this building, this was the dream thing, to have an infirmary separate."

Back in the great room, the center serves lunch and two snacks each day. They’re substantial enough to provide all the nutrition clients need for the day, says Crosier, which is especially important for those who live alone. "They may go home and just have tea and toast or cereal," she says, "so at least you know they’ve eaten here and had a hot meal served to them."

With an inexpensive hair salon, therapeutic tub room, geriatric physicians and physical therapists on site, the center functions as a mini-town where seniors can access many services at once. This is just as helpful to family members and caregivers as it is to seniors themselves, Crosier says.

"We wanted to do kind of like a one-stop shopping theme, so while that caregiver is taking her respite break or going to work, she can drop Mom or Dad off [at day care], and if they have a doctor’s appointment, the doctor’s nurse will actually take them for their appointment, then call the family member and give them an update."

Though the agency is involved in affordable housing for seniors (Woods Edge, an apartment building for seniors in Charlottesville, and Mountainside Senior Living, an assisted-living facility in Crozet), JABA is primarily committed to giving seniors the services that will allow them to remain at home as long as possible. "That’s where we find people are happiest," says Gentry.

More than 600 volunteers make JABA run smoothly. Many are able to offer more than just their time, bringing useful skills and experience to JABA programs.

"I think the University is one of the plusses in the community," Gentry says. "We do have people of means here, and also we have people who are very knowledgeable about a wide array of information."

 

 

Crosier and Gentry are each positive about the success JABA has had in its 27-year history. Yet they acknowledge that there are limitations to what JABA can do. Many of its services are free, and the ones that are fee-based operate on a sliding scale. Day care, for example, costs $50 per day, but many clients pay $5 or nothing at all.

"We serve everyone," Crosier says, "and any profit that is made would be just to balance out these programs for the indigent."

The day care program successfully serves about 75 registered clients and has no waiting list.

Other JABA services operate on shakier ground, with seniors who cannot afford to pay left on waiting lists. With State budget cuts looming, even successful programs like day care are threatened.

"When funding sources are cut, that means the indigent will have a waiting list because there won’t be scholarship funding available, or it might be more limited," Crosier says.

Gentry believes that, with budget cuts, the biggest gap that may open in JABA’s services will be with in-home care.

The uncertain plight of some JABA clients clearly is a far cry from a comfortable life on Pantops Mountain. The cost of health care can be an impossible burden.

"It’s not unusual, if someone has a $500 to $600 per month income, and they have a prescription that costs $200 to fill, they don’t fill the prescription," Crosier says. "That’s very common for us to see."

Even seniors who find a way to pay for assisted-living or nursing home care often encounter serious problems in the quality of care they receive. Angela Johnson is JABA’s ombudsman, in charge of investigating and resolving complaints about long-term care. She says the most common complaint is that a resident’s care plan is not being fulfilled. For example, a care plan may include "pressure ulcer [bedsore] prevention for a person who has been identified to be at risk: turning every two hours, hydration, nutrition and personal hygiene." A turn chart is meant to document how often the resident is turned. Yet visiting family members may repeatedly find the chart empty, or worse, their loved one soaked in urine.

Johnson believes that the root of this problem is the typically low wage paid to nursing home staff. Certified nursing assistants have demanding jobs and notoriously high turnover rates.

"The bottom line seems to boil down to staffing, the availability of staff to turn residents every two hours. If you have three people caring for 30 people in a shift, is it realistic to expect that to truly happen along with the other responsibilities they have in the provision of care?" she asks. "In some of the smaller assisted-living facilities, those people are even responsible for cooking and cleaning, along with resident care."

 

 

If JABA faces challenges now, those challenges promise to expand in the future. With baby boomers heading into their retirement years, health care costs rising and Social Security on uncertain ground, the future of aging is of national concern.

"You have all this drain now on the economy because of elderly who need support and services, and it’s only going to increase," Crosier says. "This isn’t a situation that’s just isolated to us, it’s across the nation." Indeed, throughout JABA’s jurisdiction, the Virginia Employment Commission projects a 25 percent increase in the over-65 population by 2010.

JABA’s planners are trying to chart a course for the future that will maintain its current level of service for a burgeoning population. Again, a shortage of nurses and nursing assistants is of critical concern.

"We just have to be as innovative as we know how to meet needs," Gentry says. "It’s not going to go away. We’re either going to meet those needs or we’re going to be in a bad situation."

She worries about elderly people on fixed incomes finding their way through a more austere financial landscape. Those at the lowest income level qualify for Medicaid, the Federal- and State-funded program that provides health insurance to very low-income people, but those with slightly more income are most at risk, according to Gentry. That’s because they can’t get aid, yet can’t afford to pay for services themselves.

"Those are the ones who are vulnerable, because they’re caught, and there’s not very much offered to them," she says.

At Westminster-Canterbury, O’Halloran agrees that aging boomers will cause major shifts in years to come.

"I think we’re seeing the beginning of that now," he says, gesturing to a huge construction project visible through his office window. Westminster is adding a 250-bed addition to its independent-living apartment building, including a new dining room and many other common areas.

"We found there was a very strong desire, and all the apartments were reserved before we broke ground," he says.

Despite that evidence of overwhelming demand, O’Halloran is optimistic about the future.

"We feel the expansion will serve the needs of seniors in this population for the foreseeable future," he says. "I believe we have a great many talented people in the community who are thinking long-term to ensure this continues to be one of the great places to live for all ages, including seniors."

Asked if Charlottesville lacks anything major in their eyes, the Morrises look at each other, laugh, and shake their heads. "Really! I can’t think of a thing," says Ned. Westminster-Canterbury seems to fulfill its promise of high-quality care in a beautiful, well-rounded city. But not everyone is able to claim a piece of this dream.

"I get lots of calls from around the country where people say ‘I’m interested in living in Charlottesville, but I need to know about low-income housing,’" JABA’s Gentry says.

"And I say you’ve come to the wrong place. Our resources are very limited for low-income housing; subsidized housing has waiting lists. There’s not enough of it," she says.

"So if you have a good situation where you’re living, you’d better hold onto it."

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