The data is clear: like the rest of the country, Martha’s Vineyard is bracing for a sharp increase in the population of older residents.
The number of Vineyard residents 60 and older is growing at a faster rate then the rest of the state, and that demographic is expected to grow as the baby boomer generation gets older. Some estimates show that Island residents between 60 and 70 years of age will triple by 2020.
The population shift will be especially evident on the Vineyard, with a large number of older residents who live here, come to retire here or come to live with family members of the Island. Vineyard residents young and old will face new issues: housing and transportation for the elderly, how to coordinate social and medical services, and how to provide support for older residents and those who provide their care. Tensions will play out on a rural Island where many people live alone and access to health care for all ages is often a problem.
To begin to tackle these questions and to foster Islandwide preparedness, the Martha’s Vineyard Donors Collaborative is sponsoring a project by rural scholars at the University of Mass-achusetts Medical School that will look at creating an aging-friendly Island. The scholars, who will work with the Healthy Aging Task Force of the Dukes County Health Council, will be on the Island for two weeks in October to compile data, look at the Island’s upcoming needs and make recommendations. At the end of October, they will present their findings to the committee.
The project will look at how the community can be expected to change over the next 30 years, identify barriers and pose recommendations for the Island community. Some of the information will be narrowed down to specifics: how many hip replacements, physical therapists, Alzheimer’s units will be needed in the future?
“We as an organization looked at health care across the board as a possible issue,” donors collaborative executive director Peter Temple said, but he said that felt like too big an issue. So the elderly population was a starting point, and the collaborative will serve as a catalyst to start a discussion.
“This is a pretty good place to grow old right now,” Mr. Temple said, and the project is about “building off our assets and preparing for the future need.”
“We’ve only seen just the little tip of the iceberg.”
As a kickoff to looking at the issue, the collaborative will host a morning event on June 17 at the Martha’s Vineyard Hebrew Center with a variety of community leaders.
The keynote speaker will be Dr. Ann Bookman, a senior research scientist with the Center on Youth and Communities at Brandeis University. She will describe what an aging-friendly Island would look like.
To be sure, in many ways the Vineyard is already a great to place to grow old, Mr. Temple said. Dukes County often ranks high in measures of health, and the Island has a full-service hospital, nursing and assisted living homes and hospice care, plus a range of programs including Meals on Wheels and the Visiting Nurse Association, councils on aging, active senior center programs, and a wide range of nonprofits.
But these services will soon have to serve a rapidly growing population.
Data shows that the first wave of aging baby boomers is here. According to data from the donors collaborative, the number of Americans older than 65 was expected to double between 2000 and 2030. While the total Island population grew by 10 per cent between 2000 and 2010, the population over 60 grew by more 50 per cent.
A recent draft housing needs assessment for the Island found that almost half of those 65 years or older have yearly incomes of less than $35,000.
In 2011, 16.7 per cent of the population was older than 65, compared to the state average of 14 per cent.
By 2030, about 7,000 people on the Island could be 60 or older, compared to about 4,000 in 2010. Those between 80 and 84 could triple to about 1,000 people.
That age group is most at risk, Mr. Temple said, and especially prone to dementia and Alzheimer’s Disease.
In a telephone interview with the Gazette this week, Ms. Bookman elaborated. “There’s a lot of anticipation about the fact that many people who have been seasonal or part-time residents may decide to retire to the Cape and the Islands,” she said. “The elderly population is going to grow everywhere but more so on the Cape and the Islands.”
A social anthropologist who has done extensive research on aging-friendly communities, Ms. Bookman said the elderly care model is changing from the old concept of “aging in place,” which supported seniors to stay in their homes as long as possible.
“Over the last five years or so, we’re seeing more and more elders organizing themselves in their neighborhoods, stepping forward and saying we want to shape what conditions are going to be like both on a physical level and social conditions,” she said.
The existing services on the Island are excellent, she said, but there’s room to grow.
“I’ve been really impressed with number of services already there. There’s a lot to build on,” Ms. Bookman said. “On the other hand there’s not necessarily a level of coordination and integration of these services. A lot of people don’t know about them. There’s a lack of information and communication, so there’s a lot to be done.”
But she also said that the Vineyard does not have to reinvent the wheel, and at the June 17 presentation she’ll speak about other examples of aging friendly communities.
“One thing that is true all across the United States and the world is there’s a mismatch between the needs of an aging population and the way our cities and rural areas have been designed. So the question is what can we do now in the next couple of decades to redesign them?” she said.
Housing, transportation and outdoor spaces are three areas to focus on, she said.
“Transportation promotes personal mobility; it’s a very important vehicle for social participation that elders could have if they wanted it,” she said. “We’re trying to maximize access and participation for elders.”
Beyond infrastructure and coordination of services, Ms. Bookman said an aging-friendly community sees its elders as an asset, not a burden.
“There’s a way to see elders, and it’s certainly how many elders see themselves, as an asset to the community and not just see them as a burdensome population we have to figure out how to help,” she said.
And the elderly can help each other, she added.
“It’s very clear that people who have certain needs can also be helpers to other people,” she said. For example, someone who can no longer drive may be able to cook for someone in exchange for driving.
Organizing neighbor-to-neighbor relationships will help cut costs, too, Ms. Bookman said.
She emphasized that these decisions need to come from the community itself. “What do residents of Martha’s Vineyard want for themselves?” she asked. “They need to shape a process that feels authentic to them . . . I want to help the Islanders think about how can these be adapted to conditions on Martha’s Vineyard so it can be their own.”
Hospice of Martha’s Vineyard executive director Terre Young said services are lacking on the Island for people with dementia, Alzheimer’s and Parkinson’s Disease.
“Our Island does not have an agency or system that supports those illnesses,” Ms. Young said. “I can’t help all the people who call me because I have to hold onto staff and funding to support the people who are really approaching the end of their life.
“We do take Alzheimer’s [patients] but they have to reach a certain stage and unfortunately the caregivers are so exhausted.”
Martha’s Vineyard Hospital president and chief executive officer Timothy Walsh said he expects to see a growing demand for geriatric care and future increased need for medical services on the Island.
“The last fairly expansive look we did at the aging population and demographics was when we were designing the new building,” he said. “The building was designed so it could be expanded if it ever called for it.”
Primary care, orthopedics and oncology are all areas of increasing demand for elderly health care, Mr. Walsh said. To meet those needs, he said the hospital is working to improve access to primary care here. Also the hospital hired a new orthopedic specialist who will start in July and opened a special oncology wing in April.
“We meet with the hospital staff about once a year and they identify needs,” Mr. Walsh said. “They see more of what’s needed here than most people and they know who they have to send off-Island for care. I think the oncology program is a result of that.”
Juliette Fay, who recently took over as executive director at Martha’s Vineyard Community Services, said she, too, sees an increased demand for elder services.
“We see it in the outpatient clinic and the demand for the various groups that we’re running,” she said.
Elder care programs available through Community Services include CORE, which brings the services of Island Counseling Center to homebound seniors. There are also support groups for the elderly suffering from dementia and a caregivers group.
The impact of an aging population ripples out across the Island, even to unexpected places. The Animal Shelter of Martha’s Vineyard sometimes receives animals from elderly residents who move to nursing homes or can no longer care for their pets. Towns sometimes provide snow plowing and other services for the elderly who cannot do it themselves, and support is needed for those caring for aging parents.
Mr. Temple said a key focus is how to create collaboration among Island towns and organizations.
Robert Tonti is chairman of the healthy aging task force committee and chief executive officer of the Vineyard Nursing Association. He said the goal of the study is to understand potential connections between existing services and identify gaps.
“If you put the patient at the center of the circle and build a circle around them, attach different providers and needs, what picture emerges?” he said.
“The goal is to make a more robust network,” he continued.
Isolation, at-home injuries, unsafe homes, poor medication management, transportation, nutrition and access to health care are some key issues VNA patients are facing, Mr. Tonti said. Internally, he said VNA’s major challenge will be having enough staff to meet the growing demand.
“Where is the labor going to come from, because it’s clear the elder population is growing reasonably fast,” Mr. Tonti said. “And to do it effectively, that’s the challenge constantly in front of us.”
With a growing population that is aging and living longer, Vineyard director for Elder Services of Cape Cod and the Islands Jacque Cage said having agencies work together is key to success.
“Collaboration is extremely important to us because of limited resources, but it’s essential,” Mrs. Cage said. “We’re looking to meet a variety of needs for people. You really need to be able to work across the boundaries of agencies. Some agencies are largely medical and others are largely social, the population we’re attempting to serve has both of those needs.”
She concluded: “Growing older is natural. Yes, there are needs, but our retirement community is a great resource to our community at large.”