September 22, 2014 by Jean
After writing a post (Getting By With A Little Help From Our Friends) about the importance of building a community of friends in retirement, I was alerted to Beth Baker’s book with a similar title and on a similar theme: With A Little Help From Our Friends: Creating Community as We Grow Older (Vanderbilt University Press, 2014). Baker is a journalist, and her book is an exploration of how we might live as we age.
The book is divided into three parts. Part I, “A Time Like No Other,” builds a case for why we need to be intentional about how we will live in our old age. Baker notes that most people express a desire to “age in place,” but that they don’t plan for doing so in any realistic way. The problem, she argues, is denial; we can’t (or don’t want to) imagine ourselves getting old and frail. Baker characterizes her goal in writing this book as follows:
My wish is that instead of pretending that we will live forever young, until a crisis forces us to realize we’re not, we will ponder the big questions: Which of the many ways to live will I choose? What will give my life the most meaning and joy? How will I get myself from here to there?
Denial, long the drink of choice for those facing their twilight happy hours, no longer seems so appealing to many of my peers. And that is a welcome development. Because only by facing this stage of life, by really thinking about what is possible – and what is not – can we do what all of us want to maintain our independence, a sense of autonomy, and the connections that give our lives purpose and happiness. (p. 26)
Part II, “A Wealth of Options,” is the heart of book. Here Baker explores a variety of models for living in old age. She has used her journalist’s skills well here, traveling the country to learn about various models in existence and bringing each to life with specific examples and the use of interviews with participants. The types of communities she examines include the village (neighbors helping neighbors), cohousing communities, naturally occurring retirement communities (NORCs) with supportive social services, the creation of community without walls, intergenerational communities based on elders providing help and support to those who are younger, affinity group communities of members who share some common characteristic, house sharing (with friends or strangers), and new arrangements for intergenerational family living.
Baker considers both the strengths and weaknesses of each model, and she also emphasizes important features that all have in common. All of them emphasize the importance of elders as agents in charge of their own fate rather than as clients who must submit to the rules of service providers. All of these models also focus on helping as an outgrowth of community and on fostering interdependent relationships among community members. And in many models, elders are envisioned as both helpers and helped.
Baker’s presentation of these various models of community is so engaging that it moves the reader from denial to actually feeling excited about the prospects for living in old age. This leads to Part III of Baker’s book, “Getting From Here to There,” a discussion of issues that need to be addressed by any model for creating a viable community for aging in place and policy considerations for making these models possible. Four chapters in this final section each address a different issue:
- “Design for Life” examines the design of homes and neighborhoods, from accessible design to universal design
- “How Will We Pay?” considers the strengths and weaknesses of available options including government funding, private insurance (especially Long Term Care insurance), and reverse mortgages.
- “Who Will Help Us?” focuses on the importance of direct care workers, the poor pay and working conditions that they generally experience, the looming shortage of such workers as the baby boom generation ages, and possible alternatives.
- “Is There a Robot in Your Future?” looks at non-human help and technological solutions as an alternative or complement to help from human caregivers.
The final chapter of the book, “What if? – Mapping Plan B” comes back to specifics by presenting case studies of how individuals were able to age in place under different models. These include a cohousing community near Seattle that was able to support a founding member through ALS; Full Circle, a program in small-town Maine that combines technological solutions with creating a circle of caring; the Green Houses model of group care homes; and home and community-based services.
Baker’s book is both helpful and hopeful in its presentation of options. As I read, I found myself stopping to look up various models online and to see what was available in my area. I got really excited when I got to the Full Circle program in the final chapter. Many of the programs in the book seemed more suited to urban and suburban neighborhoods than to rural communities, but here was a model created to work in rural Maine, and one that I could easily imagine myself participating in as both a recipient of care and a member of others’ circles of care.
Whether you are actively thinking about how you will age in place or have been avoiding thinking about it, Beth Baker’s book provides a valuable resource. As soon as I finished reading the library copy, I bought a copy of my own. This is a book that I want to revisit over and over as I work on creating my own caring community.