Are communities ready for aging-in-place movement?

From several states away, Benjamin Alexander's daughter tries to keep tabs on him. At 81, he's in good health and gets around easily, but he said she still worries.

"She urges me to do this or that, to be careful walking down steps. My house is a ranch, but I have a basement. She cautions me about those," Alexander said.

Anyone who lives alone probably has wondered what would happen if there was an acci dent at home. For older people, it can be more than an abstract thought. It can be an ongoing concern as knees start getting wobbly, hips get arthritic and visual acuity and balance become unpredictable.

An aging-in-place movement that aims to keep older people in their homes and communities -- if that's where they want to be -- is gaining momentum, driven by a huge cohort of baby boomers nearing retirement age. But are communities ready?

Starting in 2011 and continuing for close to two decades, there will be a huge surge of older Americans born between 1946 and 1964 -- the baby-boom years -- turning 65.

As Alexander is doing now, many will enjoy good health for years to come.

But there is likely to come a time when they will need help to remain at home. They may no longer be able to drive or fix their own meals or take care of the family home. A report from the University of Virginia's Weldon Cooper Center for Public Service notes that the oldest seniors are more likely to live in poverty, to be less educated and to have more health problems.

The aging-in-place movement urges communities to start thinking about how they are going to accommodate these residents who want to remain home, many who will be alone as spouses die and children who have moved away try to help from long distance.

"We have to move aging from the health-care agenda to the civic agenda," said Robert McNulty, president of Partners for Livable Communities, at a meeting in June on aging. "Most of our communities are still almost unwalkable for people." Roads and streets in many communities, for example, are not only unfriendly to the elderly but also to the disabled and anyone who is frail, he said.

McNulty spoke at the June workshop in Richmond sponsored by his organization and the MetLife Foundation with the National Association of Area Agencies on Aging. The goal of the workshop was to get the community talking.

There is evidence that there's a big need for more awareness. Helen Eltzeroth of the National Association of Area Agencies on Aging said a survey of 10,000 communities showed that less than half had started to plan for this coming age wave.

"It's so amazing how many people don't know about this," added John Martin of the Southeastern Institute of Research. He outlined several areas of concern, including the way communities and homes are built and planned and long-term care.

The Older Dominion Partnership, a nonprofit initiative with statewide reach, has begun one of the most comprehensive efforts to help Virginia prepare for a larger population of older people. Martin's research agency is facilitating the partnership's planning work, which has been under way since late 2007. One recent project of the partnership is an age-wave preparedness resource center available online and intended for government, nonprofits, businesses and others needing data or status reports on the aging population.

(Richmond Times-Dispatch president and publisher Thomas A. Silvestri is chairman of the board of the Older Dominion Partnership.)

Older doesn't necessarily mean sick or frail. Looking at health status, the Weldon Cooper Center report shows that 71 percent of those 65 to 74 report that they are in good to excellent health. For the 75-plus age group, 55 percent report being in good to excellent health.

Alexander feels fortunate.

"My family doctor is just a block from where I live," Alexander said. "I am lucky I have never been hospitalized in my life. I just had a physical a month or so ago. . . . I get out every day. I do drive."

Alexander, who retired from the military and later from a job with the state, lives by himself. His wife died in 1995. Last year, he lost his dog, a Lab mix.

"It would be too much of an adjustment for me to be living with someone under the same roof." He said he has thought about getting another dog, but only "if it's love at first sight."

The Weldon Cooper Center report, which analyzes demographic data from the U.S. Census Bureau's 2007 American Community Survey, also looks at rural-versus-urban and gender differences in aging. About 30 percent of rural seniors live alone, compared with 27 percent of seniors in urban areas. And because women have a longer average life expectancy than men, women are more likely to live alone in their older years. About a third of women 65 to 84 live alone, compared with 15 percent of males. Among Virginians 85 and older, 45 percent of women live alone, compared with 29 percent of men.

As an only child, Cas Overton, 70, learned early on how to reach out and how to take care of herself. For the past 29 years, she has lived in an older neighborhood in Henrico County that she said is filled with older people but is seeing an influx of younger professionals.

"I know a lot of the people on my block and the surrounding blocks and [I] especially have been responsive to seniors," said Overton, who works from home and also volunteers at the Shepherd's Center of Richmond, an organization of seniors helping other seniors.

"In my own experience, I really understand how vital it is for people to have support," she said. "I recognize how often people don't and don't reach out. That is not my problem. I have learned to do that because I have been alone all my life."

Overton has what she calls a "large extended family" of friends and neighbors she can turn to if she needs help.

"I really do depend on them for company and for keeping me active and involved in things," she said. They were there for her six years ago, when she had a hip replacement.

"That was amazingly debilitating," Overton said. "I had to go into rehab for 10 days because I had nobody to take care of me, and I really didn't want to impose on somebody by moving into their home." She did get her friends to walk her dog for several months.

That kind of community can go a long way toward keeping seniors in their homes.

Talk to older adults, and you hear concerns about not being able to get to the grocery store or to doctors' appointments because there's very little public transportation. If they live alone and need to have an outpatient procedure, they have to find someone to come along, or the facilities will not treat them.

There is concern about financial difficulties, about getting help with fixing meals, home repairs and about falling and getting ill while home alone. Some set up a system with friends -- agreeing to check in daily with phone calls by a certain time.

At 89, Olive T. Ritchie is one of the oldest-old, and she is thriving, preparing recently to travel for a national meeting of an organization of educational-office professionals that she has been a member of for 51 years.

Ritchie said she sees seven medical specialists who "try to keep the old girl going." She has two children in the area but tries to be as independent as possible. She has someone come in to clean every six weeks. She has a chair lift to get her upstairs. She tries to get out regularly and makes time to visit a sister who lives a few blocks away.

"I know I can't do but so much anymore," said Ritchie. "I am satisfied with what I am able to do. That means a whole lot . . . If I don't go out for a full week I am perfectly content. I don't think there are many people my age who are satisfied."

Contact Tammie Smith at (804) 649-6572 or .