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Aging in Place

A Promise or a Prison?

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Further north in the Hudson Valley, things look even greyer. Sixteen percent of Dutchess's population is over 65, a 2.5 percent leap in just five years from the 2010 Census. Ulster County has an over-65 population of 17.9 percent, an increase of over 3 percent in five years. Sullivan County is at 17.3 percent, Greene County at 20.5 percent, and Columbia County at 21.5 percent. All four of those final counties have a notable counterpoint, their overall populations are shrinking even as their senior population increases rapidly.

A business factoid perhaps best suggests the prospective isolation facing seniors aging in place. Companies including Toyota and IBM are working perfecting care-bots programmed to tend to seniors living alone. Merrill Lynch estimates the personal-care robot market could exceed $15 billion annually by 2020.

There are, of course, more human-friendly options. European studies show seniors universally seek to get out more but feel they lack safe options. The researchers advocate creating low-cost, low-tech "short distances strung together with staging posts," such as safe sidewalks, benches, and bathrooms. Though this sounds simplistic, it is a starting point for elder health.

The discipline of gerontology cites the concept of "lifespace": The further a person travels from their bed every day, the stronger their health correlations. A smattering of so-called "age-friendly cities" seek to build on these findings, highlighting ways for improving mobility and inclusion through universal design initiatives for public spaces and public transport. While garnering strong theoretical support, age-friendly cities remain largely unfunded.

Meanwhile social isolation suffered by many seniors, besides being deadly, is enormously expensive. With Alzheimer's alone projected to cost $1 trillion annually by 2050, the choices and outcomes are already stark, and the stakes are only going to grow. Fortunately, low-cost initiatives are available.

Kingston as Template

Kingston, with 15 percent of its current population 65 or older, is emblematic of challenges facing small cities. What do seniors need to live well here?

"Transportation is number one. The most important piece for seniors right now is getting to and from places," says Francesca Ordolono, operations manager of two privately owned buildings in Kingston, the Governor Clinton building and Yosman Towers, that provide publicly subsidized apartments for senior citizens.

Public officials are aware of the problem. "We have a very active senior population who struggle with our poor sidewalks and inadequate public transportation system," says Kingston Mayor Steven Noble. The Broadway Streetscape Project, an infrastructure initiative by the city to be started this year will install ADA-compliant sidewalks and benches in adition to other safety features.

Kingston has plenty of company in confronting such problems. The National Association of Area Offices on Aging says transportation is the number one reason seniors call their national Eldercare hotline.

"There is no doubt we are going to need better services for seniors, and we know it," says Robert DiBella, director of Ulster County Area Transit. He estimates providing "demand-response" transit to pick up by appointment would double the agency's $5 million annual budget.

There is a lower-cost option, sidewalks, as the foundation for stringing together attractions. Hudson Valley's dense riverside cities like Kingston have an advantage toward becoming age friendly. In their very compactness, they foment opportunity for NORCs to develop. These are naturally occurring retirement communities, where long-time neighbors are facing the same challenges as they age together. But NORCs don't happen automatically; they develop best where seeds of infrastructure and assistance are designed to develop a community.

British gerontologist Dr. Sheila Peace describes the work as a process, not a policy, saying those creating NORCs must work toward "Neighborhood as a goal to be achieved, rather than a starting point."

Like most Hudson Valley cities, Kingston is full of surprise vistas and historic pocket parks, which are ideal to start stringing together staging posts to facilitate seniors. One theoretical opportunity exists behind the Governor Clinton apartments: Off Albany Avenue there is a peaceful oasis garden boasting a splendid vista of the Catskill Mountains. It hints at NORCs that could be created, regionally, using neighborhood assets around an existing senior building, and also illustrates the complications of upgrading facilities, using imagination and public private-partnerships.

The garden is on private property and not visible from the street, so insurance arrangements and signs would be necessary to take full advantage. The garden abuts a large but little used dining space that could be a thriving café, perhaps under public-private partnership.

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