Each month, “Why Crozet” examines the many reasons people move here, and why they stay here. It’s no secret that Crozet and the communities around it have become magnets for retirees. At the same time the population already here is aging. This month, we take a look at the larger community served by the Gazette to identify resources for healthy, safe, community-based aging.
Each year, young retirees buy or build houses at Wintergreen Resort, taking advantage of its beauty and year-round recreation. But time goes by, said Linda Harrington, who lives in Wintergreen’s Stoney Creek section, in the valley next to Nellysford. “Many of us came here 20 years ago. Now we’re older.”
The aging of the community poses a bit of a dilemma. Many residents chose Wintergreen so their grandchildren could ski, swim, play tennis and ride horses, but of course the grandchildren got older, too. Although the resort provides excellent fire, rescue and police services and there are community health resources nearby, the aging residents were mostly at a distance from their families as well as from medical specialists.
Some had expected to move to independent living at retirement communities to ensure access to health care, companionship and transportation, transitioning to assisted living if it became necessary. “Things have changed, though,” Harrington said. “Residential care has become so expensive and also so restrictive, with all kinds of rules that weren’t there before.” She said the Covid years have amplified the community’s reluctance to take that route unless absolutely necessary. Other elders have expressed their wish to be around children and adults of all ages, rather than being part of a community restricted to those older than 50, and to shop and worship at their regular places with people who know them.
In Wintergreen, aging residents realized how much their surroundings, friends and community meant to them. Many emphasized that they were in their homes to stay. In fact, when the community formed a non-profit providing services for those needing help, they chose the name “Here to Stay in Wintergreen.”
The organization, inspired by the national Village-to-Village movement, quickly grew to about 200 members, about the right size for such a group, Harrington said. Many members signed up for services and are also volunteers who give rides, bring meals, do limited housework, provide assistance with technology, and make small household repairs. Those who need assistance register through the website (there’s help for that if needed) and are matched with appropriate volunteers. There’s more: social events, classes, lectures, training in technology, friendly visits, caregivers’ support, help with pets, and information about the resources available in the wider community.
The Village-to-Village network began in 2009 to serve grassroots groups like Here to Stay in Wintergreen, and now has more than 300 member organizations throughout the world, all nonprofit and volunteer and started by community leaders themselves, with more than 40,000 members who pay a small fee to cover legal and administrative costs. There’s another group affiliated with the village movement forming in Charlottesville. Called CVille Village, it is recruiting members from the east side of the city for now: Belmont, Carlton, Woolen Mills, Martha Jefferson, and Pantops.
It’s worth observing that these structured organizations duplicate what the villages of decades ago might have provided organically, but with people living longer, moving farther, and their children traveling to find work, many of the traditional supports are simply not there. Harrington noted that Nelson County churches continue to do a good job of filling community needs, and provide many resources to the close-knit Nellysford community.
Organizations in the village movement address the general day-to-day needs of normal aging, but aren’t designed for those with advanced dementia, lack of mobility, or other situations needing around-the-clock caregiving.
Have a Plan
Tracy Meade is a financial consultant specializing in long-term care, and she often works with people who have misconceptions about who will pay for their future needs. One of the major mistakes people make is assuming that Medicare will pay for residential care, although there are specific cases where Medicare will pay for short-term rehabilitation after a hospital stay.
Another mistake, Meade said, is assuming that your children will be able to care for you regardless of their own situations. “That’s a conversation that needs to be had before you need care,” she said. She recently learned that the holidays bring a spike in people buying long-term care insurance, both because families come home and notice what’s happening with their parents and because seeing their aging parents makes them worry about their own futures. Still, many of her clients don’t come to her until they’re in their 70s or 80s, when the time to start planning is decades earlier.
A third problem is that often neither the person who needs care, nor the family, recognize the personal cost to the one––whether it be a child, a daughter-in-law, or a spouse––providing the around-the-clock caregiving. “I’ve seen plenty of cases where the caregiver predeceases the one who needed the care,” Meade said.
But the situation is not only of personal importance, Meade said, it’s a matter of public policy: “About 10,000 people each day are turning 65 and retiring in this country, and this will go on until the baby boomers have reached retirement age, about five more years. Many people are retiring to our area, and this increases the strain on our systems.”
Some innovative local programs are designed to ease this strain, providing an alternative to full-time family caregiving, fulltime in-home care, or residential treatment. JABA, the Jefferson Area Board on Aging, has established two Respite and Enrichment Centers (REC), one in Charlottesville and one in Louisa, to provide the daytime services that a residential facility might offer. The Charlottesville center serves Crozet and western Albemarle families.
The centers are open all day on weekdays, and families choose either a full-day or half-day stay for older adults and those older than 18 with cognitive disabilities. Specially trained professionals, including a staff nurse, oversee dementia care, medications, and personal hygiene. Other staff members serve meals and plan fun activities ranging from music and games to trips outside the center to bowling alleys, museums and parks.
Hope Harlow, JABA’s assistant director for center services and health education, who oversees the centers, said the biggest problem she sees is that families wait too long before taking advantage of this service, as it has significant benefits for those at earlier stages of dementia, and for the families who might have enjoyed more time with young children, or at their jobs, to do errands, or pursue their own interests. JABA staff helps families arrange transportation through Jaunt and helps them figure how to pay for the service. Sometimes there are funds available through grants, Medicare, Medicaid, or long-term care insurance.
Another resource that provides care and also respite for the caregiver is the Innovage model, part of the countrywide system of total case management for the elderly known as PACE (Program for All-Inclusive Care for the Elderly). Innovage PACE provides an alternative to residential facilities for those needing nursing-level care. The center, in Charlottesville’s Belmont neighborhood, provides the healthcare and companionship that allow older adults to remain in their homes.
Betty Sharp, the outreach director for Innovage, said participants are carefully evaluated to determine exactly what they need to remain independent, including any needs that an aide can provide within their own homes. Buses serve Crozet and western Albemarle each day, and each person in the program has a team of medical experts, as well as a personal care plan. Most of the medical services are on site, including doctors, dentists, and eye doctors. Should a specialist be needed, the staff schedules the visits and provides transportation. There’s also physical therapy and supervised exercise programs. Participants can choose how often to attend.
Family members can become exhausted, not only with the needs of their elders, but with the complex paperwork and regulations needed to find ways to pay for help. Experts at Innovage help figure it all out. “Many people we serve have fluctuating abilities,” Sharp said. “We keep that in mind when we evaluate them for eligibility. Some people may have no trouble dressing or getting around on their good days, but can barely move on their worst days. We try to be mindful of that.”
Sharp is proud of the Innovage education and social programs: “We treat participants with respect,” she said. “We offer programs that any adult would be interested in.” She acknowledges that there is a mix of people with cognitive and people with physical difficulties, so having a variety of options is important. “Many of the activities are ones I would enjoy.”
When residential care is unavoidable, the Innovage model continues to support its participants with daytime social activities, physical therapy and onsite medical care.
Not all elders will ever need this kind of care. Some will live out their lives on their own or with family caregivers and some will be better served in a 24-hour residential setting. JABA offers help for every scenario, said Sheri Lutz, JABA’s assistant director for community services. For families with concerns about the treatment of their elders in long-term care, JABA offers ombudsman services. Many people in the western Albemarle area take advantage of the home-delivered meals program and transportation management options. Like other JABA staff, Lutz sees the importance of these vital services for the health and quality of caregivers as well as those receiving direct services.
She also has some words of advice for those wanting to help the caregivers among their families and friends. “People are often thrown into caregiving suddenly,” she said. “Make sure to listen carefully to their needs, share information about resources you know about, regularly give them a break, help with some simple daily tasks, and show up exactly at the time you arranged.” By necessity, caregivers often plan their days with very little time to spare, she said: “If you say you’re going to do something, be sure to do it.”
To find help at JABA, start with the hotline: 434-817-5244 or email [email protected].
Reach Betty Sharp of Innovage directly at 434-962-0380.
Find out more about Here to Stay in Wintergreen by calling 434-373-7829