Kathy Spirer is Executive Director of Cambridge at Home, a non-profit group that helps elderly people stay in their own homes. Cambridge at Home provides a desirable, economical, option to assisted living and other institutional care. Aging in place is important among the continuum of options that allow us to grow old with grace, dignity, and safety. We spoke at her office in Cambridge, MA.

Cambridge at Home started eight years ago. We are the second oldest ‘village for aging’ in community in the United States. The first was founded on Beacon Hill, in Boston. Now there are 160 groups within the village-to-village network across the United States. All operate with same goal: to enable people to live at home with independence and safety. We connect members to services, from home health to handymen, to meals. We also sponsor a range of exercise and social activities, including a book group, scrabble, bridge, a discussion group, and even an exercise group that meets three times a week. About three-fourths of our members are mobile, so sociability is a big part of what we provide.

We currently have just over 200 households and have been steady in that number for many years. Anyone over the age of 50 can join. Current members range between 58 and the late 90’s, though most are over 80.

I asked Kathy if research about villages for aging provided data to support their efficacy.

The Village-to-Village network works with researchers at UC Berkeley to get data and quantify the benefits of these programs, to see how aging in place affects length and quality of life. Since we’ve been around for such a short time and the variables are great, it is difficult to quantify at this time. However, we are going to need data to get insurers or other third party payers to decide these programs are worthwhile. Our demographic are people with too many assets to get public assistance but not so wealthy they can easily pay all the costs of staying in their homes.

People join for many reasons. For some, this is a friendly charity; others join as insurance against a catastrophe. Some join from their hospital bed – the catastrophe has already happened. Still others join for the social aspect and come to use the other services in time. Adult children often try to enroll their parents, but we prefer the parents to enroll. We want parents to want our services. Adult children can be enemy #1, pressing parents for more services or moving them before parents are ready. Children want peace of mind that their parents are safe, parents want to hold on to what is familiar and gives them independence. 

When assisted living developments began, people flocked to them. Then, around 2008, many people realized they couldn’t afford them. Assisted living has a run rate from $4000 to $10,000 per month. Plus the extras. The least expensive option for most seniors, until they require 24-hour care, is to stay in their home.

Home modifications can be an obstacle to aging in place, but they are a one-time cost. The biggest challenge for most people is actually transportation. People want independence, and that is difficult without a car. Public transportation is a real challenge for people with mobility issues, shared van services are affordable, but inconvenient, while taxis and ride services are expensive.

I asked how buddy systems, where seniors check in on each other every day, contribute to people staying in their own homes.

Buddy systems are popular and effective in many parts of the country, but we’ve had little luck instituting them in Cambridge. People in Cambridge are very independent. They bristle at the idea that someone ought to check in on them. The reason we don’t have 300 households in Cambridge at Home is because too many people don’t think they need our services, until it is too late, and then they need even more services.

I asked Kathy, how will we live tomorrow?

In order to live in the future, we are going to need to learn how to ask for help and receive help in a respectful manner. I know an 82-year-old man who every day drives to Newton to care for his 100-year-old mother. She never counted on living so long; he never counted on giving her care when he is so old. We are living longer, our frail years are extending, but it is difficult for us to ask for and receive help.