Ethel Eventoff is not your typical 93-year-old. She works out regularly, travels with friends, directs a seniors-only singing troupe and lives independently in her own apartment on Park Heights Avenue.
A professional musician, Eventoff retired last year after working as a music therapist at Taylor Manor for more than half a century. She has spent her entire life in Baltimore and hopes to never have to move. Thanks to the services provided free or for a nominal charge from Comprehensive Housing Assistance Inc., a nonprofit community development agency of The Associated Jewish Federation, she is getting her wish.
Eventoff is one of about 1,000 Northwest Baltimore seniors, and an estimated 10 million nationwide, living in a naturally occurring retirement community (NORC) -- a natural byproduct of the increased longevity and growing independence of America's elderly population.
NORCs include apartments, condominiums, public housing and neighborhoods in which there are high concentrations of seniors who, like Eventoff, have chosen to age in place, in the cities, towns and neighborhoods where they are likely to have spent most of their lives.
Still content and capable to live independently in their own homes, they represent a growing phenomenon and with it a challenge for public policy makers, landlords and service organizations. They also represent a potential reprieve for a nation that, according to estimates by the U.S. Department of Health and Human Services, spent $98 billion in 2000 for seniors who required institutionalization.
Recognizing the growing number of seniors who are remaining in nearby developments and the lack of readily available services, CHAI set out to meet the needs of those living in the Park Heights area. In 1997, it established a "senior-friendly" apartments program to promote affordable rental apartments in the northwest corridor as housing for seniors. CHAI then established Eating Together, a dining program twice a week, complete with transportation.
The U.S. Department of Health and Human Services recently took note of CHAI's efforts, awarding the agency $1 million to expand its services within Baltimore's northwest corridor. The program is a coordinated effort of several area agencies and will serve as part of the National NORC Demonstration Project, a five-city study to determine how to assist seniors who remain in their homes. Cleveland, Pittsburgh, Philadelphia and St. Louis also will take part in the project, which was granted a total of $3.68 million.
The funding will provide NORC residents in Northwest Baltimore with transportation services, expansion of current services to include 800 additional seniors, the designation of additional complexes, and subsidies for in-home emergency medical systems for low-income seniors. It also will provide assistance for the modernization of facilities; increased mental health counseling; cultural and educational training; and community building.
A resident of Bristol House since 1994, Cora Bigger believes that living in a NORC has given her a more fulfilling life.
"It makes your life better, because you really feel like you belong to a family, a lovely community," she explained. "We go to the movies; we see shows; we go out to lunch sometimes; we have special days where we go to the malls. There is always something to do. ... I don't think I would have done as well closed in, in a regular apartment building, if I wasn't a part of the senior-friendly program. It's wonderful."
At 72, Bigger gives back to the program by serving as the building's liaison. She assists seniors in filling out change-of-address forms, organizes trips to the voting booths during elections, attends all on-site functions and stays in contact with her neighbors, to make sure no one is left out. She says her dedication to the community is in direct response to all it has given her.
Eventoff, like Bigger, is amazed by the number of services available to her and other residents in her area. "We have exercise programs, crafts programs, Rom dance classes, and so much more," she said. "CHAI provides us with a calendar for the whole month, so we know what we can do every day. It gives us a reason to get up in the morning. And we have a wonderful social worker who you can cry your eyes out to in the privacy of your own home."
"Imagine yourself not being able to drive, or not having a car at your disposal. It can make life so difficult. Well, CHAI provides us with transportation. Can you imagine what CHAI means to us? ... It is our lifeline. ...
"God had to be on my side, because I was looking all over. Where was I going to live? I didn't know. I looked at every place and when I saw it I knew I would like to live in the Windsor House -- Windsor Castle, if you please. I can only tell you what you're hearing from me you will hear it from everyone who is fortunate enough to live in such a community."
And growth is on the way, with a goal of expanding to serve all senior adults in the community, said David Schimmel, CHAI's program coordinator. "The funding is strictly for all new services. We are not putting money back in to existing programs," he said. "There will be three to four new apartment buildings that will be considered senior-friendly sites. There will be a neighborhood outreach worker who will work within the communities. ... We are fortunate that we already have a senior-friendly program and we already have a model that works. Now the idea is to duplicate that program in a number of different areas."
Previously, services targeted residents of apartment complexes, but with the new funds CHAI will expand those services to seniors living in single-family homes. "It's very different to pick a block where there are 10 senior homes and provide services to the people on that block in the same way we have in the high-rise apartments," he said. "It's going to be a challenge, but we think we can do it."
Jewish Family Services is a social service agency, founded in the mid-1800s, that historically has a strong service delivery to older adults. For several years it has partnered with CHAI to provide services to the "senior-friendly" program, which supports apartment complexes where the residents have aged.
"The whole intent is to maximize and enhance the quality of their lives, without their needing to uproot themselves at a time in their life when to do that could be much more difficult," explained Elaine Kitt, an administrator with JFS. "We meet with tenants, work with management, provide recreation and social services to the people in the buildings who are interested in these services."
But there were and still are many others out there. "Over the years, we've had people who have identified that they have problems, but what about the rest of the people who live behind closed doors, who for whatever reasons are not asking for help? They weren't maximizing the usage of the services here or at the Jewish Community Center, which also provides these services and also knew that within this corridor there are a lot of older people. So, historically, we were all providing certain services and trying to reach out in our own ways," she explained.
"When we collaborated, that's what really made this a much more comprehensive service and allowed us as a group to offer so much more to the community."
The building management also supports the local NORC initiative, according to Kitt, who claims much of the effort relies on the fact that it is a management-driven service. On a practical level, "it helps to maintain stability within the building," she said. In some apartment buildings, the management has installed bulletin boards, distributed fliers and even allotted a community space for seniors.
Together, community-based agencies aim to keep people living independently in their own homes as long as possible, said Sara Lee Woolf, a social worker with JFS.
"We started meeting as a group to look into ways of helping these people. Things like a van to take them shopping. Transportation, mobility is always a big issue with the elderly. And of course as you keep people in place it also helps to stabilize the neighborhood, so that we were coming from all different directions," she said. For example, Sinai's Life Bridge community services has a health educator who offers programs in the apartment buildings.
Denial is a challenge seniors often must overcome before they can fully appreciate the independence the services offer, according to Woolf. "The elderly often see help as an admission of lack of independence, rather than understanding that this boosts their independence," she said.
Residents respond positively when they learn of the counseling component, but sometimes are hesitant to meet with Woolf themselves. "Everybody thinks it's a good idea -- for somebody else. They'll say, 'I'm fine, but I have a neighbor who could use some help,'" she said.
She added, "But once you've got a relationship established, then all kinds of things begin to come out."
Galina Borodkina works for JFS in Millbrook, at an apartment complex of 720 apartments, where the majority of residents speak mostly Russian. She works with intake and immigration issues and runs a psych-educational group that includes a variety of topics -- the most recent being how to deal with stress. "They feel this social isolation even more than some native speakers," she said.
"We are trying to make them feel that they are part of the community. As one of my clients puts it, 'A person needs to offer help in a way that another person would love to accept it,'" Borodkina said. "We are trying to send a signal that we are here for you, whenever you need it, in whatever form you need it."
As the federal government looks to Baltimore and the other four cities to pave the way for perhaps an alternative to expensive and often unnecessary institutionalization of America's elderly, CHAI's Schimmel joins the others in their excitement to take their services to the next level. "This is a really neat challenge. It's a demonstration grant. Basically, the government is saying, 'Here are some dollars that we're putting as seed money to these communities. Show what you can do,'" Schimmel said.
"For me, this is something where if we can do this right, it's going to have an impact not just here, but in cities across the country. In addition, we can make sure that our community is taking care of a population that we will all be a part of one day."