- [Anita Brown-Graham] Coming up on ncIMPACT, many older adults want to avoid elder nursing care and stay in their own home for their remaining years.

We explore what community collaborations are emerging to age in place.

- [Male Narrator] ncIMPACT is a PBS North Carolina production in association with the University of North Carolina, School of Government.

Funding for ncIMPACT is made possible by.

- [Female Narrator] Changing the course of people's lives, that's the impact UNC Health and the UNC School of Medicine work to deliver every day.

Our 40,000 team members across the state of North Carolina are committed to caring for you, our patients and communities, as well as educating the next generation of healthcare professionals.

Individually, we can do a little, but collectively we can do a lot to create impact.

- Hello and welcome to ncIMPACT.

I'm Anita Brown-Graham.

Nearly 90% of adults age 65 and over wanna stay in their current home and community as they age.

This is called aging in place.

It's the ability to live in one's own home and community safely, independently, and comfortably.

However, there are many barriers standing in the way of older adults hoping to age in place.

ncIMPACT's Evan Howell introduces us to two individuals who are trying to overcome these barriers in different ways.

- [Evan] In 2013, Gloria Harrison was facing serious health complications.

Doctors told her if she could make it through the next 24 hours, she had a good chance of surviving.

The odds of going home were slim to none.

But Harrison did come home saddled with a feeding tube she would use for the next six months.

- Well, right now I still can't do a lot of heavy lifting and stuff but I was determined, and with the help of the Lord, I made it back.

- [Evan] Harrison's health has complicated her desire to stay in her home by herself.

She's lived in Littleton area for generations and like many rural communities, there aren't too many resources or services to help her age in place.

Harrison has turned to her church community to fill in the gaps.

- The church is just like a community.

We are close.

We look out for each other.

And if there's anybody in the area that's not a member of the church and need help, we reach out to them.

- And part of that same thinking is to have the tools you need.

- [Evan] For Bill O'Connell, he also wants to remain in his home as he ages, but the Asheville retiree has health issues looming and no family in the area.

- I'm sure if I fell down and fell on my head and I was a basket case, yeah, my kid would take me in.

But short of that, I would prefer to be able to figure this out myself.

This has a small tilt inwards so that the water runs this way.

- [Evan] He says he's fortunate to have the money to make life easier by adapting his living environment to his needs.

He's hired a local organization that renovates homes with accessibility in mind.

- And I think the first base for me to round is that I've done, with the assets, intellectual, financial, and health assets I've got, I've done my best to plan for the future.

- [Evan] O'Connell says every detail in his home was designed in anticipation of the challenges he may have as he gets older and figuring out how things should work and where they're situated is a driver behind a growing construction trend for retirees called architectural accessibility.

- We kind of age in place badly in many cases instead of successfully because the house increasingly doesn't fit what we need to be doing and what we wanna be doing.

And so we wind up doing fewer things, kinda living smaller lives and living more dangerous lives.

So we don't do as many things as we used to, and the things we do, we do in a way that puts us at risk and maybe our spouses, our family members, and eventually caregivers too.

So there's that person-housing mismatch.

- You want to make things really simple.

- [Evan] O'Connell says it's not just the practical changes he's made, but it's the social network he's worked to build that's key to successfully aging in place.

He says it isn't rocket science.

It just needs to be what works.

- I think a lot of people could do this, whether you spend a lot of money on it, or whether you spend a little money on it, that's scalable.

[indistinct] - [Evan] For Harrison, she says her plan and reliance on her community works for her, and her preference is to live the rest of her days at her home rather than an assisted living facility.

- To me, there's no place like home.

- [Evan] At the end of the day, both Harrison and O'Connell have different approaches to aging in place, but what they have in common is the desire to stay in their homes as they age.

For ncIMPACT, I'm Evan Howell.

- Joining me now is Jenisha Henneghan.

Jenisha is the assistant director at the Area Agency on Aging at the Triangle Council of Governments.

Jenisha, thank you for being with us.

- Thank you.

- Let's talk a little bit about what is the value of aging in place?

How does it benefit an older adult and their family?

- One of the benefits, it allows an older individual to feel like they have their independence so they can maintain their independence.

But as far as a family unit, it allows families to stay connected.

You have the intergenerational connections that are able to be maintained.

- So then what are the barriers for older adults who want to be able to age in place?

- Cost and resources are probably top of the list.

You know, when you talk about making sure the home is accessible for longevity, that can cost, trying to retrofit homes to make them safe.

And also the resources, making sure you have the resources to have people come in, maybe to assist you, and those things can add up financially.

- And this is an astounding statistic to me, but only about 1% of homes in the US are actually conducive to aging in place.

Given how many elderly people we have, why do you think the percentage is so low?

- I think trying to retrofit older homes and then to make them accessible, and then also this idea of maybe even current new build homes, when you think about making them for someone aging in place, sometimes our educational level of what that might look like is different.

Sometimes people think of a more sterile look, where it can be appeasing, new designs you know.

It can be attractive.

And I think that's the education showing that that can be attractive.

- So Jenisha, what are resources that are available through agencies such as yours across the state, and how can our viewers access them?

- So I'm with Triangle J Council of Governance and Area Agency on Aging.

And so we are connected with our local providers who have resources for those who want to age in place, such as if they need caregiver support, that network, or even if they need maybe assistance within the home.

So our local providers in our, within our region also provide those kind of resources.

- Excellent.

Thank you so much Jenisha.

Aging in place is especially important in communities like Buncombe County, which has one of the fastest growing older adult populations in the entire state.

ncIMPACT's David Hurst shows us how this county provides older adults with the resources they need.

David.

- Yeah Anita, you talk about growth in Buncombe County.

One in five adults are over the age of 65 and by 2025, that number is expected to be one in four.

That's why the community created a comprehensive initiative to serve the needs of older adults.

When Ann Cox moved to Asheville three years ago, to be closer to family, she struggled to find affordable housing.

- It was a challenge initially, housing is sky high in this area, and there was no way that I could afford even thinking about purchasing a home, let alone rents were beyond me.

[indistinct chatter] - [David] She settled for an apartment where they put her on the fourth floor.

- That just really wasn't something that I could find sustainable for long.

I mean, it just wasn't gonna work out for me.

So this is a walk-in shower.

- [David] But then she found an aging in place, townhome community in West Asheville built by the Asheville Area Habitat for Humanity.

She's getting ready to move into the neighborhood, which will have eight aging in place townhomes built with universal design features.

- I can stay where I am as I age and hopefully for my lifetime and feeling joyous about that.

[indistinct] - [David] Asheville Area Habitat for Humanity, executive director, Andy Barnett says the neighborhood is made up of 90 households of all different ages and backgrounds.

- Our homeowners working on their home and working on the homes of their neighbors and going to, classes together with their neighbors so that by the time folks move into their neighborhood, they know their neighbors already.

And that's a really critical part to aging in place is just knowing that you've got the social connection to make sure that people are safe and secure in their homes.

- [David] Barnett is also a member of the Asheville Housing Options for Aging in Place working group.

The group's goal is two-fold to make sure everyone in the community understands the importance of aging in place and to examine policy improvements, to make it easier for folks to age in place.

- One of the things that we've discussed a lot in the group is targeting messaging to people in their thirties and forties who are buying their first homes maybe, or who are thinking about maybe moving into their next homes for their, rest of their adulthood to get that population thinking about how this may play out in their lives and building on the front end into their plans to age in place.

- [David] Cathy Avery is another member of the working group.

Her organization helps older, low income housing residents with aging in place.

She's working to enhance a community nursing model in the community saying there's a strong link between healthcare access and housing.

- And if we can do that and get to it quick, immediate change to help people, where they are not struggling and people are trying to help don't feel all alone and there's no one there for them to help them.

Yeah, I can get real excited around that, cause it could be me one day.

It could be you one day.

- [David] And for Ann Cox, she looks forward to moving into her town home to have a space to host family and also build a new kind of family, in her new community.

- I'm so grateful.

I feel, you know, so thankful to have that in my life especially as I age, that's just been such an important factor for me.

- Buncombe county is also part of the AARP age friendly network.

There are currently 11 age friendly communities in North Carolina.

Allison Klima, who you heard from in that story says there's a tremendous benefit being a part of that network as they're able to share best practices and learn from other communities and their efforts as it relates to aging in place.

- David, thank you for highlighting what's happening in Buncombe County.

Joining me now is Heather Burkhardt.

Heather is the executive director for the North Carolina council on aging.

Heather was saw in that story that townhomes specifically built with aging in place in mind.

How common is that across North Carolina and what are some of the benefits?

- I believe we're growing in terms of our new construction for universal design as North Carolina's population is growing.

So historically, the investment is, has been in refitting, retooling, existing housing, but we need to think about the new constructions and the needs as people grow older at North Carolina to age in place successfully as well.

- Absolutely.

So of course there are no one size fit all situations and there are times when aging in place just doesn't work.

What are some of those situations?

- As people age in place, they need to have that connection to social connectedness.

You heard that in some of the clips and I think making sure you have access to healthcare is really critically important as well as transportation, grocery store access.

And if that can't be maintained at a specific level as your needs change, as you progress and grow older, you may not be able to successfully live in place if you're not safe and secure and don't have the supports that you need.

- And we've seen that this is a multifaceted issue with lots of needs, physical social supports.

How does the community benefit from having organizations working together across sectors to make aging in place possible?

- They absolutely grow stronger.

There is a point where it's an individual's responsibility for planning, but as North Carolina's population continues to grow, we have more older adults than we do children at this point in North Carolina.

And so it's the community's responsibility as well to make sure that we have policies and programs in place to accommodate the needs of, the diverse needs of North Carolina's older adults.

And so communities grow richer as they plan for older adults.

And we find that most of the things that a community needs for older adults also benefit younger families as well.

- So wonderful for those communities that have all of these resources and just need to coordinate them.

But how do we deal with communities where we don't have these resources that are completely underserved?

- Right, we have rural communities and they have resources, but sometimes they're different and the coordination needs to happen differently.

And so that's another reason for the community needs for planning.

And so the needs of somebody in a Raleigh are different from somebody in Scotland Neck.

And so knowing those people in those communities and what they bring and what they offer, are really important.

But we know by and large that transportation access, affordable housing access are really underserved in a lot of these rural areas as well.

- Indeed.

Aging in place often requires a focus on more than just housing.

In Forsyth County their aging in place efforts include providing a robust selection of services and resources for older adults.

ncIMPACT's Melody Hunter-Pillion introduces us to the Age-Friendly Forsyth Coalition, Melody.

- Anita, This is a wonderful innovation.

Age Friendly Forsyth is all about giving voice to the older adults they serve.

During the COVID-19 pandemic the biggest need was combating social isolation.

Age-Friendly Forsyth they innovated to meet this need and community leaders tell me it highlights the importance of taking aging in place one step further by pursuing an aging in community mindset.

- [Melody] Carol Penney had been tea teaching the kinder music class for decades.

The early childhood music and movement program is meant for young children, but Penney had an innovative idea for the class after her grandson was born and her husband was diagnosed with Alzheimer's.

- And I was noticing that when I brought out my box of instruments for Joey, who was 18 months old and Carl, they loved the same things.

- [Melody] This gave Penney the idea of having older adults help teach the kinder music class.

During the first class, she saw her husband light up for the first time in a while.

- With his declining executive function and Joey's developing executive function, they were like meeting and, I just thought, wait a minute, we could do this for more seniors with dementia, take a kinder music class there.

And that's what got the wheels turning.

- [Melody] They branded the new class Format as kinder music bridges, and it's become one of the most popular activities for older adults at the Williams Adult Day Center.

- The very first class with children and participants by the end of it, one of the little boys had climbed on to the seniors lap and it's the first day he ever met him.

So it was on believably easy.

[indistinct music] - [Melody] It's one of the many programs that have come out of the Age-Friendly Forsyth initiative.

The coalition is made up of nearly 20 organizations that focus on connecting and engaging aging adults.

It began in 2015 after a randomized telephone survey of over 1000 older adults in the community.

- And we have treasure trove of data from that research that has led us to this initiative now that involves hundreds of folks in many many community conversations.

- [Melody] Recent community conversations have centered around how to engage senior citizens after months of isolation due to the COVID-19 pandemic.

- What happens oftentimes is when someone chooses to stay at home, there is the chance that that can lead to loneliness and isolation.

So if we take this community approach and try to work to help keep folks connected, then we can avoid that loneliness and isolation that sometimes is a reality.

[indistinct] - [Melody] With classes and activities coming back older adults say they're grateful for all the opportunities made available.

- You don't know what that means to the elderly that comes here.

They enjoy it.

I enjoy it.

- Lets wave goodbye.

- [Melody] And with the kinder music bridges program back in person, Penney says it's making a difference in the lives of aging adults, like never before.

- Who doesn't light up with music and with children?

And so when we put those together, it's the perfect combination to engage these seniors.

- To continue to serve older adults, Age-Friendly Forsyth is about to start building a 60,000 square foot building for new intergenerational center.

This will be a first of its kind center in the state, bringing together health, wellness, and arts to connect and serve multiple generations, Anita.

- Love this collaboration.

Thank you, Melody.

Let's bring back our wonderful earlier experts and joining us for our ncIMPACT roundtable is Bryan Godfrey.

Bryan's a clinical social worker with a UNC geriatrics clinic.

Bryan, let's start with you.

We heard in that story, the term aging in community, what does that mean and how does it relate to aging in place?

- Definitely.

Many people are familiar with the concept of aging in place, but they tend to associate it the most with aging in my house.

And that can be great.

It can be a comfortable, familiar environment with lots of independence, but it can also become a prison.

And I think a lot of us have felt that during this COVID-19 pandemic, whether we're a senior or not.

And imagine for someone with dementia, how much of an imprisonment that that can be when they don't have the interaction they need.

So instead the idea of aging and community emphasizes that while you might be at home part of the time, it's not where you're stuck.

Like you can go out into the community and partake in things that will enrich you and the people around you.

- Thank you.

So Jenisha, if we're all lucky enough we are going to be elderly at some point.

What are specific things that viewers can do in their communities to help older adults age in place?

- I think one of the first things is inclusive being inclusive, including older adults in the community.

Sometimes it's just knowing who your neighbors are, taking those approach, noticing that we may have older adults in our neighborhoods as our neighborhoods change and grow, making sure that we're bringing older adults also to the table of the conversation of how that neighborhood and community should look.

- Lovely.

Heather, we spoke earlier about how multifaceted the needs are.

Let's look specifically at health fed housing.

How do those issues intersect to support aging in place?

- They're critical in terms of what providing what people need to age in place.

And so making sure that you have good health access and are living in a safe environment are really important to make sure you're maintaining that living good quality of life in your own home.

- Jenisha, I'm gonna go back to you for a second.

Let's talk about community models that integrate housing and healthcare to support housing stability.

- When you look at different housing opportunities, you want to make sure, they're in a area that you can have access to different health needs.

You know, when we talked about the rural areas, they access is a little bit different than if we were in a more urban setting, even to get transportation to our health needs.

So you look at maybe some in our urban areas, there are maybe at home doctors that are coming to visit people, older adults, which makes things a little bit more accessible.

So those are some things to keep in mind.

- Ron, you wanna jump in on this?

let's talk about this intersection point a little bit more if we might.

- Yeah, definitely.

So I'm of course at the geriatrics clinic and as the social worker there, my role is to make sure that I'm aware of the resources in the community so I can pass those on to the patients that we serve.

It's amazing what can be accomplished when you actually know about the resources and you have someone to not only inform you about them, but help you access them.

I think a great example from the videos is we saw people concerned about wanting to keep their home safe, do home renovations, which can be very costly.

But if you're familiar with the independent living program in North Carolina, there could be funds available to help you take care of those renovations, even something expensive, like a bathroom renovation.

But if you don't know about it, you can't access it.

- Indeed.

So let's play with this just a little bit more because it feels so germane.

How do community workers and leaders, work with builders and other organization to create more opportunity?

So Bryan, how great if somebody runs into you, but who else knows about these things and, how do we get the information out more widely?

- Yeah, it's such a good question.

And in particular, if you're in a rural county where there aren't as many resources and maybe there is no social worker like me to help connect you to that resource, I think the most important thing to know is, as you're growing older, to be aware that there are certain resources in every county and there's usually certain folks that know how to access them, the area agencies on aging that we mentioned are a great resource to connect you to your local option.

And if all else fails, you can call the local senior center.

Sometimes they are the group that provides those resources.

- Terrific.

- I was gonna add something if that's okay.

- Yeah, absolutely.

- Okay.

I mean, I think too, we need some innovation, right?

There's a lot of people who wanna age in place in North Carolina, it's gonna be exponential in the next 20 years.

And so thinking about housing developers is one way to build new construction, but also house sharing also across North Carolina there's is a lot of conversation about accessory dwelling units and rezoning, you know, thinking about how to make property tax more affordable for older adults who want to stay in their home, who have limited, excuse me, income.

I think there's a lot of different potential partners to make this reality for our citizens in North Carolina.

- So Heather let's stick with you for a moment.

Even beyond the housing challenges, what are some other solutions that you've seen implemented at the local or state level, that are showing promise in allowing our elderly residents to age in place and age in community?

- Right.

The village, there's a village model that has taken really national hold of natural recurring retirement areas.

And so it's having people who are living within their own neighborhoods come together and sort of band together in a formal way to develop services and programs, to come into their community.

Sometimes it's a concierge service.

Sometimes it's, you know, starts out as a book club, and they really grow in terms of their connectedness and leverage their resources as a neighborhood that's growing older to bring in vetted provider.

So maybe it's a handy man service, maybe it's an in-home aid, but they work collectively to make sure those services are provided and often can, you know, access nursing and social work services too, but being part of just the regular community.

And you would never know what driving through the neighborhood, that they have, this sort of virtual retirement community, that they've established themselves.

And there's several of these villages in North Carolina.

- Thank you all for joining us and thank you for what you're doing in your communities across North Carolina to support this really important topic.

Thank you to the local communities who let us share your amazing stories of collaboration and thank you to our audience for watching and engaging.

Tell us what your community is doing, or how we can help you and be sure to join us every Friday night at 7:30 for new episodes of ncIMPACT.

Coming up on ncIMPACT, COVID-19 has been challenging for all of us, but for some children it's been traumatic.

We explore some innovative ways communities are helping children to build their resilience.

[upbeat music] ♪ - [Male Narrator] ncIMPACT is a PBS North Carolina production in association with the University of North Carolina, School of Government.

Funding for ncIMPACT is made possibly by.

- [Female Narrator] Changing the course of people's lives, that's the impact UNC Health and the UNC School of Medicine work to deliver every day.

Our 40,000 team members across the state of North Carolina are committed to caring for you, our patients and communities, as well as educating the next generation of healthcare professionals.

Individually, we can do a little, but collectively we can do a lot, to create impact.