About seven years ago, Bill Cousins realized he was having more difficulty climbing the stairs of his home in the Chevy Chase neighborhood, a result of aging and his post-polio syndrome.
Cousins, a widower who is now 88, said he felt his independence in his home in Northwest Washington slipping away.
But he learned that by making some key modifications to his Cape Cod and joining an organization that provides various in-home services to elderly people, he could perhaps stay.
Over a period of about five years, he installed an elevator, erected ramps and widened his kitchen to accommodate a wheelchair. He lowered his light switches on the walls and put in an easier-to-use kitchen faucet. He also joined a senior “village” organization, which among other services provides rides to doctor’s appointments and periodically checks in with him to make sure he’s okay.
In the Washington region, the population of people 65 and older rose 29 percent from 2000 to 2010, according to the Brookings Institution. That has spurred a number of new programs in the “aging in place” movement, which aims to help elderly people such as Cousins remain in their homes rather than relocate to assisted-living facilities.
“I’m an independent man,” said Cousins, who’s lived in the house since 1968. “I don’t like to be on an institution schedule. I don’t take well to rules I don’t agree with.”
The movement to accommodate elderly people in their homes is growing rapidly in this region, with villages becoming a more popular option.
Villages, typically organized by geographic areas and neighborhoods, are run by nonprofit groups that recruit volunteers to provide the most-needed services for older people who want to remain in their homes. By paying an annual fee of about $500, elderly people can receive transportation and technology services and lists of approved repair vendors. They also may participate in social clubs and activities.
The District has six villages, with a seventh in Cleveland Park expected to open later this year. Montgomery County has four active villages, with three more to emerge soon, according to Elinor Ginzler, director of the Jewish Council for the Aging’s Center for Supportive Services.
And Northern Virginia has three in operation, with four more in development, said Barbara Sullivan, a member of the Fairfax County Long Term Care Coordinating Council and executive director of Mount Vernon at Home.
“What’s happening here in D.C. is part of a national phenomenon,” said Elizabeth Fox, board member of the now-forming Cleveland Park Village. “It’s a very collaborative situation for something that is really grass-roots-based.”
Because of his degenerative post-polio syndrome, Cousins said he knew he was going to shift from a walker to a wheelchair. So when he started a major renovation of his home, he included accessibility elements.
Over time, he modified the height of the front stairs (while he was still walking); installed a lift onto the front porch for his wheelchair and a ramp off the back deck; moved the wall of his galley kitchen out 18 inches; and installed a special bathroom with sink, shower and toilet that easily accommodate a wheelchair.
He also lowered a built-in wall oven, installed a cut-out under the range to allow for a wheelchair user to pull up close and moved light switches lower on the wall.
One of the most important modifications was the installation of an elevator between the first and second floors. “It’s very handy. It’s very simple. It cost money but it wasn’t extraordinarily expensive,” said Cousins.
Cousins declined to disclose the cost of the modifications. Costs for retrofits typically run from $250 to tens of thousands of dollars, said Louis Tenenbaum, a consultant and remodeler specializing in universal design and aging-in-place living. For instance, he said, a grab bar can cost $250; a door widening, $800 to $1,200; a ramp and lift, $2,500 to $20,000; and an elevator, $20,000 to $35,000.
But Cousins found another accessibility solution in his kitchen that cost him nothing. “I use drawers for things I can’t reach in the upper cabinets,” he said. All of his dishes and “the things I really use” go in drawers, while upper cabinets are essentially for storage.
“It’s just generally a much more convenient space now,” he said.
Experts say many people make the modifications as they need them. A big push, they say, is to get older people to think ahead, as Cousins did.
“People don’t plan in advance,” said Tenenbaum.
“When the time comes, it’s hard to get any remodeling done quickly enough and get it done well,” he added. “If you have a shower you can get in without lifting your feet, you can stay in your house longer than if you only have a tub, or a shower with a curb.”
When Peggy Small’s husband died eight years ago, she began making plans to move from the house in Alexandria they’d owned for more than 40 years to a retirement home. “That was not the lifestyle for me, but I thought, ‘I can’t live alone,’ ” she said.
She was packing to move when her daughter came to visit and noticed an ad in the local paper for an organization called Mount Vernon at Home.
That’s how she found out about the village concept. “With Mount Vernon at Home, I don’t have to move out of my house. I can stay right here,” Small said. Small calls for repair work and rides to the doctor’s office and biweekly hair appointments. “They come over and replace my light bulbs in the ceiling. I don’t get on ladders,” said Small.
The first village was founded in 2002 in Boston’s Beacon Hill by a group of aging adults who wanted to help each other. They provided their own network of support in their homes, with medical care and social activities. They didn’t want to have to move to unfamiliar cities, to retirement homes that held no memories for them. They wanted to stay in their homes and maintain connections to familiar settings, activities and neighbors.
However, they knew that as eyesight and hearing failed — inevitable results of aging — they’d no longer drive or easily walk to the store or doctor’s appointments. They would need help that would be expensive through private fee-for-service models. Over time, in-home care and taxis for transportation are expensive for anyone on a fixed income.
By 2012, the number of villages across the United States had grown to more than 70. Including the United States, Canada, Australia and the Netherlands, there are now 89 villages in operation and another 123 in development, according to the Village to Village Network.
“The fundamental thinking behind the village is that it reflects the community that is forming it,” said Ginzler, of the Jewish Council for the Aging’s Center for Supportive Services in Montgomery County. “Neighborhoods put together an organic structure that allows people to stay in their own communities.”
While wealth is not necessary, the village concept does require modest means. “It’s primarily a middle-class phenomenon for now,” said Fox of the Cleveland Park Village. She said she isn’t aware of villages organized by low-income neighborhoods, perhaps because of the costs of membership.
She said she expects dues to be $750 per couple and $500 per individual per year. The money, she said, covers the staff member’s salary, insurance, security check for volunteers, Web site construction and maintenance, printed materials and light refreshments for occasional social functions.
Mount Vernon at Home charges similar member fees. “I think I paid $650 for last year. The peace of mind they give me is worth it,” Small said. During the recent storm, a volunteer came to her house to make sure she was okay.
“You can’t even think of a dollar value for that,” Small added. “They are so giving, it’s amazing. Every volunteer I’ve had, I think, ‘Oh, I could just hug you,’ and I do. I feel so grateful to have this service.”
Susan Straight is a freelance writer.