Stephen Smith started smoking in the ninth grade of Catholic school, when buying cigarettes required only parental permission.
“Back in those days, a pack of cigarettes showing through your white shirt that said Kool on it was absolutely important with your style,” said Smith, sitting on the couch of his manufactured home on the southern outskirts of Bend. “It was like, ‘Boy, he’s cool.’”
He spent much of his life surfing off the shores of Hawaii, and there are still hints of a beach bum in his longish slicked-back hair and manner of speech. Down there, pork comprised much of his diet, which he admits wasn’t always the best choice.
“It’s fattening,” he said.
These days, Smith’s body is showing its wear. He has chronic obstructive pulmonary disease, an inflammatory lung disease that makes it hard to breathe, and uses an oxygen tank when he sleeps. He also has asthma, sleep apnea and arthritis in his lower back.
“It’s basically from surfing and having too much fun in my life,” he said, “and it hurts.”
The worst part is a foot condition that makes it difficult to walk and drive, rendering him largely homebound. For a guy whose primary joy is the laughter that punctuates each sentence of a conversation, that’s tough. The usually cheeky 67-year-old turns grave when he reflects on his isolation.
“I need people,” Smith said. “Most people need somebody to talk to, to laugh with, you know? And to at least have that other person look at you and go, ‘Are you OK?’ Because I might not be OK.”
Isolation is a big concern when it comes to an aging population. The number of people in the U.S. older than 65 is growing rapidly: It’s about 15 percent today, and is expected to grow to 1 in 4 residents — 98.2 million people — by 2060, according to the Census Bureau. This shift in demographics is especially evident in Deschutes County, which experienced some of the state’s fastest growth in its over-65 population between 2010 and 2016: about 28 percent, according to Portland State University’s Population Research Center.
In parallel is a growing movement among academics, nonprofit groups, city planners and others working to ensure people will be able to live comfortably in their homes and communities as they age. While they share the same mission, their work is complicated by the fact that many sectors are involved, including housing, transportation, medicine and planning.
Much of the effort revolves around people’s overwhelming desire for independence, which for most communities means solving a transportation puzzle, ensuring necessary services exist and — perhaps most importantly — keeping people engaged to prevent loneliness and depression from taking hold.
It’s not all complicated, though. And it doesn’t always require money.
“If you have an elderly neighbor, do something nice for them,” said Jean McPherson, marketing and outreach manager for the Council on Aging of Central Oregon. “Make sure they’re OK. Visit. Talk about their experiences.”
Help in homes
Smith moved to Bend about 12 years ago to be near his son and grandkids. He found his home through a Craigslist ad. When he first pulled up, the scene took him back to Maui’s Upcountry, the rural area inland from the touristy shoreline.
“With the pine trees and green grass, I said, ‘Yeah, I want this place,’” he said.
It’s nearly 20 miles from downtown Bend, hidden on a dead-end gravel road and surrounded by trees. His doctor once tried to get him to move closer to town in case of a medical emergency, of which he’s had a few. His answer was a firm, “Heck no.”
The way Smith sees it, his medical problems aren’t getting better. Most of his high school buddies are dead. Freedom is what he’s got left.
“At least I have my own house,” he said. “I can do what I want in my own house.”
But not without help. He’s enrolled in a state-funded program designed to keep people in their homes called Oregon Project Independence. OPI, which serves people 60 and older who don’t qualify for Medicaid, sends a home health worker to Smith’s house once a week. She cleans it from top to bottom: vacuuming, scrubbing, washing clothes and bedding. And, more subtly, she keeps an eye on Smith’s health, assessing his gait, asking about his pain level and whether he’s been exercising.
The program costs a fraction of what Medicaid does, especially if it’s able to keep people out of long-term care facilities, said Susan Rotella, executive director of the Council on Aging of Central Oregon, which administers the program locally.
“The whole purpose of OPI is to keep seniors in their homes as long as possible and to keep them as independent as possible,” Rotella said, “to keep them off the Medicaid roles for a nursing home.”
In the last legislative session, OPI narrowly avoided a 75 percent budget cut, managing to keep its funding flat. Still, the program operates on a limited budget, and there’s not enough funding to serve everyone who needs it. Currently, between 40 and 45 clients use the program at any one time in Central Oregon. It operates on a sliding-fee scale, with some people receiving the service for free.
Smith also gets a friendly visit each week from a Meals on Wheels volunteer whose life story has become familiar. Those small human connections are often the most important part of his day. He prepares by making sure he’s cleaned up, pointing out during a recent visit that he had specifically chosen his bright green shorts to match his bright green T-shirt.
From his living room couch on a recent afternoon, Smith summoned his dog, Max, who, wearing a bandanna that matched his owner’s outfit, eagerly hopped on Smith’s lap and licked his face.
“He’s a good boy,” Smith said in a baby voice. He then lowered it back to normal, “But yeah, having the contact with other humans is important.”
Dr. Rosemary Laird, medical director for the Florida Hospital for Seniors in Winter Park, Florida, a facility with a team of geriatric emergency medicine providers, said as important as it is to ensure adults can age in place, it presents the challenge of getting them to things like medical appointments, social outings and religious events. Individual homes are often disconnected from important services people need because of one important factor: transportation.
“If they want to age in place, they need transportation to be able to stay there or they need services brought to their home, and that network is not reliable in many communities,” she said.
What’s happening here?
The city of Bend recently approved growth plans that include the development of so-called complete communities, areas where varied housing options and essential services like shopping, parks and medical services are located within close proximity to one another, said Robin Lewis, a city transportation engineer. The zoning in those areas is designed to encourage density over single-family housing, she said. These neighborhoods are planned for expansion areas on the edges of existing city limits.
The city is also constructing so-called neighborhood greenways, a network for bicyclists and pedestrians that will offer easy routes to services, parks, schools and jobs, Lewis said. They’ll be located on side streets mostly in residential neighborhoods, and will include reduced speed limits, increased signage and striping to make sure people of all ages feel comfortable driving using them.
“It’s going to increase that neighborhood livability, that social contract with your neighbors so that you’re more likely to get around and know your neighbors,” she said.
Future greenway areas include NW 15th Street parallel to NW 14th Street and NE Hawthorne Avenue.
Meanwhile, the state Legislature approved a $5.3 billion transportation funding package this year that will dramatically increase funding to Central Oregon counties, Lewis said. With that additional money, the region’s public transit provider plans to expand its route frequency, stops and hours, she said.
Some cities have been criticized for not having enough older adults on their planning commissions, said Caroline Cicero, an instructional assistant professor in the University of Southern California Leonard Davis School of Gerontology. Sometimes, even when older adults show up to meetings and advocate for their needs, it doesn’t mean they’re heard, she said.
“Older adults do have a stake in the planning process,” Cicero said, “but often we write them off, or we write off their interests because they might be homeowners and they might be taxpayers, but that doesn’t mean they might appear as the large-income generators for the city.”
In Bend, at least three of the seven members of the city’s planning commission are 65 or older, said Damian Syrnyk, a senior planner in the city’s growth management department. It’s a ratio that appropriately reflects the community, in which about 17.8 percent of residents are 65 and older, he said.
Portland has been a leader nationally and worldwide in terms of its age-friendly programming. There, Margaret Neal, director of Portland State University’s Institute on Aging, has been tinkering away at creative alternatives to driving alone for older adults, especially at night. One particularly innovative idea is to create a long-range ride program, wherein people volunteer as drivers when they’re able, and then use the program down the road when they can no longer drive.
“I’m 10 miles to the nearest store and if I can’t drive anymore, I’m going to be stuck here,” Neal said. “So maybe it’s in my best interest to volunteer for my neighbors.”
Older adults as a resource
Those leading Portland’s age-friendly efforts are pushing for a paradigm shift away from viewing older adults in terms of what they can’t do and toward seeing them as a resource.
Communities must leverage their aging populations by getting older adults involved in their planning and improvement processes and in working with younger generations, said Alan DeLaTorre, a research associate with PSU’s Institute on Aging and co-coordinator of the Age-Friendly Portland and Multnomah County Initiative.
Bend in particular is attracting a number of college-educated older adults who are retiring or changing careers, he said.
“That should be looked at as a positive in many ways and not a, ‘What are we going to do?’” he said. “What are the opportunities that are there for trying to move forward engagement, move forward process, move forward a number of opportunities with respect to older adults?”
One of the ways that’s happening in Central Oregon is the Foster Grandparent Program, funded by the Corporation for National and Community Service, the same division of the federal government that funds AmeriCorps. The program pays low-income seniors a small stipend of $2.65 an hour to tutor children in schools that need extra help.
Shirley Ryder works as a foster grandparent five days a week at High Lakes Elementary School in Bend’s NorthWest Crossing neighborhood. The 74-year-old Ryder moved to Bend to be closer to her grandchildren and has been tutoring in local schools for the past 10 years. Known by teachers and students as “Grandma Shirley,” she teaches handwriting, reading, math — whatever kids need help with.
On a recent morning, she pulled up a chair at a short table in the back of a first-grade classroom and helped children sound out words in picture books. The teacher sent students one at a time to work with Ryder, a task that involved selecting from a number of raised hands. She’s popular.
“This is really what we need,” said Sandy Lyon, a substitute teacher working in the classroom Ryder was visiting. “We need more people like this who are working.”
The program has 20 volunteers in Central Oregon, with room for more. They also work Head Start programs and at a religious school.
Ryder lives less than a mile away from the school in Discovery Park Lodge, a large apartment complex in NorthWest Crossing for low-income seniors. She said she’s not the kind of person who can sit around in a chair all day. She’s got to be doing something. And she loves working with children.
“In looking at some of my neighbors, I’m glad I’m doing something because I think it keeps your mind better,” she said, “and it keeps you on top of things and gives you something to do.”
A remedy for ageism
On a recent weekday morning, a Redmond classroom was abuzz with giggling children and hoots of laughter from older adults, who patted the kids’ heads as they whizzed by. Everyone was gathered around a table on which jars of paint were piled high.
It’s not a common sight outside of this building, but it’s a daily ritual for this gang, which includes kids who attend Whoopsy Daisy Child Care. The day care is just down the hall from Thelma’s Place, a day program for older adults — all of whom have dementia. It’s designed to provide respite for their caregivers.
Around this table, the heartbreak of memory loss feels far away, replaced with a flurry of constant activity. Today, there’s face painting. A man wearing a top hat with both cheeks painted white and his nose painted red laughs while pointing at the kids’ faces. One boy is painted to look like a tiger. The older man takes off his hat and places it on the boy’s head.
Angie Martinez, sitting nearby in her walker, asks another boy if he’d like new eyebrows. He nods yes and patiently holds himself still while she sweeps a paintbrush above his eyebrows, making big, blue half circles.
“Atta boy!” she says when she’s done, grinning widely and tapping her finger to his cheek. She then adds a mustache and beard. “Isn’t he cute?”
Next to Martinez, her friend Helen Cereghino shakes her head and said she loves playing with the kids.
“They climb onto your lap and put their arms around you,” she said.
Martinez marveled at all the wide smiles in the room.
“I wish there were more places like this,” she said. “It’s so much fun. This is for all ages.”
Intergenerational day cares like this one are still rare. This is Central Oregon’s first, and it just opened earlier this year. The up-and-coming concept is lauded by aging advocates, and some studies have found it can have benefits for the young and old alike.
Stephanie Roderick, the executive director of Thelma’s Place and Whoopsy Daisy, said she loves watching the seniors light up when they’re around the children. One man teaches them to tie their shoes. Another helps them collect and identify rocks.
“Think about that self worth that they’re getting,” she said. “‘I used to just sit at home and watch TV all day, and now I have some value somewhere.’”
A study in Japan, for example, brought 48 adults aged 68 to 101, most of whom had some degree of dementia, and 50 preschool kids aged 5 to 6 years together in an intergenerational play area. Interviews with the older adults afterward indicated they enjoyed the experience and felt a greater sense of dignity, according to the study, published in 2014 in the journal BMC Geriatrics. The kids’ caregivers said they found value in it for the kids as well.
Such a program familiarizes children with the aging process, so that the sight of wrinkled hands, gray hair or oxygen tanks aren’t new or frightening to them in the future, Roderick said.
Understanding through tech help
Overcoming ageism is a pivotal part of creating age-friendly communities, Portland State University’s Neal said. People carry lots of negative stereotypes about older adults, and society must find a way to overcome that, she said.
One of the most promising strategies Neal said she’s seen is fostering relationships between older adults and kids, like what’s happening at Whoopsy Daisy. In the same way getting to know people of different racial or gender identities decreases discrimination, so does getting to know people of different generations, Neal said.
“The more we can foster those intergenerational connections, the more we can foster understanding,” she said. A common intergenerational activity involves having adolescents teach older adults how to use technology. A successful version of this is happening at Crook County Middle School in Prineville, where students help older adults with a variety of tech issues, including sending and receiving emails, using an iPhone and posting on Facebook.
Before the program started, there was nervousness on both ends, said Becky Carter, an eighth-grade language arts teacher at the school who also runs a college readiness course.
The older adults worried that the students wouldn’t be patient with them, and would just try to do the tasks for them rather than teach them. For their part, the students were worried the older adults would get frustrated with them.
“It was that same kind of like, ‘Oh, how is this going to go?’” Carter said, “and so when it turned out going amazingly well and they got to know each other as people, it just broke down all of those. It didn’t matter what age anybody was. It was just, ‘Oh, I’m so happy to see you. How have you been?’”
Ultimately, Carter found that grouping the students and older adults into pairs worked the best, as they developed bonds and truly seemed to care about one another. It shook the stereotypes harbored by both groups.
“They really came to know them as people and care about them as part of our community,” Carter said. “It was much more than just, ‘Here, let me show you how to do that.’”
Roderick said she sees that happen all the time. She recalls one little girl who, on her first day at Whoopsy Daisy, refused to join the group that was going to play with the older adults. After some convincing, she finally agreed to go. The children had so much fun, they stayed and had lunch with the adults.
The next day, Roderick said she asked the girl if she wanted to visit the older adults again, and she was all for it.
That’s an example of a small but simple first step toward creating age-friendly communities: bringing people of different generations together, and helping them move beyond stereotypes. And for her part, Roderick believes the earlier in life you can dispel those myths, the better.
“If we can plant the seeds now when they’re young, look at what that might do for the future,” she said. •