By the time my mother turned 90, she had outlived the several friends and neighbors who lived in the Brookline apartment building where she'd spent the past 25 years. It was getting lonely and a bit risky. She and I began touring assisted-living complexes, whose apartments for the most part were small and pricey. ''This is for old people," my mother said.
Then we stumbled on something new and wonderful -- virtual assisted living.
The idea is that you stay in your own apartment, and any service you need comes to you, a la carte, as well as a rich program of social and cultural activities.
As it turns out, there is exactly one such full-service program in the entire country, Beacon Hill Village, in Boston, serving residents of Beacon Hill, the Back Bay, and the West End since 2002.
According to Judy Willett, the dynamo who directs the program, Beacon Hill Village was organized by local residents who wanted to stay in their homes rather than moving into retirement communities as they approached their 70s and 80s.
Most of the roughly 300 members pay an annual fee of $500, which then counts against the cost of services. Beacon Hill Village can find you anyone from an electrician to a nurse, provide in-home meals or exercise classes, and basically provide anything a residential program does.
My mother is one of the first members who moved into the area to take advantage of the program, rather than a local resident who began needing help. She found an apartment in the city, not far from where we live. For a time, while my daughter and family were living nearby, we actually had four generations in the same neighborhood.
So far, my mother doesn't need special health services, though she goes on grocery expeditions organized by Beacon Hill Village, attends lectures and meetings, and feels part of a support system. Her monthly expenses are well below the cost of assisted living.
Beacon Hill Village regularly gets inquiries about duplicating this unique program. This month, Willett will be hosting a delegation of Japanese, who felt that the model fit well with an aging society of people who value their dignity. She also fields questions from commercial developers, but Beacon Hill Village is proudly and fiercely nonprofit, seeing itself as a community resource.
About one-fifth of its members receive subsidized services, thanks to support from the Boston Foundation and several other grants. The rest pay for the services they use, though Beacon Hill Village does negotiate member discounts. It also benefits from the help of neighborhood volunteers.
The closest equivalent that I've been able to find is a model called the ''naturally occurring retirement community," pronounced ''norc." Fittingly enough, these are burgeoning in New York, where many apartment buildings are inhabited by people roughly of the same generation. As they get older, several groups of tenants have organized themselves to contract with home-health agencies and other providers, so that people who are not quite able to live on their own can stay in their apartments as long as possible. None of these, however, has the full range of services of Beacon Hill Village.
This is an absolutely marvelous invention. It is allowing my mother to live independently, as she approaches her 92d birthday, and it gives my wife and me some peace of mind knowing that our family has a reliable back-up system.
If you read this column faithfully, you just know there will be a political and policy inference. Here it comes:
In a just world, this kind of community institution would be available to everyone. For people who can't pay out of pocket, nursing-home costs are covered by Medicaid. But assisted living is not, and what elderly person looks forward to moving into a nursing home?
Assisted-living communities are great, for those who can afford them. While some are subsidized, most aren't. At a going rate of $3,000 a month and up, most are beyond the pocketbooks of most seniors.
Rather than cut taxes yet again for America's most affluent, why not keep the federal estate tax and use some of the money to have the government provide a program of challenge grants so that senior citizens in communities all over America could have counterparts to Beacon Hill Village? It taps local volunteer energy (remember the thousand points of light?), and it's a lot less costly to society and more dignified than an old folks' home. Talk about family values.
Robert Kuttner is co-editor of The American Prospect. This column originally appeared in the Boston Globe.
