Roma Harris, Elise Feltrin, Margo Robeson, Brenda Blair, Grace Koehler, Pat Pal, Joan Spittal and Shelagh Sully
Presented to the 14th International Conference on Ageing, August 8 – 10th 2018, Toronto, Ontario.
My co-authors and I live in a small tourist village on Lake Huron where the winter population is about 1,000 people, swelling to around 4,000 in the summer. It’s a lovely place and attracts a steady influx of retirees. The community is active – volunteers build and maintain hiking trails, parks and public gardens, there is a heavily used library, a large historical society, two service clubs as well as a variety of fitness, music, and artistic groups. Demographically, the full-time village population tends to be better educated and more affluent than elsewhere in a very large, underserved rural county with a population density of just 17 people per square kilometre (compared, say, to Toronto with a population density of more than 4,000 people per square kilometre). The largest population centre in the county has only 7,500 hundred people and nearest hospital is nearly 20 km away from our village. There is no public transit and, in winter, the main highway is sometimes closed due to heavy snow.
People who live in the village love the community but, as they age, many find it difficult to stay on and feel they have no choice but to move away, leaving behind the primary social networks that shape their lives. The group we represent, a small volunteer organization called Home4Good, was formed to respond to the problem. In 2014, we undertook a multi-stage needs assessment process and identified three major obstacles to successful aging in place in our community: (1) transportation (when people are unable to drive any longer); housing (lack of alternative housing for people who can no longer manage their single-family homes); and information (not knowing where to go for information that is relevant and specific to where we live). Small working groups were formed to address each of these issues. To date, our information group has hosted a very successful, fun info fair ‘for vintage adults’ that included a wide range of community service providers, as well as travel agents, a personal organizing service that helps people downsize, and chance to try out personal mobility machines. In partnership with the public library we have formed a ‘Seniors Info Hub’ through which knowledgeable volunteers are available at the library (once a month) to meet with people who have inquiries about local services; library staff will also direct inquiries to us. We also host info events at the library where local service providers come to speak and answer questions (for instance, what to expect when you call 911 for emergency services; how to prevent online fraud). We arrange these sessions in response to the people who ask us questions. Initially, we ran the ‘Info Hub’ once a week, but use was low. However, our presence is known and we regularly receive feedback that people from the village feel reassured that we are ‘there’ and that ‘it’s good to know people who know’. We also partner in running a ‘coffee and conversation’ group in the library for older people who are looking for social connection, something to do, and companionship, especially during the winter.
What all these initiatives have in common is that they grow out of what local residents care about. In our experience, the literature on creating age-friendly communities is really not responsive to the realities of rurality, i.e., it doesn’t really take account of what geographic distance really involves and often seems to be written as though urban solutions can be scaled down to fit small places. Likewise, the health promotion world sometimes seems to have lost touch with the needs and desires of its intended audiences. Scare programs like the Heart and Stroke Foundation’s ad, ‘Make Health Last: What Will Your Last Ten Years Look Like?’ position health in old age as an individual choice ‘and blame the elderly for “deciding” not to remain youthful and healthy’ (Harris et al., 2116). Beyond serious acute and chronic health problems, the quality of life issues that face aging individuals in our community have not really been recognized by the broader service sector, particularly by the health sector (which attracts the largest proportion of public sector funding). Within the health model, the emphasis on healthy living, i.e., eat better, exercise more, frequently translates into ‘educating’ people in a top-down fashion that doesn’t resonate well with many of the people we encounter. For instance, a local service provider is contracted through the provincial health system to run a well-attended fitness program aimed at older people in the area – the program is delivered by knowledgeable local volunteers. Unfortunately, in order for the fitness classes to be funded, the people who attend them are urged to go to lectures once a month which are often irrelevant or redundant, such as talks on fall prevention (which often boil down to being told to get rid of scatter rugs) or presentations that urge audience members to exercise more — which is why they are attending the program in the first place. Similarly, when a regional service provider came to deliver a program on self care for people with chronic conditions, participants (who attended willingly and with some enthusiasm) came away disappointed that they had learned little of use.
As for information delivery, there is an emphasis on personal responsibility for health which includes online resources such as our regional ‘healthline’. While it is fair to say that the site is nicely constructed and does contain links to lots of useful material, few people in the community know of its existence, and fewer still would think to look to a ‘healthline’ as a source of information about, say, housing assistance programs or recreation. Similarly, the province of Ontario’s 211 program is intended to provide information about community services. Again, however, few people in my community know about it, and, if one does go the site, relevant topics such as transportation for older people in our area produce many listings, few of which are local, specific or relevant to the people who live here.
The extensive research literature on help and information seeking consistently reveals that people look for information when they need it, i.e., when it’s relevant to their situation or pick it up serendipitously through encounters with others, including the media. Understandably, people prefer to receive information from sources they trust, particularly from people they know (or whom they believe ‘know’) and we want information or help to be delivered in a warm and compassionate fashion. It is for these reasons that our Home4Good project, with its small scale, is working. We build capacity in our community through events that inform, and that information is shared, in turn, with others. And, whether it is through the individuals who volunteer to help people find what they are looking for to address problems of aging for themselves or others, or through our website and facebook pages, our approach is personal, warm, often fun, and equitable in that it is peer-to-peer rather than top-down. And, we focus on connecting people with help that is local, relevant and specific to their needs.
Harris, R., Wathen, C.N., et al, 2016. ‘Blaming the Flowers for Wilting’: Idealized Aging in a Health Charity Video. Qualitative Health Research 26(3): 377-386.