What 'aging in place' means in Detroit
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Patricia Lovett maintains an impeccable lot outside her east Detroit street, salvaging her property amidst the cohabitation of blight intermittent in her neighborhood. Her home is cozy, spotless and warm, inundated with china sets, floral arrangements, trophies, and photos; souvenirs that showcase a zeal for living.
"When we came in everything was beautiful but [now] it’s a terrible neighborhood," she says. But you know, our homes are paid for. And we’re on a fixed income--even to rent a house now is more than what we get in a month."
One would never know that, underneath, her basement has flooded with two feet of raw sewage a total of four times. That affected not only her and her 80-year old neighbor, Mattie's, basement, but damaged the homes of many of her Detroit neighborhoods—quite a few of whom are elderly.
“We are aging in place alright,” she says. “Because we can't go nowhere.”
Aging Under Siege
Like many Detroit seniors, “aging in place,” a term used to describe a preferable home-based alternative to nursing homes for receiving care and assistance, can be more aptly understood as aging under siege in a city where water shutoffs, tax foreclosures, and increasing rent have levied their burdens on the city’s most vulnerable demographic.
"I just got my water bill today and I just find out that they sneaked in an extra $20 dollars onto everyone's water bill," Lovett adds.
Limited incomes can barely cover in a city where seniors all too often have to foot a rising bill for municipal mismanagement. Their struggles in trying keeping up are too often written off as delinquencies.
“Many older adults we surveyed over-estimated their monthly incomes and thus were feeling significant financial stress,” said Peter Lichtenberg, Professor of Psychology and Director of the Institute of Gerontology at Wayne State University. “This was primarily due to a large subset who had to retire early on disability which is less money than regular age retirement.”
Yet even those right on the money with estimates, including many retirees,nonetheless find themselves in a tight bind.
"When I get my bills, I make sure everything is paid off," says Mattie," but then I don't have anything left for repairs."
Glaring Affordable Housing Shortage
Closed down schools, poor services, and mass evictions have produced an exodus manifested through negative population growth for the City of Detroit—a 98,000 person loss projected for 2010 through 2040, according to the Southeast Michigan Council of Governments (SEMCOG). Yet residents age 65 and up are the only age demographic in the city expected to grow in the next 23 years.
In addition, the city faces a glaring shortage of affordable housing, with officials continuing to skirt initiatives for government-subsidized units in lieu of projects that are profitable for private developers. “There are government programs that encourage developers to build low-income housing,” Tom Jankowski explained, “but from a purely private perspective, there’s not a lot of money to be made in developing low-income housing."
Detroit's homeowners are more likely to be seniors having homes paid for before Fannie Mae systematically wrote off homes in 2008, but the region's elders nonetheless struggles with housing affordability as much—if not more than—the general population, aggravated further by limited incomes and ailing mobility. According to the Urban Institute, demand for rental housing is expected to grow and, like Lovett, many seek smaller, more accessible, and less burdensome living quarters, and Detroit's area's aging population comprises the bulk of this growth.
Sandra Hill's northwest side neighborhood remains in relatively good condition, and the nearby school that she sent her children to is still up and running. Although healthy, active, alert, she too expresses concern over her ability to age comfortably in her community.
“I thought to myself, what if I did sell my house? Where would I go?” she said. “I would want to move somewhere that I could afford [and] where I would want to stay, prices have gone up.”
Devaluation of residential properties that many seniors in Detroit own and have lived in for decades leaves them less able to sell their homes. Still, having a paid-for house, does not alleviate the financial burden of living expenses.
“Utility bills continue to go up, phone bills continue to go up,” she adds. “If you’re on a fixed income, whether you’re on a pension or Social Security, it only goes so far.”
Few Community Alternatives Accessible
In a city whose unemployment rate remains twice the national average, peaking at nearly 30 percent in the aftermath of the recession, intergenerational living has become commonplace among adult children unable to pay for housing.
“Nowadays it is not uncommon for two or three generations to be living in the same house at the same time, usually because the grandmother or the grandfather have paid for the house,” said Baxter Jones, a longtime public school teacher whose community became his classroom after a debilitating car accident took his mobility.
After working to regain his health, strength, and job back, the Emergency-Manager headed Detroit Public School system fired him in 2010, confiscating his pension and benefits and leaving him struggling to keep up with mortgage payments that he otherwise had never missed.
And just four years later, Fannie Mae took his hard-earned home.
Amidst being forced out of his home, there is one home Jones refuses to be pushed into. The activist maintains that “the worst thing” is, rather, institutionalization in a nursing home.
You feel like your freedom, so to speak, is compromised, he explained. “What it’s doing to you is programming you into a lifestyle that...is being chosen for you. This, to me, causes trauma for people.”
That's the message his caregiver, certified yoga instructor Peggy Gwi-Seok Hong, wants to relay to her community. She developed an internship she calls the “Urban Sustainable Intergenerational Cooperative Living for Diverse Abilities” program--a cooperative based project where young, socially conscious volunteers can learn skills from cooking to fishing in an intergenerational setting. The program enables older participants to comfortably and fruitfully age in place.
“Mainstream capitalism tells us it’s a waste of time to cook or to walk somewhere,” Hong said, agreeing that, like housework or walking, aging is an “interruption” to a framework that only values expediency and productivity. “[Aging] and caregiving are a reclamation of the time that it takes to be human, to relate to each other, and to be fully ourselves,” she added.
Options for subsidizing community-centric, in-home care are perhaps not too far-fetched.
"Until a few years ago there was no assisted living in Detroit," Lichtenberg adds. "Now there is, thanks to Presbyterian Villages of Michigan."
Although spaces at the river-side facility have filled up quickly, Detroit seniors overwhelmingly reaffirm a preference for aging in their homes.
Programs such as MiChoice, Michigan’s Medicaid run program, allow eligible adults, who meet low-income and asset criteria, to receive Medicaid-covered services like those provided by nursing homes, so they can stay in their own home or another residential setting.
To care for her mother, a recipient of hospice, Mattie and her five siblings took most of the initiative. "My sister would not let her go to dialysis alone," she recalls. "The nurse would come and check on her, and turn her, but it was mostly us six kids."
Michigan's history of embracing the largest nursing home lobby in the country, encouraged the proliferation of the facilities. The cost for instituting community based care, a preference for over 90 percent of seniors, is significantly less than doling out budgets for nursing homes.
Nursing home care racks up over $93,000 in expenses on average —while the cost of in-home care, averaging $40,000 yearly—falls just under half that amount, lobbies have been instrumental in limiting public support for community care options. Though the federal Medicaid law allows states to pay for home and community-based services, nursing homes must be paid first. In budget crunches, community services are the first to be axed.
Though the city connoted with its downtown DMC Hospital, many neighborhoods are medically underserved--meaning that many community areas are without any primary care. And though GOP leaders have moved to cut off healthcare to millions of Americans by framing the Affordable Care Act as a monumental horror, many Detroiters are quick to stress that some of their most basic needs go uncovered under federal programs.
“I’m trying to get surgery because I’m just all beat up,” says Joe Henry, a Warrendale resident who suffered an accident, numerous basement floods, and a bout of cancer.
Having labored for decades as a construction contractor, he was forced to stop working, joining the scores of the area's seniors retiring due to disability rather than age—a situation that gives them less money per month.
“I wish I could work. I’m trying to find work, but everytime I get up and get ready to go...I get sick.”
Moreover, Medicare’s assistance acute medical care offers only short-term help to people like Henry, who need long-term assistance for chronic conditions. Jones argues that Medicaid is no better.
“If you are a person that depends on these kind of insurances, it’s almost impossible, to get the kind of care that you really need because you’re getting the bare bottom of everything," he says, adding that such programs only pay for less than 7 hours a day of care and assistance at home. "But any kind of drugs I need, I get thousands of dollars" covered.
Most of the issues related to assistance and care, however, are concentrated among those who are disabled. Overall, Detroit's aging population, a consortium of workers, gardeners, block club leaders, writers, community organizers, and primary caregivers, are engaged and active, pining for a visceral sense of community.
"There's nothing to really do," Mattie admits, adding that block clubs have not been active for years and neighborhood organizations are largely unhelpful. While block clubs used to provide upkeep for Detroit neighborhoods, she explained that the lack of social spaces adds to safety concerns. "In our community we don’t have a senior place where we can just have fun with other seniors unless you travel out of your neighborhood."
Yet seniors reiterate community, friends, neighbors and family as go-to caretaking networks and sources of community, additionally providing what they can to their loved ones in turn.
“While some seniors need support, many are well equipped to help others. Our older population imports billions of dollars into our local economy in the form of pensions, savings, and benefits like Social Security and Medicare,” said Jankowski. “Many retirees bring a lifetime of skills and experience to the table, along with plenty of free time and a deep commitment to their communities. We need to find ways to engage those who are able in service and volunteer activities, to provide the opportunity that many want to give back to their communities.”
For the local aging population, that just means giving back to them.
"We worked for years and paid our debts to society," said Hill. "All we want is something-anything-in return."
Julia Kassem wrote this article supported by a fellowship from New America Media, the Gerontological Society of America and AARP.