1. Larimer County Summit on Aging Aging as an Out-of-Body Experience or How I Stopped Worrying and Learned to Love Gravity Philip B. Stafford, PhD Foundation on Aging for Larimer County January 22, 2010

2. Larimer County Summit on Aging Foundation on Aging for Larimer County January 22, 2010 “We’d buy half a loaf of bread if somebody offered it to us.” “When I cross a busy street I start to limp so cars will pay attention.” Philip Stafford, PhD Director, Center on Aging and Community Indiana University

3. Aging as an Out-of-Body Experience  Aging is not about time and the body, but about place, and relationships. Presenter/Organization Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University  Our work together should involve creating good places to grow up and grow old.  Communities large and small are taking up the challenge.  The Summit on Aging positions Larimer County to leap into the future with confidence.

4. Aging as an Out-of-Body Experience It’s not such a long step from Madison Avenue to Medicine. Our misplaced focus on the aging body Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

5. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

6. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University The patient is an 84 year old female…

7. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University She’s a young 80 year old isn’t she? My, she sure doesn’t look 65 does she?

8. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University Why give the credit to youth? “This is what fifty looks like!” Gloria Steinem

9. Aging as an Out-of-Body Experience What are the consequences of this myopia? Our misplaced focus on the aging body Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

10. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University Medicalizing Old Age

11. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University L. Pastalan

12. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University Lighthouse for the Blind

13. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University L. Pastalan

14. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University Central Avenue 1960 Bruce Tibbo, St. Pete Times

15. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University Green bench graveyard 1969 Tom Bennett St. Pete Times

16. Larimer County Summit on Aging Foundation On Aging for Larimer CountyJanuary 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University Central Avenue 1984 Maria Vesperi

17. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University Central Avenue, 1999

18. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

19. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

20. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

21. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

22. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

23. Aging as an Out-of-Body Experience “Community is the smallest unit of health.” * * Wendell Berry Shifting the paradigm Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

24. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University Not “When is old age?” but “Where is old age?”

25. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University Aging is not about time and the body, but about relationships… and the meaning of place.

26. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University “Health and disability refer to the balance between personal capability and environmental demand.” Verbrugge & Jette, 1993 The Disablement Process

27. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University It’s an out-of-body experience!

28. “Community is the smallest unit of health.” Wendell Berry, Health is Membership In Another Turn of the Crank Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

29. Our work should help create good places to grow up and grow old… livable communities for a lifetime Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

30. Aging as an Out-of-Body Experience What is an elder-friendly community? Data driven and participatory planning for the future Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

31. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

32. “I can just walk across the street (to the community center)… I have a choice. When I get to the steps, if I feel I am too tired, I may walk around and…take the elevator.” Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

33. Categories of information that communities need to organize and interpret in conducting effective data-driven, participatory planning efforts. Up to date demographic data Utilization data and evaluation tools Asset inventories Area consumer data and national archive Evidence based research findings Other stakeholder and participation data – incl. stories and dreams Best practice resources Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

34. ACTION EVALUATION INFORMATION DATA The AdvantAge Initiative Planning Process: Data Driven, Participatory Community Development Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

35. Aging as an Out-of-Body Experience The possibilities for planning and action are endless. Communities Around the U.S. are Moving Forward Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

36.  Six neighborhoods of Chicago, IL  Indianapolis, IN  Jacksonville, FL  Lincoln Square, NYC  Maricopa County, AZ  Orange County, FL  Puyallup, WA  Santa Clarita, CA  Upper West Side, NYC  Yonkers, NY  National Survey (2004)  Grand Rapids, MI  Contra Costa County, CA  Parsippany, NJ  Newaygo County, MI  St. Joseph County, IN  Elkhart County, IN  Kosciusko County, IN  LaPorte County, IN  Marshall County, IN  El Paso County, TX  Chinatown, NY  The State of Indiana AdvantAge Initiative Survey Conducted in: Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

37. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

38. ADDRESSES BASIC NEEDS Housing Is Modified To Accommodate Mobility And Safety “% of 65+ householders with home mod needs” The Domain The Dimension The Indicator Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

39. Percentage of householders age 60+ in housing units with home modification needs* Unweighted N=667 Weighted N=147,283 Unweighted N=4,509 Weighted N=973,489 One or more modification needed 15% No modifications needed 85% Planning to modify 79% Not planning to modify *People were asked whether their current residence needs any significant repairs, modifications, or changes to improve their ability to live there over the next five years. *People who said that their homes need modification were asked if they plan to make the change over the next five years. Figure 3.1, Indiana § Note: Percentages may not add up to 100% due to rounding and/or missing information. 17% 4% DK/RF Source: AdvantAge Initiative Community Survey in Indiana 2008 § Excludes Area 2 (Elkhart, Kosciusko, LaPorte, Marshall & St. Joseph Counties) which was surveyed in 2006. 146,000

40. Type of modification needed Cosmetic/minor repairs Better cooling in the summer Accommodations for disabilities Structural changes/ major repairs Bathroom modification Medical emergency response system Fix problem with insects/rodents Other Better heating in the winter Figure 3.2, Indiana § Unweighted N=4,509 Weighted N=973,489 Source: AdvantAge Initiative Community Survey in Indiana 2008 § Excludes Area 2 (Elkhart, Kosciusko, LaPorte, Marshall & St. Joseph Counties) which was surveyed in 2006. 11,681 5,840 8,760

41. Benefits of the AdvantAge Initiative Survey Provides a statistically valid “data snapshot” of seniors and how they are faring at this point in time (not a “needs assessment”) Provides an opportunity to: 1)Hear the voices of older people 2)Organize and prioritize aging issues 3)Bring stakeholders together and provide them with a “common language” 4)Generate enthusiasm and momentum 5)Stimulate thought and discussion about the effectiveness of current programs and help plan future programs Community data are comparable to AI national survey results Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

42. Numbers don’t stand on their own… we have to make meaning from the data. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

43. “Participation… provides a collaborative process by which community inhabitants reach common goals, engage in collective decisions, and create places, and these places, in turn, serve as material expressions of their collective efforts.” Feldman, Roberta M. & Westphal, Lynne M. 2000. Sustaining human settlement: A challenge for the new millennium. Great Britain: Urban International Press. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

44. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

45. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

46. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University “Improving a community, from beginning to end, involves organizing people. Money is secondary.”

47. Aging as an Out-of-Body Experience What does it take to move ahead? Larimer County Leadership Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

48. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University Identify the stakeholders Understand the issues Frame the problems Identify potential action steps Identify the assets in place/needed Prioritize actions Support and monitor the responsible parties Benchmark and evaluate Making our community elder-friendly

49. Livable Communities Physical Environment Accessible bldg design Shopping w/in close proximity Drugstores, grocery,& hospitals w/in close proximity Recreation opportunities Safe, well-designed sidewalks Design on a human scale Provide choices Mixed-use development Preserve urban centers Vibrant public spaces Protect environmental resources Conserve landscapes Design matters AARP “Livable Communities” AIA “Principles for Livable Communities” Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

50. “Old people everywhere.” Christopher Alexander A Pattern Language Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

51. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

52. Learning What about the intangibles? Movement Beauty Laughter Memory Choice THE INTANGIBLES Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

53. “ Every human community, if it is to last, must exert a kind of centripetal force, holding local soil and local memory in place.” Wendell Berry Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

54. Aging as an Out-of-Body Experience www.agingindiana.org Philip B. Stafford, Ph.D. Director, Center on Aging and Community Indiana Institute on Disability and Community Indiana University 2853 East Tenth, Bloomington, IN 47408 812-855-2163 staffor@indiana.edu Resources and Contacts Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University

55. Larimer County Summit on Aging Foundation On Aging for Larimer County January 22, 2010 Philip Stafford, PhD Director, Center on Aging and Community Indiana University References Stafford, Philip B. 2009. Elderburbia: Aging with a Sense of Place in America. Westport, CT.: Praeger. Oberlink, Mia & Stafford, P.B. 2009. The Indiana AdvantAge Initiative: Measuring Community Elder-Friendliness and Planning for the Future. In Creating Aging Friendly Communities, A. Scharlach, Ed. Generations, Journal of the American Society on Aging, Vol. 33 # 2, pp. 91-95. Stafford, P.B. 2006. “Creating Lifespan Communities.” Public Policy and Aging Report 15. Gerontological Society of America: National Academy on an Aging Society. Hanson, David, and Charles A. Emlet. 2006. Assessing a Community’s Elder-Friendliness: A Case Example of the AdvantAge Initiative. Family and Community Health. 29(4): 266-278. Center for Home Care Policy and Research, 2004. The AdvantAge Initiative Indicator Chartbook: National Survey of Adults Aged 65 and Older. (www.advantageinitiative.org)www.advantageinitiative.org Feldman, P.H., and Oberlink, M.R. 2003. “The AdvantAge Initiative: Developing Community Indicators to Promote the Health and Well-Being of Older People. Family and Community Health 26(4): 268-274. Stafford, P.B. 2001. “When Community Planning Becomes Community Building: Place-Based Activism and the Creation of Good Places to Grow Old.” In L. Heumann et al., eds., Empowering Frail Elderly People: Opportunities and Impediments in Housing, Health and Support Service Delivery. Westport, CT: Praeger.