Abbeyfield at the 1st World Congress for Care and Nursing Home Directors
ABBEYFIELD/Berlin
1st World Congress for Care and Nursing Home Directors.
Good Afternoon everyone. Thank you for the invitation to address this
gathering. It is a great honour for Abbeyfield International.
I am one of Abbeyfield’s 9,000 volunteers and I am, perhaps obviously, also
a member of that population explosion known as the Baby Boomers.
The baby boom generation is just beginning to reach retirement age. For
most industrialized countries this will mean an unprecedented number of
seniors in proportion to the total population -- at a time when social
supports and material resources available to the previous elder generation
will not be on the same scale. Family systems, once the backbone of elder
support, are no longer filling that function to the extent they once did.
Governments, which once provided safety nets to elders, will be overwhelmed.
Baby boomers will need to set up systems that enable them to care for each
other -- And they need to set them up now.
On that note I invite you to look at an innovative model of elder living
that was established in England in the 1950’s and which addresses a
community’s needs for self-organized, shared care.
Abbeyfield Houses are small, homelike, residences of 10 to 14 elders
embedded into the community and developed and maintained by community
members.
An Abbeyfield House is similar to the congregate housing model in the United
States wherein small groups of people live together under one roof with the
assistance of one or two paid staff members. The important difference
between the two models is that an Abbeyfield House functions primarily
through volunteer help, and an Abbeyfield House is integrated into the
social fabric of the community.
Furthermore, Abbeyfield Houses are tied into a worldwide support and
resource network. Existing in 16 countries, it is the only global society
whose care standards for elders meet the requirements of the World Health
Organization.
As a further introduction, may we view this short video that can be
downloaded from our Abbeyfield Website. Entitled ‘Living Life to the Full’,
it is a visual story about Abbeyfield.
http://www.abbeyfieldinternational.com/a_video.asp
As you have now observed, there are a number of benefits to the
social approach to elder living. Seniors report that they are happy because
they feel part of the community. They live more satisfied lives because
their needs for connection and companionship are met. They remain healthy
longer so there is less of a resource cost to themselves, to their families,
and to their governments.
Of equal importance, Abbeyfield Houses provide a structure for
citizens of a community to offer their time, talent and treasure. This meets
an individual’s need for a way to express contribution and connection
through voluntary involvement. A concept likened to Abbeyfield is Habitat
for Humanity. However, Abbeyfield volunteers are focused on providing not
only housing but also in serving seniors.
Let us look specifically at the operational and management
aspects of Abbeyfield by addressing Questions of Why, What, Who, Where, How
and When.
WHY ABBEYFIELD?
There is a problem with retirement these days. Quite simply we're living
too long for the homes and the services that are available.
Increased longevity in developed nations has added a new phase to the human
life cycle, a period of 20 to 25 active, healthy years after full-time
employment and the responsibility of rearing children. The new phase,
roughly from 55 to 75, has been called the 'Third Age.' It is portrayed as
a glorious retirement in a grand location. If one is financially secure
then this is the cruise ship and golf course ideal of growing old. It is
the age that the Baby Boomers are beginning to enter.
But then there is the 'Fourth Age,' the years from about 75 to the end of
life. This is a period characterized by gradual decline and eventual loss
of the capacity for independent living. How do we pragmatically plan
for this 'Second Retirement' -- and what is available for our increasing
needs?
Certainly, we would all like to live to be 100; but there is a
terrible fear of ending life institutionally 'warehoused'.
Through media, and conferences such as this, we are all aware of our
individual national statistics on ageing population. Speaking for North
America, Canada entered this century with more people over the age of 100
than they had over the age of 70 at the turn of the previous century. In
the United States, it is estimated that more than two-thirds of all
Americans who have ever lived to be 65 years of age are alive today.
In most nations, the present system of elder care is financially
viable only because it depends on the exploitation of women -- of all ages
-- who either give unpaid care at home or are the inadequately paid
employees of institutions or home care agencies. It is not unusual to find
a 65 year-old woman looking after her 85 year-old-mother.
Small wonder then, that the AmericanCollege of Emergency
Physicians reports over 70,000 ‘Granny Dumps’ each year. That is the
situation in which a senior, suffering from dementia, is left without
identification in a hospital waiting room.
WHAT IS ABBEYFIELD?
As you have seen on the video, the story of Abbeyfield is really
the story of a modern-day Good Samaritan, Richard Carr-Gomm, who believed
that isolated, lonely elderly should live together in a more family-like
environment.
The basic prototype that Carr-Gomm first sketched out remains today the
essential Abbeyfield House: family-sized, self-furnished rooms, a
housekeeper, centralized cooking, good relations with neighbors and,
financially self-supporting on payments affordable by pensioners. In
effect, the re-creation of the residents' lost family home life.
Abbeyfield Houses have a guest room that permits potential residents a trial
period. This room may also be used by visiting family members, or as
respite relief for neighbors wishing to vacation but unable to take along a
live-in parent.
A paid Housekeeper is the key figure in the success and
happiness of an Abbeyfield House. She, or he, helps to create the homely
atmosphere. The right sort of housekeeper makes the house very much her own
and her personality influences the whole operation. She is really a sort of
den mother and very real bonds of caring and affection develop. Many
Abbeyfield Residents refer to the Housekeeper as their 'House Mother.' I
can tell you the story of a 100 year-old resident, who slipped and fell
while out shopping. When the first-aid attendant asked who should be
called, this Abbeyfielder said. "Telephone my Mother, here is her number."
In
other stories, we did have a case of a lady Housekeeper running off with the
oldest male resident. Perhaps a case of too much care and affection!
WHO IS ABBEYFIELD FOR?
Obviously, Abbeyfield is for the elderly themselves. Most seniors want to
remain in their own home. They feel that they are displaying competence and
independence. They value having privacy and a "Place for the kids to stay
when they come to visit." But realistically, how often do the kids visit?
Following the loss of a spouse, as one continues to age and
begins to need support, this notion of privacy may become a snare and a
delusion. Cooking for oneself does not necessarily ensure the best in
nutritional meals; and the loneliness aspect is also counter-productive to
good health habits. "Nobody's going to visit me today, why should I bother
getting cleaned up?"
A typical government answer has been to promote home-care
services that keep people in their own dwellings. These state policies,
called by such names as 'Aging in Place' or ‘Care in the Community’, are
attempts to reduce the numbers in hospitals and in homes for the aged, but
the economic cost is high, and it is not for everyone.
The home-care model of Meals-On-Wheels or visiting nurses, if
not sensitively carried out, can be a fearful and terrifying experience for
seniors. A trail of strangers enters their home to feed and perhaps even to
bathe them. At its well-meaning best, home-care is really only episodic
care.
A community’s challenge is to maintain quality and dignity of
the life for its senior citizens. The crisis ahead is in affordable costs,
appropriate houses and caregiver services.
So, Who else is Abbeyfield for? It is just as importantly, for
individuals of all ages who have a desire to give back to their community.
They may want to volunteer, or to donate monies to a good cause. Many are
recent retirees, that Third Age cohort, wanting to remain engaged and to
fill their empty time with meaningful activity.
Before the isolation of living alone becomes unbearable and
one's level of health deteriorates; we feel that the supportive care aspects
of an Abbeyfield house provide the best answer. The companionship, the
security and the independence, replaces loneliness with dignity. In turn,
the community has the social value of providing this care through voluntary
effort.
WHERE ARE ABBEYFIELDS?
Abbeyfield Houses are 'ordinary houses on a normal street'. The House is
located in a hometown neighborhood within easy walking distance to all
amenities. Many elderly do not want to leave their communities, where they
have always lived near family and friends, their church and their familiar
merchants. A small Abbeyfield House gives them this opportunity to ‘stay
home’ and maintain continuity in their lives. It is a ‘family’ with
familiar faces and peer group intimacies -- a comfortable, secure and safe
haven.
The greatest strength of Abbeyfield is that it is truly preventive
medicine. With a history of over 50 years dealing with thousands of
seniors, we have discovered that very few residents require extended
hospital care before dying. Many tend to 'get younger' and they 'die
healthy.' This may seem to be an oxymoron; but we have found that because
the residents are happy and content, they are much more fit and able to live
out their natural life cycle (and longer) without becoming debilitated.
They are most likely to succumb to a sudden stroke or heart attack.
The cost-savings to government national health systems are
tremendous. In Canada, older folks already use up to 65 per cent of the
health care dollars. The pragmatic figures of over $500 a day for a
hospital bed versus the under $50 a day for Abbeyfield residency strikes
real economic sense. In the United States, nursing home live-in costs can
run upwards of $50,000 per year. During our endeavors to establish
an Abbeyfield niche in municipal, county, state, or federal health care
planning, it helps to remind governments of these savings.
We find that around 12 residents is the optimum economic size in
today's market context of financing an Abbeyfield House. What one must
guard against is a mentality that demands larger numbers of residents and
does not look to the quality of life offered by the small family setting of
Abbeyfield. It is no accident that sports teams seldom go above a dozen
members. Small is good. Small fosters a sense of belonging. This
too requires educating and working with civic officials and planners to fit
Abbeyfield into local regulations about lodging houses or rest homes.
Our international office, in St. Albans, England, is committed
to sharing our knowledge, experience, and quality standards. We want to
‘Grow Abbeyfield’. We very much encourage new member nations to be flexible
and sensitive as they adapt the concept to their own country and culture.
In turn, we have learned from their innovations. New ideas are refined with
old methods to continually evolve the strong humanistic ethos that is our
keystone. We don't believe in re-inventing the wheel, but we're not afraid
to change the tires!
Japan, for example, opened their first Abbeyfield House last
year. They added a separate community building for the use of all seniors
in the local area. Now Abbeyfield Scotland thinks that is a great idea for
wee villages in the Highlands.
An Abbeyfield House in the Netherlands occupies the entire floor
of an apartment building. This is a grand concept for high-rise
condominiums in urban settings.
As a couple of innovative Canadian examples:
The City of Vancouver leased its original Children's Hospital to
Abbeyfield. This is a listed, heritage, building that now houses two
Abbeyfields, one in each wing, thus making excellent, functional, use of a
historic structure.
Canada is a vast country and in rural townships Local Abbeyfield Societies
can bring in retired farmers or their widows from the surrounding area.
These seniors do not have to move away from their familiar countryside to
the alienation of a distant large city institution.
HOW TO BUILD AN ABBEYFIELD?
Our video spoke of a ‘Sparkplug’, someone who introduces
Abbeyfield to a community and brings together a sponsoring group to form a
Local Society. The new Abbeyfield Society could be sponsored by a Rotary,
Lions, or Kiwanis service club; a Legion or veteran's organization; a church
or temple congregation; an ethnic group; for that matter any assemblage of
interested peoples can be constituted as an Abbeyfield Society.
The new Local Society will be the purchaser, owner and operator
of the House. This Abbeyfield ownership rationale has worked very well
because dedicated local people know the requirements of their own community.
An Abbeyfield House cannot be parachuted into a neighborhood - the local
community must be the instigators.
This is why the first work that has to be done by any group
interested in sponsoring a new Abbeyfield Society is to complete a Needs
Analysis within their community. By doing this homework, fledgling
Abbeyfielders soon learn what is available, what is required, and who their
key government and social agency people are that make decisions for seniors.
This important first step also solves one of the main problems
of any new volunteer organization -- Finding out who the real workers are!
Having completed the background detail, a newly constituted
Abbeyfield Society can draw up a business plan and restructure their
productive members into two committees, an Executive Committee and a House
Committee, in order to commence their project.
An Executive Committee board of directors from the sponsoring
group will oversee the funding, construction and management of the new
Abbeyfield residence.
We suggest that this committee should be led by an entrepreneur and salesman
type personality.
Abbeyfield Canada has devised a Life-Lease method of financing.
The Canadian plan requires investment in a new Abbeyfield House by several
potential Residents. These apartment-purchasing monies are placed in a
trust to provide capital with which a conventional construction loan and
mortgage can be obtained.
When the House opens, all Residents, both those who purchased
and those who rent, will pay the same monthly fees. However, the Life-Lease
purchasers receive a monthly return on their investment. If the Life-Lease
Resident moves on from Abbeyfield, their funds are returned to them or to
their family when the Lease is sold to a new Resident.
Due to today’s high costs of building, Abbeyfield International strongly
encourages this Resident purchase form of funding in order to expedite
construction. This will lower the mortgage and keep monthly costs low for
all Residents, especially those who can only afford to opt for rental
suites.
The second committee is a House Committee responsible for community public
relations. Their key role is to market the name Abbeyfield -- to make it
known as synonymous with cheerful and healthy senior citizens. Abbeyfield
must be recognized as a viable option to the perceived step from family home
to institution.
A Volunteer leader and caregiver should head the House Committee. These
Volunteers will look after the day-by-day smooth running of the building.
They hire the Housekeeper; they screen new Resident applicants; and they
keep family and sponsors of Residents informed and welcomed. As well, they
provide one-on-one support or arrange special events.
Please do note that the Local Sponsoring organization can be paid for
overseeing the construction and for management after completion. In other
words, sponsoring Churches could count on income beyond the collection
plates; sponsoring Service Clubs could acquire extra monies to carry out
their many projects -- and Abbeyfield, in turn, has the service of their
volunteers.
And that, ladies and gentlemen, is a very simplified and short-form, HOW of
Abbeyfield.
Long before the fad for Mission Statements, Abbeyfield had its Guiding
Principle: "That Abbeyfield is a voluntary effort by people of goodwill to
assist older people to achieve a fulfilling way of life". Our work is
guided by three shared beliefs:
FIRST, that older people everywhere suffer from loneliness and
insecurity and so need care, companionship and practical support in their
daily lives;
SECONDLY, that older people still have an important role in the
lives of their families, friends and communities;
THIRDLY, That within each community, individuals can actively
help older people to have a secure and happy life by offering them a home of
their own within the companionship of a small household.
Perhaps the motto of the Abbeyfield Society of South Africa perhaps sums it
best:
Caring for the elderly is everyone's concern -- Everyone's --
Not everyone else's.
India's late Mother Theresa called loneliness the condition that
causes greater distress than physical suffering. When friends, relatives
and spouses have died; loneliness in old age is the number one problem with
all its attendant fears, resulting insecurities and health frailties. The
painful realization that one is no longer wanted or ‘belongs’ causes the
soul to give up and the body soon to follow.
Our elderly are the same the world over, whether they live in a
mud hut or a mansion; they need to be loved, they need companions and they
need security.
We are not saying that Abbeyfield is the be-all and end-all for
lonely senior citizens. But, as a very viable, time-tested and time-proven
option, this is real and this works. We have the credibility of over 850
successful houses internationally as trial and proof. A new life of
complete independence, a social network of peers, regained dignity and
community involvement, all under the security of a non-institutional roof
appeals tremendously to our elderly. They relish being able to come and go
as they please.
May I conclude by returning to the 'Good Samaritan,' Major
Carr-Gomm. Why did he give up a successful military career to become a
home-helper? In his autobiography Push on the Door, he writes
"...I realized that the resigned state (of old people) was not brought about
by material worry but by sheer and utter loneliness and their acceptance of
it... a terrible paralyzing apathy... lurking behind even the most
courageous and dignified face."
That is the double challenge that Richard Carr-Gomm defined.
Not just to house our elderly but to overcome the situation of loneliness.
Canada has begun to accept the challenge with twenty-nine Abbeyfield Houses
in operation and a further ten in various stages of development. In the
USA, the State of Illinois looks to open the first American Abbeyfield
House. Massachusetts is not far behind.
In the 1960’s, the Baby Boomers believed that they had invented
communal living. Perhaps in the end they will truly live it…
The next Abbeyfield International Global Conference - the 10th,
and held every 3 years - will take place in Toronto by invitation of
Abbeyfield Canada from 18th to 20th October 2008. Please consider this a
most warm and welcome invitation to attend.
WHEN IN YOUR COUNTRY?
I do hope that I have answered the Why, What, Who, Where, and How of
Abbeyfield. May I answer the When for Germany by reminding you that the
Video spoke of an Abbeyfield Associates Program in the city of Kassel.
Present with us today, we have Herr Alfred Hoffmann, Executive Director, of
the Abbeyfield Society of Germany.
Alfred --Please rise and be recognized… I offer you my sincere thanks for
all your national efforts and a glad welcome to our international family.
May I present to you a very important piece of equipment for your first
Housemother. (an Abbeyfield apron).
Ladies and Gentlemen: May we all live to be a healthy 100 years old and may
we live that life surrounded by a happy community of family a
nd friends.
| 
