Aging as a continuation of our lives

Atul Gawande speaks of growing old in comfort and with dignity at the West Tisbury library.

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Dr. Atul Gawande shown on a simulcast at the West Tisbury library. — Olivia Larsen

Dr. Atul Gawande strode across the stage of the Boston Public Library and settled himself into a chair across from his interviewer, Robin Young. So began “Being Mortal’s Village: The Value of Community and Choice as We Grow Older,” a simulcast video celebrating 15 years of the Village Movement that was shown in the West Tisbury library’s program room this past Monday evening. The room was completely full.

Dr. Gawande is a surgeon at Brigham and Women’s Hospital, a teacher, a writer, and from all I have seen and read, he is a very kind and thoughtful man. His last book, “Being Mortal,” discussed aging as a continuation of our lives, different, but still a time for us to abide by our own values and priorities, and live aligned with what is important to each of us.

Dr. Gawande said, “All we ask is to be allowed to remain the writers of our own story. That story is ever changing. Over the course of our lives, we may encounter unimaginable difficulties. Our concerns and desires may shift. But whatever happens, we want to retain the freedom to shape our lives in ways consistent with our character and loyalties … the battle of being mortal is to maintain the integrity of one’s life — to avoid becoming so diminished or dissipated or subjugated that who you are becomes disconnected from who you were or who you want to be.

“Sickness and old age make the struggle hard enough. The professionals and institutions we turn to should not make it worse. But we have at last entered an era in which an increasing number of them believe their job is not to confine people’s choices in the name of safety, but to expand them, in the name of living a worthwhile life.”

The book details different ways for people to age, whether at home or in a facility. Humanizing assisted-living residences and nursing homes to allow residents to maintain their autonomy and as much independence as possible is their priority. Their staffs support this autonomy. The residences are designed for people to maintain their privacy and lifelong cherished habits, surrounded with their own furniture and possessions. Cats, dogs, birds, plants, children, families, friendships, all can be part of their lives. Eat chocolate. Have a drink at night. Go for a walk. Stay up half the night and have breakfast in bed in the morning.

This is a bit of background to the simulcast we were gathered to watch. It celebrated 15 years of the Village Movement, which began with the Beacon Hill Village in Boston, where a group of neighbors got together to talk about how to stay in their homes and community — what they would need for support, and how they could maintain their friendships and activities?

As other groups began to inquire about the Beacon Hill Village model, they wrote down “how to” information to share, but it wasn’t enough; there were too many requests. They needed a separate entity to work with groups going through their individual processes. That was the new entity Village to Village Network. So far, they have helped create 350-plus villages around the world. One of them is here on Martha’s Vineyard.

Vineyard Village at Home was started in 2007 by Polly Brown. It has more than 50 members around the Island. Seventy volunteers help with everything from driving members when they can no longer drive, helping with small home repairs or organizing bigger projects, to reading to members who have lost their vision. Members go to play-reading groups and put on productions. They attend activities at the Councils on Aging. The group can even advise members on live-in home care, should that become necessary. Vineyard Village’s mission is to do whatever it can to keep members connected and part of the community. It’s a constant process of adjusting to their members’ changing needs and situations.

Ms. Brown’s original idea was for a new community that spanned residents’ needs from independent to assisted living and eventual nursing home care. That turned out not to be feasible at the time. They couldn’t find an affordable piece of land, and zoning bylaws didn’t allow such a facility. Besides, when speaking with potential members, she found that more than half the people she spoke with wanted to stay in their homes. That became the priority, so she turned to the Village model. Perhaps now things have changed enough so that the Island could support both. After all, the Vineyard is an aging community.

As with other Village communities, the goal is “to live a life with purpose, happiness, and fulfillment.” Dr. Gawande spoke about the importance of advocacy, of sitting together having a conversation, instead of him, as “the Doctor,” telling patients what to do. The Village Movement asks, “What are your goals? What do you need to achieve those goals? How can we help?”

The room where we watched the simulcast was mostly filled with people my age (67). Most were people I have known since I moved here 36 years ago, most of my adult life. Some are close friends. We have become the older generation.

Sometimes our conversations turn to questions, musings about what our lives will look like as we age. Getting older is a process. It happens bit by bit every day. Listening to Dr. Gawande, I am forced to think about what would have meaning for me, what would be important.

A while back, I had written out a list of things for my husband Mike to remember if I could no longer tell him how I wanted to be cared for. It’s probably time to revisit that list. Most of what I remember are small things like having fresh flowers on my bedside table, art books and my New York Times to read, or having lunch with a friend. Those are the things that I treasure, and I believe it’s important for all of us to think about what that list should include.

Polly Brown told me that Vineyard Village has temporarily stopped accepting new members because they don’t have enough volunteers to provide services. If you can spare half an hour a week or every other week, or more time, she asks you to please contact her or Lynn Orlando at 508-693-3038 or vineyardvillage@gmail.com. You can look at their website:

vineyardvillage.org.