Rural scholars outline strategies for aging Vineyard

This group of rural scholars from UMass Medical School took a look at healthy aging. Left to right: Gosha Smas, Arianne "Cuff" Baker, Kelli Paice, Ismael Rivera, and Caroline Royer. — Photo by Jeremy Malin

The Island needs to overhaul and expand its senior health care system quickly to respond to onrushing and unprecedented growth in its senior population, according to an assessment by a team of students from the University of Massachusetts Medical School/Graduate School of Nursing Rural Scholars Group.

The students based that assessment on interviews with representatives of Island nonprofits, medical and service agencies, and residents as part of a project to gather information and describe the expected demand for additional resources in order to begin planning for an aging community.

The Rural Scholars project provided a team of second-year UMass medical students to research the issues of Island aging, including two weeks of off-Island interviews with care providers.

The Rural Scholars team presented their preliminary findings at a public meeting on October 24 at the West Tisbury Public Safety Building on State Road.

The UMass Rural Scholars team offered a list of urgent recommendations and a second list of longer-term recommendations on how best to service a senior group, now about 20 percent of Island residents aged 65 and over, that is expected to comprise nearly one-third of residents by 2030 as resident baby boomers age and off-Island seniors retire here.

Needs identified

Based on feedback from public comment meetings with Island seniors and nearly three dozen Island caregiver organizations, the team identified four themes of senior care that need immediate attention: a central service to guide seniors through the elder services system on and off-Island, transportation, housing for seniors, and an expanded caregiver workforce as an Island-wide starting point for navigating services for seniors, caregivers, and service providers.

“The absolute requirements for success of the one-stop service,” the researchers said, are a modern, usable, regularly-updated website, a single phone number to reach a human being, and a professional, neutral director of the service.

While the scope of recommended change is large, the team noted that the Island has several key and well-functioning service pieces in place, including two hospice organizations, Martha’s Vineyard Community Services, and Vineyard Village at Home, as well as a large, functioning volunteer base.

The team recommended sweeping infrastructure changes and some less visible changes, such as amending Island hackney bylaws to allow the same cab to make delivery and return trips. Current bylaws do not permit out-of-town taxis to pick up fares in a town in which they are not licensed.

The complete Healthy Aging report is available at, the Martha’s Vineyard Collaborative website, and on YouTube.

Urgent steps now

The team recommended a number of urgent steps. These included: Island-wide strategic planning; developing a unified mission for Councils on Aging; establishing a one-stop referral service for seniors; improvement of medical care by recruiting and housing geriatric and psychological care providers; and expanding dental care options, particularly for low-income seniors.

Other urgently-needed services the group recommended are: an expansion of Portuguese-speaking care providers; funding of the CORE in-home counseling service; support for independent living and caretakers, and finding and building a single space for the multiple Island Center for Living supportive day programs.

Longer-term recommendations included: Island-wide strategic planning; developing strategies for language and cultural competency; expanding housing options for seniors and the workforce, building a political environment to support growth of affordable housing, and preparing for an increased need for skilled nursing facilities.

The team also made several recommendations regarding professional caregivers including financial and loan incentives to recruit clinicians, expanding transportation options, particularly to enable seniors to access off-Island medical care, re-establishing a once-robust Gatekeeper and volunteer Stop-At-Home programs. The team recommended that further action be taken to ensure the future viability of the recommended single Center for Living venue.

Growing issue

The initiative was sponsored by the Martha’s Vineyard Donors Collaborative and submitted by the Rural Scholars subcommittee of the Dukes County Health Council which funded the project through its Rural Scholars fund. The UMass Medical School Rural Scholars program provides research teams to Massachusetts communities to study specific health-related issues.

Based on current population (17,000 year-round residents) and growth estimates, the number of residents aged 65+, currently indicated at about 3,500, would rise to more than 6,000 by 2030. By way of comparison, the Island public education system now serves 2,075 students, according to a just-completed school census.

The team presented its findings recently at the West Tisbury Public Service building to an audience composed principally of educators, caregivers and non-profit organizations.

The team recommended that now-separate services, such as individual town Councils on Aging, which received high marks from the team, continue their work at the local level but be banded together under a single umbrella organization with a single senior day program venue and a one-stop communications center to handle senior needs and requests. The team recommended that Vineyard Healthcare Access, as a well-run Island-wide organization, be viewed as a model for the Island-wide care consortium.

The number of needed additional affordable housing for seniors and an expanded workforce was estimated at 150 units per year, compared with the current rate of 30 per year. “If you do not build it, they will not come,” the scholars said of the needed workforce. The scholars also noted that seniors currently have a two-year wait for affordable housing.