Thoughtful planning, healthy aging

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One of the defining attractions of living on Martha’s Vineyard is that many of us get to live more or less the way we like, relatively free of the compromises modern American life requires of many or most non-Islanders.

It’s true, of course that large forces — a changing economy and growing income inequality, global warming, the political disintegration of the Middle East, and the disruption fueled by the worldwide web, as examples — can intrude and may lend shape to our lives, but more than most we Vineyarders get to live as we like. It’s what has drawn many of us here and keeps us here.

Because we choose to be Vineyarders, sometimes at fair cost, there is something of a heroic element of sanctuary embedded in our self-mythology; we see ourselves as refugees from a society too competitive and aggressive, too judgmental, too fast-paced, too somehow out of harmony to allow us to be at peace with ourselves. We embrace our marginal isolation in order to keep the world from being too much with us, and so to make our world more about us than about them.

Fortunately, though, our Vineyard sanctuary is culturally, ethnically, generationally, and aspirationally diverse. We want our insulation and privacy, but not at all toward the same end. Of equal good fortune, most of us accept and even embrace the idea that if we’re not to be reduced to a cartoonish, moated enclave, we need to embrace our diversity and make community resources available to meet a wide range of community needs and interests.Our challenges — in housing, health care and education, in environmental protection, in our local economy, and in paying for the social and cultural infrastructure we’d like to have in place — are great not so much owing to intellectual complexity, but because successful coping will require vision and rigorous thought, and especially compromise, on individual issues which resonate so strongly for many of us.

Among the most demanding challenges, because of the wide range of systems and services we’ll need to draw on, is our rapidly transforming aging demographic, now well underway and dramatically accelerating over the next 15 and more years. Our average age is already significantly higher than the state average, and almost one in three Vineyarders will be over 65 by 2030, up from about 16 percent in 2010. Most strikingly, residents above the age of 85 (vastly greater consumers of health care and related resources) doubled to almost 400 between 1990 and 2010, and will increase to more than 600 by 2030.

The support required for a healthy but rapidly aging population is extensive and complex, especially if we’re committed to reducing dependence on nursing homes and other forms of institutionalized care. Solutions involve housing (and proper land-use planning and zoning), home care, primary geriatric services, education for seniors and for service workers, flexible transportation, financial support and planning services, and public awareness and prevention programs — and cut across many private and public organizations, each with its own concerns about viability.

The Vineyard’s Healthy Living Task Force on Aging is in the early stages of tabulating and interpreting community responses to a thoughtful questionnaire asking Islanders over 65 to consider their needs and preferences as they plan to navigate the exigencies of older age. Findings, discussions, and recommendations are a few months off, but it isn’t too early to begin to think about the programs and investments we’ll need to make; many, like housing and health care, can be devilishly slow to percolate and fall into place.

An aging population is a fact and not a lifestyle choice, and accommodating a preference for aging in place is good for us all. But it is complicated to plan and execute, it is expensive, and it can become politically contentious if we see Island resources as too limited to invest broadly, across our entire population, and not simply with the landed and the wealthy. To the contrary, the healthier the broad community we sustain, the more we will all be enriched. The job at hand is to be informed and to combine the volunteer dedication and expertise of our Healthy Aging Task Force and other community leadership efforts with accountable political representation obliged to solve the important issues ahead of us.