We may live in a youth-obsessed culture, but the aging of the human race is actually the biggest story of our time. The world’s population—not just America’s, but the world’s—is rapidly aging. By the year 2030, one billion people will be 65 or older—and for the first time in history, the number of people over 50 will be greater than those under 17.
Experts debate vigorously about the meaning and impact of this generational shift. But veteran journalist (and New York Times bestselling author of China Inc.) Ted C. Fishman has a leg up on the competition with his latest book, Shock of Gray, and that book begins right here in Sarasota, which, as the oldest county of more than 250,000 people in the entire country, seems a sort of experimental lab on the subject.
Fishman calls Florida, and the area around Sarasota in particular, “God’s Waiting Room”—a riff on a familiar old joke—but he also found us ahead of the rest of the country in services and opportunities for older residents. A keen observer and quick study, he zeroes in on the unique nature of our city and the important role that retirees play here in fields from the arts to philanthropy. And he believes we may have much to teach the rest of the world from our experiences, challenges and successes in dealing with an aging population. You can read some of his observations about Sarasota in this excerpt from his book, and hear him in person when he speaks on March 4 at Ringling College to benefit SCOPE’s Institute for the Ages. (See page 68.) Info: [email protected]
From Shock of Gray by Ted Fishman. Copyright © 2010 by Ted Fishman. Reprinted by permission of Scribner, a division of Simon and Schuster, Inc. For more information, go to pages.simonandschuster.com/shockofgray.
Sarasota proper has some 53,000 residents, but the greater Sarasota area is home to 800,000 people. Among communities with a quarter of a million people or more, greater Sarasota, where the median age is variously calculated, depending on how one maps the area, between 41 and 55, is credibly labeled the oldest in the United States. Nearly a third of the population in Sarasota County is over 65 years old, and one household in two is home to someone over 65.
Sarasota at its best may be the finest place in the world for older people to make new homes. The community encourages physical activity and social life, pushes people outdoors, and, despite its smallish size, stands as a capital of culture. That Sarasota attracts the well-educated and the rich informs the quality of life, too.
“People who move to Sarasota are the cream of the older crop,” says Dr. Bruce Robinson, chief of geriatrics at Sarasota Memorial Hospital. “They have resources, mobility, and a good perspective.” Robinson, who grew up in the Missouri Ozarks, contrasts the Sarasota retirees to the people over 50 he knew in his hometown. “People like my grandparents stayed there because they were poor and could not think of being anywhere else. They had family and kinship, so communities took care of people. That’s not the case in Sarasota. If you come here to retire, you’d better have money when you get into trouble because you’re far from your family and you’ll need to pay to be taken care of.”
“Eighty-five here is not the same as in an aging town in the Midwest. The 85-year-olds here look 65 in comparison,” says Pam Baron, who moved to Sarasota from Denver and is now director of senior services at Jewish Family & Children’s Service of Sarasota-Manatee. “In the North you don’t see the sun and you’re susceptible to SAD, season affective disorder. People here wear pink and lime-green clothes. The women go out dressed in coral, bright pink, and powder blue. The older guys are in wild shirts they’d never wear at home in Rockford, Illinois. Put all that stuff together and it does extend life.”
Older volunteers, nearly 650 of them, fill roles everywhere in the [museum] complex. The volunteers include a cluster of veteran wood carvers. “It’s a highly skilled group,” says Hollie Corbett, the volunteer coordinator. “I have to say that, given the age of some of them, it’s a little scary when they pull out the power tools.”
The average age of a volunteer is 72, says Corbitt. Together the hours put in by the 650 volunteers equals the work of 31 full-time employees. They save the institution millions. Corbitt adds that once volunteers are accepted, they hold on to their jobs as long as they possibly can. The tenacity of the volunteers is causing some institutional anguish. “We are entering a phase,” says Corbitt, “where health is becoming a challenge for the staff, especially relating to some of our longtime volunteers who have been here maybe 20 years. This is their second home. But we’re at the point now where some of the volunteers need us more than we need them.”
Corbitt says that for the volunteers who have a hard time with their duties, the challenges are physical, not cognitive or behavioral. “It is a difficult problem because they are also important to us in other ways. They might be generous donors, for example. We need to find ways to help them transition out of their current role, but also find ways to keep them engaged.”
Walking through Plymouth Harbor with Harry Hobson, the executive in charge of Sarasota’s oldest continuing care retirement community (CCRC), is a bit like hopping tables at a charity ball. Plymouth Harbor is one of more than 2,000 CCRCs in the United States. Many are modest. Plymouth Harbor sits at the very top of the market.
Doctors, high-priced attorneys, Wall Streeters, patent holders, professors with lots of savings and good pensions, corporate chiefs, wealthy widows, people who sold expensive houses elsewhere and other fortunates call it home.
Plymouth Harbor is just one of many senior residences in the area. The Yellow Book of Senior Living Options has 178 pages jam-packed with ads for communities for active and not-so-active older adults nearby. Competition for residents is fierce in West Florida, and communities tend to get high marks from their clients, who are happy to be in the South, and are indispensable, unavoidable sources of information for potential customers shopping around.
Hobson waves to a couple coming through the lobby in tennis clothes and whispers that the gentleman carrying a bag of rackets is near 90 and on his second artificial hip. The people who run CCRCs often offer statistics to show that their residents live, on average, a good deal longer than the general population, up to eight years longer. That would place them among the longest-lived communities in the world. CCRCs such as Plymouth Harbor already cater to a wealthier population that has a better chance at extreme longevity than the hoi polloi. They often enter when they are already near or past their average life expectancy, and before they face serious health complications. They will likely stay active for some years before they move along the continuum of care. And when they do fall ill, or simply fall, help is always just down the hall.
Elsewhere around the country, opera attracts younger audiences, but the bulk of the audience in Sarasota is over 60. Susan Danis [executive director of the Sarasota Opera] says the older demographic goes well with the vision of the house’s maestro, who is committed to performing works as faithfully as possible to how their composers intended them.
Older Sarasotans make up an indispensable foundation to the opera’s operations. There are thousands of donors in town, and hundreds who give at the top levels. The board and committees are top-heavy with people who tend to be older than those on boards and committees at other houses. “One good thing about Sarasota is that there is always someone older than you,” Danis observes. “I just had a board member turn 70 and it feels like he’s a baby. We had another board member who retired at 100. He came to every meeting perfectly groomed and seemed so vital, but his memory started to slip. We have another ex-board member who is 103 and who makes references to Tammany Hall corruption in New York [in the 1920s]. Our assistant house manager is 96 and he could kick your ass.”
The renovation of the opera house was meticulous in making sure that the company met the needs and expectations of its older clientele. “If you build everything for wheelchair access, they will come,” says Danis.
Older audiences do have patterns and preferences that no renovation can oblige. “Last night we had someone with a heart attack and the EMTs had to come,” Danis says about the L’amico Fritz opening. “One of the biggest things we have to deal with is patrons who don’t want to miss a performance no matter what has happened to them…they won’t let you call for help. I have to go up to them and say, ‘Ma’am, you’re blue, let’s call the EMTs.’”
Reportedly, Sarasota has more non-for-profit service organizations per capita than any other American city. And almost certainly, more than any its size in the world.
Sarasota’s bigheartedness centers largely on efforts to boost the arts, promote the environment and provide services to area children. The impulse to help children carries with it some contradictions in a community as old and wealthy as Sarasota. Bob Carter, the president and CEO of Sarasota’s Senior Friendship Centers, Inc., a full-service senior center in the middle of town, notes the irony that so few of the charitable dollars awash in Sarasota go for programs for seniors. Older donors, Carter says, do not get the good feeling giving to needy people their age or older. It reminds them too much of what’s in store for them later. But everyone likes to help children.
Pines of Sarasota is a nursing home that used to be called the Sarasota Welfare Home before “welfare” became a dirty word in America. Today, Pines serves 300 elderly Sarasotans who have nowhere else to go. Their average age is 87 and they typically stay for three years. Compared to nursing-home patients in the 1970s, they are much older and sicker. Younger, less infirm people have more options today, which means that homes such as Pines carry the heaviest burden for residential care. Most of its residents need 24-hour care. The vast majority are women, many of whom spent their last dimes caring for husbands now gone.
“We’ve experienced older parents living here at the same time as their children,” says John Overton, president and CEO of Pines. Overton moved to Sarasota from Canada, where he ran an assisted-living residence. When he and his wife first arrived, they took over a large family home and created a small assisted-living facility for residents who paid with their own money. That is a far cry from the institutional Pines, which, though clean and well attended, is filled with inhabitants who offer a sobering picture of a final stop, despite an earnest attempt by the staff to brighten the environment. On one visit, nurses and patients are draped with leis, and the dining room features hula girl and pineapple decorations assembled by some of the residents. But it does not look as if anyone is particularly cheered up.
Overton shakes his head when asked about the willingness of well-off Sarasota to support Pines. “It just isn’t a sexy topic for the people here, and we cannot get the wealthy to give money. Even though the need is greater than ever, it is harder than ever to get people to give. People want to hear about what their money is doing for the future. Some donors want to give to organizations that helped them. When you serve people with dementia, you don’t have a big alumni group.”
One of the mixed blessings in creating an older community that is enviably active is that inactivity is unenviable. If social currency accrues to those who remain youthful, it is debited from those who are less so. There is pressure in town to be counted among the young elderly, and that means staying active, fit and attractive. The plentiful mix of age-defying medical and cosmetic services in town attests to the pressure.
“Although it’s natural and beneficial to view active engagement in life positively, there is a danger in idealizing old age as a time of high activity,” says John A. Krout, director of the Ithaca College Gerontology Institute in New York State. He wonders whether society will label those less active as failures and create a two-class system. The view would be just as unrealistic, he asserts, as the picture of frail, inactive, poor elders it replaces, because elders are as diverse in activity levels as they are in other ways.
In Sarasota, the whirl of the migrants who have come before the boomers already presages the split Krout predicts. It shows in their age-defying activities and philanthropy. Defying stereotypes about aging is itself empowering. But denying the needs of the less active elderly may end up as a collateral price society pays for its new image of later life.
In Sarasota, the philosophy of activity spreads so deep it has become part of the institutional drive in the town’s CCRCs. The Glenridge on Palmer Ranch competes with Plymouth Harbor and the small group of other local high-end CCRC complexes. The sprawling complex, described in sales material as having “all the grandeur of a resort hotel,” consists of four-story apartment buildings with some single-floor villas. Neat rows of tall palms divide the quiet grounds. Signs around small ponds warn wanderers that alligators may lurk in the water. It’s no joke: No one sits near the ponds.
Big common areas make up the core—restaurants, an ice cream parlor, a pocket café, gift store and a canteen. The grand staircase in the lobby spirals around a 15-foot-tall cylindrical glass aquarium teeming with iridescent fish. The sight of fish gliding through clear waters has proven benefits for dementia sufferers.
Opposite the aquarium another attitude adjustment zone beckons—the Glenridge cocktail lounge, the Thistle Stop—a hub of later afternoon activity.
“I can’t imagine a lifestyle that would exceed this unless you’re [an aged] Bill Gates or Donald Trump,” says Howard G. Crowell Jr., a former U.S. Army three-star general who is the CEO of Glenridge.
Though he speaks with the authority of a man who could command an army over a continent, which he did as chief of staff of the U.S. forces in Europe, he laughs loudly and can be disconcertingly frank about his job, his residents, and the state of the very old in America. “There are those with $10 million or more who find managing their own healthcare is extremely difficult even if they can afford it. If the goal of society is to provide something like we have to a general public that’s aging,” which Crowell thinks it ought to be, “you have to provide the right mix of feeding, nursing and maintaining where older people live.”
For that, he says, you need to see younger people engaged in the process. Crowell is not sanguine about the prospects. Glenridge points to the difficulties. The residents there have already been separated geo-graphically from their families, most of them for a decade or more, by the time they get to Glenridge. “We get them in their second retirement,” Crowell says. “They moved to Sarasota long ago and like it here.” Even if their children don’t. “I see moving into the Glenridge as the greatest gift older people can give to their children,” he says. “It’s not an easy job for families. You have to provide constant distraction for the people here.”
The answer, says Crowell, is a full plate of activities. He recalls a single week during which three men at Glenridge lost their wives to cancer. “One man was a former chaplain schooled in loss. Another was a politician who was very well connected. And the third was a very wealthy individual. Every one of them was deeply involved in something here. The more involved they became, the shorter their bereavement periods.” Crowell throws up his hands. “The bereavement period vanished.”
What is the goal of the Glenridge? Crowell asks rhetorically. “We help people hit ‘the wall’ high,” he says, invoking a customary metaphor for both dementia and death. “The higher you are on The Wall when you meet it, the better your life has been and the better your children’s lives have been. Now, how do you stay high on the wall when [age conspires] to push you down? Our mechanism is to put people into as much activity as they can possibly deal with at their level.”
His description of the needs of the Glenridge could double as a description of communities where any aging population can “hit the wall high.” In Sarasota, 72.1 percent of the people over 85 years old report needing assistance with basic care activities, and because the city has one of the largest populations of 85-year-olds in the nation, it offers a view of what the rest of the country will need to provide as the number of oldest-old grows dramatically.
Society, he says, “doesn’t want to deal with old people. If you’re living at home and you are the oldest person on the block, you can feel you’re a pain in the ass. But if you’re in an environment where there’s always someone your age who shares your experiences, where people have losses together, and there are clubs and activities, you can deal with it.”
Institute for the Ages
Author Ted Fishman isn’t the only one who’s realized that Sarasota is the ideal place to study aging populations. Locally based SCOPE (Sarasota County Openly Plans for Excellence), a nonprofit organization, began work some time ago on an initiative titled “Aging: the Possibilities,” which engaged more than 900 people to explore how communities adapt to demographic shifts and what it means to be the oldest large county in the country.
Out of that initiative came the groundbreaking Institute for the Ages, a collaborative effort bringing together forward-thinkers from business, government, research and other nonprofits to form new ideas and policies for our current aging population and our future. While still in its infancy, the Institute has developed a business plan and conceived several pilot projects, including a first-of-its-kind community scale test to assess improvement in physical and cognitive fitness, nutrition and social engagement; an older user-centered hospital design project; and research into how community structure, facilities and activity offerings can meet fitness standards. To learn more about the Institute, go to scopexcel.org or call 365-8751.