Aging and Disability Care: The Village Movement

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Steve Lorberbaum:

Okay. Well, good morning everyone. My name is Steve Lorberbaum. I’m the owner of Assisting Hands Home Care Potomac. This is our latest edition of What’s Your Plan, and the goal of what your plan is to meet with industry leaders to find out how we can all better prepare and plan for our futures and what resources are available. So we’re really excited today to have Pazit Aviv who is the Village Coordinator for Montgomery County. What she’s going to do is give us a few minutes. She’s going to explain what the village movement is, and then tell you a little bit more about how you can get involved. So Pazit, share with us who you are and how you came to this.

Pazit Aviv:

Hi everybody. I work for Montgomery County Aging and Disability Services. Took this job in 2014 when the position of Village Coordinator was created as a result of advocacy by different leaders, as well as Commission on Aging. And the village movement is a very unique trend in our country. It’s a national movement. It started back in Boston in the early 2000s and it came about as a result of people’s desire to age at home with high quality of life and dignity. Recognizing the fact that if people don’t do things on their own, there’s not much out there for them. And people had decided to organize and form local, hyper-local community organizations to create those social networks, which would be there for them as a safety net when they needed that.

Pazit Aviv:

I think there are two key elements of the village movement. One is the recognition of the value of community and connections so that we are all not isolated, that we have people to turn to when we need it. And the second element is the volunteer support at home. The number one need for people when they age at home is for volunteer driving and villages provide plenty of that. So they are a key transportation solution for people who can no longer drive, or if they’re temporarily unable to drive.

Pazit Aviv:

The beautiful part about the villages is that they are driven by the people, for the people. They’re super democratic, very grassroots, and they’re not led or guided by any external oversight body that tells them what things should be done or how they should be done. So it’s a very organic movement. It’s idiosyncratic because every time a group of people want to start their own village in the neighborhood or city, they shape it in their own image because they know the community best. So they create something that makes sense to them. So every village is different from the one next to it even, because it is led by different people, they meet different needs and they do things differently. They all share the vision of helping people stay at home and age with high quality of life.

Pazit Aviv:

The way I got into it was kind of interesting. I come from the field of aging. I was a social worker with home care companies, as well as some hospitals. Then I switched over to work with affordable housing, people who live in affordable housing, the local housing authorities, HOC, Housing Opportunities Commission. I was tasked with providing people with programs that can help sustain them and keep them happy and healthy. One of the insights I had is that once you are no longer able to live independently in affordable housing and you are low income, there isn’t much out there for you in terms of affordable, assisted living, or affordable nursing home, unless you fall on Medicaid. And so that really pushed the needs to help people stay at home, happy and active and independent as really as much as possible.

Pazit Aviv:

And I was doing research on different solutions and found the villages as a really viable way for people to accomplish that and got so interested in it that I started a village in my own city of Tacoma Park in collaboration with wonderful people, including Wolfgang [Bergner 00:29:03], who was the president for many years. And so it was a fascinating exercise of organizing a community and starting something for the benefit of everybody. I was on their board for six years. And so when the position became available with the Aging and Disability Services, I felt it was a really good way for me to contribute from my knowledge and experiences to the benefit of other villages and other people.

Steve Lorberbaum:

Okay. So, really the villages are not a County program. You’re a guide, if you will, to help people that want to start a village.

Pazit Aviv:

Or not just start a village. I do help with startup and a lot of outreach and education around it, but we have about 30 active villages and they rely on one another and on my support to help them sustain themselves to grow because keeping an organization alive and well takes effort. My job is to help all the villages throughout their life cycle, with whatever goals they need.

Steve Lorberbaum:

So if I wanted to know if there was a village in my neighborhood that I could join, how would I go do that? I mean, it seems like they could be anywhere.

Pazit Aviv:

I keep an interactive map on the web. I can share my screen if you’d like at some point to show people where it is and how it looks like. And that map, villages provide me with their boundaries because each village decides for themselves, what is the area they’re able and willing to serve as part of their community. And I, in collaboration with some skilled individuals, they have the skills I don’t, we created this map where you can plug in your address and it will tell you if you’re within the area of a village, as well as how to connect with that village. Most of the villages we have right now are in down county area, Bethesda, Chevy Chase, Potomac, Silver Spring, Tacoma Park. There are a few further up county in Gaithersburg, and on Olney and some in East Silver Spring and I hope that the trend continues

Steve Lorberbaum:

Great. So maybe we could type the website into the chat and that way everyone could.

Pazit Aviv:

I can do that now if you like.

Steve Lorberbaum:

Great. That would be super. So, for me, I’m on the Board of Potomac Community Village, so I have worked with Pazit a great deal. But tell me, because I don’t know all the villages, what are the kinds of services that villages can provide if I’m living at home and I’m a senior, or maybe I’m not a senior and there’s a village in my community. Why would I want to join it? What’s the reason? How do they help me?

Pazit Aviv:

So this is a really good question and the way we phrase it, I want to turn it a little bit on its head. One of the things that I want to emphasize about the village movement, it’s not about me. It’s not about services. It is true that many of them do provide support when somebody needs it, but the focus is about creating a vibrant community that you can be a part of. All of us have been completely isolated by the lifestyles this country has pushed us to, and I refer to this automized, super automized society. People get up in the morning, they go to work, they work all the time, all the day. Work, work, work, work, work. They go back and many of them to their suburban communities and they don’t see a lot of neighbors and they spend time and evening at home where their family, kids or other people they’re live with.

Pazit Aviv:

And then when the kids leave the house and you retire from work, then two key social connections, networks you’ve had are no longer there. And we forgot. We, as people forgot the value of having a close, geographically close community to be a part of. And that is not a frivolous thing. This is not something that should be an afterthought to any of us. We have to have vibrant community around us. And villages are mostly about that.

Pazit Aviv:

Now, some people come to the village because they need services and so they join and that’s fantastic for them, it works for them. But I’d like to point out that anyone should be a part of a village regardless of the fact that they need services or not. It’s about connecting. It’s about building that network. It’s about giving from your own time and talent and knowledge base to other people. And then if you need the help, then they’re there for you. But the focus is really first and foremost about creating a vibrant local network. And I will say that, and I think you’ve heard that many times, if villages only focused on the services they offer and they don’t explain that they are really a platform of social connections, people will say, “Well, I don’t really need that help, so I don’t see any need to join you.” But I think that’s a false way of seeing things.

Pazit Aviv:

But I will answer that question, Steve, because you asked it.

Steve Lorberbaum:

Fair enough. That’s a great point you make there. It really is a great point.

Pazit Aviv:

So every village decides for themselves what their volunteers are capable and willing to do. It’s not as though there’s a set sort of shopping cart you can choose from. Most of them focus on volunteer transportation. Many of them offer other in-home support, such as a little handyman work here and there, helping people with yard work or fixing things outside, picking up prescriptions if you’re not feeling well. Some villages help people when they’re discharged from hospital with delivery of warm meals and other small chores around the house on a temporary basis. Some villages will take care of your own Home if you go away to Bahamas and you want your aloe vera plant watered properly.

Pazit Aviv:

And I’m saying that because I think it’s important to note that some villages will tell you this. If you’re a member, and you have any kind of need, just call us. If we have a volunteer that can meet that need, we have a match. Or the villages will say, “We only do transportation and friendly visits home.” And that’s fine. That’s just really their privilege to decide what they do and how they do. So when you are a part of the village, you should ask them what kind of services do you offer to understand the gamut? The focus again is on helping people age at home with high quality of life and anything that falls under that.

Pazit Aviv:

There’s some other really cool programs. Sorry, one really cool thing. Some villages have they call it note taking, medical note taking. So they buddy people up and a person gets training. I think [inaudible 00:12:25] has a nice curriculum. And they offer training to people to accompany individuals as they go to a doctor’s appointment. Because you know, if you’re not feeling well and there’s a lot going on and you have five minutes with a doctor, it can be very overwhelming. And so a person comes with you and their job is to simply keep track of the conversation. And at the end, they give that notes back to you so that you’ll have records of your discussion with the doctor. And that’s something villages have been doing, a few of them, and people love that service. Just an example.

Steve Lorberbaum:

Got you. I know Potomac village, we do a lot of social programs. So we used to do, and I think Chevy Chase as well, but that’s the Metro, it did a lot of social programs where we used to get together. Now everything’s on zoom, but you can go out to your local village and find a variety of entertaining programs, book talks, educational programs as well, that people can be a part of. So I do think that’s also a really useful option.

Pazit Aviv:

Yeah, it’s interesting you’re noting that and the services and for me, that is not a service, that’s the program. That’s the social component that I was talking about and I haven’t expanded on it yet. Let’s just go back to that. And I think when you consider the ways in which people connect, it’s very often around a reason. You don’t just randomly just go down the street and then you see somebody. Some outgoing individuals might find friends this way, but more often than not, you do need opportunities to find ways to connect with like-minded people or people who are just from your neighborhood in a way that’s content-based. And so what villages do to facilitate that connection, they create those social programmings.

Pazit Aviv:

And the villages, it’s really important to know, the programs and the ideas come from the villages themselves. It’s not as though there is this external entity that chooses for people what topics or what content they will have. Village members themselves volunteer their time and energy to create social programming that they think people would be interested in. Very often time a person would come to the village who, a new person says, “Oh, do you guys have a chess club?” And the village would say, “Well, we don’t have a chess club, but do you want to start one?” And that’s just how you grow it and build more network around different topics.

Pazit Aviv:

So the kind of programmings are either very small and intimate, these book clubs that you had mentioned, Steve or walking groups, gardening clubs, or just going out. There’s some villages have these, they call them Romeo clubs. They are for men who live alone and they go and have lunch together once a month. Some of them are around a topic. So they will bring a presenter to inform people about scams, social security, foreign affairs. Some really accomplished neighbor who had done a lot of work in the state department would bring the topic of interest to people. And it’s very vibrant because it’s fed by people’s interest. And around those social opportunities, people get to know one another and form friendships.

Steve Lorberbaum:

Yeah. So just for people that don’t know, Romeo stands for Real Old Men Eating Out. Potomac had one for awhile Coronavirus. Maybe we’ll get back to that at some point in time. But you’re right, we have walking clubs, we have talks about Medicare when Medicare is coming up so that people [inaudible 00:16:04] We have an industry expert that will come in. We have talks about the CNO Canal, about history in the area. So we do an awful lot of things that are really just fun. It’s an opportunity for people to get together. We do movies, we rent movies through the library and show them. So you’re right, I think there’s a huge opportunity to get engaged and then have a talk afterwards to get to know your neighbors a little bit so we rebuild the safety net that …

Steve Lorberbaum:

Look, 50, 60 years ago, you didn’t need a village because everybody knew their neighbors, everyone walked on the street. But now everyone’s so busy we have to sort of force ourselves to step back in time, if you will, to create those interactions that we used to just take for granted. When you picked up the paper outside, your neighbor was doing it at the same time and you chatted for a few minutes or when you walk your dog. So, all right. That’s great.

Steve Lorberbaum:

So what other kinds of things? If somebody is interested in, let’s say, starting a village, how would they go about doing that? Is that something that they would call you? Do they call other villages? What kind of, how would they do that?

Pazit Aviv:

If you’re in Montgomery County I think the best way to start is calling me and I will walk you through the steps. It is not a simple task to start a village because you are essentially building an entire organization from the ground up. Whether you’ve had experience in nonprofits or not, villages are a unique organization that requires a certain set of preparations and decisions to be made. One of the key element is the community organizing around it.

Pazit Aviv:

So in other words, you can’t just individually start a village on your own. This is not a one person show. To start a village you need a mini village, of your own to collectively build organization and its capacity and its direction. And because I’ve helped over 15, 16, I’ve lost count, villages startup, I have a lot of knowledge based on their experiences that I can share with people. I have access to documents and resources and options for you to choose from. I would just encourage anyone who is interested in this to contact me directly. I can put my email in the chat box.

Steve Lorberbaum:

Great.

Pazit Aviv:

You will have it on the website, but I will have that separately.

Steve Lorberbaum:

Good. One of the other things that I hear sometimes where someone will say, “Well, look, there’s already a homeowners association that I belong to. Why do I need a village? Why do I need to do that?” Can you talk about the differences between those? I realize every village is different, but what’s your experience in that?

Pazit Aviv:

If you’ve listened into this discussion so far, and you still think that villages and homeowners association are one in the same, you’re very lucky because you have a very vibrant homeowners association. Because most of them, if you have ever been involved, are very focused what I call the brick and mortar. They care about the roads, the grass, the trees, public safety, regulations, advocating on behalf of the neighborhood with the county for different decisions or whatever that may be. Some of them organize a 4th of July parade. Some of them organize a Thanksgiving parade or some kind of cookout, but that is usually the extent of their involvement in the social networks of people. Rarely do they have, and that’s fantastic if they do, can I just say that? I will not take away any initiative done by anybody, regardless of the village or not, for creating social connections?

Pazit Aviv:

The reality is that in most places and I’ve traveled the county far and wide, either the neighborhood association does not exist or a civic association, or it exists by name, it has no interest in supporting people’s social networks and volunteer support. And for that purpose, you do need an infrastructure because these things don’t really happen organically, as much. As you noted, we’re all busy and we need to intentionally build that infrastructure. Some villages partner with the civic association, because they see this as a really added value to them. They worry about that component of what I call brick and mortar and the villages take on the role of the social connections and the social hubs. I think that is the ideal situation, where the civic association, homeowners association, supports the local village because it adds to the quality of life of the residents in that area.

Steve Lorberbaum:

Great. One other quick question, and then I want to open it up in case we have any questions. Does every county have a you or is this something that really is very unusual in that Montgomery County does?

Pazit Aviv:

It is unusual for Montgomery County. I think there Fairfax County is trying to stand something similar. I haven’t heard recently about what the status is there. They have a staff person that’s working on that. I think they are the second county that has it, but to the best of my knowledge, from county government perspective, there aren’t a whole lot of them. I’ve heard recently that Albany in New York have a foundation that supports a person of a similar function. California villages have a nonprofit that supports all California villages, but they’re not a part of the government and they are more on an advocacy level, than on a state level.

Steve Lorberbaum:

Got you. So the county is really making a commitment here to help get this going because they see the value in creating community, simply put.

Pazit Aviv:

Very simply put and very accurate.

Steve Lorberbaum:

Now I know just because I want to give a shout out to Rockville, that Rockville has someone with a similar position that you have. I don’t want to describe it since I don’t really know what Trish does exactly, but she has a similar role just focused on the city of Rockville.

Pazit Aviv:

Yeah. You were asking about counties and I was thinking county-wide but I think, yeah, you’re right. Trish does similar things for the villages of Rockville and she’s been doing a phenomenal job with Pump House and Patricia would know, as well as East Rockville and Twin Brook village. There’s an initiative right now that COVID killed with Town Center, Rockville. And yes, we collaborate a lot and she has helped the Rockville area villages exchange forum, which helps villages create a hub of operations so that they can grow their autonomous operations on their own while connecting to the hub.

Steve Lorberbaum:

Got you. So I do want to give a chance for anybody that has a question. You can either put it in the chat certainly, or the mics are open. I believe you can just unmute yourself and ask a question. I want to give time for that as well. If not, I’ll keep asking questions, but feel free. Anybody? I see one here. Hold on a second. Nope. That’s your information. Okay. Well we have a few more minutes left Pazit, so anything else that we really … that I didn’t touch on that we’re missing out on. That we need to know that as we’re all aging, as we’re all looking for social connections, that we ought to be doing or looking for, that is that special tip you’ve learned from all the years you’ve been doing this. I hate to put you on the spot, but [crosstalk 00:24:24].

Pazit Aviv:

No, I think we need to remember that anyone of us would need help at some point. That people who are in the business of providing care often forget that they are just as vulnerable. So what I’ve learned a lot from working with villages is that as providers, we sometimes put a lot of barriers between us and the people we serve. I think that we can do a better job in organizing ourselves around the idea of reciprocity of mutual support. Of not having a hierarchy of who has the power to do things and who doesn’t, and also recognize that everybody has assets to provide and I’ll just give one example. There’s a woman in Little Falls village who is 90 and needs a lot of help with volunteer transportation with the rides to different appointments, but that doesn’t stop her from being a very active volunteer with the village doing office work and writing and typing and other admin functions.

Pazit Aviv:

And so it’s important to see the asset in values in every single person that you work with because we all have that and people need to feel like they are contributing meaningfully to their communities. It’s important to create opportunities for each other to join in meaningfully to whatever activity, organization you create.

Steve Lorberbaum:

Well, one of the things I’ve read through our work at Assisting Hands is that social isolation is a huge problem. It causes depression, it can shorten people’s lives. And so, I guess I really see the villages as one of the many ways to try to reverse that trend. To try to give people that are home bound an ability to communicate with their neighbors in a way that they maybe hadn’t thought to do so. Obviously technology now has become a barrier to some because we can’t all get out and it is definitely harder than it used to be to try to engage with people. But I do think villages make an effort to try to encourage communication with everybody. Look, that’s a great example where someone who is in her nineties is still an active, vibrant person. Maybe they can’t drive, but they’ve got a lot to give to their community, and villages I think really do help give people opportunities to continue to serve their communities.

Pazit Aviv:

Yep. Someone had asked about a list for villages and I’m adding a link to the villages. It’s another webpage that’s connected to the map, but it’s a more of a detailed list of the villages and how to connect to them. If you live in an area without a village, I want to emphasize the fact that aging and disability services will not necessarily be able to solve the social networks we’ve talked about, but there are other options for services and resources out there. So if you live in an area where there’s no village and you know someone who has a need, or if you’re the person with a need, I’m going to put a number to call us for information and referrals for alternative resources.

Steve Lorberbaum:

That’s great because really one of the things I’ve learned in my work, and then we’ll end this, is that Montgomery County has a tremendous number of services that are accessed through the Aging and Disabilities Department. And so it’s not just the village, but there are rides, there are meal programs, there are housing support programs. It’s a tremendous amount of supports that are out there and available. I’m sure it’s not enough, but we do far more than probably most other counties that people have ever lived in. With that, I want to thank everyone for joining and Pazit, thank you for your time today. This was really helpful and insightful. I think we’ve given people an opportunity to figure out how they can find a village in their community. Again is, as Pazit said, every village is completely different. Some have membership fees, some don’t. So if you’re interested, find your village, give them a call and see how you can get involved with your community. Have a great day, everybody.

Pazit Aviv:

Thank you everybody.

Steve Lorberbaum:

Bye-bye.

Pazit Aviv:

Bye.

If you would like to schedule an appointment to discuss your Alzheimer’s and Dementia care needs or to set up a free in-home evaluation with one of our nurses, call us today in MD at (301) 363-2580, or in VA at (703) 556-8983. We are located in Bethesda, MD, (301) 363-2580, and Reston, VA, (703) 556-8983.