John P. Stewart: Aging in the City

Stewart is helping to reshape current thinking about how cities can meet the needs of elder citizens.

March 1, 2009

John P. Stewart, founder of a Baltimore-based think tank on aging, has helped create a blueprint for how cities can best meet the wide-ranging needs of older Americans.

Tell me about the agency you run—CARE, the Commission on Aging and Retirement Education.

STEWART: We are a broad aging services program that’s authorized as an Area Agency on Aging, a federal designation. We fund and operate 22 programs and services in Baltimore, including 15 senior centers and 42 nutritional sites that serve 5,000 older adults daily. We serve about 38,000 different clients annually. We balance serving our existing population with planning what we’ll have to do differently for the incoming baby boomer generation. To that end, we’ve created a plan called the "Blueprint for Aging-Friendly Baltimore."

What impact does the aging population have on planning for seniors’ needs?

STEWART: Baby boomers will be more vocal and demanding. For example, they won’t want the traditional meal that’s served in a senior center. They’ll want a menu and a café. We’re going to make those kinds of changes. We’re in partnership with 16 other cities, including Chicago, Atlanta, and Philadelphia. They’ve agreed to collaborate with us and share best practices. With the aging demographics and flat government funding, we need to take steps locally to make fundamental changes in aging services and financing strategies. We have to make the delivery of aging services more of a business proposition. We need to demonstrate return on investment when we ask for money.

Historically, older adults have often been isolated from their larger communities. Is that changing?

STEWART: You are going to see more people who want to age in community. We need to integrate older adults into the community and the community with older adults. For example, traditional senior centers are isolated, stand-alone buildings that few people other than older adults know about. That needs to change. We are changing their name to "centers for healthy and active aging." They will have intergenerational activities, day care programs, and a state-of-the-art fitness center. Older adults will have priority, but we want the whole community to use them.

How is the housing industry addressing the changing needs of seniors?

STEWART: We’re seeing a new industry of assisted-living providers, which are more affordable and viable than nursing homes. Older people would rather reside in the community and will be able to do so if the assisted-living market grows. The problem is that most people in urban America can’t afford private-sector solutions. Unequivocally, there’s a need for affordable and accessible communities that offer a continuum of services, and I think the market will create it.

Baltimore has begun to adopt your blueprint for an aging-friendly city. What does it entail?

STEWART: This model has four domains: basic needs, health care and wellness, supportive environments, and social and civic engagement. In each neighborhood, we’ll work with city agencies, community organizations, and businesses to look at assets and liabilities and then develop a strategy for meeting these requirements. For example, does the community have police who are friendly about assisting the older population? Are neighborhoods easy to get around with cut-curb sidewalks and timed street lights? We’re starting with two neighborhoods, and scaling up to a citywide level. It’s an unprecedented approach.

What long-held assumptions about seniors are changing?

STEWART: More and more service professionals are viewing older adults not as having diminished capacity but as having adaptive capacity. Seniors do change and adapt. I’m 63. We are an incredible untapped resource that can add value to a number of programs. For example, Baltimore has made significant progress with its school system. We have the largest Experience Corps program in the country—it puts older adult volunteers in K–3 classes, where they serve as mentors to students and assist teachers. In those schools, research has demonstrated that the kids perform better, have fewer behavioral issues, and they have a greater commitment to school. In addition, the older adults reduce their medications, have fewer visits to doctors, and have a greater sense of commitment to the community.

What are seniors looking for in a home?

STEWART: When my wife and I were looking for a home, we paid attention to things that would allow us to stay in that house as we age, such as living on one floor. It’s not only about bricks and mortar or what it looks like, but what kinds of services are available to keep us there instead of having to move into assisted living or a nursing home. Are there other services available, and is there access to cultural amenities? Can someone assist us if my wife or I have a disability or illness?

Have notions about retirement shifted?

STEWART: More and more people are not retiring at 62. Many want to stay active and many will have to, given the economic situation. The whole definition of retirement is changing radically.