A Good Age

A Good Age
by Bert Kruger Smith

Foreword

The difference between a dream and reality, in many cases, is a simple but difficult thing, hard work. In the following pages, Bert Kruger Smith chronicles the efforts of one very determined group of people in converting their dream into reality. Her story is an important one for at least two reasons. First is its message that amazing things are possible if you just believe hard enough, work hard enough, and endure.

Its second lesson, however, may be the more important. I believe that the Austin Groups for the Elderly history reminds us that it is still possible to find creative solutions to difficult problems. It underscores the ability that people have to face a crisis and convert it into a vision. And the crisis that the founders of AGE faced is not a unique one, nor is the solution one applicable only to agencies serving the elderly. Indeed, if anything, all those who are attempting to deliver services in this time of such great need and so little plenty should study carefully the efforts of these dedicated people.

As I read the AGE story, I thought of the old song "High Hopes." It is very easy nowadays to dwell on the negative, to mourn the unchangeable "way things are," and forget that "high in the sky, apple pie hopes" still can make differences. Austin is a better place in which to live, and, even better, in which to grow old because of Austin Groups for the Elderly.

Marion Tolbert Coleman
Executive Associate
Hogg Foundation

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Austin Groups for the Elderly started, as does everything worthwhile, with a dream. The college career, the new job, a spouse, a baby-all of these began with a vision and a hope. This dream was to forge new links among agencies serving the elderly, among people with special needs, and with volunteers looking for meaningful projects to accomplish.

Dreamers were board members of small agencies serving the elderly. They recognized that important life chains which hold together families, groups, and communities sometimes weaken in a society which suffers from numbers of discontinuities. They were concerned that each agency seemed to hold to its own turf and that mutual sharing of ideas, experiences, and programs was too little recognized.

How could new links be forged? Who should take responsibility for shaping innovative ways of binding together needed persons and services, they asked themselves?

The year was 1986. The Texas economy was down. New buildings-all glass and steel-stood vacant. Many people, terminated from jobs, searched for new positions. Small agencies, struggling for existence, spent most of their staff and board time worrying about how to pay the next month's rent. With such worries hanging heavy, dreams seemed to be far removed.

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Behind the Plans

Small agencies trying to provide services for older adults reflected the national trend toward care for the elderly. This growing population of older people presented new challenges and dilemmas for caregiving groups.

Not only was the population of elders growing significantly from 12.1 percent of the population in 1986 to a projected 21 percent by 2030, but the population of the old-old, those 85 and over, was increasing at an even more rapid pace. This old-old population called on a major portion of health services. This fastest growing segment of the United States population was expected to go from 5.9 million to 17 million by 2030 and to 26 million by 2050.

The great numbers of older people called upon 30 percent of health care costs. In addition, many ethical issues surfaced. How could the health dollar be divided among age groups in equitable fashion? How much of the highly sophisticated and expensive technology was to be directed toward the elderly, infants, or other age groups?

These facts concerning the senior members of society disturbed many agency directors. They pondered on ways in which their services might help to energize the well elderly and give stimulus and support to the frail elderly. They considered methods for offering support to caregivers, who might then be more able to help older people to remain in homes instead of relocating to institutions.

Those worries about serving the old had their parallel among agencies devoted to the very young. More than half of the women with young children are in the work force today compared with one in eight in 1950, and this enormous growth in the numbers of working mothers has posed many questions about the quality and quantity of child care services.

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The Beginning

The needs of the young and the old populations spurred the planning group to action. Everyone who showed interest in an integrated project was invited to meet and share their concerns with others.

Questions were raised. How could people from various agencies with different agendas and goals learn to work together? What would be the benefits to each of them from such interaction? Would the large organizations "swallow" the small ones? Who would decide about duplication of services? Who would manage such an endeavor? Would groups be willing to share their funding sources? Would funding sources be less reluctant to help finance a consolidated effort than an individual agency? And, finally, was it worth the effort to try this experiment? Discouragement surfaced and disappeared. Ideas were offered, rejected, approved, and improved. The groups kept meeting.

Their meetings took place at 7 in the morning in one agency's offices where powdered doughnuts, small sausages, and coffee fueled the deliberations. There had to be ways, they decided, that services could be coordinated, savings effected, and increasing numbers of people served in good fashion. As more people joined in the discussions, they met in borrowed space in a local board room. Two dozen meetings and hundreds of chocolate chip cookies later a plan began to evolve.

With so many vacant office buildings in Austin, why not try to find one which would lease a floor for minimal rental? Then two or three agencies could move in together and share their expertise, with overhead divided among them. The plan began to grow. People heard of the discussions and asked to join. Before long a larger meeting room was needed, and the numbers of people attending increased. Invitations came by word of mouth.
"We heard your group is talking of consolidating some agency efforts. May we send someone to your next meeting?"

"Of course. Here's the time and place. . . . "

And so they came. They were agency directors, officials of small organizations, workers from various agencies, architects, builders, private business persons--a group which varied from meeting to meeting. Only the small nucleus remained constant,--the half dozen stalwarts who had conceived the idea of working together.

The agency people considered the needs at both ends of the population spectrum and decided on a dramatic and different approach. To services for the well and frail elderly, they would add a well run nursery for infants and toddlers. Here young children could mingle with the older people and could have the delights of interacting with foster grandparents, while the older people could hold the babies, play with the toddlers, and enjoy being participants in new life.
One day, during the height of deliberations, a phone call came from a resident of the historic Hyde Park neighborhood to one of the involved persons. "Did you know that the old Confederate Widows Home is for sale?"

That call began a new and energetic effort on the part of the committee. The home for widows, a mustard-colored two-story structure with castle-like turrets on the corners, had been built originally by the Daughters of the Confederacy at cost of $10,985. It was officially dedicated in 1908 and given to the State of Texas in 1911. As the numbers of widows diminished, the building was used as a nurses' residence of th
e Austin State Hospital and then was remodeled for the State School for the Blind in 1973.
In 1982 the building was abandoned and stood vacant for three years. Since it had not been prepared for closing, the building suffered severe damage in a 1983 freeze when a fire sprinkler in the main building burst.

When it had been built, the home was on the outskirts of Austin. Now it lay in the central part of the city, in the heart of the Hyde Park and North University neighborhoods. Members of the neighborhood groups were determined not to let the building go to developers or other commercial-minded persons.

Naivete and enthusiasm overcame good business judgment and practice. With a great deal of hope, little cash, and one large pledge (later rescinded), representatives of several of the organizations signed a note and went to work to try to fill the building with nonprofit agencies concerned with the wellbeing of older people. Meetings were held with members of state agencies, local groups, interested citizens, legislators, and attorneys. Regulations had to be met; forms needed documentation; foundations and legislators were approached. The neighborhood groups were enlisted.

An initial example of public-private cooperation was the early assistance of the Travis County Commissioners Court, which made a sizable grant to the program. Others included a major challenge from the Meadows Foundation and a Hogg Foundation contribution for the hiring of a program coordinator.

When the City Planning Department stated that the group did not fit the zoning regulations, neighborhood residents and some of the board members went to the City Building Inspection department and convinced them of the worth of the project. The organization took on a name. Austin Groups for the Elderly (AGE). Officers were elected. Non-profit status was achieved.

People attended sessions. Many dropped out. New persons entered. Volunteers appeared. They mowed grass, planted flowers, made repairs, painted walls, fixed pipes. Individuals brought paint brushes and garden tools, brooms and dollies.

People rallied. Many of the problems were solved by volunteers who came in to patch the furnace, repair the air conditioning system, replace ceiling tiles, recondition the kitchen stoves, and, in general, make the building habitable. Other volunteers helped in the office, answered telephones, and aided in the search for funds.

Agencies became involved. Boy Scouts worked on the grounds; women's groups made draperies; some people wrote checks. United Action for the Elderly set up a Meals on Wheels kitchen, and within a few weeks Lutheran Social Services instituted an adult day care program for frail elderly persons. Then, under the aegis of the Texas Department of Human Services, respite care for abused elders was placed in the same area.

Shortly after, the Open Door Nursery School opened a branch facility for infants and toddlers. A playground evolved in the front of the building, right under the "Austin Groups for the Elderly" sign, true indication of the intergenerational philosophy of the program.The quiet building began to resound with human voices, the murmuring of the very old as well as the gurgles of the very young.

The University of Texas at Austin and Austin Community College became involved. From the University, students in social work, nursing, law, and communications began to do practicums and field work with the various agencies. Austin Community College supplied an environmental design class which undertook an artistic restoration of the building. Following old pictures of the structure, they designed a mural which pictured the building as it appeared originally. That mural is what passersby see on the north wall, facing the busy thoroughfare. Another class worked inside the building to produce an intergenerational mural.

The organizational structure which emerged was a board of directors composed of persons who had worked toward implementing Austin Groups for the Elderly. In addition, each agency in the building was invited to send a representative to the AGE board. The Program Director of the joint project set up monthly meetings with staff members of each agency. It was hoped that the dual meeting structure would provide communication and information at all levels.

Simultaneously, efforts were made to secure funds to pay off the building, to entice agencies to move into the structure, to inform the general public of the efforts under way, to maintain a minimum crew to keep the building in working condition, and to continue with the philosophy of interagency cooperation which was the foundation of the organization.

Agencies were promised that, once the building was paid for, they would be able to stay in that space at low cost. The AGE board decided to attempt to follow a model set by the Meadows Foundation of Dallas in its restorations of several historic houses to accommodate nonprofit services. Monthly charges to the agencies were set at 60 cents a square foot, including utilities and maintenance.

The concept of coordination held. Agency members helped one another in finding resources, in fund raising, and in sharing of materials. Soon the building was three-quarters full with groups which either served the elderly or used services of older volunteers. Every agency painted its own office, provided furniture, and brought in rugs, window coverings, and pictures to brighten rooms which had stood vacant since 1982.

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Difficulties Encountered

This still unfolding story is not, however, all of storybook quality. Many difficulties emerged. Many have yet to be solved.

First of all, the building was in worse disrepair than had been imagined. Ceiling tiles had been ruined when the sprinkler burst. And much equipment, such as the elevator, needed major repairs.

Second, burn-out took place in human terms as well as in mechanical portions of the building. Many people enthusiastically endorsed the idea generated by Austin Groups for the Elderly but failed to follow through on the multitude of tasks required to bring the project to fruition. Promises made in terms of money, goods, or personal help were not fulfilled. The people who remained worked with new commitment and endurance.

Third, numerous problems were encountered in satisfying the neighborhood groups, obtaining the proper permits, finding the funds to pay necessary deposits, enlisting the non-charge help of various service organizations-and all of these were absorbing and sometimes discouraging.
Fourth, establishing cohesiveness of programs within the building posed major problems in terms of diplomacy and ingenuity. How to maintain a balance between agency needs and public service became a difficult feat.

Fifth, obtaining public visibility and support was an ongoing challenge. With paid personnel of only one person and another working half time, the task of community education fell largely to the volunteer board, all of whom held other positions in the community.

Sixth, paying off the building debt became a challenge of gigantic proportions as deadlines needed to be met. These time limits came from a major foundation, which offered a capping grant, and from the State General Land Office concerning payment on the building.

Then a major and near-overwhelming problem surfaced early in 1990. With a quarter of a million dollars needed as a deadline approached on the capping grant, directors found many businesses, corporations, and foundations unwilling or unable to make major grants to AGE.
This transition time might be likened to the personal one which occurs after the honeymoon phase of a marriage, or follows the initial and unrealistic delight at an infant, or comes after the first enthusiasm over a new home. Reality struck.

Many board members became fatigued and less enthusiastic than before. Funds for the program director's salary ran out and were not replaced. The Capital Fund Drive slowed alarmingly. Agency directors began to question many of the overall policies.

However, the small nucleus of persons who had originally shared their belief in the concept held to that belief. They continued to work on fund-raising, on personnel placement, and on building maintenance. Having climbed three-quarters of the way up the mountain, they felt they could not and would not let go.

Moving examples of personal commitment come from unexpected sources. Church groups sent in checks. Individuals offered to sponsor fund raisers. Others made ongoing pledges. Perhaps the most memorable came in the form of an envelope without a return address. Inside was another smaller envelope with these words penned: "I wish this widow's mite had three more zeros." With the note was a yellowed $50 bill.

A comparable gift came from a woman who brought an envelope with two $20 bills and one $10. She said, "When I was thirsty, I ordered a small Coke instead of a large and put the money aside for Austin Groups for the elderly. Here is the amount I have been able to save on your behalf."

The belief expressed by these persons outside of the organization gave strength to the determination of the board members.

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Rewards Discovered

Perhaps trust was the hidden ingredient for success. The steady group of board members had a great deal of mutual respect, which they demonstrated in their constant efforts on behalf of the program.

With all of the difficulties stated, was the project worth doing? The answer is an unqualified "yes." What are the positive aspects of this program?

A facetious answer might be that it has taught all of the persons involved the qualities of endurance and determination! However, there are other positive responses to be made. Here are some of them:

First, the answer to the worth of the program can be seen, not in documentation or in budget reports, but in the faces of people-the old persons in the day care center who now spend their hours in human contact, in activities such as cards or dominos, in sing songs, and in mutual exchanges of experiences. These are persons who might otherwise spend their time in solitary confinement in their single rooms.

Second, the program has provided the concept that the whole in human services IS greater than the parts. Agencies have gradually learned that working together is an improvement over competing with one another. Being in the same building, meeting together, seeing one another frequently has taught most agencies the worth of the other and the power of mutual efforts.

Third, in an economy which has slowed and is having difficulties in meeting human needs, programs like Austin Groups for the Elderly demonstrate a financial savings. For example, through a foundation grant a large copying machine has been purchased for the use of all the agencies. A minimum charge provides maintenance expenses, while all agencies are able to have the benefits at greatly reduced costs. Forthcoming postal meter and FAX machines will add to the economical aspects of the arrangement.

Fourth, the surrounding area has learned that AGE has become a good neighbor. Instead of disrupting a historic district of the city, AGE has enhanced it by upgrading the grounds, adding a mural to the side of the building, holding arts and crafts fairs on the grounds, hosting musicals, and inviting the neighborhood to participate in various events.

Fifth, the community has become increasingly aware of the needs of the older population and of some innovative ways of meeting them. As the philosophy of maintaining people in an environment as stimulating as possible becomes known, other groups endeavor to emulate the AGE model.

Sixth, the principle of cooperative endeavors has taken root and is being tried with other age groups such as children, needy families, and homeless populations.
These are interesting programs, one might say, but what makes them different from other ventures concerning older people? The country abounds with retirement homes, nursing centers, day care facilities. How and why is Austin Groups for the Elderly unique?

The philosophy of Austin Groups for the Elderly is the power of consolidation and coordination. As agencies work together, each is strengthened by the information from the other. Each gains knowledge and ability from joint venturing. Doing fund raising together and planning seminars and workshops with one another gives added strength to each endeavor.

In addition, agencies previously vied with one another for attention, volunteers, and funding. This "turfism" became destructive to all the entities and affected the referral system essential to performing good services. As "turfism" is diminished and joint planning strengthened, the programs are enhanced to the benefit of the recipients.

The numerous components under one roof at Austin Groups for the Elderly bear testimony to the philosophy. Care for frail and abused elders; a nursery for infants and toddlers; 17 agencies serving the elderly or using older volunteers; students from the nearby universities doing field work or placement; volunteers serving the agencies; community residents taking classes; groups holding annual meetings or training sessionsall these share a new and viable concept.
Austin Groups for the Elderly is a microcosm of human services. Elderhaven, a day care center, provides not only shelter but friendship and activity to 35 or 40 older people who attend. Some are victims of abuse who take refuge at the center and stay there for days or weeks. These elders are referred by the Department of Human Services because they have been abused physically, verbally, psychologically, or financially by their caregivers-or numbers of them have neglected to care for themselves to the extent that their health and safety are in jeopardy.

Lifeline is a project which provides devices to be worn by people of any age to use in case of emergency. By pressing a button they can send a call for help, a call which is recorded on a computer in the Lifeline bay station. A thousand people from a territory of more than 200 miles can be served in a matter of minutes. Meals on Wheels, using volunteers, delivers to shut-ins three times a week enough food for two days' supply. Many people who might otherwise suffer malnutrition are maintained in their homes because of the delivered nourishment.

The Open Door day care brings infants and toddlers with special needs together with those who are mainstream children. The small ones are of diverse ethnicity and capability.
In the offices of Adult Services Council the Advocate newspaper is produced monthly. It offers information, advice, resources, and interesting features to thousands of readers.
Community Residences for the Elderly provides group home living in other quarters as well as personal care for people who cannot live alone but do not want to be in institutions.
The Austin Alzheimer's Association offers support for caregivers and information.
Family Eldercare oversees the Information and Referral Service, offering long-term care consultation, volunteer guardianship, Elder Housing Resources, and caregiver support.
Two of the programs demonstrate the intergenerational aspects of the plan. Family Outreach deals with child abuse prevention and used older volunteers as mediators. Aging Connection Training places trained volunteers, some of them middle-school children, in nursing homes.
In-home support is given by Seniors Respite Services, which helps both the homebound elderly and their caregivers by providing persons to go into homes and help care for older people. Many of the caregivers are themselves of retirement age. Rites of Passage devotes its efforts to in-home support for the terminally ill.

Aging Family Services specializes in mediative counseling and provides pro-bono services to older adults. The National Kidney Foundation, Central Texas Chapter, and the Texas Nurses Association, along with The University of Texas School of Nursing serve people of all ages.
All these groups maintain offices in the AGE building. The spectrum is a life-span range of services from infancy to oldest years. The program is also a training ground for students, both undergraduate and graduate. The University of Texas, Austin Community College, and St. Edward's University have all participated in the effort.

Future plans call for the remodeling of an empty building on the grounds and providing a day care program for victims of Alzheimer's Disease. The need has been demonstrated and interest has been expressed by statewide and local groups and by individuals.

More than 24,000 people benefit from the varied service of Austin Groups for the Elderly. Many are of minority race and/or are within the poverty guidelines.

if, as it has been said, all life is a circle, then Austin Groups for the Elderly demonstrates the completeness of the circular approach. Ralph Waldo Emerson has said, "Our life is an apprenticeship to the truth that around every circle another can be drawn; that there is no end in nature, but every end is a beginning; that there is always another dawn risen on midnoon, and under every deep a lower deep opens.'

"The one thing which we seek with insatiable desire is to forget ourselves, to be surprised out of our propriety .... in short, to draw a new circle. "2 New circles of concern for people of all ages are being drawn at Austin Groups for the Elderly.

To bring together the numerous programs for a particular population or service need into one historic building is a model for the nation. The coordination of services as exemplified by Austin Groups for the Elderly can well serve as a guide for other agencies. The benefits of such cooperation dre threefold: first, the monetary saving is significant; second, the cooperative skills which are developed help the agencies to function more effectively; and, third, the clients are the ultimate beneficiaries of the savings effected and the cooperation developed.

Austin Groups for the Elderly proves that "terminal optimism" can bring results, that what seems to be an impossible dream can turn into a possible reality. Antoine de Saint-Exupery has said that a rock pile no longer is a rock pile the moment a single person looks upon it bearing within himself the image of a cathedral. At Austin Groups for the Elderly the image of a cathedral is a vision of reality.

Notes
1. Ralph Waldo Emerson, "Circles." Essays [1st series, 1841].
2. ibid.

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A publication of the Hogg Foundation for Mental Health The University of Texas at Austin ©1990, 2002