​What we owe our elders and each other: a call for community support and smarter aging solutions

By Dr. Marc Sapir, MD, MPH

jessica@pellienpublicrelations.com

Across America, families are quietly struggling with a rising challenge: how to care for aging parents, siblings, grandparents, neighbors and friends. Most seniors want to remain independent but lack the resources (sometimes the energy) they need to do so.

It doesn’t have to be this way.

During my nine years as the founding medical director of the Center for Elders’ Independence — a PACE program in Oakland, California — I helped manage this comprehensive, community-based model that supports frail and disabled elders with dignity, autonomy and joy. But it starts with a crucial paradigm shift; elderly people are not just care recipients — they are social beings with social needs, including protecting their rights as decision-makers and community participants. Most have insights, preferences and a deep desire to share and to shape the way they live. When we begin by honoring their voices, their capacities, their creativity — not just their limitations — everything changes.

The stories I share in my book, “I’ll Fly Away,” are a testament to that possibility. They reveal what can happen when we invest in creating responsive communities of caring, not just medically, but socially, emotionally and relationally. They’re about listening, sharing, trusting. And building systems that don’t merely aim to keep people alive — but to invigorate them and help them re-imagine themselves.

Take Ara Belle Kingsby, for example: a deeply spiritual former schoolteacher who chose to face her terminal illness on her own terms, surrounded by loved ones, without aggressive interventions. Or Barbara, a withdrawn, restless, heavily medicated though intelligent former alcoholic, who transformed herself into a sharing, loving mother and community presence as she went through the most difficult closing chapter of her difficult life. And then there’s Locario, a man with chronic paranoid schizophrenia who surprised us all by confidently advocating for his right to travel back to his native country, ultimately deciding to stay here after being well heard and affirmed. These stories — and dozens more — reveal how life’s trajectory can remain rich, vibrant, and meaningful.

But magical outcomes don’t happen by accident. They require social systems and cultures that highlight elders as whole people (which PACE does). What can we do?

Get involved with local social support service organizations and projects

Learn about how/whether local and state governments are funding (or now defunding) programs for independent senior living. Advocate for expanded transportation, adult day care, easy access community health services, educational, artistic, public event opportunities for all, the elderly in particular.

Check in on elders in your life

Isolation is a huge threat to elder well being. A regular phone call, visit, or a ride out to an event or just shopping is a lifeline. Listen carefully to how your elderly friends and family describe their life situations. Learn from listening to them.

Encourage advance planning

Talk with your loved ones about power of attorney, living wills and preferences for aging and end-of-life care. Having these conversations early can prevent crises later.

Aging is not a crisis to be managed. We are all aging and hope to be respected. Most elders want to continue to participate in our communities even knowing that becomes harder. Creating communities that collaborate, create and listen to elders strengthens the fabric of our larger community and country. We are perfectly capable of building a rich future with the supports we all need to live well and to age with dignity.

Marc Sapir, a retired primary care, geriatric, and public health physician, is an essayist and political activist. He was the first Medical Director of the Center for Elders’ Independence for disabled elders for nine years. He is the author of “I’ll Fly Away: Stories About Amazing Disabled Elders.”