Rolling Rains Leaders Interview:
Esther Greenhouse Environmental Gerontologist
Interview by Monica Guy
A powerful advocate of inclusive design and an expert on issues around aging in place, Esther Greenhouse was acknowledged for her efforts in January 2009 with the prestigious Certified Aging in Place Specialist (CAPS) of the Year award. An experienced speaker and articulate writer, here she explains CAPS, her own work in gerontology and training, and her visions for the future:
How did the CAPS program come about?
In 2000, the US non-profit organisation AARP (American Association of Retired Persons) conducted a study entitled 'Fixing to Stay", in which 83% of respondents aged 45 and older reported that they wanted to remain in their own homes until the end of life. AARP then approached the National Association of Home Builders (NAHB) and together they developed the Certified Aging in Place Specialist (CAPS) program.
Has the CAPS program made any impact? Has awareness increased, have attitudes changed?
Recently, I was cleaning out my professional library, and found publications by AARP and other groups delineating the needs for and explaining the details of aging in place and housing needs for seniors. These documents were 20-25 years old. Why is this relevant? Because while both experts and society have known about the huge growth of the aging population for the last 30-60 years, we have all been slow to act.
There has however, been a significant shift towards addressing issues around the ageing population in the last 5-10 years. Why? In part because we can no longer ignore them, but also due to increased awareness and training via the CAPS program. The professionals have the awareness and training to address the needs of the consumers, and now have the resources in knowledgeable professionals.
How did you get involved?
Nearly 20 years ago I was the first Interior Design student in my college to pursue the then-new Gerontology program. Conducting a semester-long review of housing options for seniors, I came to the conclusion that aging in place was the ideal. I then committed to making this a reality for many via my professional work.
My husband is a builder, and very active in the builder's association. Through him, I learned about the CAPS program. I pursued the designation, and then realized that here was a powerful means of achieving my goal. Teaching CAPS is extremely rewarding - I have the opportunity to raise awareness, inform, and inspire 10-15 professionals during each two-day session. I know that each one in turn will then go out and help dozens to perhaps hundreds of people throughout their career. Plus, those accessible homes will be around to enable people to live independently for generations.
In August, I will begin a PhD program in which I will focus on funding options for accessible home modifications. I intend to analyze the existing government programs, and then make recommendations for revisions, or develop a new model or program. There will also be a sustainability component to my work.
What do you do on a day-to-day basis, and how does this fit into the bigger picture?
My work varies daily, which I really enjoy. Several times a year, I teach the CAPS classes. Other than that, I work to build relationships with non-profit organizations like Independent Living Centers (www.ilusa.com/links/ilcenters.htm). I send frequent emails to my former CAPS students, to make them aware of new issues and articles. I also try to help them form relationships with each other: for example, by introducing an occupational therapist to a remodeler in the same region, or two designers who are miles apart but may serve as sounding boards for one another. I speak at seminars and conferences as well.
I also have a young child who comes first, as much as possible, so I try to build my work schedule around him.
Recently, I was invited to join a new group at Cornell focusing on the intersection of an aging society and environmental problems. I am thrilled to have the opportunity to be at the forefront of this work, and to collaborate with a wide range of researchers to address these issues. Spending the afternoon brainstorming about the direction to go in, hearing about issues which are new to me, knowing that this is the first step in making a difference, these are meaningful ways to spend my time.
How do you see yourself? A researcher, a campaigner, a business woman?
Recently, the National Association of Home Builders published an article about me on their website, in which they called me a 'business woman'. In my case, I am not a business woman. I consider myself an advocate and educator. Much of the work I do is pro-bono.
I had a two-year research appointment which ended this past October (the grant ended). Shortly beforehand, my husband asked, "What will you do next?" I explained that my gut was telling me to focus on advocacy, and ideally, enough paid teaching opportunities would come along to enable that. So far they have.
Originally I trained as an interior designer. I think it is important for CAPS professionals to come from a wide variety of backgrounds, the more multidisciplinary the better. One hallmark of the CAPS curriculum is the emphasis on having a multidisciplinary team of professionals working together to address the aging in place needs. When you have an OT and remodeler work together, you are more likely to a successful, enabling environment. This is one of the hallmarks of the CAPS curriculum.
Do you find that society's attitudes to people with disabilities are changing now that the population is ageing?
I have always been a gerontologist, but since becoming a CAPS instructor I have been thrilled to find that the needs of people with disabilities are now coming into the mainstream, along with the renewed attention on accessible homes for seniors. More and more, the lines between age-related disabilities and non age-related disabilities are blurring. I feel that this is the next big wave in our society - a new level of awareness and understanding for persons of various abilities and needs. It has been growing for decades, but there is a significant shift now.
Disabled Iraqi veterans are changing society's views as well, in terms of not simply accepting what they can no longer do, and relegating them to a life of limited opportunity. Many veterans are showing us that their abilities have changed, but that they can still lead rewarding lives if we don't stand in their way. People over 50 have been doing that too, for the past 20-30 years. Today's definition and concept of what it means to be "old" has changed dramatically in my lifetime.
I wish I could say that all of the shift we are having and will have is due to increased awareness and demand. But actually two of the biggest factors driving the change are legislation and litigation. Determined advocacy groups like Concrete Change and others are working very hard on two fronts: firstly, to promote 'Visitability' and to have Visitability ordinances passed; and secondly, to sue developers and landlords of multi-family housing who are in violation of the Fair Housing Act.
How do you see the situation for seniors and people with disabilities 50 years from now?
Terrific! These issues are the next big wave which our society will address. I see a society where we have embraced abilities and disabilities as a continuum, rather than as distinct, restricted groups.
Do other countries have similar projects? If not, should they? How do you recommend they should go about setting them up?
Absolutely! When I co-presented our seminar 'Green Building and Aging in Place: Building Homes to Meet the Needs of the 21st Century' at the International Builders Show, I was later contacted by Jean-Christophe Vanderhagen, Director General of the Confederation of Construction. Mr. Vanderhagen also serves as Chairman of the European Committee of the International Association of Homes and Services for the Ageing (www.iahsa.net).
What advice can you give to older people who want to remain at home until end of life, but don't know how to go about making the necessary adaptations?
First and foremost understand that the design of your home is the issue, not you. If you move to a lovely senior community, or assisted living, it will only enable you to thrive if it is properly designed.
If you live in the US, go to the following page on AARP's website and search for a CAPS professional in your region who can work with you to modify your home: www.aarp.org/family/housing/articles/caps.html
Tell us about your work assisting the city of Ithaca in its bid for the Accessible America award
I have only been able to have limited involvement due to scheduling conflicts. My assistance to them has been very minimal. However, it has served to further raise my awareness of the obstacles faced by persons with disabilities, and drives home the point that aging in place is a complex societal goal, which encompasses home design, transportation services, medical services, sidewalks, snow removal, among many others.
In conclusion...anything else you want to tell the world about?
Yes! Do not underestimate the power of the built environment to enable, or disable, to uplift, or depress, to limit you, or to help you thrive!
Think of the great cathedrals of Europe - wonderful examples of how the built environment can make you feel: small in the presence of the Almighty, uplifted by the soaring spaces, enraptured by the exquisite artwork. Through the proper design of the built environment, we can actually delay or prevent institutionalization for millions of people.
How can we not address this? This concept is nothing new, but that does not make it any less important.
AARP study: http://www.aarp.org/research/reference/publicopinions/aresearch-import-783.html
CAPS web page:
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