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It takes a village to help keep seniors confidently independent

by Cathy Dyson The (Fredericksburg) Free Lance-Star       Jan 26, 2019 [as reprinted in the January 27, 2019 issue of The Daily Progress

LOCUST GROVE — Marguerite Badger faces a dilemma that many adults may experience as they get older.

She wants to stay as long as possible in her home, in the Lake of the Woods community of Orange County, but her grown children in Northern Virginia worry about her. They don’t want her climbing a ladder to pull leaves out of the gutter or to change light bulbs. Because she lives alone, Badger is nervous about hiring contractors she doesn’t know, so repairs of broken doorbells or leaky toilets often go undone.

A program called LOWLINC (Lake of the Woods — Living Independently in Our Community) seems to solve all the problems. Seniors like Badger, who’s 83 and doesn’t like the way people put so much emphasis on age, pay an annual membership. The fee of $500 per household or $400 per individual covers the program’s operational expenses and only paid employee, Stacey Madigan, who takes calls from members.

She schedules the group’s volunteers, who visit and perform a variety of services. As part of basic home maintenance, they change filters in furnaces and batteries in smoke detectors, clear snow from steps, move furniture, hang photos or do simple plumbing and electrical repairs.

Volunteers also drive members to local doctors’ appointments, pick up mail, medicine or groceries and pay “friendly visits” in which they spend an hour or two talking, playing cards or watching TV.

The more Badger finds out about the nonprofit program, the more she likes it.

It just makes you feel really secure,” she said, adding that she knows her children mean well, but she’s not ready to move. “I didn’t think it was fair of me to make them worry, either, but if I can do this, it makes all of us happy.”

That’s the purpose of the “village movement,” an effort that makes it possible for seniors to stay independent longer. The movement started in Boston more than 15 years ago and has developed into an organization called the Village to Village Network with more than 200 programs nationwide and another 150 in the works.

LOWLINC started offering services in 2016, two years after residents Mary-Jane Atwater, Jeff Flynn and Joe Sakole began talking about ways to bring such a program to their community. Atwater was involved with a similar program in Alexandria, and Flynn often heard from residents who simply couldn’t keep up with home maintenance as they got older.

I knew where they were coming from when they said they don’t want to move,” Flynn said. “I’ve lived here forever and I love it. I don’t want to move, either.”

About a third of LOW’s 8,000 residents are older than 65, so the trio sent out a survey to the community’s older population. It asked, among other things, what kind of services seniors could use and if they would be willing to pay for them.

The organizers knew that its cadre of retired workers could volunteer to do the legwork, but the program would need funding to cover insurance, a phone line, the salary of a part-time coordinator and background checks on all the volunteers who would be going into peoples’ homes.

LOWLINC also offers a list of about 60 local service providers who can do more complicated repairs. Volunteers have checked out their credentials.

The program has grown steadily as 90 older volunteers provide assistance to 71 older members. Most volunteers are in their 70s and are active older adults such as Rick Rappoport, who visited Badger’s home recently. He spent 40 years in law enforcement in Fairfax, working for both the county and city police departments.

When we go in and do things for people, they are so grateful for the little things” like changing light bulbs or replacing a toilet flapper valve, he said. “It’s like their life has changed.”

Eileen Appleyard gets the same reception from Lynn and Carol Hein, who both have health issues and use walkers. She brings their mail twice a week, takes Carol Hein grocery shopping and helps around the house, when the two aren’t chatting about people and places they know in the Midwest.

She thanks me profusely every time I come,” Appleyard said. “She says, ‘You don’t know how much I look forward to your coming, and thank you, thank you, thank you.’”

And I hug her, too,” Carol Hein added.

Alice Ann Halverson, 81, is both a member and a volunteer. She calls a neighbor every morning at 9 to make sure the woman is OK. Sometimes, the neighbor says she’s busy and hangs up; other times, the two talk for more than an hour.

I wish I could do more, but I kind of have my hands full,” she said.

Her husband, Randy, is 84 and has dementia. She gets some relief from round-the-clock care every Wednesday, when she goes out to play bridge while a volunteer comes to play cards with her husband.

I couldn’t live without it, and I know other people who say the same thing,” she said. “For one thing, I feel secure. I know if I call, somebody will come.”

In 2018, the 71 volunteers with LOWLINC performed 3,112 services, which accounted for 2,369 hours. They drove 19,307 miles, taking members to doctors’ appointments between Culpeper County and Fredericksburg, or driving older residents to the grocery store or hair salon.

Volunteers also did 829 phone checks, making sure older neighbors were doing OK, and picked up mail 319 times. They went on 409 social outings, paid 203 friendly visits and made 165 health and wellness visits.

LOWLINC has a seven-member board of directors and seven committees that oversee various offerings, from member outreach to social activities, one of the most popular.

More information is available by emailing, calling (855) 569-5462 or visiting the program’s website,

More information on the village model is available at the Village to Village Network website,

The Mary Washington Hospital Foundation gave LOWLINC $5,000 in December — and the Lawrence and Martha McMurtry Award for Excellence and Innovation in Community Health and Wellness.

LOWLINC’s board wants to use the money on health and wellness projects to benefit as many seniors as possible. Members are considering CPR and automated external defibrillator training; fitness equipment or classes for seniors; classes on improving balance; dementia training and support; or help with medical transports.

A committee is taking suggestions on how to use the funds. LOWLINC members and volunteers can email Emily Slunt at

Lake of the Woods Living Independently in our Community volunteer Margaret Driscoll compares hands with Lake of the Woods resident Randy Halverson after a game of gin rummy on Tuesday, Jan. 15, 2019. LOWLINC was launched in 2016 and volunteers in the group make regular visits to “members” of LOWLINC and while there, they do maintenance checks on the house, visit and play games, or take the members shopping.



From the Ashby Village website  May 2017


By Jessica Yu

The newly-released 2016 National Survey of US Villages [LINK} from Mather LifeWays Institute on Aging surveyed 155 villages in the United States and found rapid growth and development in the Village Movement. An estimated 25,000 older adults belong to villages in the United States. More villages are developing in response to the demand for communities that promote independence and avoid unnecessary disruption of friendship and community connections while at the same time offering companionship, support, and meaningful engagement. Self-determination is key. Villages are often created and governed by older adults themselves, providing services to one another with an average members-to- volunteers ratio of 1.9 to 1.

Accelerating Growth and High Retention

From the first villages established in 2002, the number grew to 35 by 2010, and to 155 by the beginning of 2016. The fastest growth of the village movement occurred between 2010-2013, at a quick rate of 44%. On average, a village had 146 members in 2016 through recruitment of approximately 36 new members. Most villages had excellent retention rates in the prior year, with 38% of villages retaining over 90% of their members and 42% retaining 81–90%. 

Broad Recruitment Efforts

Most villages reported efforts to recruit under-represented segments of their communities. By 2016 almost three-quarters of villages offered discounted membership, opening up village membership to lower-income members. In addition, over two-thirds of villages made additional efforts to increase diversity to include: 

  • Younger members (30%)
  • Ethnic minorities (25%)
  • Sexual minorities (13%)
  • Male members (10%)

Recruitment strategies to build more diverse and inclusive villages included developing a wider selection of activities or services, building diverse boards and volunteer bases, and engaging with community groups.


The villages in the study offered several common services and report growing interest in technology assistance, rising 15% from 2012 to 2016. Common services included:

  • Social events (provided by 95% of villages)
  • Transportation (94%)
  • Educational events (90%)
  • Companionship (90%)
  • Technology assistance (88%)
  • Health promotion programs (79%)

Community Engagement 

Villages also commonly collaborate with outside organizations, including social service agencies(32%), hospitals or health clinics (30%), and religious institutions (26%). 

The Future of Villages

Villages feel that they are fulfilling a previously unmet need in their communities. The national survey found a high degree of optimism about the future of US villages. In 2016, villages were asked to rank their confidence that their village would still be in operation 10 years in the future. On a scale from 0 to 100, where 0 means “not at all confident” and 100 means “absolutely certain,” the average confidence level was 77. The most commonly cited source of confidence were:

  • Responding to unmet member and community needs
  • Strong support from the community
  • Strong commitment of the members
  • Strong volunteer program, and
  • Financial sustainability

As a leading voice in the village movement, Ashby Village is active in the support and development of new villages and to sharing innovations and best practices to support continued growth and development of the village model. 

Graham, Carrie L., PhD MGS, Andrew E. Scharlach, PhD, Roscoe Nicholson, MA, and Catherine O’Brien, PhD. 2016 National Survey of US Villages. Rep. Mather LifeWays Institute on Aging, 2017. Web. 15 Apr. 2017,

Visit to read the full report.



The simulcast of a conversation with Dr. Atul Gawande scheduled for February 13th, had to be postponed due to the winter storm that hit Boston with heavy snows.   This event will be rescheduled sometime over the summer.  We will let you know as soon as we have a definite date.


Celebrating Community and Choice in a Conversation with Dr. Atul Gawande !

Dr. Gawande to speak at Beacon Hill Village’s 15th Anniversary Event which will be simulcast to CvilleVillage,  DATE AND TIME FOR RESCHEDULING OF TO BE DETERMINED. 

Charlottesville , VA – CvilleVillage is proud to announce that renowned surgeon, public health researcher and writer Dr. Atul Gawande will be the guest speaker at the 15th Anniversary Celebration of the founding of Beacon Hill Village and the subsequent Village Movement their innovative model inspired, on Monday, February 13, 2017. His conversation, entitled “Being Mortal’s Villages: The Value of Community and Choice as we Grow Older” will feature a discussion on aging, living life with purpose, and how we can transform the possibilities for the later chapters in everyone’s lives.

The event will begin at 5pm and will be simulcast from Boston to more than 150 of the 350-plus villages open or in development across the country, including CvilleVillage. All are welcome to join CvilleVillage for a viewing, followed by conversation at Unity of Charlottesville, 2825 Hydraulic Rd. Doors will open at 4:30. Admission is free and parking is also available.

Community and choice are concepts long honored across the United States. They are also among the life altering concepts in Dr. Gawande’s seminal book Being Mortal: Medicine and What Matters in the End, and the underlying principles of Beacon Hill Village, whose founders were determined to remain in their own homes as they aged. To accomplish this goal, they created an organization, a virtual village, which opened in Boston’s Beacon Hill in January of 2002 and offered people over 50 years of age the option of choosing how and where they live as they grow older. The concepts behind Beacon Hill Village have spread cross the country, thus creating a “Village Movement” and have attracted interest in many countries around the world.

One of the great issues world wide today is how to support and care for aging populations. By 2030, twenty percent (20%) of our nation’s population will be over 65, an estimated 83 million people. The numbers are even larger in many countries around the world. The Village concept and Dr. Gawande’s profound understanding of the importance of community and choice offer valuable insights and solutions for this challenging phenomenon.

The Village Movement is a burgeoning, world-wide movement that champions an alternative approach for adults as they grow older. Villages are unique in that they are created by and for older adults, empowering their members to make wise, safe, and vibrant choices about how they wish to live.

CvilleVillage is a village in development. If you are interested in helping to build our own CvilleVillage e-mail us at We are particularly in need of individuals who will assist with strategic planning and development.


As the New Year 2016 begins, we want to give you an update on the status of CvilleVillage. We are moving forward, although not as rapidly as we had expected.


Carolyn Benjamin represented CvilleVillage. Nationwide, interest and enthusiasm for the village concept remains high, as evidenced by 350 people in attendance. Within the Village to Village Network ( there are now 190 fully operational villages with another 185 in development. The speed at which villages develop varies widely: 1) depending on an adequate number of committed people actively involved in building the village infrastructure and 2) determining how the village will complement/partner with other organizations serving seniors, which varies geographically.

SURVEY, June 2015.

Our thanks to all of you who responded to the survey sent to our email list to measure ongoing interest in creating a village in Charlottesville. The survey revealed that there is still strong interest in having a village here; however, there are not enough people with The time and/or commitment to assist in creating it. Many people expressed their desire to have a village in Charlottesville, and their willingness to support it once it opens, especially when assessing the financial reality of retirement homes and assisted living facilities.


 IMPACT (Interfaith Movement Promoting Action by Congregations Together) has selected Elder Care as their focus for this year. They have asked for our input as part of their community-wide research on this issue, and we look forward to working with them to raise awareness of the state of Elder Care in Charlottesville. (


Carolyn Benjamin, M.K. Gleason, Helen Plaisance, and Judy Zeitler are continuing to reach out to individuals and groups to educate them about the village movement. We hope to attract more individuals with the skills necessary to support a thriving village. We would also appreciate your suggestions, questions and involvement as we make CvilleVillage a reality, providing another option for helping seniors “age in place”.


You can find out more about who we are by exploring the rest of ourwebsite or you can email us at


By Issie Lapowsky July 12,2015

Technology and the elderly go together like peas and guacamole, which is of course to say, they don’t go together at all. At least, that’s what you might think if you’ve ever tried to teach your mom or dad to use an iPhone.

So it’s no surprise that in its attempts to manage the ballooning aging population in America, the government hasn’t often relied on tech tools as its first line of defense. Now, that’s starting to change. This week, the White House is kicking off its Conference on Aging, the once-a-decade gathering that has given birth to landmark government programs like Medicare and Medicaid. On Tuesday, the White House Council of Advisors on Science and Technology will also meet to discuss the pressing issue of aging. In both cases, the government has invited technologists to the table, in hopes of finding new ways to scale senior care, without sacrificing on quality.

Seth Sternberg believes his company might be able to help.

Sternberg is the founder and CEO of Honor, an Andreessen Horowitz-backed start-up that helps seniors find home health aids through an online marketplace, and this week, Sternberg will be in D.C. presenting his thoughts on how technology can make it easier for people to age independently. The conversation coincides with Honor’s public launch in the Bay Area today, as well as the announcement that the company plans to donate $1 million in free care to seniors in 10 different cities.

Honor’s goal, says Sternberg, is to ensure that the next generation of aging Americans—a generation that, thanks to baby boomers, will be unprecedented in size—will be able to grow old without leaving their homes. To do that, Honor is trying to improve the quality of care in the industry by increasing care professionals’ wages and using technology to make the process of selecting and working with one of these caretakers as transparent as possible. Its mobile platform alerts family members when caretakers are coming and going, and the company has even redesigned the interface of the tablet they give to seniors that allows them to rate their care professionals on a daily basis.

“There’s been this problem where we have not as an industry invested in innovation around products for seniors, because people are scared that innovation comes from technology, and seniors and technology don’t mix,” Sternberg says. “I think there are a lot of misperceptions that can be cleared up. The market is massive and the opportunity is huge.”

The Lower Cost of Staying Home

The concept of using technology to help people age in place has become a focal point for the U.S. government, says Valerie Steinmetz, program director of the Center for Technology and Aging.

“I think the government is mirroring society in general,” Steinmetz says. After spending the last decade evangelizing the promise of technologies like telehealth for the aging demographic, Steinmetz says it’s only over the last year or so that she’s begun to see these technologies really talk off. “People are starting to believe in it and test it out for themselves, and the government is following right in line with these innovations.”

Of course, it also has a lot to do with cost. Evidence has been mounting for years that technology that allows people to age in place can actually have a substantial impact on reducing the cost of care for seniors, because it leads to more frequent monitoring. And, with the ever growing demand for a reduction in Medicare spending, that evidence is becoming more and more compelling to government agencies.

Just last month, the United States Senate Committee on Aging held a hearing in which a panel of researchers laid out all the ways that tech tools could help prevent things like falls, which disproportionately impact people over 75 and which cost billions of dollars to treat each year. Medicaid also recently reported the results of a year-long study that showed house calls can reduce the cost of care for frail seniors by an average of $3,070 per beneficiary. But Steinmetz says the real thought leader in this space has been the Veteran’s Administration, which has successfully run a telehealth program for veterans for more than a decade. One VA study showed that this technology has led to a 35 percent reduction in hospital readmission and a 59 percent reduction in “bed-days.”

“The government has looked at these programs and sees that they’ve been able to reduce costs, specifically in the medicare population, and says, ‘Let’s look at this further,’” Steinmetz says.

In-Home Care for All

She also sees an increasing willingness by the government to reimburse seniors for home care professionals, like the ones Honor provides, and that’s critical, says Sternberg. “If you look at the pricing structure for home care, by and large, it’s out of pocket, and the only way government helps is if you’re on Medicaid,” he says. “I’d really love to see us create a system through Medicare, where in-home care is proactively provided to people.”

Of course, technology alone can’t fix the massive shortage of home health aids that the country is already facing. This may be the biggest obstacle to Honor’s ability to scale, particularly given that the company only accepts about 5 percent of applicants for these jobs. But Sternberg is hoping that as both tech companies and the government continue to invest more in this space, jobs caring for seniors will become more desirable.

“These people are now considered unskilled labor, but they’re doing something critical for society,” Sternberg says. “We’re trying to make being a care professional a true career path for people.

“There’s been this problem where we have not as an industry invested in innovation around products for seniors, because people are scared that innovation comes from technology, and seniors and technology don’t mix,” Sternberg says. “I think there are a lot of misperceptions that can be cleared up. The market is massive and the opportunity is huge.”

‘Sandwich generation’ worries about own care as they age

By Lauran Neergaard, The Associated Press | July 10, 2015

WASHINGTON — Caught between kids and aging parents, the sandwich generation worries more than most Americans their age about how they’ll afford their own care as they grow older, a new poll shows. But most aren’t doing much to get ready.

Nearly 1 in 10 people age 40 and over are “sandwiched” — they’re supporting a child while providing regular care for an older loved one, according to the poll by The Associated Press-NORC Center for Public Affairs Research.

Another 8 per cent may join the ranks of double-caregivers in the next five years, citing declining health of an older relative or close friend.

Dueling responsibilities can make some days feel like a tug-of-war.

“If my mom needs something badly, I get pulled away from my kids a lot,” said Kamila Al-Najjar of Santa Rosa, California, a lawyer with two children and self-described health advocate for her mother. She visits her mother’s assisted living facility at least twice a week and checks in daily by phone, to oversee a list of illnesses.

“You’re dealing with someone who is aging, toward the end of their life; then you have to deal with a teenager. I hear from my mom and daughter that I’m a nag. There’s no winning in it,” she said.

Adding to the challenge, 40- and 50-somethings tend to be at the height of their careers — and need to hang onto their jobs despite difficulties of caregiving, said Susan Reinhard, who directs AARP’s Public Policy Institute. Employer flexibility is a top issue as the population ages, she said.

“It’s not just their own financial security, it’s the financial security for their children and for the future,” Reinhard said.

After age 65, government figures show nearly 7 in 10 Americans at some point will need long-term care — from a relative, home aide, assisted living or nursing home.

Yet the AP-NORC Center poll found overall, most Americans 40 and older — 54 per cent — have done little or no planning to get ready for this often pricey reality. Only a third reports setting aside money for those needs. That’s even though Medicare doesn’t pay for the most common types of long-term care, and a nursing home can cost more than $90,000 a year.

Drill down to the 9 per cent of this age group who make up the sandwich generation, and their experience leaves them far more concerned about their own senior years.

About half worry about being able to pay for their future care needs or having to move into a nursing home, compared with just over a third of other adults, the poll found. Also, 44 per cent of sandwichers fear leaving debts to family, compared with 28 per cent of others polled.

But the poll found the sandwich generation no more likely than other middle-aged adults to be planning and saving, possibly because of time or resources.

Al-Najjar is glad her mother “saved all her life … so she didn’t have to stress out about stuff like that.” Caring for her has changed how she spends and plans for the future.

“It’s like a wake-up call,” she said. There are “a lot of seniors in the United States that don’t have that money.”

The squeeze isn’t ending as children grow up. Among currently sandwiched parents, 29 per cent have adult children living at home, the poll found; others are providing adult children with financial assistance, meaning some are sandwiched even after their children leave the nest.

Another challenge: Finding services to help seniors live out their days at home. AARP recently opened an online “livability index” to rank communities on such factors as accessible housing and transit options.

And the National Association for Area Agencies on Aging runs an Eldercare Locator to help people find local resources. Last year, the locator averaged more than 22,000 requests for assistance a month. A recent report found the top needs: transportation, mostly to get to doctor appointments; in-home services, such as meals and personal care; and finding affordable housing or making age-friendly home modifications.

“People don’t generally make these calls until they’re in crisis,” said association CEO Sandy Markwood. “If mom and dad need this as they get older, you should prepare for that, too.”

Carroll Burnett of Whitesboro, Texas, cared for his 88-year-old father, who’d suffered a stroke, for a year before he died in March.

“I felt good that I could take care of him,” said Burnett, a retired tool and die maker who had help from his wife and one of his three grown children. But he’s saving up: “I don’t want any of my kids to go through what I did.”

The AP-NORC Center survey was conducted by telephone April 7 to May 15 among a random national sample of 1,735 adults age 40 or older, with funding from the SCAN Foundation. Results for the full survey have a margin of sampling error of plus or minus 3.2 percentage points.

Associated Press writer Stacey A. Anderson and AP news survey specialist Emily Swanson contributed to this report.

Two Public Events of Interest

Elder Lawyer Doris Gelbman  will be repeating her series of informative seminars “Aging Gracefully”  at the new JMRL Northside Library.

The seminar segments will be at 6:30 p.m. on the following dates:

Wednesday, June 24: Staying in Your Home

Wednesday, July 22: Independent and ‘Continuing Care Retirement Communities’

Wednesday, August 26: Assisted Living and Nursing Facilities – What’s the Diff?

The library is located at: 705 Rio Road West (1/2 block west of Route 29 – the old Phillips Supply Company).  This seminar is free and open to the public.


Attorney Gelbman will be giving a seminar  “Using Government Benefits to Your Benefit”

WHERE:     The Senior Center,  1180 Pepsi Place, Charlottesville, VA 22901

WHEN:       Tuesday, June 16 from 10 am – 11 am

WHAT:        An explanation of Medicare and Medicaid, as well as Veteran’s Benefits and other programs that may be of  benefit to you.  Again this event is free and open to the public.


Proposed CvilleVillage Services

The following list was developed by the CvilleVillage Programs and Services Committee to show the proposed initial services that CvilleVillage will offer.   Once we begin offering services we will add additional services when we can.     Please feel free to add your comments on this list with your suggestions for additions.

  • Transportation
    Drive (and sometimes accompany) members to and from doctors, dentists, veterinarians, physical therapist, fitness centers,  banks, post office, hair salon/barber, grocery store, meetings, church, social events, train station,
    airport, etc.
    Run errands for members wherein member provides lists and funds but does not go with volunteer (pick up prescriptions, dry cleaning, etc.)
  • Household Chores
    Change light bulbs
    Replace smoke detector batteries
    Change furnace filters
    Check fire extinguishers
    Make simple repairs
    Perform minor infrequent housework (light dusting, etc.)
    Organize items (rearrange closets or cabinets for easy access such as kitchenware, summer/winter clothing, seasonal decorations)
    Assist in compilation of emergency numbers
    Assist with pet care
  • Yard Chores (limited; at discretion of Village or volunteer)
    Rake/blow leaves
    Shovel/blow snow
    Put out and retrieve trash/recycle bins
    Do light weeding/planting
  • Social Assistance
    Make friendly visits
    Make daily phone calls
    Take walks
    Play games
    Read Aloud
  • Technology/Electronic Assistance
    Help with computers, printers, cell phones, DVD players, E-reader
  • Financial Assistance
    Provide limited help in paying bills; sort bills from other mail and place with member’s checkbook
  • Group Socialization
    Host pot luck dinners
    Go to restaurants, theater, concerts, movies
  • Village Office Assistance
    Perform administrative duties such as answer phones, maintain database, compile mailings, coordinate volunteers

Support CvilleVillage when you shop at Kroger Stores

You can support CvilleVillage when you shop at Kroger’s by linking your Kroger rewards card to the Kroger Community Rewards program.  Then every time you swipe your card at Kroger they will make a donation to CvilleVillage.

To register on-line for the Kroger Community Rewards, have your Kroger rewards card handy and go to

Click on  CREATE AN ACCOUNT at the bottom of the page   [If you don’t already have a Kroger card, you can get one by first clicking on REGISTER in the upper right hand corner].

Enter your email, create a password and enter your zip code, and again click on CREATE AN ACCOUNT.

Follow the steps entering your card number and other information as requested.  NOTE: you will need to click on SAVE after you enter each line of information.

Next click on EDIT, and under Kroger Community Rewards, type in Cvillevillage or enter our NPO number which is 93124.

Next click on SEARCH.   The screen should say:   “CvilleVillage  93124”    Click on the little circle next to “CvilleVillage” and you are done.

That’s all there is to it.   Once your are registered, everytime you swipe your card at Kroger, they will make a contribution to CvilleVillge   [NOTE: this has no effect on their separate program of Reward Points for Fuel].

The medical system may treat you well, but less so after you reach age 80

From the Washington Post 04/06/2015 by Louise Aronson


The clinic was in a dilapidated old building, yet the entryway retained a worn grandeur. Tapering, semicircular walls extended like welcoming arms, and a half-moon of sidewalk stretched to the quiet side street.

That’s where I first saw her, standing at the curb with her cane propped on her walker, squinting toward the nearby boulevard. The woman was clearly well into her 80s, with a confident demeanor and with clothes and hair that revealed an attention to appearance. She had a cellphone in one hand and seemed to be waiting for a ride.

I had been heading into the clinic for a 4:30 p.m. appointment, and when I came back out, night had fallen. But for her tan winter coat and bright scarf, I might have missed her leaning against the clinic’s curved wall. She still held the cellphone, but now her shoulders were slumped and her hair disheveled by the cold evening breeze.

I hesitated. On one side of town, my elderly mother needed computer help. On the other, our dog needed a walk, dinner had to be cooked and several hours of patient notes and work e-mails required my attention.

I asked this woman whether she was okay. She looked at the ground, lips pursed, and shook her head. “No,” she said. “My ride didn’t come, and I have this thing on my phone that calls a cab, but it sends them to my apartment. I don’t know how to get them here, and I can’t reach my friend.”

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