More Seniors Age in Place Thanks to Growth of ‘Villages’ 

For a small group of people in 1999 Boston, moving into a retirement community was not desirable, making them determined to stay in their own homes. The trailblazers found their own solution to enable aging in place — a village.

From that beginning, a movement was born, and the growth of villages today is supporting aging in place and could provide partnership opportunities for home health and home care providers moving forward.

“It wasn’t our intention to change the world,” Susan McWhinney-Morse, board member and co-founder of the Beacon Hill Village, told Home Health Care News.”It was our intention to make our world, for us, more agreeable.”


Beacon Hill Village was the first village and began enrolling members in 2002. It currently has more than 400 members over the age of 50 that live across central Boston, including the neighborhoods of Back Bay, Fenway and Beacon Hill. The village currently employs seven people.

Villages are grassroots community-based efforts to keep seniors living in their homes. The organization provides mutual support and resources, and can also counsel and refer members on services such as home care.

The movement creates opportunities for in-home care companies to build partnerships and tap into an ever growing connected group of seniors who are committed to aging in place.


“I wouldn’t be able to survive as an executive director for a village without my partnerships with home health agencies,” Barbara Hughes Sullivan, executive director of the Village to Village Network, told HHCN. “The whole idea with villages is not to recreate the wheel, but to partner with the community-at-large … We create the network to get people more involved, be able to connect and be at home and independent, safely, as they age.”

Villages gain momentum

There are nearly 240 active villages and 150 in development across 45 states and Washington,D.C., according to Village to Village Network.

St. Louis-based Village to Village Network is a national organization that works to maximize the growth and sustain individual villages and the overall village movement. There are 203 member villages in the Network. Founded in 2010, the Network provides resources, guidance and support for communities to build and maintain their villages.

Beacon Hill Village Beacon Hill Village members (left to right) Susan McWhinney-Morse and Anne Almy.

“As we get older, our social networks diminish — it’s just a part of the deal,” Kate Hoepke, executive director of the San Francisco Village and chair of the leadership team at the Village Movement of California, told HHCN. “Older folks find themselves threatened by isolation and we know that there are all kinds of negative health outcomes associated with isolation.”

Isolation can cause older adults to be sicker, die sooner and have higher health care expenses, studies have found. Finding a solution to isolation for seniors within the home health sector has been a key driver for many providers. Some startups have also seen a need for tackling this problem and have built their business around being a part of solution to this issue.

“Social isolation has the potential negative consequences on health equivalent to smoking 15 cigarettes a day,” Majd Alwan, senior vice president of technology at Leading Age and executive director of the Center for Aging Services Technologies (CAST), previously told HHCN.

D.C.-based LeadingAge is a trade association representing 6,000 providers — mostly nonprofits — that work in aging.

San Francisco Village was founded in 2009 and includes more than 340 current members, between the ages of 60 to 96 years old, across 25 different neighborhoods. The village has 14 member-led neighborhood circles that meet regularly. It has a five person staff and 175 volunteers.

Village Movement of California is a statewide coalition of villages that are banding together to increase visibility, invigorate California villages and build momentum for the movement. There are 40 member villages. In California, there are about 50 village networks.

“One of the things we are advocating [for] in California is scale,” Hoepke said. “We think it is growing rather slowly and we want to give a boost. I have a vision that millions of people [will] belong to villages.”

There is no one type of village. Each is different based on member needs and location. Yet the principles are similar. Each village tries to utilize the resources around it and reflect the needs of its members.

“The most dramatic illustration is there are villages in tiny rural communities in New Hampshire,” McWhinney-Morse said. “A lot of what they do, particularly as winter comes, is help people stack wood [or] change their tires and shovel snow.”

Villages are not concierge services or networks, however, all members participate and provide for each other in different ways.

“We’re in the business of building community,” Hoepke said. “We are creating intentional communities, relationships that weren’t there before, and it requires a lot of thought and planning and cultivation.”

There are many benefits to this model, according to advocates and village members.

“I have lived on Beacon Hill for over 50 years, so one would assume I know everybody, but half of the people I know have died or moved away,” McWhinney-Morse said. “And so, one’s world gets smaller. But with a village, that doesn’t happen because there is so many new people to meet and so many new adventures to take.”

Activities inside a village can vary, but some include singing groups, creative writing sessions, political discussions and wellness information exchanges.

A more affordable option

By 2030, all baby boomers will be over the age of 65, according to the U.S. Census Bureau’s 2017 National Population Projections. One in every five Americans will be of retirement age.

Meanwhile, the cost of home health care alone in the United States will reach nearly $173 billion by 2026, according to analysis from the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. Total national health spending will account for 19.7% of the U.S. economy by 2026, according to findings published in the journal Health Affairs.

“Villages are helping state and local governments because we don’t have the financial resources — Medicaid only pays for so much — so many different things [villages do help seniors] to embrace that aging in place model,” Hughes Sullivan said.

For advocates, the villages are a solution to an aging population that society doesn’t have the capacity to care for.

“Being involved in something that’s larger than oneself automatically just keeps you going,” McWhinney-Morse said.

All villages are nonprofits and rely primarily on membership fees and fundraising to finance the operations.

“We are always in a fundraising mode,” McWhinney-Morse said. “Always.”

The San Francisco village is in a more ideal situation, as the city of San Francisco has seen the advantage of the model and has provided funding to the program.

“Only about 25% of our operation budget comes from membership fees,” Hoepke said. “The rest of it comes from a combination of individual donors, [grants and] significant funding from City of San Francisco, which makes us unique. Most villages do not have municipal funding, but we think they should, and so we are working at that at a statewide level.”

Villages of the future

As the aging population continues to grow, it is reasonable to expect that the village movement will as well.

“I can’t imagine why this wouldn’t, [because] if you have a very modest income there is nothing for you [out there],” McWhinney-Morse said. “This is a model that should fit everybody who either feels very strongly about being in one’s community or has no other resources.”

Optimism around the movement seems to be strong across the board.

Educating people about available options is key, according to Sullivan.

“I see the village movement just booming,” Sullivan said. “We have the tools and we use the tools to show how [seniors] can benefit.”

There are some new partnerships and projects in the near future within the network.

“We are in the process of doing more and more collaborations,” Sullivan said. “I think it is really coming together for the whole network, all the villages, it’s a win-win for all the villages to have national recognition.”

Sullivan didn’t share details on the national collaborations or partnerships as the negotiations are ongoing.

The village model may have challenges, but a key benefit to advocates is that they get to live their lives how they want.

“I want to be in the world, not what I call the warehouses of older people,” McWhinney-Morse said.

Written by Kaitlyn Mattson