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Aging in A2: A warm harbor for a graying population

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John and Barbara Romani  by Benjamin Weatherston

Barbara Anderson and John Romani
by Benjamin Weatherston

Story by Julie Halpert

Photos by Benjamin Weatherston

Three days a week, year-round, Fredda Clisham can be found walking briskly up the steep incline on Observatory, past the University of Michigan dormitories onto Medical Center Drive. It’s a five-mile round trip that she makes by foot to her paying job in the Women’s Health Resource Center at the U-M Hospital.

This wouldn’t be particularly significant, except that Clisham is 94 years old. She regrets that this winter the ice has curtailed her journey, which she relies on for exercise; she’s been forced to take the bus.

Is an aging population good or bad for Ann Arbor?

When she’s not working, she’s performing with the Burns Park Players. She’s played an elderly villager in “Fiddler on the Roof,” a disgruntled cleaning woman in “How to Succeed in Business” and a witch casting a spell of doom on the prince in “Beauty and the Beast.”

“It gets me out of the house, into another venue, with people and excitement and make believe,” she said.

She never takes her job, her friends or her health for granted. “I just feel like I’ve been blessed a million times,” she says.

Wendy Mead, 61, and her husband deal with what they see as Ann Arbor’s main negative — oppressive winters — by fleeing to the Southern Hemisphere during winter.

Wendy Mead, 61, and her husband deal with what they see as Ann Arbor’s main negative — oppressive winters — by fleeing to the Southern Hemisphere during winter.

Clisham is among a rapidly growing number of older Ann Arborites. The total population age 65 and older was 9,017 in 2000, representing 7.9 percent of the city’s total. Those numbers grew to 10,612 and 9.3 percent in 2010, and are expected to reach 18,271 and 15.6 percent by 2020, according to the U.S. Census Bureau and the Southeast Michigan Council of Governments.

The rest of the U.S. is “graying” too, but not as fast as Ann Arbor. From 2000 to 2020, there will be a 60 percent increase in the number of Americans 65 and older, compared to more than 100 percent in the same age group in Ann Arbor.

Why? Word’s getting out that Ann Arbor’s a great place for older folks. It was named the seventh best small city in the U.S. for successful aging by the Milken Institute in 2012; it made the list of U.S. News and World Report’s best affordable places to retire in 2009; AARP named it the healthiest city in the U.S. in which to live and retire in 2008; and it ranked No. 5 on Forbes’ 2011 list of best places for an active retirement.

Among the reasons cited on the lists was an inexpensive and accessible local public transit system, a strong intellectual and cultural environment nurtured by nearby colleges and a great health care system.

Ann Arbor is conducive to establishing social connections, participating in meaningful activities and continuing to learn — all elements that contribute to healthy aging — said Richard Birkel, senior vice president for health at the National Council on Aging, who has visited the area numerous times.

The qualities Birkel highlights are evident in Ann Arborites like Robert Kahn, 95, who has lived here since he left Detroit to attend U-M in 1935. He and a co-author, John W. Rowe, literally wrote the book on aging, called “Successful Aging,” in 1998, and though compulsory retirement forced him to leave his posts as a professor of both psychology and public health 25 years ago, Kahn remains a professor emeritus at U-M’s Institute for Social Research.

“I don’t feel old. We have good friends who have lots of physical problems and they say they never knew pain came with age. We don’t know that. How old you are has a lot to do with how healthy you are.” Carol Maccini, 71, pictured with her husband Lou

“I don’t feel old. We have good friends who have lots of physical problems and they say they never knew pain came with age. We don’t know that. How old you are has a lot to do with how healthy you are.”
Carol Maccini, 71, pictured with her husband Lou

Kahn and two of his colleagues at the institute, Toni Antonucci and Noah Webster, researched two high-income retirement communities and found that exercise and social connectedness can help people age healthfully. The three are now studying whether the same benefits can be seen in low-income retirement communities.

Kahn says social support is a fundamental component of healthy aging: “We are not programmed to live alone.” Birkel agrees, saying social connections provide a buffer, allowing people to better weather the inevitable stresses of aging, like loss of function.

Kahn witnessed those benefits firsthand when a car rounding the bend in a parking garage hit him and his wife in 2006. His suffered a skull fracture and a shattered leg. “I was fortunate in being in a place where I had the best medical care,” he said. But just as crucial to his recovery was the social support; each of his three daughters, who live out of town, took turns caring for him at his Ann Arbor home, keeping him out of a rehabilitation facility.

“I had a tremendously moving experience about the power of social support and what it means to be surrounded by people who love and care for you,” he said. Within a year, he had regained the use of his leg as well as his memory, which had initially faltered with bleeding in his brain. Now, he exercises three times a week, spending an hour on the treadmill followed by 40 minutes lifting weights. He works to remain mentally engaged, memorizing poetry, starting with the Elizabethan sonnets.

John H. Romani, professor emeritus for both public health administration and Program in the Environment at U-M, will be 89 this month. He said his wife, Barbara Anderson, a professor of sociology and population studies, helps him to continue living a full, vital life. She’s 23 years his junior. They met in 1993 while serving together on a university committee. Anderson’s husband had died two years earlier; Romani had been divorced since 1981.

“The short part of it is I went after him and he didn’t run too fast,” says Anderson. When Romani revealed his concerns about the age difference, she was unfazed. “I thought, ‘He doesn’t look, act or think like it, so who cares?’” She says she told him, “I’m a demographer and mortality expert and if I’m not worried about this, you shouldn’t be,” and he never brought it up again. She points out that her first husband died when he was 45, so “you never know what’s going to happen anyway.”

U-M’s Dr. Kenneth Langa tells aging patients to “walk, read and talk” to stay healthy  for the long haul.

U-M’s Dr. Kenneth Langa tells aging patients to “walk, read and talk” to stay healthy
for the long haul.

She and Romani married in 1994. They’ve published 15 papers jointly and since 2002 have been teaching an honors seminar together in U-M’s College of Literature, Science, and the Arts titled, “Population and Health in South Africa in Transition.” For the past five years, they’ve taken students who completed the course to South Africa in May, where they visit places studied in the course and hear presentations by South African scholars.

Romani and his wife enjoy attending University Musical Society concerts and have season tickets to the U-M basketball games. He couldn’t imagine leaving a place where he’s lived for 60 years: “I don’t golf. I work all the time. I wanted to remain an active academic, so where else could I be?”

His recipe for a long life? “Continue to do the things you enjoy doing and continue to be engaged.”

Kenneth Langa, a professor of medicine at U-M specializing in dementia and Alzheimer’s disease, says Ann Arbor has a higher than average number of healthy older residents. He says it’s hard to know whether the city helps keep people healthy or there’s a selection effect, where healthy people are drawn here. But he suspects it’s a combination of both.

His mantra to patients to stay well is to “walk, read and talk,” and he says Ann Arbor makes it easy to engage in all three. Streets are walker-friendly and there are plenty of social and cultural activities to keep people engaged.

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Carol and Lou Maccini, both 71, moved here in May 2013 from Baltimore. Carol says Ann Arbor has “a high-quality medical center that you don’t normally find in a small town.” Lou was grateful to have had top-notch physical therapy here, following knee surgery in Baltimore. When people decide where to retire, the medical center is a big factor, Carol said.

U.S. News and World Report ranks the U-M Health System 12th nationally in adult specialties and the medical school ranks No. 7 in the country in geriatrics training for new physicians.

UMHS’ 27-year-old Geriatrics Center is made up of primary care physicians, social workers, nurses and specialists, including geriatric psychiatrists, gastroenterologists and rheumatologists. It’s designed to provide a comprehensive approach to care, instead of patients seeing a variety of doctors who often don’t interact. From June 2012 to July 2013, 23,850 patients visited the center.

UMHS has one of the largest geriatric psychiatry programs in the country, aimed at treating emotional issues that can cause significant distress in older people. “Even though we’re psychiatrists, we don’t just prescribe medication,” said Mary Blazek, director of long-term care consultation in geriatric psychiatry.

Helen Kales, director of geriatric psychiatry and the Program for Positive Aging at U-M, said much of the program’s focus has been in non-pharmaceutical interventions for emotional wellness in later life. The focus areas are dementia, depression and anxiety. With dementia, “behavioral symptoms like wandering and agitation are ubiquitous and there has been a tremendous overuse of anti-psychotics that are often of limited benefit and of significant risk,” she said. Her program’s emphasis instead has been on practical interventions to reduce these often disruptive behaviors, and on making helpful adjustments at home.

For older adults who experience depression and anxiety, mindfulness and meditation practices can help, Kales said. Mindfulness programs help people learn to live in the present, allowing those who view the world negatively to develop a clearer understanding of how such thoughts and emotions impact their health and quality of life.

Kales believes attitude can trump good genes in aging gracefully. She argues that a huge part of healthy aging is tuning out negative stimuli and thinking positively, and even in later life it’s possible to shift pessimism into positivity through the use of proven strategies. It’s “how you react to things that happen” that affects your ability to age well, she said.

The Geriatric Centers also provides social connections through its Turner Senior Resource Center, a place focused on health and wellness activities, offered for free or at low cost. It attracted 22,000 visitors last year. Walls display the brightly colored artwork of those age 55 and older. There are large rooms for lectures, as well as smaller spaces for one-on-one counseling and support groups covering everything from caring for your mate to living with diabetes and coping with bad eyesight.

There are day programs for those suffering memory loss, even a housing bureau to help seniors avoid eviction. A computer lab provides technology mentoring. There’s an arts and crafts room as well as a fitness facility. On a recent weekday, a group of Korean seniors were playing cards.

“The combination of programs is probably hard to find in other places, even in the Detroit area,” said Mary Rumman, a social worker at the Geriatrics Center. She says it’s easy and inexpensive to get there — and anywhere within Ann Arbor. Taxis charge $3 each way for seniors going within the city limits. Buses are free for those age 65 and older.

The Turner Center also houses the Osher Lifelong Learning Institute, where more than 1,200 residents age 50 and older participate in study groups and lectures taught by volunteers. OLLI also provides travel excursions and social and cultural gatherings. Participants pay a $20 membership fee plus a per-class fee ranging from $8 to $45 for a 15-week class. Topics range from the architecture of Scandinavia to physics for non-scientists and script reading and analysis.

OLLI has been a lifeline for those who have left their jobs or other longtime roles and are looking for meaningful ways to connect with others and to contribute, says Abbie Lawrence-Jacobson, program director. It shows them that they’re able to continue absorbing new information, but also that “the things you have to say about what’s going on in the world are valuable.”

Lawrence-Jacobson’s own parents have participated in OLLI study groups. Her mother, now 70, moved here from the Boston area four years ago, while her father, a former engineer, now 80, moved from Fairfax, Va., seven-and-a-half years ago and both are taking advantage of the city’s many activities, Lawrence-Jacobson says. Her father ushers at sporting events for the U-M Athletic Department. “Both believe that, despite the weather, Ann Arbor is the perfect place to retire,” she said.

The Maccinis got involved with OLLI as a way to meet people. Lou Maccini was astonished when he saw more than 300 people at a kickoff meeting. Carol says those they’ve met through OLLI are similarly intellectually engaged, and it’s proven to be a great way to build social connections.

The Maccinis also get intellectual stimulation attending lectures and wine and cheese receptions where they live, in a contemporary 2,700-foot condo surrounded by trees in University Commons. The 55-plus community was founded by U-M alumni to create a community of those with similar interests, where lifelong learning is a priority. They also enjoy opera simulcasts at local theaters and recently attended an afternoon performance of “Rusalka” at Rave Cinemas. “It’s an opportunity to see the best performances around. We’ve never seen anything like it,” said Lou.

The Maccinis said they headed to Ann Arbor primarily to be closer to their daughter, son-in-law and 4- and 9-year old grandchildren. They had been testing the waters, staying here for extended periods for several years before they moved here permanently. “So we knew it was a great place to live,” Carol said. “But we have found it an even better place now that we are here.”

Wendy Mead, 61, and her 67-year-old husband elected to move here after retiring from their jobs as vice presidents of Compuware Corp. in Detroit. After living in Bloomfield Hills for 20 years, Wendy appreciates Ann Arbor’s public transportation and the ability to walk to so many places. “It’s like living in a little New York City neighborhood” without the downside of the high costs and crime, she said.

The Meads deal with what they see as the main negative — oppressive winters — by fleeing to the Southern Hemisphere during winter. She’s enjoyed her retirement here so much that she started a blog, Retired in Ann Arbor, which highlights inexpensive and fun activities. She’s attracted 800 views a month.

One of her top picks is The Science Cafe, a monthly discussion at Conor O’Neill’s. A recent discussion, on whether there is life on Mars, was led by one of the heads of the Mars rover team. “How many times can you sit down and talk to somebody like that?” she asked. “It was very quirky, which is what I love about Ann Arbor.” She says there are also ample volunteering opportunities, everything from ushering at concerts to helping the homeless. Her husband volunteers at Nichols Arboretum, weeding twice a week during gardening season.

The volunteering opportunities in Ann Arbor provide another ingredient for optimal aging, said Peter Lichtenberg, director of the Institute of Gerontology and a professor of psychology at Wayne State University. Even those with chronic diseases “often report themselves as aging successfully if they’re doing things that are very meaningful to them,” he said. “They get confirmation that what they’re doing is important to the rest of the world and is connected to others.”

Lichtenberg, who is on the board of the Area Agency on Aging, which includes Washtenaw County, says Ann Arbor “is a magnet for people who have lived a healthy lifestyle.”

Dr. Bill Thomas is an aging expert and senior fellow with AARP’s Life Reimagined Institute. He’s also the author of the upcoming book “Second Wind,” which argues that society wrongly lionizes and celebrates youth, judging older people by how young they act and look. He believes the secret to aging healthfully is to slow down and develop a sense of connection, something he sees in Ann Arbor. Like Lichtenberg, he says that those who are more concerned with another person, cause or belief age better than those who are more self-centered. He says what’s attracting people to Ann Arbor is that feeling of community, of shared purpose.

Michael Martin, a former chemistry professor and assistant dean at U-M, says good health has been key in helping sustain him. Martin, 78, says he was blessed with a solid childhood, good parents, a thriving marriage (since 1965) and a fulfilling career — all which helped shape his positive outlook. But what helps to keep him engaged is his life view: “I have always really marveled at the mere fact of existing.” He used retirement as an opportunity to leave his field of chemical ecology behind and learn something entirely new — military history.

Of course, Martin and others profiled here are, in many ways, fortunate. They’re comfortable financially. They don’t have persistent, painful chronic illnesses that can significantly impair even the most optimistic person’s life. Good genes are on their side — not an insignificant factor. Romani’s paternal grandfather died when he was 91 and two of his grandfather’s daughters lived to the ages of 94 and 89. Six of his nine cousins on his mother’s side lived into their late eighties. Clisham lives independently with only her two cats as company. She takes no medication — not even aspirin. Her mother lived to almost 97.

But Thomas says good health alone doesn’t account for healthful aging. He says that the 94-year-old Clisham’s upbeat attitude is likely what keeps her going.

Birkel points out that many poor older Americans can live rich, robust lives, provided they have meaning and social connection. “Money is not a requirement to age well,” he said.

That may be true, but it’s hard to age well if you don’t have a place to live. Beth Adams, director of the Housing Bureau for Seniors and Ann Arbor Meals on Wheels, says there’s a six-month to two-year waiting list for most low-income senior housing facilities. The high cost of housing, as well as housing with services, like assisted living, makes for a challenging situation for many Ann Arbor seniors, she said.

Martin considers himself to be one of the lucky ones. He reflects the positive attitude that seems infectiously pervasive among many of Ann Arbor’s seniors: “I have really enjoyed, and still do enjoy, being alive. There are certainly some disadvantages associated with being 78 instead of 40 and I’m very much aware of the fact that the clock is ticking and that this party isn’t going to last too many more years. But I’m perfectly OK with that. It’s been a great ride, and it still is.”

 

<Edited March 22 to fix incorrect photo caption.>

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