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Book Review – “Creating Unlimited Options for Aging: The Path Forward”

The issue of elder care became a major concern for Joe Carella when he was just a teenager. As the result of a freak accident in gym class that resulted in a torn ACL in his right knee, he was admitted to the hospital the next day for repairs to the ACL and to stop internal bleeding.

Typically, he would have landed in the pediatric ward, but, having been told the area was closed, they placed Joe in the geriatric ward.

For four long days and nights – until the mistake was rectified – this child witnessed, and experienced, the emotional and psychological deprivations and isolation of the elderly patients around him; the lack of stimulation, the simple warehousing – however well-tended they might have been – of these once vital people.

The experience, as the author makes clear, devastated him, leaving an indelible impression and changing his life in many ways.

A Personal Story

In a phone interview with The Senior List, Carella revealed something significant that he was too modest to include in his book. Despite the genetic kidney condition, he had always been exceptionally fit, confident, energetic and focused.

He had assumed there would be no obstacle to him recouping and then resuming his former life as a high school student, an athlete, and one who worked an after-school job. Instead, as he told us here, that eye-opening experience affected him so profoundly that he never completely physically recovered from it.

His days as a top athlete may have been over, but his focus, intelligence, and energy were now largely dedicated to finding a better model for elder housing, whether in a hospital, nursing home, assisted living or aging-in-place.

A Scandinavian Approach to Elder Care

And that’s just what he did, after venturing to Scandinavia, where he discovered their natural, community-based approach to elder care, resulting in a lifestyle he terms “authentic living” (p. 21). This model encourages seniors to continue living in a neighborhood (whether in their own home or in an elder-care facility), surrounded by people of all ages, interacting in a natural way.

Elders are – like anyone else – to ask for assistance when needed but to retain as much autonomy and sense of identity as possible, continuing to contribute and interact, and to feel securely rooted in the community. No one is to be labeled or categorized. People – regardless of age or any other quality – need to be accepted and respected for what and who they are.

Here are the four principles on which the Scandinavian senior housing model (in-home or in a facility) is based:

  1. Elder housing should create a positive residential reality.
  2. Housing should allow residents to maintain their lifestyle.
  3. Housing should encourage autonomy.
  4. Housing should be built around the concept of community-centered living.

Creating Unlimited Options for Aging: The Path Forward (2017) by Joe Carella

Steps in the Right Direction

Eventually, after carefully researching the topic, Joe returned to the U.S to tour, lecture, further confer with elders and doubting elder care professionals, and to write about what he had discovered. He also worked with others to establish the first of a growing number of elder housing communities, the Scandinavian Living Center in Newton, Massachusetts.

A key point is that the SLC shares the same property as the Scandinavian Cultural Center, where events of various kinds are held. These events include the residents, to the extent each chooses to be involved. Other such communities are being created, though it’s early days yet.

An encouraging fact is that there are also burgeoning variations on this theme, one of which is the University-Based Retirement Community (UBRC) which allows the senior to live on campus, take classes, interact with college students, and do volunteer work.

Having read many reviews of assisted living facilities recently, I can attest that the concept of attempting to ensure that elders/residents are part of the surrounding neighborhood and connected to the community at large is, however gradually, becoming a more common attribute of senior housing.

As Carella discovered, it is a practical approach that makes for happier, healthier residents who age better and experience a lower likelihood of depression and other ailments whether physical, emotional, or mental.

Who Is This Book For?

Clichéd as it may sound, this book is a must-read for anyone who has an interest – for themselves or a loved one – in knowing what can be done to make the most of one’s later years and benefit everyone involved.

It’s too easy and too common to label things as well as people. Labels can be handy, even necessary, when applied to medicine bottles or food containers. But when applied to people? We all lose when that label stops us from seeing what and who is truly in front of us.

To neatly label people as “old” or as retirees, or as disabled, strips them of their accomplishments, their very humanity. Carella’s message is that one does not stop being human at a certain age, but – given the opportunity – can go on developing and growing throughout their entire lives. They can continue to be a part of the community, taking what they need and giving back at the same time. In short, everyone benefits.

In Brief – Creating Unlimited Options for Aging: The Path Forward

There are three basic things to be said about Creating Unlimited Options for Aging: The Path Forward:

  1. The title of this 102-page book says it all. Contrary to the prevailing attitude, at least in the USA, seniors should not merely be tended to and treated as though their age, and what conditions might accompany that age, somehow makes them less – less valuable, less capable of further growth, less human. To treat them so is to alienate and isolate them, almost inevitably hastening their decline. Simultaneously, it deprives those around that person of the benefits of knowing and socializing with them.
  2. This is a very personal book in which Carella shares how, when only in his teens, he was confronted with a truth that most of us come to appreciate only much later: namely, that aging is part of the human condition, and, as stated above, elders are not to be shunned or shut off. He also takes us on his journey to find alternatives, to persuade others (in the US) that the alternatives are practicable, and then to implement them.
  3. With a cautious yet firm optimistic realism, Carella wishes nothing more than for the reader to come away with an empowering realization that he or she can choose to take part in shaping the future of elder housing. We can all help to ensure that it is not at all institutional, but instead a positive, nurturing and community-based continuance of what the elder’s life was before reaching this age. The author also includes many sources of information to help the reader to gather yet more data.

About the Author

Joe Carella earned an MBA from Babson College and an undergraduate degree from Northeastern University. Besides his work as an author, lecturer and researcher, Carella is the Executive Director of the Scandinavian Charitable Society of Greater Boston.

The principles expressed in his first book, Unlimited Options for Aging (1995), were used to establish and then to continue to shape the Scandinavian Living Center in Newton, Massachusetts. Additionally, Carella was a founding member of the Newton Cultural Alliance, while also serving on the boards of two nonprofit elder care organizations: the Elizabeth Seton and Marillac Residence, Inc., both in Wellesley, Massachusetts.

A family man, he lives in nearby Bedford, MA, with his wife, Carole, and their three children. The book reviewed here is an expanded version of his 1995 volume, enriched by the knowledge he acquired during that 20-year interim.

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