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Karl Singer, Exeter

“I’m a primary care physician trained in internal medicine, and, after several years in practice, also passed my boards in geriatrics. I’ve been thinking about the problems of older people for more than 30 years. One of the issues is ‘where should people live as they get older?’

“When I began my career people started having issues probably in their late sixties. But now it’s more likely to be in their early eighties. 

“Did you know that somewhere between 82 and 87 virtually everybody needs help?
They have a lot of difficulty living in their own home and handling complex things. Almost nobody can live without some kind of community assistance, a child, a friend, something. 

“Like if there’s a hole in their roof, finding three contractors, vetting them all, dealing with a complex problem and not getting cheated.  If you live in a rural state like New Hampshire and can’t drive, it is very challenging since there is very little public transportation. And isolation and loneliness are terrible issues. I’ve been looking at all of the various possibilities and one of the things that caught my eye many years ago was the Beacon Hill project in Boston. I know that was the originator of your Seacoast Village Project. 

“When my partner’s wife said to me, ‘I’d like to introduce you to Nancy Euchner, who’s working to start the Seacoast Village Project,’ I said, ‘Sign me up.’ I’m interested both professionally and personally because I’m 77 and, I want to live in my own house while I’m still working. I don’t want to lose it and I don’t know where to move. I can’t do what I’m doing now if I’m not living in this community. On the other hand, I live in a single family, five-bedroom house at the end of a 100-yard long driveway. I know that there are some real issues, particularly if I can’t drive."

“I’m happy to provide any kind of help or advice on geriatrics that’s useful for the Seacoast Village Project and the Board. You can create your own community that helps people with the issues that are really important—making sure members can get all the help they need to stay in their own homes, whether it’s contractors who are vetted and are going to be responsive and not cheat them—or people who can help out when they need it. My hope is that it’ll have social aspects and that the volunteers will give people a sense of worth for their life. One of the things we all want to know is ‘why am I getting up this morning?’ And one of the problems when you leave your main career is ‘what direction am I going to go in next?’ 

“I see the Seacoast Village Project as a way of saying, ‘okay, we’re all in this together.

We’re struggling with certain problems, let’s share our experiences, let’s help each other out.’  

“You know trust is a big factor for people as they age. The whole concept of volunteers, maybe who you even know, coming into your home, I see that as a real potential benefit of the Village. 

“We know that people in healthcare administration are excited about this project because they know that many of the people with repeated hospitalizations are those who just don’t have the resources at home. So much of why people get hospitalized repeatedly is because of the social determinants of disease—loneli-ness and frailty. The more we can build up an infrastructure, the more it helps hospitals who are now sort of on the hook for total care and re- hospitalizations. 

“And one of the things we are trying to do with the hospitals is to get some funding to enroll people who cannot pay the Seacoast Village Project dues. Because very often the people who might be most in need can’t afford the membership fee. It could be a lot for a family with limited income. But by the same token, if you look at it from that standpoint of what you’d pay for a couple of taxi rides, you’re already at $50 a month. 

“There are so many positives [to the Village] that the real challenge is ‘how do you get it going?’ 

“I think we just have to keep reaching out to people and saying, ‘we’re here. 

Are there things that we can help you with?’ It has to be a constant effort. People have to constantly see this until they realize, ‘Oh, that would be wonderful!’ 
“I think a lot of people are not facing the fact that they’re getting older, but when you present something like this, it’s really … in your face, right?  They’re going to need these services and they don’t want to admit it … I think that’s just the reality.”

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