With Public Dialogue, individuals in small groups led by trained facilitators and notetakers discuss topics that may be sensitive or controversial and about which there is a diversity of opinion. Participants are encouraged to share their views as others listen respectfully. Appreciative Interviewing is an individual interview technique in which the interviewer probes for the feelings and perceptions behind an interviewee's opinions. Both techniques encourage active listening with an attempt to understand the speaker's perspective.

From September to December 2003, dialogues were conducted with 201 participants from eleven organizations in Greene County. Individual interviews were conducted with 23 homebound individuals who either were recipients of home-delivered meals or were participants in the Springfield/Greene County Library District's Walking Books program.

The purpose of this investigation was to assess the needs of older adults in the community in order to help the Community Foundation more effectively distribute its funds earmarked for improving the lives of older adults. The perspective of older adults themselves, along with their caregivers, was sought. Notes from the Public Dialogues and Appreciative Interviews were recorded and analyzed. They are summarized in this report, which focuses on the top concerns of older adults and the role of the community in helping address these concerns. Facilitators posed the following questions to guide the dialogues and interviews:

1. What do you think the top concerns of older adults are?
2. What is most important to you in your life right now?
3. What do you most look forward to in a day?
4. What is the best thing about growing older?
5. What people, places or situations in the community make your life better?
6. What is the hardest thing about growing older?
7. What people, places or situations in the community make your life more difficult?
8. What, if anything, do you think the role of the community should be in helping meet the needs of older adults?
9. Given everything that you've learned in your life, what would you most want to pass along to others?

The first 26 pages of this report summarize the information, identify recurring themes, and suggest what role the community can play. There are likely to be no surprises in this report; instead, the findings verify data from earlier reports and provide a context for understanding why certain issues are important to older adults. Appendix C contains verbatim renderings of the flipchart notes recorded during the actual Public Dialogues; Appendix D contains summaries of the individual interviews. We encourage readers to peruse both appendices and not to rely solely on the summaries because no summary can fully capture the richness and detail of the original notes. Following are highlights from two main foci of this investigation.

Top Concerns of Older Adults

• Health care: access to affordable health care, the ability to pay for health care, the high cost of prescription drugs and insurance, and the solvency of programs such as Medicare and Medicaid.
• Transportation: a critical need for affordable, convenient transportation, particularly for individuals in outlying areas.
• Housing: need for affordable, safe housing; desire to stay at home as long as possible; need for reliable and affordable help with home maintenance, yard care, housekeeping.
• Finances: concern about whether finances will last; rising property taxes; rising cost of living in general.
• Loneliness: a need for companionship; friends; social activities; a place to go to be with others.
• Awareness of and access to services: a single, centralized place to learn about services available to help older adults; help accessing those services.

Older adults want to live independently in their own homes in as normal a fashion as possible for as long as possible. They would like for appropriate accommodations to be made that ease things for them and allow them maximum independence. They also want the opportunity to be of use to the community and to share what they have learned.

The Role of the Community

• Improving transportation to older adults, especially those outside Springfield proper. Possibilities: vouchers for taxis, rerouting city buses to include retirement centers, expanding the role of volunteer programs such as RSVP.
• Maintaining/enhancing programs that allow older adults to stay in their homes for as long as possible. Includes: meal delivery, grocery delivery, homebound shopping programs, home maintenance/repair programs, help with housekeeping and yard work, safety audits, creating an elder "neighborhood watch" program.
• Maintaining/enhancing the role of the senior centers. Adding and diversifying activities, adding more centers, providing flu shots, medical exams, financial planning help.
• Promoting physical changes in the environment to accommodate aging. Adding ramps, railings, benches to sit and rest, making sure sidewalks and entrances are clear.
• Increasing public awareness of services available to older adults. Ideally, there would be a central clearinghouse where someone could go to receive information about all senior-oriented programs.
• Enhancing social support for caregivers, who are in serious danger of burnout.
• Increasing the public's knowledge of and appreciation for elder issues. Making the public aware of the contributions of older adults and their value to the community.
• Enhancing the role of older adults in the community. Providing increased opportunity for flexible volunteer work; highlighting the contributions of older adults.

The suggestions highlighted here focus on what can be done through local initiative to improve the lives of older adults. Many concerns and suggestions pertained to issues that must be addressed beyond the local level. The goal should be to prolong older adult independence and to ensure that older adults are included fully in the life of the community.