Philanthropy’s Role in Ageing Issues

The Atlantic Philanthropies’ approach to funding in ageing, including its emphasis on advocacy, is outlined in this speech by Gara LaMarche, Atlantic’s President and CEO, at the Annual Meeting of Grantmakers in Aging in San Diego, California in November 2007.

When I was asked a few months ago to give a title for this talk for the GIA program, I thought about it a little bit and finally came up with “Reflections of an Aging/Human Rights Activist.” I thought that would be a slightly clever way of saying that I was a human rights activist who now finds himself the president of the world’s largest private funder of aging issues, and give me an opportunity to offer my impressions about a field that is newer to me through the lens of the one that is more familiar.

And that is what I intend to do, though a typo in the program removed the all-important slash, so now I am simply an aging human rights activist, as in one who is getting older. That’s fine, too, and I will resist the usual jokes, since one of the things I’ve come to be more sensitive about in my few months as a baby aging activist is that they’re mostly not that funny, based as they are on stereotypes about frailty and impairment.

People often ask me, since I had a pretty terrific job for eleven years as Vice President and Director of U.S. Programs at the Open Society Institute, why I was drawn to the job of President of Atlantic Philanthropies. My general response is something along the lines of, “What part of $4 billion do you not understand?” But more seriously, high on my list of reasons was the opportunity to learn more about and work more deeply on issues of aging in the United States and around the world. I am indebted to Dr. Robert Butler, an Open Society Institute grantee whose International Longevity Center was launched with generous early support from Atlantic, for building my consciousness about aging issues in recent years, so by the time the Atlantic opportunity came up I was primed for immersing myself and using what experiences and capacities I bring to exercise some leadership in a new area in what I hope will be the prime of my own life. I am humbled by the fact that I know so little compared to Atlantic’s terrific staff – Brian Hofland, our program director, program executives Laura Robbins, Stacey Easterling and Ken Logue, and program associate Jackie Deslauriers are here with me in San Diego – and compared to the people in this room, who comprise the leadership of those in the growing but still too small funding community dealing with the way society perceives and treats older persons.

What we really need, of course, is for this room to be much bigger, or at least the same size but standing room only, because something I feel strongly about, and will do my best to get across in my tenure at Atlantic, is that aging is not a niche funding area or a special interest group. The number of funders with a primary focus on aging, like our close friends at the John A. Hartford Foundation, will always be finite, though it too needs to grow. But the number of foundations which ought to be concerned with aging is almost infinite, for no funder ought to get away, in this day and, well, age, with saying “we don’t do aging.” Any issue that our colleague foundations deal with – health or democracy or education or immigration or lesbian and gay rights or housing or community development, and on and on – affects and is affected by the role of older adults. And any foundation that is not taking that account in its strategies is not doing its job, not seeing the whole picture. No foundation would say, “sorry, our guidelines don’t let us deal with issues affecting black people.” And no funder should be able to say that about aging.

A word before I go on about what Grantmakers in Aging means to us at Atlantic. We couldn’t make a fraction of the impact we are making and hope to make without the opportunity that GIA provides to learn from and work with all of you. Our partnership has taken many forms. Because of GIA’s centrality to supporting and strengthening our field, we’ve provided core organizational capacity building support. Beyond that, many of you here are local or regional partners in three initiatives. First, “EngAGEment, a collaboration of six Regional Associations of Grantmakers designed to attract more foundations to aging. Competitively selected, each RAG orchestrated a 1 to 1 match and designed a local outreach program to foundations in its jurisdiction – at least two new to aging. Baltimore, Milwaukee, South Florida, the Northwest Region, and Michigan have all participated, and the program has encouraged new, and in some cases, collective grantmaking in aging. In Milwaukee, for example, I understand that an Aging Issues Funders Collaborative has been established which meets every few months, designing and monitoring projects which they co-fund, including an architecture competition for older adult housing and a program to develop seniors as advocates for clean water.

Our grants to the Hurricane Fund for the Elderly in 2005 and 2006, coupled with support for GIA to manage administrative costs, directed philanthropic dollars and resources to organizations providing assistance to vulnerable older adults in the Gulf States, especially those who are poor and isolated. We awarded $750,000 to support projects to expand and strengthen the capacity of Louisiana, Mississippi and Alabama nonprofits to serve the longer-term needs of vulnerable older adults, which remain serious and daunting. The Hurricane Fund parlayed the initial $500,000 in investments of Atlantic and the Robert Wood Johnson Foundation into more than $4 million in funding for services for older adults in the Gulf States, addressing issues of poverty, health, and disaster preparedness. Our proud colleagues in this example of philanthropy’s capacity to rise to meet unanticipated and emerging needs include The Woods Charitable Trust, UJA Federation of New York, The Retirement Research Foundation, the AARP Foundation, the New York Community Trust, the Lower Pearl River Valley Foundation, the Los Angeles Jewish Federation; and the Hartford Foundation.

And finally, Atlantic has joined with Grantmakers in Aging through the Community Experience Partnership, the initiative to increase civic engagement opportunities for older adults in communities across the country by creating partnerships with the existing network of community foundations. There are at least ten community foundations here who are participating in the GIA conference for the first time. Come again, and bring your friends!

Now I think it would be a good idea just to say a few things about what has shaped my thinking about aging before coming to Atlantic. Some of this grows out of my work, and some from my life outside work – a zone that has a tendency to shrink if I am not careful, but which I try to keep as robust as I can. I’ve been warned that non-gerontology folks like me have a tiresome tendency to talk about their elderly relatives to establish their bona fides with an expert audience, and I hope you don’t think this is what I am doing. I simply believe that one of the most powerful things about aging as an issue for Atlantic or any foundation is its universality – the capacities and challenges of aging and society’s response to them are something every person has to navigate, for themselves, for their parents or grandparents, and if we are fortunate, at all those stages of life.

I confronted the challenges of dealing with opaque and unresponsive medical bureaucracies, and of caring for a parent while balancing my own family and work responsibilities ten years ago when my father lay for months in a coma brought on by an aneurysm, and emerged for the remaining few years of his life with multiple disabilities, passing into the night and the new year in a nursing home ten years ago on January 1. I see first-hand the capacities of older adults to make amazing contributions to society, from Atlantic board member Fritz Schwarz, who in his seventies, following a successful corporate law and government service career, is leading the fight against unchecked Presidential power at the Brennan Center for Justice; to 76-year old Atlantic founder Chuck Feeney, who travels the world coach class, like a Johnny Appleseed of philanthropy; to my own 77-year old mother, who manages to be a dynamo in both the Garden Club and VFW Ladies Auxiliary while working with women old enough to be her own mother, reading to and cooking for them.

At OSI we had a wide-ranging fellowship program, and one who opened my eyes a lot was Eric Klinenberg, whose book Heat Wave, supported through his OSI grant, explored the question of why so many older people died in the Chicago heat wave of 1994 – and why so many are unaware that it even happened. We saw the same thing in Katrina, where 60% of the storm’s victims – or rather, the victims of public policy failures – were over 61 years of age. Isolation and the lack of community and social capital amount, where older adults are concerned, to a major public health challenge.

The global dimensions of Atlantic’s work excite me because they make it possible for us to make connections that are harder for a funder operating only within one nation’s borders to make. The context for our aging work in the United States is familiar to all of you. The enormous advances we’ve made in medicine in our lifetimes mean that most people live much longer, and many are alive and healthy for decades beyond what not long ago would be considered a normal career or lifespan. They have much to do and say, experience and contribute, but we have hardly begun to catch up with these realities in our workplaces and in our commercial, community and government institutions. The huge changes in our society in the 20th century – the greater social and personal mobility that has given us sprawling cities, leaving behind rural town squares like ghost towns, that has children and grandchildren living hours by plane and car from the places and people who raised them – are now beginning to take place in other countries in which Atlantic works, like Bermuda, Viet Nam and South Africa. Our public health initiatives in Viet Nam, where we work in close cooperation with the government and with other donors, will along with other development advances steadily increase life expectancy, and the combination of that with growing social dislocation will mean that Atlantic’s experience, and network of grantees, in more developed countries like the U.S. and Ireland will have much to contribute to getting it right there, at an earlier stage.

There are a few themes I have been stressing in my early months at Atlantic that are worth mentioning here today, because I think they’re highly relevant to the work we are doing together.

The first theme is universality. What do I mean by that? I mean that virtually all of the things we do at Atlantic touch the lives of every person in an individual way. We may not have designed our initiatives that way, but if you take a step back and look at them, that is what they are. And what that means, among other things, is that those of us who work here must negotiate a personal relationship to the issues we deal with: children, aging, rights and health. What is the best school for my child? Where will my child be when the school day is done, and I am still at work? What will I do if she becomes sick? Will my cousin’s citizenship application go through? My nephew was wrongly accused of a crime – will his court-appointed lawyer do a good job? How will I spend the last few decades of my life? Who will care now for my aging father? What kind of treatment will I get in the hospital, and who will be looking after me there?

Not only the themes we deal with but also many of Atlantic’s strategies are things we can relate to in a personal way. Take advocacy, something we’ll be discussing shortly. In all our preliminary discussion of advocacy, we rarely bring it home to our own lives. Everyone is, or has to be, an advocate at one time or another, in various ways. Earlier in my career, I didn’t blink at testifying extemporaneously three times in a day before three different Texas legislative committees on three different subjects. But a few years later, as I mentioned a few minutes ago, I found advocating for my father’s care in the hospital when he was in an extended coma the hardest thing I have ever done. I was at sea about who to talk with, which levers to pull, simply how to help him best. There are many of you in this room who have done that bravely and brilliantly, or done the same for a child who has a difficult teacher, or with a landlord who is being unfair. Yet some of you might prefer to have dual root canals without Novocaine than get up here and do what I am doing now. We all have our strengths and weaknesses, and theaters of advocacy in which we do well.

The more we recognize, all our necessary and appropriate respect for evidence and assessment notwithstanding, that we are dealing not in abstractions and data but in people, in their most central passages through life, the better we will be as grantmakers. These are not matters affecting only clients, grantees, or populations. They are about us. It is not a laboratory experiment we are conducting. It is more like a reality show.

The second theme is about the essence of the language we use to talk about our work, and the people we work with. We are about, or should be about, utilizing assets and maximizing success, rather than addressing deficits and avoiding failure. In our line of work as funders, indeed in all public policy and social change work, there is a powerful tendency to talk about what is missing, what is in danger, what needs protection, what must be fought and challenged. I am comfortable in this kind of language, as a human rights crusader myself, and indeed sometimes it is necessary.

But there is a different way of looking at and talking about our work, right there in front of us, and I’ve been increasingly excited about it as I’ve realized this. Michael Carrera of the Children’s Aid Society, an Atlantic grantee for a terrific, nationally respected youth program, has it exactly right when he describes the young people he works with as being not “at risk,” but “at promise.” It is the potential of these kids, so often feared or written off by society, that inspire our investment, not their problems.

This is just as much an issue in the last phases of life as in the early years. Though it is beginning to change, with the civic engagement initiatives that Atlantic and others are supporting, from the Purpose Prizes to be awarded next week to the Experience Corps, ReServe and other programs that tap into the unbounded abilities of older adults. These initiatives, and the lived experience of millions like my mother, give the lie to the pernicious stereotype of older adults as a drag upon society’s resources. To the contrary, they are a great national treasure, and as public policy moves more and more in the direction these initiatives are charting, we’ll discover a huge source of constantly renewable energy too long consigned to the margins in our youth-worshipping society – our elders.

I know you’d like me to talk a bit, as the billing of my talk promised, about the role of foundations in advocacy. I am generally allergic to grand designs – which makes me an unusual person to be leading a large foundation, I realize – but I have evolved over the years a kind of theory of change, and it is this. Social change is an ecosystem with interdependent parts. Research and scholarship play a role, and so do elite policy and big service organizations. But foundations often undervalue and undersupport advocacy, perhaps because they fear the controversy that often attends more aggressive strategies like litigation, public education campaigns and lobbying, or because they think they don’t have the capacity or expertise to evaluate them. Funders who do have that experience and expertise, like Atlantic, can and should be good allies, advisers and partners.

I want to add an additional word about an even less well-supported part of the ecosystem. I don’t know any significant social change that has taken place without grassroots movement from below – not the end of apartheid or the collapse of Communism in Eastern Europe, not the women’s, civil rights or gay rights movements – and indeed many if not most of that change took place with few or no philanthropic dollars. Atlantic is large enough, and sophisticated enough about change, to invest in every part of the ecosystem, but my own bias is that to do so without investing in change from below is to risk wasting our money. So I am always looking for that element, and I have been happy to find it in much of our existing funding, like the Older and Bolder Campaign that organized older adults in Ireland to press the new government for a dedicated ministry and a national strategy for older people.

No funder, certainly no funder in aging, can afford not to be concerned with advocacy for stronger policies, governmental and private, that support the needs of older adults. Your own priorities, board and staff philosophies and competencies and comfort levels, will determine what point or points in the ecosystem you may choose for entry. We saw the importance of advocacy in the fight against Social Security privatization, which at OSI we were proud to support, we see it in debates over the Medicaid and Medicare programs, prescription drug benefits and a host of other issues affecting many older persons. From the depths of the Depression of the 1930’s, this country made a social compact with its citizens that no one should spend their later years in poverty, without access to health care. Even as we need to make that commitment universal – to expand and complete the compact for all children and adults – we need to maintain the one we have. This cannot happen without a strong role for government, and it cannot happen if we continue along the path of creating a new Gilded Age by redirecting tax dollars from human needs to the most wealthy among us.

It’s been tremendously energizing for me, as a lifelong human rights activist, to come to a foundation that is not only one of the leading funders in the world in human rights – for example, the fight for immigration reform, and to preserve fundamental rights in the wake of 9-11 – but the largest private funder in aging. Many issues affecting older people are easily approached in human rights terms. To name just a few:

• One out of six incidents of elder abuse, neglect, and exploitation is brought to the attention of authorities.
• Older patients are significantly underrepresented in clinical treatment trials for all types of cancer, and most notably in trials for treatment of breast cancer.
• 54 percent of nursing homes fail to meet minimum standards, but only half of one percent are cited an penalized for patterns of care that cause harm to residents.
• Fewer than 2 percent of prime-time television characters are age 65 or older, though this age group is almost 13 percent of the population.

And yet these issues are hardly on the agenda of the nation’s leading civil rights and liberties organizations, and the capacity of aging organizations to deal with them is far too thin. Civil rights advocates for forty years have challenged abuses of power in institutions like prisons and mental hospitals, yet nursing homes receive much less attention and scrutiny from advocates. Anti-defamation campaigns have raised the cost of racist, sexist and homophobic insults and stereotypes, yet older people remain virtually the last social group that can be made fun of with impunity. There is a lengthy and important agenda of rights issues involving older persons that cries out for greater attention, focus and resources.

And at the same time it must be acknowledged that, as with other groups in society that have been traditionally marginalized and discriminated against, there are both vulnerabilities and capacities to address. Groups who have suffered generations of bias, economic deprivation and substandard schooling need affirmative action to take their rightful place as full citizens. Most people who live long enough move at some point from strength to some measure of need, and society must be capable of providing outlets for the former and support for the latter.

The older I get, and the more experience I have with people and with social movements, the more I believe that most of the planet’s human challenges are rooted in respect – or in the failure to provide it. Every human rights abuse, every labor dispute, every matter of war and peace, political, tribal and ethnic tension – every one is sparked by the failure to accord the respect we owe one another as humans. And so it is with aging. Older people do not deserve our respect because they are old, and I’ve seen too many septuagenarian politicians to believe that wisdom invariably accompanies age. Sometimes age, like illness, intensifies your innate qualities and characteristics, for better or for worse. But older people deserve respect because they are human, and the dehumanization that comes with stereotyping, institutionalization and isolation is a dismal aspect of American life that I am proud to join all of you in working to eradicate.

I think I may have sold myself slightly short at the beginning when stressing how new I am to the aging field and how much I have to learn. Preparing for this talk I remembered that the very first thing I published anywhere – you can go and look it up – was a letter to Time Magazine in 1969, when I was fourteen. Time had done some kind of feature on aging, and my letter to the editor cited Marie Dressler, a vaudeville performer and actress in silent films and early talkies who died at the age of 66 in 1934. Don’t ask me how I came up with this quote, but what I wrote to Time citing something Dressler once said seems like be a nice way to end this talk: “It’s not how old you are; it’s how you are old.”

Thank you.