Monday, May 12, 2008

Health

USN Current Issue

Aging at Home With Government Help

Posted November 5, 2007

In parts of the country, seniors who are less than self-sufficient don't necessarily need to move out of their own homes. About 80 communities nationwide are experimenting with an approach that uses outside funding to provide resources to aging residents. These experimental communities, called naturally occurring retirement communities supportive service programs, exist mostly in neighborhoods or residential buildings where many residents are 60 or older and want to stay put as they age.

The programs, which began in New York City in 1986, are funded through public-private partnerships that include a mix of government and philanthropic dollars at the community level, with funding and support from building owners and managers, nonprofit groups, and neighborhood associations. There are usually nominal membership and activities fees.

An estimated 40 NORC service programs are now operating in New York, most of them in New York City. Nationally, since 2002, Congress has funded an additional 40 demonstration programs that serve roughly 20,000 older adults in 25 states. Cities include Albuquerque, N.M., Baltimore, Miami, Philadelphia, and San Diego.

In the Upper Park Heights neighborhood of northwest Baltimore, for example, 950 seniors—mostly women—are members of the NORC program called Senior Friendly Neighborhoods, which covers 11 apartment buildings that are within 10 blocks of one another. It's a five-year-old program spearheaded by the Associated Jewish Federation of Baltimore and jointly funded by a $2 million federal grant and money from the city of Baltimore, Baltimore County, and the Harry and Jeanette Weinberg Foundation, among others.

Groups of members, whose average age is 80, go on excursions to concerts at the Meyerhoff Symphony Hall, visit the Inner Harbor, or get together in their apartment buildings for art workshops and meals. A free shuttle is available for trips to the supermarket and other stores. A nurse practitioner regularly offers on-site blood pressure clinics, assessments, and other health-related services.

But federal backing for NORCs is hard to come by. Last year, Congress included NORC programs in its reauthorization of the Older Americans Act but hasn't yet funded them. "Securing federal backing for a new initiative is very difficult," says Rob Goldberg, senior director of legislative affairs for the United Jewish Communities, the umbrella organization for Jewish social service agencies that has championed these efforts.

Nevertheless, some politicians are on board. "I have visited the NORCs in Maryland and seen their tremendous impact," says Democratic Sen. Barbara Mikulski of Maryland. "I will continue to fight to keep seniors across the country a priority in the federal checkbook so they may be able to age in place."

The NORC model also has to win over its prospective members: Goldberg says older adults can initially be hesitant to be perceived as needy, and some see stigma in living in a "retirement community" that receives social services. They also may be unwilling to pay fees for membership, typically $20 per year.

The payback, though, seems to be worth it. In a survey of 500 NORC residents, sampled from each of the 24 longest-running federal demonstration programs, the vast majority of respondents reported they knew and spoke to more people than they used to and that they participated in more group activities and events and left the confines of their home more often. They also tended to feel healthier than they had prior to participation in the NORC-SSP demonstrations.

"You're involved with other people, so you don't get bored or depressed," says Baltimore NORC resident Cora Bigger, 77, who battles arthritis and high blood pressure. "It's wonderful. You come together and forget about what hurts you."

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