Supportive Services Programs in Naturally Occurring Retirement Communities. DISCUSSION

Improving the ability of older people to remain in their homes for as long as possible is desirable for at least two reasons. Surveys have shown that staying at home is what older people want and that it is less expensive for most individuals than institutional care. As the baby boomers approach this phase of life, it will become even more important to find ways to achieve the dual goal of managing the cost of long-term care services while providing services in a desirable setting.

The NORC supportive services program is an intuitively appealing model to help more seniors age in place. As our review of the literature and visits to five, admittedly unrepresentative, sites has shown, there is little available evidence on either side as to whether that appeal is borne out in practice. The literature and the site visits have, however, yielded a great deal of information about useful practices in supportive services programs.

However clear the motivation for promoting supportive services to allow aging in place, the execution can be challenging, as the case studies presented here show. The needs of older people can and do differ widely across different groups, in different settings, and over time. Some older people do not need supportive services; others need a great deal. Over time, individuals may move either gradually or suddenly from no or low need to higher need. Identifying the physical, social, and emotional health needs of older people and designing programs to meet these needs requires constant attention to evolving circumstances and preferences.

Even if needs are identified and programs developed to meet them, the very frailties that supportive services programs are designed to counter often contribute to implementation challenges. Older people may be unaware of the extent or implications of their frailties, or outwardly deny them. Older people may fear that if the frailties are recognized they will be forced to move from their homes, making them reluctant to admit any need for help or accept services. Further, physical weakness, declining mental capacity, and daily fluctuations in health and energy levels can make even regular, eager participants not wholly reliable.

In discussing what constitutes a NORC, we included both the community's population and its resources. In that sense, once a supportive services program is established, it becomes part of the NORC. To understand the role of supportive services programs, it helps to think of them as just one of many community resources that can help successful aging in place. Our research here highlights many ways that supportive services programs can contribute to this goal. It also suggests some limitations that should be kept in mind as policies are developed.

View full report

Preview
Download

"NORCssp.pdf" (pdf, 762.02Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"NORCsspA1.pdf" (pdf, 636.12Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"NORCsspA2.pdf" (pdf, 360.82Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"NORCsspA3.pdf" (pdf, 92.08Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®