Supportive Services Programs in Naturally Occurring Retirement Communities. NORCs and Community Resources

All the grantees define the communities they serve with reference to a specific geographic area or areas where a large share of the population is older. Some grantee sites cover a specific part of a city or neighborhood, such as Center City Philadelphia or Baltimore's Upper Park Heights. In contrast, the Pittsburgh program serves communities in a group of contiguous neighborhoods. In each study site, program representatives view the NORC as encompassing both the housing complexes and independent housing units where older residents reside, as well as the various resources available in the community. Most often, the grantees have established services programs for one or more specific housing complexes within the NORC, such as an apartment building or co-op. However, all sites except Philadelphia are also trying to establish programs to serve residents in neighborhoods with single-family homes.

The grantees have estimated the concentration of older people in their service areas, but most programs do not have an exact count of residents in the target age range. In St. Louis, where research on resident demographics was conducted before program implementation, staff cited 2000 Census data showing that 32 percent of the residents of its NORC, as defined by a census block, are age 65 or older. St. Louis program officials estimate that at least half the residents in the apartment buildings they serve are age 65 or older. Aside from St. Louis, the grantees have little firm demographic data about the communities or buildings they served.

In each community, local resources include community centers, houses of worship, health care providers, shopping centers, and some public transportation, although distance to and accessibility of these resources vary across the sites. In the Cleveland, Pittsburgh, and Philadelphia NORCs, some amenities are within walking distance of residents' apartment buildings or homes, but even short distances can present problems, particularly for older people with mobility impairments. In other sites, residents who can still drive have access to a broader range of services and amenities, but poor signage and residents' aversion to driving at night can limit accessibility and participation in some activities. Baltimore, Pittsburgh, and St. Louis have Jewish community centers and social services programs housed in or located close to the communities they serve. These facilities are open to residents of all faiths and are not frequented only by Jewish residents. In St. Louis, staff noted that making non-Jewish residents aware that services are open to all was a particular challenge.

Although resources in the community are an attraction for residents, respondents in all five sites identified physical layouts that present problems for older people as they become frail. Many apartment buildings have steps leading up to the entryway, and a few have automatic doors that close too quickly for people with mobility problems. Physical access barriers are more pronounced in row houses or single-family homes that have stairs without railings and bathrooms or laundry facilities that can be reached only by stairways. Neighborhoods with hilly landscapes or without sidewalks, particularly those neighborhoods farther from amenities such as shopping or entertainment, present additional obstacles for older people who can no longer drive or who would like to walk to their destinations. Similarly, neighborhoods with only sporadic public transportation present obstacles for those who are unable to walk to their destinations. Grantee staff identified inadequate transportation most often when asked about the challenges older people in their communities face.

According to grantee staff at all five sites, most older people have lived in their communities for decades, staying largely because of ties to friends and neighbors as well as connections with community resources like houses of worship, community centers, and health care providers. Staff also pointed to migration both into and out of the various communities. In some communities, such as Baltimore and Pittsburgh, out-migration has led to a growing though not dominant aged-left-behind population. In others, such as Philadelphia, older residents have moved in, frequently drawn by the amenities of city living. Most communities have a concentration of older Jewish residents.

Migration to the study communities includes immigrants from foreign countries. Staff in both Baltimore and Pittsburgh mentioned that an influx of older Russian immigrants in the late 1980s contributed to a change in the culture and languages of the community. In Pittsburgh, the small existing Russian community, itself the result of an earlier wave of migration, attracted these immigrants. In-migrants have also included retirees looking for smaller residences with lower maintenance requirements and easier access to amenities and necessities. In Philadelphia, some retirees migrated from suburban areas to the city to reduce their social isolation, and staff in St. Louis reported that older residents moved to the NORC to be closer to family, friends, and the Jewish community center.

The grantee sites provide good evidence of the dynamic nature of NORCs, and understanding these dynamics suggests steps that services programs can take to address resident needs. Each community has a core of long-term residents, and the amenities that bind those residents to the community attract other older people. The importance of a familiar culture in a foreign land in the case of the Russian immigrants or of centers for Jewish culture and community are part of the community resources for older people who are not of the majority culture. These cultural ties can focus outreach to new residents and ease the integration of newcomers into the community. The programs' use of Jewish community centers is an example. For other residents, the availability of living arrangements more in keeping with their needs and abilities attracted them to the communities. Outreach to residents without specific cultural ties or without existing ties to service organizations or houses of worship in the community may take more planning.

The grantee sites do not represent as wide a range of NORCs as depicted in the conceptual framework. Since most sites are characterized by continuing in-migration of older people, they seem to be places that remain attractive. There are, for example, no sites with a predominantly aged-left-behind population where the lack of amenities has driven all who can leave away. Nor are there the more dispersed communities that would be found in rural areas not adjacent to a large city or suburban communities. As will be discussed later, program staff in Baltimore, Pittsburgh, Cleveland, and St. Louis are considering expanding services to suburban neighborhoods with single-family homes. Supportive services programs in these communities will likely differ from those represented by the AoA grantees in the current study for several reasons, including lower population density, the lack of an internal organizational structure, scarcity of public transportation, and lower availability of health and social services resources.

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