Supportive Services Programs in Naturally Occurring Retirement Communities. Short-Term versus Long-Term Program Outcomes

Supportive services programs can be a vehicle for meeting either the immediate or anticipated needs of older community residents as they age. The short-term outcomes of these interventions are intuitively appealing--providing assistance with such immediate health and social needs as depression, isolation, or a particular health condition. A longer-term outcome of a good program will include developing trust between the residents and the program, so the program becomes a source residents can turn to when their needs change.

Broadly, a successful program must address community awareness by educating residents and their families about available services. Staff should not only have a range of services that they can tap for daily and ongoing needs and immediate crises, but should also be able to anticipate likely future needs based on experience. By meeting the current needs of residents reliably and with dignity, programs can establish themselves as places to go when new needs arise. Programs initiated by external organizations may have to first establish their legitimacy in the eyes of the community and, over time, earn the community's trust as a source for personal and health-related services.

In the programs we visited, we saw activities designed to further this longer term goal through the development of communication mechanisms between community residents and program staff. Staff members were able to assess resident needs without arousing their fear that assessment was a prelude to removal from the community. Staff also worked to maintain respect for residents' abilities and sensitivity to their ambivalence about recognizing or admitting their frailties. Programs sought by residents, as opposed to those initiated by service agencies, may have had an advantage in this area because residents had a greater sense of control over the program. As a result, the necessary relationship of trust may have been able to develop more quickly.

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