A Tale of Two Community Initiatives for Promoting Aging in Place: Similarities and Differences in the National Implementation of NORC Programs and Villages

Abstract

Decision Editor: Rachel Pruchno, PhDPurpose: Villages and Naturally Occurring Retirement Community (NORC) Supportive Service Programs (NORC programs) are among the most prominent community-based models for promoting aging in place. To advance systematic understanding of their development, this study examined how these models have been implemented nationally and the models' similarities and differences. Design and Methods: A survey of program leaders representing 69 Villages and 62 NORC programs was conducted from January to June of 2012. Bivariate analyses compared measures of the initiatives' services/activities, beneficiaries, service delivery processes, and funding sources. Results: Village members were reportedly more likely than NORC program participants to be younger, to be less functionally impaired, to be more economically secure, and to reside in higher socioeconomic communities. Reflecting these differences in populations served, NORC programs reported offering more traditional health and social services, had more paid staff, and relied more on government funding than Villages. Implications: Findings indicate that Villages and NORC programs both aim to promote aging in place by offering a diverse range of supports and services to older adults within a locally defined geographic area. Nevertheless, key differences were found in the means through which they seek to achieve these aims, as well as the populations likely to benefit from their efforts. These differences raise questions regarding the models' inclusivity, sustainability, expansion, and effectiveness and have implications for community aging in place initiatives more broadly.

Community-Based Supports and Services for Older Adults: A Primer for Clinicians

“…The development partnered with a local social service agency (United Jewish Appeal Federation of New York) to establish the services necessary to convert what was an apartment complex into housing that could meet the needs of those in declining health. NORCs are public-private partnerships and receive support both from local agencies and the federal government, via Title IV of the OAA [29]. …”

“…There are approximately 100 NORCs, half in New York and the rest scattered throughout the USA [30]. NORCs are formal organizations, with paid staff and volunteers who provide services including socialization, care coordination, and transportation, in addition to expedited referrals to other community services such as home health, nutrition, or legal services [29].…”

“…NORCs are formal organizations, with paid staff and volunteers who provide services including socialization, care coordination, and transportation, in addition to expedited referrals to other community services such as home health, nutrition, or legal services [29]. A newer alternative, known as Villages, is membership-driven and privately funded, originating most often in areas of greater wealth [30]. Another option is independent senior housing programs that employ service coordinators who link residents to CBSS.…”

Using the Social Determinants of Health as a Framework to Examine and Address Predictors of Depression in Later Life

“…A sense of community has been linked to lower stress, better outcomes for health and mental health, and an increase in both social support and physical activity (Hombrados-Mendieta et al 2009;Young et al 2004). The idea of 'aging in place,' or staying within the same residential area, has become increasingly common for older adults (Cagney and Cornwell 2010;Greenfield et al 2013;Löfqvist et al 2013). U.S. Census data from 2000 showed that almost one third of older adults have remained in the same home for 30 years or more as their geographic areas are reduced and their routines become closer to home (Cagney and Cornwell 2010).…”

Participation in community activities through Naturally Occurring Retirement Community (NORC) Supportive Service Programs

“…advisory council meetings, meetings with local government officials and intergenerational volunteering) (Vladeck 2004). Congruent with these descriptions of the programme model, a national survey of 62 NORC Programs in 2012 – with approximately half located in New York City and the other half located across the USA – found that 98 per cent of the programmes offered social-recreational activities (Greenfield et al 2013), and approximately 90 per cent noted strengthening older adults’ social relationships and reducing social isolation as among their programmes’ top goals (Greenfield et al 2012 a , 2012 b ).…”