As more Americans reach retirement age, they must consider where they will spend their later years. Research shows that the vast majority of adults in the United States prefer to "age in place," according to Emily Greenfield, a gerontologist and associate professor at Rutgers School of Social Work.
"Most older adults want to remain in their own homes, just like anyone may prefer to live where they've been comfortable for a while," Greenfield says. But by 2035, 20 percent of Americans will be 65 or older, an increase from 13 percent this year, and “there are many limitations on supportive services that allow people do that,” she says. “As people get older, they are likely to face challenges that threaten their ability to live on their own."
To address these critical health and social service needs, two community paradigms have emerged that aim to help people remain in their homes instead of moving to age-restricted communities or assisted-living facilities: Villages, membership-based organizations in which older adults provide support to one another; and Naturally Occurring Retirement Community (NORC) programs, which bring together service providers, housing managers and older adults themselves to support aging in place.
But which of these models are more effective? In a national study, Greenfield, along with four other researchers, is attempting to determine the major differences between them. The study, which surveyed leaders of 69 Villages and 62 NORC programs in the first six months of 2012, found that the two models not only use different methods to serve aging adults but also serve different populations.
The Village concept originated in 2001 when a group of seniors in Boston’s Beacon Hill neighborhood organized a network of support services to allow older adults to stay in their homes. Since then, more than 85 Villages have sprung up across the country and another 120 are under development.
The services offered in Village communities are often provided by volunteers and funded by membership fees, which on average cost an individual $430 annually, according to Greenfield. Villages tend to serve middle- and higher-income seniors and are concentrated in the Northeast and along the coasts.
NORC programs developed earlier, with the first created in 1986 in a cooperative of 2,800 apartments in Manhattan. It paved the way for the development of 100 similar programs throughout the country.
Unlike Villages, NORC programs typically have at least one paid staff member to facilitate recreational, cultural and social activities and gatherings. NORC programs also rely on governmental and philanthropic funding and are more likely to be located in apartment buildings where lower-income adults reside.
Greenfield said a baseline study was needed to understand how these models have been implemented before assessing the outcomes they have had for older adults. The study was funded by a $40,000 grant from the Lois and Samuel Silberman Fund, which supports social work research and service delivery.
"The similarities and differences between these program models raise a lot of questions for future researchers to grapple with – what needs to be in place for them to be implemented successfully, and under what conditions are they most effective for enhancing older adults’ well-being?" says Greenfield, who was recently awarded a Rutgers Board of Trustees Research Fellowship for Scholarly Excellence.
In a separate study, Greenfield is now analyzing six NORC program sites in New York City to determine how residents become involved in their communities and how the programs can create opportunities for seniors to become civically engaged. That study received a $100,000 grant last September from the John A. Hartford Foundation, a private philanthropy working to improve the health of older Americans.
One organization that helped spur the growth of NORC programs is The Jewish Federations of North America, a Washington, D.C.-based umbrella organization of local federations, which created demonstration projects of NORC programs across the country. Between 2002 and 2010, the organization's initiative received $30 million in federal funding distributed to 40 projects in 26 states.
Because of federal budget problems, however, that funding has ended, putting many NORC programs in jeopardy. Robert Goldberg, senior director for legislative affairs at the Jewish Federations, said Greenfield's study could help make the case for federal policymakers to reinstate funding for the NORC projects.
"Anytime that you can shed light on what's happening and connecting the dots for policy makers is critical," Goldberg said. "Emily's report is another and more current iteration of what's happening. There's quite a bit of advocacy involved for community-based providers to convince stakeholders – whether it's state or local government – that they should invest in these programs."
