How Communities Create Safe Environments for Aging

Community Innovations for Aging in Place

Neighbors like those on Western Way could choose to form an alliance to support their mutual goal of staying in their homes while maintaining the highest quality of life possible. These support systems must take into consideration the physical, behavioral, and social needs of an aging population.

One community innovation for aging in place is the Naturally Occurring Retirement Community (NORC). NORCs often form in places with a significant population of older adults, even if the places were not built specifically as older adult living facilities. The unifying feature is a high number of older adults already living there who want to continue living there.

Classic NORCs are formed to support residents in high-rise apartment buildings or housing complexes. Typically, the majority of the NORC participants must fall within HUD’s low-income or moderate-income levels. Neighborhood NORCs are comprised of residents in buildings six stories or less or in stand-alone single or multi-family homes. In some areas of the country, NORCs are formal entities that receive local government funding and actively support aging residents with medical, wellness, social, and educational services, some for free and some at a cost.
 

Additional Community Innovations for Aging in Place

A supportive community environment for aging needs to meet health and social needs, including access to healthcare, nutritious meals, transportation, and mental health and emotional enrichment activities. In addition to NORCs, cohousing, villages and university-based retirement communities (UBRCs) are community innovations for aging in place that are gaining popularity.

The focus of cohousing models is to change the housing physical structure so multiple people live together, with a mix of community and private spaces. Successful cohousing units rely on being surrounded by supportive neighbors to meet community residents’ ongoing support needs.

The villages model connects residents to low- and no-cost services, including healthcare. As a grassroots model, it is run by volunteers and some paid staffers who work to reduce isolation by increasing social interactions in their community.

UBRCs have proven attractive to those who were affiliated with universities during their working lives, and 10% of residents are required to have an existing connection with the university. UBRCs are near the main campus of the university and integrate residents with faculty, students, and staff. They also provide access to the full continuum of care needed as the community members age.
 

More Ways to Age in Place in the Same Community

Howard and Mitzi knew they wanted to stay in their two-story home on Western Way, even after Howard was diagnosed with multiple sclerosis. They renovated their dining room and bathroom into a fully accessible bedroom and bath suite and widened all first-floor doorways to accommodate a wheelchair should Howard need one. They purchased a combined washer-dryer unit, so they don’t need to transfer laundry from one machine to another, and had it installed on their home’s main level. Howard and Mitzi feel safer knowing they do not have to use the stairs daily.

Their neighbor, Bella, wanted to stay in her home, but her budget wouldn’t accommodate it. She wanted the security of having her son close to her, especially after she broke her hip. She sold her house to him, using the money left after paying off the mortgage to build a single-story, detached accessory dwelling unit (ADU) on the large lot. Her 450-square foot, one-bedroom, one and a half-bath ADU was built following universal design principles so she can stay there as her needs change as she ages. While her family members are near, she still lives independently.
 

Tapping into Community Resources

The Western Way neighbors can tap a number of community resources that may help them age in place. These include:

• Home delivery of items from local pharmacies, grocery stores, and other retailers.
• Telehealth and in-home medical visits. Home care helps build teams who are available to meet physical and behavioral health care needs.
• In-home support, home health aides, and companion services from local agencies to help with personal care, activities of daily living, and social connections.
• Help with household chores, home repairs, and lawn maintenance through community groups.
• Assistance from their local agency on aging, including recommending resources that can help them manage their finances as well as resources to provide support as their mobility, vision, cognitive, and hearing abilities change.
• Long-term support services (LTSS) for those who qualify for Medicaid.

While the neighbors have lots of ways to accommodate their needs, they have less control over the built environment. There are no sidewalks in the neighborhood, so they have to walk on the street with car traffic, which can be less than ideal for their physical safety. While the community center provides enrichment programs, parking can be challenging, and shuttle service isn’t available yet.
 

Deciding Not to Age in Place but in a New Community

Elka thought she would spend the rest of her life in her Western Way home. Dementia and Alzheimer’s disease run in her family. She knew she’d need more intensive support and care if she developed either condition.

She sold her home and moved into a high-rise retirement community apartment in the city that offers different levels of medical care and support, including long-term care. If needed, she could transfer into the assisted living section or their memory care section for those who develop Alzheimer’s disease or dementia.
 

Where to Age Remains an Individual Decision

Like the Western Way neighbors demonstrated, where to age is a personal decision based on numerous factors. Some may want to age in place in their current home within their current community. Others may not want to or be able to age within their current community.

For those who want to age in place in their current communities, can their homes safely accommodate their changing physical, behavioral, and social needs as they age? Are the right community resources in place to help them stay connected and meet their daily needs of living within their financial constraints? Answers to those questions will help people determine whether aging in place within their current communities is possible.

In contrast, many of those who move to age-specific communities find their new homes have been designed to anticipate and accommodate their changing needs with ease. While they are aging in a new community, they might be farther from their existing friends and family.

It’s important to respect all people’s unique situations and support their decision to find or create the right location and environment for aging.