What Have We Learned From 30 Years of 'Aging in Place'?

A new study on "naturally occurring retirement communities" shows that cities must adapt to and support the needs of elders for them to thrive.

Image AP Photo/John Raoux
A new study shows how elders can thrive in "naturally occurring retirement communities." (AP Photo/John Raoux)

Next year marks the 30th anniversary of New York City's first staffed Naturally Occurring Retirement Community (NORC) Supportive Service Program. This is an important milestone, as over the next 30 years these programs will inform how we care for and support aging populations.

A NORC is a community, neighborhood, or housing development that was originally designed for families but over time came to support older adults (aged 60 years or older). A NORC Supportive Service Program, on the other hand, is a partnership between a neighborhood and a housing development to help residents there age in place. Social workers, nurses, and other support staff help residents and caregivers as their needs change.

The two terms, NORCs and NORC SSPs, are often used interchangeably, but they aren't the same thing, according to a Gerontological Society of America report. As Baby Boomers age, identifying the communities where they live that could be considered NORCs—and implementing NORC SSPs to assist them—will be an increasing priority in New York and beyond.

But global climate change in particular may make identifying NORCs and establishing NORC SSPs in climactically sensitive areas a critical priority.

The report, which was released Monday, spells out the value of the NORC SSP model to communities:

The NORC-SSP model represented a paradigm shift in aging services in 1986. It brought together health care and social supports, recognizing that both were necessary as people age. Ahead of its time, the NORC-SSP model was an early example of a "place-based" program. It brought together service delivery and community-building efforts. Rather than just focusing on reacting to individuals in crisis—"one hip fracture at a time"—it recognized that the community itself plays an important role in how residents aged.

The model has seen its greatest gains in New York, in part because the city's high density allows for the kind of NORC that's easiest to support, at least on paper.

There are two kinds of NORCs, broadly speaking. Most of the NORCs in New York are "closed" or "vertical" communities marked by apartment buildings or clusters of buildings. The very first NORC SSP was established at Penn South Co-operative, a 2,800-unit housing development in Manhattan's Chelsea neighborhood, after residents there realized that most were seniors and most had no desire to leave.

"Open" or "horizontal" NORCs tend to occur in single-family or two-family housing developments. These are more often created through the out-migration of young people from the development.

Needless to say, retirement communities can naturally occur in all sorts of communities: urban and suburban, apartment and condo, single-family or dense development. Pledging funds to turn NORCs into successful NORC SSPs depends upon correctly identifying the naturally occurring retirement communities that will thrive with public–private support.

"Today in New York, $13 million in public financing and approximately 50% more in matching community support fund over 50 housing- and neighborhood-based NORC-SSPs in moderate- and low-income communities," the report reads.

NORC SSPs foster more than good health and safe aging: By providing roles for residents that change as their needs do, they contribute to an over-arching sense of place. Aging in place isn't just a matter of building housing types for families and retirees. It's about fostering supportive community structures that evolve with age.

And community is key in times of crisis. As the report observes, older residents died at much higher rates than younger residents in the 2002 heat wave in Chicago and the 2003 heat wave across much of Europe (but specifically Paris). Climate crises are only growing more common.

"In each of these [climate crises], the older adults were either not known to anyone in the community or were disconnected from anyone around them," the report reads. "Connectedness to other people (not just service providers) and the broader community is a determinant of well-being in old age."

About the Author