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Support services allow older residents to age at home

This article first appeared in the St. Louis Beacon, Oct. 24, 2011 - At age 85, Bess Garland believes that lots of varied activities are the key to maintaining a healthy body and a keen mind.

"I need to be active and I need to have my mind alert," she says. "Otherwise, I get extremely bored."

She has no space to fit boredom into her life these days. She's too busy meeting and interacting with people through fitness classes, lectures, concerts, an occasional "coffee concert" by a St. Louis Symphony violinist, shopping at Soulard, visiting museums and wineries and -- she hasn't tried this yet -- dancing with a pro.

Such events are offered to Garland because she lives within what's known as a naturally occurring retirement community or NORC for short. It's a physical space in which seniors 65 and older are given access to a range of services and activities that ultimately keep them fit enough to age gracefully in their homes, as one observer puts it.

She came to the United States from Canada when she was in her 40s after her late husband, a pharmacist and choir director, took a job here. His death in 1998 left a void in her life, filled at first by children and grandchildren, she says. But NORC has shown her that interacting with peers can be equally uplifting.

In addition to the social and health activities, Garland can count on volunteers, some of them other NORC members, to help her with a range of minor chores around the house. These might include installing a grab bar to prevent falls in the bathroom or providing a reacher to retrieve an item from a kitchen cabinet or even help with using Facebook and other social media so she can interact in new ways with family and friends.

Aging in place

The St. Louis NORC, located in the Jewish Federation of St. Louis complex near Schuetz and Lindbergh, was one of a handful of similar programs set up across the nation in 2002 through grants from the Administration on Aging. The local program became a public-private collaboration between the Jewish Federation of St. Louis and Washington University's Center for Aging. It initially served residents over age 65 in a one-square mile area bounded roughly by North Lindbergh on the east, Olive on the south, Schuetz on the north and Barre Haven and Willow Brook drives on the west. The boundaries have since expanded another two miles, stretching westward to Craig Road and allowing NORC to serve about 1,600 people over 65.

At the start, Washington University's research in the one-square-mile area showed needs for fitness activities, transportation, minor home repairs and, most of all, a sense of community, says Karen Berry Elbert, NORC's manager.

"People didn't know who lived next door or down the hall or in the next building," she says. "It was a very fragmented community, so we knew our first priority would have to be re-creating a sense of community. We set out to help people connect with their neighbors."

These connections are important for the well-being of seniors, she says.

"One of the cornerstones of what we do is the socialization piece. Keeping people mentally happy, socially engaged are things that keep their physical health intact. We're touching people's lives and helping them live longer."

Elbert says the program and its many activities speak to the desire of seniors to stay in their homes as long as they can, allowing them to "maintain their independence and live a dignified, high quality of life."

Based on data from nearly 1,200 of NORC's 1,600 members, Elbert says 123 are between the ages of 65 and 69; 443 are between 70 to 79; 468 are between 80 and 89; 117 are between 90 to 99, and four are 100 or older.

NORC is also about seniors providing services to the larger community, says Garland, the NORC member. She mentions a local Jewish group's drive to provide back-to-school supplies to needy children. A NORC member's granddaughter, who chaired the Back to School Store project, noticed that children under school age would leave the event with nothing. The granddaughter came up with the idea of NORC participants making 200 dolls to hand out to the youngsters. Garland was part of the knitting group that made the dolls.

"The siblings were very sad because they were not in school and didn't walk away with clothing and backpacks," Garland recalls. "Our knitting group got together to make the dolls. I was glad to do that because NORC isn't just about receiving but giving to others."

She also recalls little moments when others have stepped in to help and brighten her own life. Some of her family memories are captured on old home movies that had become grainy and difficult to watch. A computer savvy NORC member not only "cleaned up" the movies but "put some music in the background."

She says, "It made me cry because of the memories and the pleasure I got from being able to watch these movies about anniversaries and birthdays again."

Less expensive alternative to nursing homes

NORC, and groups like it, may become increasingly important to accommodate the needs and desires of an aging U.S. population. Roughly 40 million Americans are 65 and older, representing more than 13 percent of the total population. That number is expected to double in three decades. Ordinarily, that would mean more spending on health care and nursing homes, but Berry says some of that cost could be offset through programs like NORC.

A semi-private room in a nursing home costs about $47,000 a year, she notes. The annual cost of serving the 1,600 seniors in NORC is $395 a participant. A NORC membership costs only $30 because it is subsidized through donations. Elbert isn't suggesting that NORC prevents health and nursing home care for the elderly, but that exercise and social programs by NORC tend to help people live longer in their homes and reduce the need for nursing home care. The nursing home placement rates of St. Louis NORC members is 2 percent, compared to a state average of 4.8 percent and a national average of 4.5 percent. Elbert says the numbers demonstrate the value of allowing seniors to "age in place."

She also views NORC's health-focused activities as a way of helping reduce or avoiding some of the costs associated with falls, heart disease and stroke, common among the elderly. In addition, she says the program makes seniors more aware of community resources and services that can help them, promotes volunteering among seniors, and gives them positive perceptions about health, aging and living in a community among other older adults.

While acknowledging that physical services, such as sending a meal on wheels, are obviously important to people who cannot get out, she argues that "socialization makes a difference because it helps people age with grace and dignity."

She says she leaves work daily feeling good about the services the group provides.

"I know we are helping people live their dream of not having to move out of their homes. I think most of them would like to die where they are."

Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.

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