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Published in: BMC Geriatrics 1/2022

Open Access 01-12-2022 | Research

Identification and engagement of naturally occurring retirement communities to support healthy aging in Canada: A set of methods for replication

Authors: Vincent G. DePaul, Simone Parniak, Paul Nguyen, Carri Hand, Lori Letts, Colleen McGrath, Julie Richardson, Debbie Rudman, Imaan Bayoumi, Helen Cooper, Joan Tranmer, Catherine Donnelly

Published in: BMC Geriatrics | Issue 1/2022

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Abstract

Background

Naturally occurring retirement communities (NORCs), unplanned communities with a high proportion of older adult residents, offer a model to support older adults to age well in place. The aim of this paper is to provide a comprehensive description of the methods used to identify and engage NORCs appropriate for the development of supportive service programming in Canada.

Methods

Three steps were used to identify and select NORCs in which to develop supportive service programming including: 1) identification of potential NORCs using Canadian Census Dissemination Areas, the Ontario Marginalization Index and Google Maps, 2) engagement of property owner/manager to determine the availability of common space for communal programming and willingness of the owner to support programming and, 3) engagement of older adult residents within the NORC to co-design programming.

Results

Four cities in the south-east, south-central, and south-west of Ontario, Canada were identified to develop NORCs with supportive service programming. Using the methods described, six NORCs were identified, landlords and older adult residents were engaged, and programs initiated between April 2018 and March 2019. The sites included two private high-rise apartments, a city-owned low-rise subsidized apartment complex, two multi-building private high-rise complexes and a mobile home community. An average of 35 (min 20, max 78) older adult members were engaged in an average of 20.5 unique activity sessions at each site per month. On average, social (54%) and physical activities (30%) were more common than nutritional (10%) and knowledge-sharing (8%).

Conclusions

The increased prevalence of unplanned, geographically-bound NORCs creates an opportunity for governments, social and health service providers and policy makers to support healthy aging in their communities. Our experience with the creation of six new NORCs with supportive service programming provides a tested set of methods that can be applied in other communities.
Literature
4.
go back to reference Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B. Loneliness and social isolation as risk factors for coronary heart disease and stroke: Systematic review and meta-analysis of longitudinal observational studies. Heart. 2016;102(13):1009–16.CrossRef Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B. Loneliness and social isolation as risk factors for coronary heart disease and stroke: Systematic review and meta-analysis of longitudinal observational studies. Heart. 2016;102(13):1009–16.CrossRef
5.
go back to reference Coughlin SS. Social determinants of breast cancer risk, stage, and survival. Breast Cancer Res Treat. 2019;177(3):537–48.CrossRef Coughlin SS. Social determinants of breast cancer risk, stage, and survival. Breast Cancer Res Treat. 2019;177(3):537–48.CrossRef
6.
go back to reference Hajek A, Riedel-Heller SG, König HH. Perceived social isolation and cognitive functioning. Longitudinal findings based on the German Ageing Survey. Int J Geriatr Psychiatry. 2019;35(3):276–81.CrossRef Hajek A, Riedel-Heller SG, König HH. Perceived social isolation and cognitive functioning. Longitudinal findings based on the German Ageing Survey. Int J Geriatr Psychiatry. 2019;35(3):276–81.CrossRef
7.
go back to reference Yang R, et al. Loneliness as a mediator of the impact of social isolation on cognitive functioning of Chinese older adults. Age Ageing. 2020;00:1–6. Yang R, et al. Loneliness as a mediator of the impact of social isolation on cognitive functioning of Chinese older adults. Age Ageing. 2020;00:1–6.
8.
go back to reference Domènech-Abella J, Mundó J, Haro JM, Rubio-Valera M. Anxiety, depression, loneliness and social network in the elderly: Longitudinal associations from The Irish Longitudinal Study on Ageing (TILDA). J Affect Disord. 2019;246:82–8.CrossRef Domènech-Abella J, Mundó J, Haro JM, Rubio-Valera M. Anxiety, depression, loneliness and social network in the elderly: Longitudinal associations from The Irish Longitudinal Study on Ageing (TILDA). J Affect Disord. 2019;246:82–8.CrossRef
9.
go back to reference Santini ZI, et al. Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis. Lancet Public Heal. 2020;5(1):e62–70.CrossRef Santini ZI, et al. Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis. Lancet Public Heal. 2020;5(1):e62–70.CrossRef
10.
go back to reference Everard KM, Lach HW, Fisher EB, Baum MC. Relationship of activity and social support to the functional health of older adults. J Gerontol B Psychol Sci Soc Sci. 2000;55(4):208–12. Everard KM, Lach HW, Fisher EB, Baum MC. Relationship of activity and social support to the functional health of older adults. J Gerontol B Psychol Sci Soc Sci. 2000;55(4):208–12.
11.
go back to reference Sheean P, Farrar IC, Sulo S, Partridge J, Schiffer L, Fitzgibbon M. Nutrition risk among an ethnically diverse sample of community-dwelling older adults. Public Health Nutr. 2019;22(5):894–902.CrossRef Sheean P, Farrar IC, Sulo S, Partridge J, Schiffer L, Fitzgibbon M. Nutrition risk among an ethnically diverse sample of community-dwelling older adults. Public Health Nutr. 2019;22(5):894–902.CrossRef
12.
go back to reference Boulos C, Salameh P, Barberger-Gateau P. Social isolation and risk for malnutrition among older people. Geriatr Gerontol Int. 2017;17(2):286–94.CrossRef Boulos C, Salameh P, Barberger-Gateau P. Social isolation and risk for malnutrition among older people. Geriatr Gerontol Int. 2017;17(2):286–94.CrossRef
13.
go back to reference Arvanitakis M, Vandewoude M, Perkisas S, Van Gossum A. Undernutrition in community dwelling elderly. ESPEN J. 2013;8(5):e213–5. Arvanitakis M, Vandewoude M, Perkisas S, Van Gossum A. Undernutrition in community dwelling elderly. ESPEN J. 2013;8(5):e213–5.
14.
go back to reference Taube E, Kristensson J, Sandberg M, Midlöv P, Jakobsson U. Loneliness and health care consumption among older people. Scand J Caring Sci. 2015;29(3):435–43.CrossRef Taube E, Kristensson J, Sandberg M, Midlöv P, Jakobsson U. Loneliness and health care consumption among older people. Scand J Caring Sci. 2015;29(3):435–43.CrossRef
15.
go back to reference Newall N, McArthur J, Menec VH. A Longitudinal Examination of Social Participation, Loneliness, and Use of Physician and Hospital Services. J Aging Health. 2015;27(3):500–18.CrossRef Newall N, McArthur J, Menec VH. A Longitudinal Examination of Social Participation, Loneliness, and Use of Physician and Hospital Services. J Aging Health. 2015;27(3):500–18.CrossRef
16.
go back to reference Hanratty B, Stow D, Moore DC, Valtorta NK, Matthews F. Loneliness as a risk factor for care home admission in the english longitudinal study of ageing. Age Ageing. 2018;47(6):896–900.CrossRef Hanratty B, Stow D, Moore DC, Valtorta NK, Matthews F. Loneliness as a risk factor for care home admission in the english longitudinal study of ageing. Age Ageing. 2018;47(6):896–900.CrossRef
17.
go back to reference Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review. Perspect Psychol Sci. 2015;10(2):227–37.CrossRef Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review. Perspect Psychol Sci. 2015;10(2):227–37.CrossRef
18.
go back to reference Hunt ME, Gunter-Hunt G. Naturally occurring retirement communities. J Hous Elderly. 1986;3(3–4):3–22.CrossRef Hunt ME, Gunter-Hunt G. Naturally occurring retirement communities. J Hous Elderly. 1986;3(3–4):3–22.CrossRef
19.
go back to reference Bronstein L, Kenaley B. Learning from vertical NORCS: Challenges and recommendations for horizontal NORCS. J Hous Elderly. 2010;24(3):237–48.CrossRef Bronstein L, Kenaley B. Learning from vertical NORCS: Challenges and recommendations for horizontal NORCS. J Hous Elderly. 2010;24(3):237–48.CrossRef
20.
go back to reference Greenfield EA, Mauldin RL. Participation in community activities through Naturally Occurring Retirement Community (NORC) Supportive Service Programs. Ageing Soc. 2017;37(10):1987–2011.CrossRef Greenfield EA, Mauldin RL. Participation in community activities through Naturally Occurring Retirement Community (NORC) Supportive Service Programs. Ageing Soc. 2017;37(10):1987–2011.CrossRef
21.
go back to reference Kloseck M, Crilly RG, Gutman GM. Naturally occurring retirement communities: Untapped resources to enable optimal aging at home. J Hous Elder. 2010;24(3):392–412.CrossRef Kloseck M, Crilly RG, Gutman GM. Naturally occurring retirement communities: Untapped resources to enable optimal aging at home. J Hous Elder. 2010;24(3):392–412.CrossRef
22.
go back to reference Bedney BJ, Goldberg RB, Josephson K. Aging in place in naturally occurring retirement communities: Transforming aging through supportive service programs. J Hous Elderly. 2010;24(3):304–21.CrossRef Bedney BJ, Goldberg RB, Josephson K. Aging in place in naturally occurring retirement communities: Transforming aging through supportive service programs. J Hous Elderly. 2010;24(3):304–21.CrossRef
23.
go back to reference Altman A. The New York NORC-Supportive Service Program. J Jew Communal Serv. 2006;Spring(81):195–200. Altman A. The New York NORC-Supportive Service Program. J Jew Communal Serv. 2006;Spring(81):195–200.
24.
go back to reference Elbert KB, Neufeld PS. Indicators of a successful naturally occurring retirement community: A case study. J Hous Elderly. 2010;24(3):322–34.CrossRef Elbert KB, Neufeld PS. Indicators of a successful naturally occurring retirement community: A case study. J Hous Elderly. 2010;24(3):322–34.CrossRef
25.
go back to reference Ivery JM, Akstein-Kahan D, Murphy KC. NORC Supportive Services Model Implementation and Community Capacity. J Gerontol Soc Work. 2010;53(1):21–42.CrossRef Ivery JM, Akstein-Kahan D, Murphy KC. NORC Supportive Services Model Implementation and Community Capacity. J Gerontol Soc Work. 2010;53(1):21–42.CrossRef
27.
go back to reference Radin BA, Boase JP. Federalism, political structure, and public policy in the United States and Canada. J Comp Policy Anal Res Pract. 2000;2(1):65–89. Radin BA, Boase JP. Federalism, political structure, and public policy in the United States and Canada. J Comp Policy Anal Res Pract. 2000;2(1):65–89.
28.
go back to reference Huguet N, Kaplan MS, Feeny D. Socioeconomic status and health-related quality of life among elderly people: Results from the Joint Canada/United States Survey of Health. Soc Sci Med. 2008;66(4):803–10.CrossRef Huguet N, Kaplan MS, Feeny D. Socioeconomic status and health-related quality of life among elderly people: Results from the Joint Canada/United States Survey of Health. Soc Sci Med. 2008;66(4):803–10.CrossRef
29.
go back to reference Blumberg MT, Jones P, Nesbitt M. Community approaches to meet residents’ needs in an affordable public housing community. J Hous Elderly. 2010;24(3):413–29.CrossRef Blumberg MT, Jones P, Nesbitt M. Community approaches to meet residents’ needs in an affordable public housing community. J Hous Elderly. 2010;24(3):413–29.CrossRef
30.
go back to reference Bookman A. Innovative models of aging in place: Transforming our communities for an aging population. Community, Work Fam. 2008;11(4):419–38.CrossRef Bookman A. Innovative models of aging in place: Transforming our communities for an aging population. Community, Work Fam. 2008;11(4):419–38.CrossRef
31.
go back to reference Kyriacou C, Vladeck F. A new model of care collaboration for community-dwelling elders: findings and lessons learned from the norc-health care linkage evaluation. Int J Integr Care 2011;11(2). Kyriacou C, Vladeck F. A new model of care collaboration for community-dwelling elders: findings and lessons learned from the norc-health care linkage evaluation. Int J Integr Care 2011;11(2).
32.
go back to reference Maclaren C, Landsberg G, Schwartz H. History, accomplishments, issues and prospects of supportive service programs in naturally occurring retirement communities in new york state: Lessons learned. Hous Elder Policy Pract Issue. 2013;4372:127–44. Maclaren C, Landsberg G, Schwartz H. History, accomplishments, issues and prospects of supportive service programs in naturally occurring retirement communities in new york state: Lessons learned. Hous Elder Policy Pract Issue. 2013;4372:127–44.
33.
go back to reference Vladeck F. A Good Place to Grow Old: New York ’ s Model for NORC Supportive Service Programs. New York: 2004. Vladeck F. A Good Place to Grow Old: New York ’ s Model for NORC Supportive Service Programs. New York: 2004.
34.
go back to reference Greenfield EA, Frantz ME. Sustainability Processes among Naturally Occurring Retirement Community Supportive Service Programs. J Community Pract. 2016;24(1):38–55.CrossRef Greenfield EA, Frantz ME. Sustainability Processes among Naturally Occurring Retirement Community Supportive Service Programs. J Community Pract. 2016;24(1):38–55.CrossRef
35.
go back to reference Greenfield EA. The longevity of community aging initiatives: A framework for describing norc programs’ sustainability goals and strategies. J Hous Elderly. 2013;27(1–2):120–45.CrossRef Greenfield EA. The longevity of community aging initiatives: A framework for describing norc programs’ sustainability goals and strategies. J Hous Elderly. 2013;27(1–2):120–45.CrossRef
36.
go back to reference Anetzberger GJ. Community options of greater Cleveland, Ohio: Preliminary evaluation of a naturally occurring retirement community program. Clin Gerontol. 2010;33(1):1–15.CrossRef Anetzberger GJ. Community options of greater Cleveland, Ohio: Preliminary evaluation of a naturally occurring retirement community program. Clin Gerontol. 2010;33(1):1–15.CrossRef
37.
go back to reference Cohen-Mansfield J, Dakheel-Ali M, Frank JK. The impact of a naturally occurring retirement communities service program in Maryland, USA. Health Promot Int. 2010;25(2):210–20.CrossRef Cohen-Mansfield J, Dakheel-Ali M, Frank JK. The impact of a naturally occurring retirement communities service program in Maryland, USA. Health Promot Int. 2010;25(2):210–20.CrossRef
38.
go back to reference Greenfield EA, Fedor JP. Characterizing Older Adults’ Involvement in Naturally Occurring Retirement Community (NORC) Supportive Service Programs. J Gerontol Soc Work. 2015;58(5):449–68.CrossRef Greenfield EA, Fedor JP. Characterizing Older Adults’ Involvement in Naturally Occurring Retirement Community (NORC) Supportive Service Programs. J Gerontol Soc Work. 2015;58(5):449–68.CrossRef
39.
go back to reference Ivery JM, Akstein-Kahan D. The naturally occurring retirement community (NORC) initiative in Georgia: Developing and managing collaborative partnerships to support older adults. Adm Soc Work. 2010;34(4):329–43.CrossRef Ivery JM, Akstein-Kahan D. The naturally occurring retirement community (NORC) initiative in Georgia: Developing and managing collaborative partnerships to support older adults. Adm Soc Work. 2010;34(4):329–43.CrossRef
40.
go back to reference Enguidanos S, Pynoos J, Denton A, Alexman S, Diepenbrock L. Comparison of barriers and facilitators in developing NORC programs: A tale of two communities. J Hous Elderly. 2010;24(3):291–303.CrossRef Enguidanos S, Pynoos J, Denton A, Alexman S, Diepenbrock L. Comparison of barriers and facilitators in developing NORC programs: A tale of two communities. J Hous Elderly. 2010;24(3):291–303.CrossRef
41.
go back to reference Rivera-Hernandez M, Yamashita T, Kinney JM. Identifying naturally occurring retirement communities: a spatial analysis. J Gerontol B Psychol Sci Soc Sci. 2015;70(4):619–27. Rivera-Hernandez M, Yamashita T, Kinney JM. Identifying naturally occurring retirement communities: a spatial analysis. J Gerontol B Psychol Sci Soc Sci. 2015;70(4):619–27.
45.
go back to reference Donnelly C, Mahoney J, Hay M, Parniak S, Goes S, DePaul V. Oasis Senior Supportive Living Program : A model of active aging. OT Now. 2019;21(5):22–4. Donnelly C, Mahoney J, Hay M, Parniak S, Goes S, DePaul V. Oasis Senior Supportive Living Program : A model of active aging. OT Now. 2019;21(5):22–4.
46.
go back to reference World Health Organization. WHO | World report on ageing and health. World Health Organization; 2016. World Health Organization. WHO | World report on ageing and health. World Health Organization; 2016.
47.
go back to reference Matheson FI, van Ingen T. Ontario Marginalization Index: User guide. Toronto: 2016. Matheson FI, van Ingen T. Ontario Marginalization Index: User guide. Toronto: 2016.
48.
go back to reference Matheson F, Dunn J, Smith K, Moineddin R, Glazier R. Development of the Canadian Marginalization Index: a new tool for the study of inequality. Can J Public Health. 2012;103(8 Suppl 2):S12–6.CrossRef Matheson F, Dunn J, Smith K, Moineddin R, Glazier R. Development of the Canadian Marginalization Index: a new tool for the study of inequality. Can J Public Health. 2012;103(8 Suppl 2):S12–6.CrossRef
51.
go back to reference Masotti PJ, Fick R, Johnson-Masotti A, MacLeod S. Healthy naturally occurring retirement communities: A low-cost approach to facilitating healthy aging. Am J Public Health. 2006;96(7):1164–70.CrossRef Masotti PJ, Fick R, Johnson-Masotti A, MacLeod S. Healthy naturally occurring retirement communities: A low-cost approach to facilitating healthy aging. Am J Public Health. 2006;96(7):1164–70.CrossRef
52.
go back to reference Greenfield EA, Scharlach AE, Lehning AJ, Davitt JK, Graham CL. A tale of two community initiatives for promoting aging in place: Similarities and differences in the national implementation of NORC programs and villages. Gerontologist. 2013;53(6):928–38.CrossRef Greenfield EA, Scharlach AE, Lehning AJ, Davitt JK, Graham CL. A tale of two community initiatives for promoting aging in place: Similarities and differences in the national implementation of NORC programs and villages. Gerontologist. 2013;53(6):928–38.CrossRef
53.
go back to reference Bennett PH. Exploration and assessment of the NORc transformation process. J Hous Elderly. 2010;24(3):373–91.CrossRef Bennett PH. Exploration and assessment of the NORc transformation process. J Hous Elderly. 2010;24(3):373–91.CrossRef
54.
go back to reference Greenfield EA, Scharlach A, Lehning AJ, Davitt JK. A conceptual framework for examining the promise of the NORC program and Village models to promote aging in place. J Aging Stud. 2012;26(3):273–84.CrossRef Greenfield EA, Scharlach A, Lehning AJ, Davitt JK. A conceptual framework for examining the promise of the NORC program and Village models to promote aging in place. J Aging Stud. 2012;26(3):273–84.CrossRef
55.
go back to reference Warburton J, Everingham JA, Cuthill M, Bartlett H. Achieving effective collaborations to help communities age well. Aust J Public Adm. 2008;67(4):470–82.CrossRef Warburton J, Everingham JA, Cuthill M, Bartlett H. Achieving effective collaborations to help communities age well. Aust J Public Adm. 2008;67(4):470–82.CrossRef
Metadata
Title
Identification and engagement of naturally occurring retirement communities to support healthy aging in Canada: A set of methods for replication
Authors
Vincent G. DePaul
Simone Parniak
Paul Nguyen
Carri Hand
Lori Letts
Colleen McGrath
Julie Richardson
Debbie Rudman
Imaan Bayoumi
Helen Cooper
Joan Tranmer
Catherine Donnelly
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2022
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-022-03045-z

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