Lori Moss
08/16/2005
Indianapolis NORCs
What is “aging in place”?
Aging in place is a phenomenon in which individuals who moved into housing when they were younger have remained there and grown older.
What is NORC?
NORC is an acronym for “naturally occurring retirement community.” A NORC may be an apartment building, housing complex, or neighborhood not originally built for seniors where many individuals have aged in place.
What is a NORC program?
The overriding goal of NORC programming is to enhance the ability of seniors to continue living independently in the community through increased access to supportive services. NORC programming involves a collaborative partnership among a housing entity or neighborhood, health care & social service providers, government agencies, and funders to locate and provide a wide array of social and health care services at a housing site or within a geographic neighborhood. NORC programs are by nature proactive and take a holistic, preventive approach to the health and well being of seniors.
Why do varying organizations come together to create a NORC program?
Often times, neighborhoods and residence buildings find themselves dealing with similar issues or problems that are faced by the older members of their community, such as residents who may leave water running or stoves on, or who wander or lock themselves out of their homes. By joining together, NORC collaborative partners can develop and provide supportive services and programming that is more coordinated and comprehensive than if provided by organizations alone, on a one-by-one basis.
What is the role of each collaborating organization in contributing to the NORC program?
Each collaborator plays a critical role in shaping and implementing the program. Health care and social services partners will work with the neighborhood associations and aging residents to assess the needs and wishes, and help develop, coordinate and implement services and programs.
Examples of what collaborators may provide include the following:
Health care organizations, such as hospital systems, provide health care services like medication management; home visits and home care; onsite physician, psychiatrist, and nurse services; and health promotion activities such as blood pressure screening and monitoring, vision and hearing screenings, flu shots, and diabetes monitoring.
Social service organizations provide services such as counseling, case management, and referrals to other available services or agencies. They coordinate educational and recreational activities such as exercise classes, lectures, trips, and support groups, and manage volunteer and ancillary services such as friendly visiting, transportation, shopping, adult day care and housekeeping NORC residents, both young and old, serve as volunteers.
What is the role of the Albert & Sara Reuben ElderSource Program, the Jewish Community Relations Council (JCRC), and the Jewish Federation of Greater Indianapolis (JFGI)?
ElderSource: AoA contract and communication; Hire and oversee NORC staff that will coordinate implementation of programs and services; Coordinate communication and meetings among neighborhood associations, residents, and advisory committee members; Steering Committee member.
JCRC: Conduct advocacy to secure initial and potential future supplementary funding streams from the government; Coordinate public announcements/meetings, and communication among neighborhood associations, residents, and advisory committee members; Steering Committee member.
JFGI: Financial oversight; Steering Committee member.
How do NORC supportive service programs differ from traditional health care and social services?
In most cases, traditional health care and social services function in reaction to an acute need, emergency, or impairment, and generally only provide episodic care. For example, a frail elderly woman who lives alone and has difficulty remaining independent might not come in contact with health care providers and social workers until she falls and is hospitalized with a hip fracture. A discharge plan calling for a Medicare-reimbursed home health aide, visiting nurse, and physical therapist would be put in place, but these services often end within weeks of the hospital stay. Few mechanisms exist to monitor her progress and changes in her condition, ensure continuity of care, and help her reintegrate into her community.
Now assume that a woman lives in a neighborhood or housing complex with a NORC program. She regularly attends an art class and decides that since she has been feeling a little dizzy lately, to have her blood pressure checked by the NORC nurse. The nurse finds her blood pressure to be high, and with the woman’s permission contacts her doctor to arrange for medication to stabilize it. With the medication plan in place, the woman no longer feels dizzy and a fall is averted. When the woman returns home, the NORC outreach worker visits the woman to discuss her needs once Medicare services end and arranges for a private-pay home health aide, Meals on Wheels and transportation to and from doctors’ appointments. The NORC nurse begins monitoring her medications and blood pressure to prevent another fall.
What are some distinctive characteristics of NORC supportive service programs?
· NORC programs provide a wide range of health care and social services that match the varied needs and interests of seniors, whether they are well and active, frail, or ill.
What are some examples of potential NORC services?
Adult Day Services
Casework and Assessment
Environmental modifications
Exercise and fitness programs
Health education and wellness programs
Home health care
Homemakers
In-home assistance
Intergenerational programs
Mental health therapy
Nutritional programs
Personal finance programs
Project evaluation and dissemination
Project coordination and planning
Resource and referral programs
Transportation services
Volunteer development and coordination
Who pays for NORC program services?
NORC programs are public-private partnerships funded jointly by governmental agencies, philanthropies, and housing corporations. Health care and social service providers make in-kind contributions, offering un-reimbursable services.
Does Medicare or Medicaid cover any of the costs of NORC program services?
No.
Do NORC programs duplicate existing services?
Rarely, if ever. NORC programs either provide services that do not exist, relocate inaccessible services to the housing site, or help seniors apply for and/or put in place and advocate for available services.