housing + services: overview » housing + services models
Among older adults who choose to receive services in their homes, some can afford to hire caregivers to provide individualized in-home support that can range from companionship and light hospitality to more intensive services and medical care. However, by offering communal services in or near developments where large numbers of older adults already live, providers may be able to lower per-person costs and more affordably serve the community.

While less efficient than services provided in supportive housing, these "economies of scale" may be achieved in a variety of settings. Residential models that present a natural venue for delivering services important for older adults include:

Federally subsidized rental housing - Estimates indicate that older adults occupy more than half of all federally subsidized private rental units. In order to provide older residents with essential services, roughly 3,700 subsidized properties employed service coordinators in 2007. For slightly fewer than half, funding for that position was provided by the U.S. Department of Housing and Urban Development through a variety of grant programs. The remainder of the subsidized properties funded the position through their operating budgets and excess revenues. [2]

Naturally occurring retirement communities - Naturally occurring retirement communities, or NORCs, are housing developments or neighborhoods in which older adults make up a large share of the residents. In general, NORCs were not initially developed to serve an older population, but as residents have aged in place or other older adults have moved in, a "community" has developed. NORCs can include publicly-subsidized housing, market-rate rental communities, and owner-occupied developments.
The role of service coordinators

Many of the development types discussed below effectively use service coordinators to connect older adults in the development and surrounding community with appropriate services. Service coordinators work with residents to identify their needs, line up providers to meet those needs, and build awareness of available supports and activities. In some cases, public programs such as Area Agencies on Aging make service coordinators available; in others, building management employs service coordinators directly. [1]

With their concentration of older adults, NORCs present a natural venue for the efficient delivery of services. In some communities, residents and property managers collaborate with nearby service providers to develop programs that address the health-related or service needs of aging residents. [3] Other communities may bring in service coordinators to arrange care (see sidebar).

Dorado Senior Apartments, Buena Park CA -- courtesy of Meta Housing
Cohousing - Cohousing is a form of residential development that fosters community interaction and active "neighboring" through collaborative ownership and management of the community. Individual residences may be clustered around shared facilities, creating an ideal site for delivery of jointly-purchased or managed services. Additionally, suites in a common house can be offered to individuals willing to provide on-site services for older residents. [4] Learn more about cohousing.

Co-locating housing and services - The co-location of housing and services allows residential developments that lack the required staff expertise or resources to provide social services on-site or close by. Service providers may choose to locate near certain residential developments because they recognize a demand for their services; co-location may also occur through purposeful outreach by residents or property managers. Services often co-located with housing are meals programs and health and wellness centers. [5]

Villages - The "village" approach to coordinating housing and the delivery of social services incorporates attributes of each of these models. In an increasing number of communities across the U.S., village members pay an annual fee to gain access to services that allow them to remain in their homes and communities as they age. Small staffs and volunteers coordinate the services, although members oversee management of the village organization.

An example of this model is Beacon Hill Village, which was founded in 2001 and provides services for members age 50+ in several Boston neighborhoods. Participating households may arrange for concierge-style assistance, health and wellness services, and a host of cultural and social programs.

Click here to view a list of Villages, hosted on the Beacon Hill Village website.

Learn more about the challenges and solutions associated with coordinating housing and service delivery

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[1] Developing Appropriate Rental Housing for Low-Income Older Persons: A Survey of Section 202 and LIHTC Property Managers. 2002. By Andrew Kochera. Washington, DC: AARP Public Policy Institute.
[2] Direct communication with Judy Chavis, executive director, American Association of Service Coordinators, November 20, 2009. More on grant funding for service coordinators in subsidized housing is available on HUD's "Service Coordinator Program" page.
[3] Inventory of Affordable Housing Plus Services Strategies [PDF] 2006. Washington, DC: American Association of Homes & Services for the Aging.
[4] Senior Cohousing: A Community Approach to Independent Living - the Handbook. 2005. By Charles Durrett. Berkeley, CA: Habitat Press.
[5] Inventory of Affordable Housing Plus Services Strategies [PDF] 2006.

The views expressed herein are for information, debate and discussion, and do not necessarily represent official policies of AARP.