How can communities best help their elderly citizens to stay out of nursing homes if they don't need to be there? The federal government wants to know, and Pittsburgh is one of five cities where grant-funded pilot projects will be working on some answers.
The cities -- Philadelphia, Cleveland, Baltimore and St. Louis are the others -- all have substantial pockets of people who've remained in place as they aged. The experts calls these places "naturally occurring retirement communities," or NORCs.
NORCs are widely seen as preferable to institutions. They're less costly, and older people do better in familiar surroundings near family and friends.
But for people to remain as independent as possible while they age, they need access to a continuum of social and medical services. Finding out what's available and how to get it, however, can be so frustrating for the elderly and their families that nursing homes sometimes seem like a more viable alternative.
These problems loom even larger as the baby boom bubble nears retirement age. So the U.S. Department of Aging will be funding an array of small NORC projects aimed at eliminating the barriers to services.
The grants are for one year only, but U.S. Rep. Mike Doyle, D-Swissvale, has introduced legislation that would create a constant funding stream for NORC programs nationally.
Doyle will hold a news conference this morning at the Carlyle Arms NORC on Centre Avenue. He'll be sharing the podium with the two local grantees, the United Jewish Federation, which will receive $200,000 to design barrier-free "care teams," and the Homestead LIFE Center, which will receive $300,000 for a program in the public housing high-rise for senior citizens on Eighth Avenue.
Both agencies already administer programs supporting the elderly.
The United Jewish Federation project will create teams of workers from the Jewish Association on Aging, Jewish Family and Children's Service and the Jewish Community Center. Their task, said association on aging President Barbara Gottlieb, will be to hold monthly information meetings in the community, visit clients in their homes to assess their needs and run each agency's services through a single system.
"Say Mrs. Smith goes to the JCC for breakfast and the health club," Gottlieb said. "Maybe she could use hospice services for her husband through the JAA and counseling through JF&CS. We would streamline everything using one assessment tool, get everyone working together to serve her most efficiently, or get her services that she might not even know about."
In their first year, the care teams will target 60 clients in the city's 14th Ward who are already being served by those agencies, but planners are hoping for more money next year to reach more people.
The Homestead NORC project is designed to help people in subsidized housing keep their living spaces clean and avoid eviction.
"Public housing is not set up to help a population aging in place," said Ransome Towley, executive director of the Homestead LIFE Center.
"When older people have a problem maintaining cleanliness, their places tend to get infested and the landlords evict them. The only place left for them to go is a nursing home."
The NORC program will provide in-home housekeeping and help with chores. In addition, the organization opened a NORC center in the high-rise on Eighth Avenue that provides physicians, nurses, physical and occupational therapists, meals, recreation activities and transportation to and from appointments. It also has its own pharmacy that dispenses prescription drugs at no cost, financed by Medicare and medical assistance.
"NORCs offer the potential of achieving some efficiencies with public dollars," said Kari Benson, policy analyst with the U.S. Administration on Aging in Washington, D.C.
"Older adults don't want to move into nursing homes to get the assistance they need," she said. "This will help us find ways of using our resources more wisely."
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