Lillian Miceli owns her home, has no plans to leave, and looks forward to many more good years. But, at 89, with knees "that are shot," she needs a lot of help to remain independent. Fortunately, a program in the western suburbs of St. Louis sends volunteer students from Washington University in St. Louis to tend her yard. Pete Pozefsky, a Boeing engineer who lives in the area and volunteers for the program, stops by to help her solve a computer problem, then sticks around to move some heavy boxes. Other volunteers periodically assist with physically demanding chores, and staffers of this unique program provide social and community support services.
[Photo Gallery: Inside the St. Louis NORC.]
Miceli lives in a "naturally occurring retirement community," also known as a NORC. This one, in St. Louis, includes 600 members and offers a range of services to aging seniors who choose to remain in their homes. Services include home repair, social activities, volunteer support, and discounts at local merchants. The St. Louis program charges modest dues but gets most of its funding from grants and relies extensively on volunteers.
Overwhelmingly, people who are getting older want to stay in their homes, and their numbers are soaring. Nearly 14 percent of the U.S. population, or 40 million Americans, will be at least 65 years old next year. By 2040, there will be twice as many, and 28 million of them will be at least 80 years old, according to Census Bureau projections. NORCs, which sprouted up about 20 years ago, have multiplied to approximately 300 throughout the country today. They are located in areas with heavy concentrations of seniors and are "natural" in the sense that they are not brick-and-mortar retirement complexes that seniors move into.
These new communities have become more popular as they have become easier to arrange, enabled by online communications tools that help connect members to support services and merchants who participate in these neighborhood-centric programs. They're designed to be small and responsive to member needs, and members may live in high-rises, suburban apartment complexes, or single-family homes. Programs exist in densely populated cities, suburbs, and even rural areas. Some have high-income members who pay hefty fees for self-supporting programs that emphasize discounted merchant services, and others, like the one in St. Louis, are centered in more modest neighborhoods. And still other NORCs receive government support and provide extensive social services, which is the case in a network of more than 50 such communities in metropolitan New York.
Lois Perryman and Sherrell Pflueger are seated in the basement of Perryman's home in front of her aged PC (running Windows 95), trying to figure out how to use a spreadsheet program. Perryman, 67, is a member of the St. Louis program, as is Pflueger, 73, a retired consultant who spent much of her career working with defense contractors on computer projects. Today, Pflueger is providing volunteer support to Perryman, although she admits that her own computer skills could use some work and that she, too, will need more volunteer PC training.
Personal payoff. Perryman, who is not completely retired, uses the computer to track the social-work clients she still serves. Her most important client was her dad. Perryman moved in with her father, Sheldon Katz, and looked after him for eight years during a period of physical decline and dementia that preceded his death in 2006 at the age of 88. "It was a privilege to help my dad," says Perryman. "I had those last eight years to get close to him." To Karen Berry Elbert, who manages the St. Louis program, hearing about Perryman's close relationship with her father provides yet another reminder of why her job benefits go well beyond a paycheck. Berry Elbert has overseen the program since 2002 when it was one of about 45 NORCs in cities throughout the country that received federal funds under a pilot program fashioned by the United Jewish Communities. Nearly all of those programs, which are open to non-Jewish members, still exist and have developed various alternative funding sources. The St. Louis program has been particularly successful in drawing members.
Barry Rosenberg, executive vice president of the Jewish Federation of St. Louis, says that the federation wanted to provide more elderly services. "There is a very profound commitment to aged services within the Jewish tradition," he says, and services to seniors have been "a leading priority." The Jewish community is much older than the national average. A national UJC census in 2001 found that people ages 65 and up accounted for 19 percent of Jews.
The St. Louis program's expenses run about $300,000 a year, which breaks down to roughly $500 per member. Members pay a small portion of this—$30 per person or $45 per couple annually. Most funds are raised from public and private sources, including a $127,000 state grant this year. Expenses for residents are extremely modest compared with nursing homes, which can cost $75,000, and full-time home healthcare, nearing $100,000 a year. Berry Elbert and her four colleagues think that they're a real bargain. So does Jill Schupp, a Missouri state representative whose district includes the NORC: "I'm hopeful that we will be smart enough to recognize that, dollar for dollar, this is a great use of our taxpayers' money."
Sharing memories. Older community members may live quietly, but they have rich and emotional stories to share about their past lives. Frank Friedman, 90, was a P-38 fighter pilot in World War II. He has long kept physically fit and active by helping to put on an annual Broadway show in the area. Bess Fine, also 90, worked with him on the show, and the two have become very close. "Her patio faces my patio," Friedman says lightheartedly, but Fine is quick to add that this is as close as the relationship will get. "We find it better to not be married," she says, "and our children don't feel threatened" by estate squabbles that could emerge if they were married.
Two years ago, Fine had a serious heart attack. She credits the program for providing her with access to a chair yoga class that helped her relearn how to breathe. "I don't want my life to be spent attached to an oxygen tank," she says. "Through the NORC, I have a much higher quality of life," which includes frequent outings with other community members. "I don't know what we'd do without it," she says of the program. "At Frank's age and at my age, a lot of our friends are gone."
Friedman and Fine can often be found at the Mount Zion United Methodist Church, which donates the space for a chair yoga class. Before one recent class, attendees hugged one another like long-lost friends. Many of the 20 or so participants are frail; walkers, wheelchairs, and signs of other infirmities show why chairs must be used for the class. Members do some movements standing but generally stay seated for breathing and meditation exercises. As the class winds down, instructor Joyce Lawrence asks people what they are thankful for that day. Answers include their spouses and waking up that morning. Lillian Miceli says she is thankful for Nicky, her 11-year-old bichon.
A monthly blood-pressure screening is also available through a partner agency and is conducted by nurse Pam Allen. "This group is pretty healthy," she observes, "and I think that's because of the physical exercise they do." Allen is a home-care nurse with many elderly patients. "I see the other side, and they are not so healthy."
Aside from excursions to area museums, educational programs, and entertainment, many activities and services are home based. The St. Louis program, like most others throughout the country, has fixed geographic membership boundaries. It's in an unincorporated part of St. Louis County and includes a few streets in adjacent Creve Coeur, Mo.—a roughly circular area that fans out for 3 miles from a complex of St. Louis Jewish community buildings, where program activities are centered. Only people within this area can participate in community activities. The exclusion has led to some bruised feelings from those on the outside who would like to join. But by limiting the area, Berry Elbert explains, the program retains a local, neighborhood focus. It allows for a deeper understanding of area residents, enables organizers to build a network of local merchants offering discounted services (another common feature of NORCs), and makes it easy to develop resident councils within individual neighborhoods and housing complexes.
Listening. Jacki Newfield, the program's community outreach supervisor, says building relationships with community members and facilitating interaction between them are not an overnight process. Earning residents' trust requires frequent visits, responsiveness to their concerns, and lots of listening. Once these relationships are built, residents sometimes open up about very private and personal issues that they have been wary of sharing, even with close family members. At a recent resident council meeting, for example, Newfield encourages everyone to participate and have their say. After the meeting, in private, one woman breaks down and tells Newfield she is lost as to how to find more meaning in her life.
One of the program's older residents, 96-year-old Ida Seltzer, works hard to stay active by attending a knitting and crocheting circle and tooling around her housing complex in a motorized wheelchair that sports a metallic-red paint job. Still, she acknowledges that loneliness is a frequent companion at her age and that being in her own home surrounded by a lifetime of memories helps a lot. "Sometimes I get depressed and feel like giving up," she says, "but the NORC ... makes me feel more like a person and keeps me in touch with other people."
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