Rebalancing Institutional Care to Grassroots Aging in Place Models

Nearly 10 million Americans are in need of long term services and supports (LTSS), a number expected to increase to 15 million by 2020. The majority of adults will need some type of long term care and many lack any insurance protection against the cost of LTSS. In the US, there are approximately 55 established neighborhood “villages,” and 120 in various stages of development, that help seniors lead safe and healthy lives in their own homes by creating aging-friendly communities that work in conjunction with community services. Participants are referred to and given help with a variety of services, including groceries, transportation, geriatric care management, caregiver information and home care, as well as volunteers who help with a range of services. With moderate levels of support and formalized coordinated efforts that could help seniors avoid or delay nursing homes admission, these aging in place communities may well be the models of the future. Maintaining independence is important for seniors and overcoming the barriers of decreasing functioning capacity is critical to this goal. Programs that provide respite and other supplemental supports for seniors and their families are generally under-funded. Understanding the components that make successful models may help rebalance institutional care with home based settings. Since diversion from institutional care will decrease the impact on state budgets, policymakers should take note how these village models operate and support policies that strengthen these community-based supports.