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Press Room

Naturally Occurring Retirement Communities:

Expansion of the Aging in Place Concept in Hawai‘i

Ashley Yoshiko Muraoka

Master of Urban and Regional Planning

Department of Urban and Regional Planning

University of Hawai‘i, Mānoa

Spring 2010

Summary

Aging is a life long and active process, meaning we’re all on the same path. The trends of the aged are very important for our social well-being and economic future, as a state and a country. The strain on health care and social services will be exacerbated because of the increase in older adults who qualify for services and the growing need for long-term care. As defined by the Administration on Aging, older adults are persons aged 65 years and older. Our average life expectancy is ever increasing and is due to genetics, environment, ethnicity, and gender factors. The fastest growing elderly cohort is those above the age of 85. The number of such people is projected to triple between 2000 and 2050 (AOA, 2008). The United States and Hawai‘i have taken many steps towards addressing the dramatic increase in elderly. Several policies and programs have been enacted, at the national level, focusing on the aging population, Social Security Act of 1935, the Older American’s Act 1965 (OAA), Medicare, and Medicaid. Through the OAA, State Offices on Aging, and Area Agencies on Aging, many programs and services are funded.

In Hawai‘i, the Executive Office on Aging is charged with the responsibility of statewide planning on elder care issues. It delegates the funds to County Area Agencies on Aging and relegates responsibility to them for providing programs and services to the states older population. At the state level, Hawai‘i has been able to implement key programs that provide services to eligible elderly through the Kupuna Care Program (KC), the state’s Home and Community Based Services (HCBS). Services include: transportation, in-home services, legal services, outreach, information, referrals, case management, homemaker services, home health aides, housing assistance, residential repairs, ombudsman program, translation services, crime prevention, victim assistance, visiting and telephone reassurance efforts, home-delivered meals, training for family caregivers, and conferences. Many initiatives in Hawai‘i focus on the aging-in-place concept.

The Aging in Place model allows for older adults to make the necessary decisions for long-term care, based on their own needs and desires. There is a shift in orientation from type of care to place of care. Seniors are empowered and educated to make decision in regards to the “timing and intensity of health and personal care services delivered to them in their home” (Marek & Rantz, 2000). Care coordinators, who are trained professionals, conduct a comprehensive assessment to check their physical and cognitive capabilities, strengths, limitations, existing support, and needed supports (Marek & Rantz, 2000). Clients are monitored for quality assurance, where services are adjusted as the clients’ needs change. Instead of segregating elderly by building more retirement communities and nursing facilities in outland areas, Aging in Place models, such as Naturally Occurring Retirement Communities (NORCs), could be a community-based approach to tackling our current and future elder care and to promote the active participation of elders in the community.