Naturally Occurring Retirement Community Development and Research

Researchers have identified over 6,000 naturally occurring retirement communities (NORCs) in the United States, with the majority being located in suburban areas.

These communities are often characterized by high concentrations of older adults, with some NORCs having populations that are 50% or more made up of residents aged 65 and older.

NORCs are often found in areas with desirable amenities, such as good schools, parks, and shopping centers, making them attractive to older adults who want to age in place.

Studies have shown that NORCs can be effective in promoting social connections and community engagement among older adults, with some NORCs having high rates of volunteerism and civic participation among their residents.

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NORC is a type of community where seniors live together in a single building or campus, but unlike traditional retirement communities, they don't have to move in by a certain age or pay a large entrance fee.

These communities are naturally occurring because they evolve over time as older adults move into a neighborhood and start to build relationships with one another.

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NORC residents often live in the same building or neighborhood for many years, creating a sense of community and connection among them.

They typically have a mix of renters and homeowners, which can create a diverse and inclusive environment.

NORC residents often rely on each other for support and help, creating a strong sense of community and social connection.

They may also have access to shared resources and services, such as transportation, meals, and recreational activities.

Naturally occurring retirement communities, or NORCs, offer a unique approach to aging in place. They can be found in various forms, including classic NORCs, neighborhood-based NORCs, and rural NORCs.

Classic NORCs are often single age-integrated apartment buildings or housing complexes with multiple buildings under common management. They can also be an area where several apartment buildings are clustered together.

Neighborhood-based NORCs, on the other hand, are typically age-integrated neighborhoods of one- and two-family homes. These communities emerge naturally when people choose to age in place, there is an influx of older residents, or the majority of younger residents move out of the community.

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Rural NORCs, also known as Naturally Occurring Retirement Regions (NORRs), cover a large geographic area with low population density, typically comprising one- and two-family homes.

Here are the three main types of NORCs:

A NORC develops as residents move in and age in place over time, leading to evolving age demographics. This natural process can occur in a building, group of buildings, or residential area.

Younger residents moving out and older residents moving in are common factors that contribute to NORC development. This can significantly impact the age demographics of the area.

The age demographics of a NORC can change as residents move in and out, but it's not a sudden shift, rather a gradual process that occurs over time.

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NORCs, or Naturally Occurring Retirement Communities, come in different forms. A Classic NORC is a type of NORC that must have at least 40 percent of its units occupied by older adults, with a majority of those older adults being low or moderate income.

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There are three main types of NORCs: Classic NORC, Neighborhood NORC, and Rural NORC. Classic NORC is also known as a "housing-based" or "vertical" NORC. It can be a single age-integrated apartment building, a housing complex with multiple buildings under common management, or an area where a number of apartment buildings are clustered together.

A Neighborhood NORC, on the other hand, is a type of NORC that is typically an age-integrated neighborhood of one- and two-family homes. It is also known as a "horizontal" or "open" NORC.

Rural NORC, also known as a Naturally Occurring Retirement Region (NORR), covers a large geographic area in which the population density is low, typically comprising one- and two-family homes.

Here are the main types of NORCs:

Each type of NORC offers unique benefits and opportunities for older adults to age in place.

The researchers started by identifying a broad research question with a clear scope of inquiry, which guided their search for relevant studies. The question focused on how naturally occurring retirement communities (NORCs) support older adults to remain living at home in their communities.

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To develop this research question, the authors articulated three subquestions: What methods are used in the literature to identify NORCs? What mechanisms or resources are in place in NORCs and how are these provided? What outcomes are used to determine the benefits of NORCs?

A professional health sciences librarian conducted the scoping review search in July 2020, and a subsequent search was conducted by the authors in January 2022. They searched multiple databases, including CINAHL, Ovid MEDLINE, and Embase, using the search term "naturally occurring retirement communit*" and its expanders.

The NORC movement has its roots in New York, specifically in New York City where high-rise apartment buildings created conditions for early NORCs to evolve.

New York's first NORC started in 1986 using private funding. This marked the beginning of the movement in the state.

The state legislation in 1994 led to the creation of 10 NORC programs, expanding the reach of the movement.

New York City introduced its own NORC legislation in 1999, further solidifying the movement's presence in the state.

Today, New York funds 43 NORCs serving thousands of clients, a significant growth from the initial 10 programs created in 1994.

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Developing a clear research question is crucial to any study. In this case, the research question was kept broad but with a clearly articulated scope of inquiry.

The research question was developed to guide the search, focusing on how and in what ways Neighborhood Older Adult Resource Centers (NORCs) support older adults to remain living at home in their communities.

Three subquestions were articulated to help guide the data extraction, including what methods are used in the literature to identify NORCs, what mechanisms or resources are in place in NORCs and how they are provided, and what outcomes are used to determine the benefits of NORCs.

These subquestions will help ensure that the data extracted is comprehensive and relevant to the research question.

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To identify relevant studies for a scoping review, a comprehensive search is conducted using various databases. A professional health sciences librarian performed the initial search in July 2020, and a subsequent search was conducted by the authors in January 2022.

A single search term was used: "naturally occurring retirement communit*". This term was expanded to include equivalent subjects and related words in some databases. The search covered databases from their earliest data of coverage through January 2022.

The following databases were searched: CINAHL, Ovid MEDLINE, HealthSTAR, Embase, APA PsycINFO, Allied and Complementary Medicine Database, JBI Evidence-Based Practice Resources, REHABDATA, Sociofile, Education Source, Education Resources Information Center, Urban Planning, and the Cochrane Library.

In addition to database searching, the authors examined and cross-referenced three review papers [5-7] to handpick additional references that were not identified in the search.

Some databases were searched from their earliest data of coverage through January 2022. The databases searched included CINAHL, Ovid MEDLINE, HealthSTAR, Embase, APA PsycINFO, Allied and Complementary Medicine Database, JBI Evidence-Based Practice Resources, REHABDATA, Sociofile, Education Source, Education Resources Information Center, Urban Planning, and the Cochrane Library.

A PRISMA flow chart was used to guide the search process.

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Data Analysis was a crucial step in this study, and the authors took a rigorous approach to ensure accuracy and consistency.

They developed a data charting table to organize the variables, including author, date, location, study design, and NORC definition used.

Two authors independently extracted data from 8% of the articles to check for consistency, which is a great way to catch any potential errors.

Once they reached consensus, they proceeded with extracting data from the remaining articles.

The authors conducted a qualitative content analysis of the final 64 articles, guided by the framework developed by Greenfield et al.

This framework examines the potential of NORC programs to promote aging in place and identifies the different elements of NORCs as well as the outcomes at the individual, community, and organization levels.

Participating in NORC programs can lead to increased self-efficacy, with 9% of participants reporting improved self-efficacy.

These programs also foster a sense of community, with 11% of participants reporting a greater sense of community. This can be attributed to the development and participation in NORC programs.

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NORC-program participants reported increased social support and reduced isolation, with 16% of participants experiencing this benefit. This can be attributed to interactions with NORC-program staff, participation in service programs, and increased interactions with neighbors and friends.

Access to support and reduced unmet needs are also outcomes of NORC programs, with 22% of participants reporting this benefit. This is primarily due to the program's function of providing increased access to services and information, including referrals, screenings, and educational workshops.

Collective efficacy, or the belief in the ability of a group to work together, is also improved through NORC programs, with 3% of participants reporting increased collective efficacy.

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Longitudinal research exploring the impacts of NORCs and NORC-SSPs on older adult health and well-being is recommended.

Future research should also explore ways to improve the sustainability of NORC-SSPs.

NORC-SSPs have potential as an alternative model of supporting aging in place.

By studying NORC-SSPs, we can better understand how to support older adults in their communities and improve their quality of life.