Bringing services to where seniors already live could be an alternative to long-term care, experts say

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As Canada grapples with a crisis in the long-term care sector, some experts say we're missing out on a hidden opportunity to provide seniors with alternative types of care.

Naturally occurring retirement communities, or NORCs, are geographic areas where adults 55 and older make up at least 40 per cent of the population, according to Catherine Donnelly, an associate professor and director of the Health Services and Policy Research Institute at Queen's University in Kingston, Ont.

NORCs are usually unplanned, she said, and many people don't even realize they exist. They can be neighbourhoods where young people grew old together because they never moved away, or apartment buildings that have attracted older residents because amenities are located nearby. 

And while some NORCs have access to services for older adults, that's not the case for all of them.

In rural New Brunswick, for example, it's difficult for seniors to grow old in some NORCs, said Catherine Bigonnesse, a postdoctoral fellow at the Université de Moncton's Research Centre on Aging. That's because seniors have to drive out of town to access the services they need, she said.

"They are dependent on helping each other," Bigonnesse said of the residents. "It's a challenging place to age in place."

Donnelly sees NORCS as an opportunity to tailor services to the people who live there. 

"These are only getting more frequent in Ontario and [are] really a great way to think about how we might reorganize and reconceptualize how we provide services and supports to older adults," she told The Current's Matt Galloway.

However, "for the most part in Canada, we do not capitalize on NORCs at all," she said.

Donnelly and her colleagues mapped out the number of NORCs in Ontario using Statistics Canada's data on dissemination areas, which are neighbourhoods of 400 to 700 people, she said.

In 2006, about nine per cent of dissemination areas in the province were considered NORCs, said Donnelly. But that number grew to 20 per cent in 2016, the most recent year census data was available.

Bigonnesse has studied other NORCs in B.C. and New Brunswick. However, they're not well-mapped outside Ontario, she said. 

Creating programs for seniors

Christine McMillan, 91, has worked in naturally occurring retirement communities for years, and says it's critical that seniors determine what services they need. 

That's why she created the Oasis Senior Supportive Living program in Kingston. It brings together seniors who are still able to live on their own, and builds communal ties through activities like dancing, exercising, and communal meals.

She came up with the idea several years ago while educating seniors living alone in apartment buildings about the dangers of elder abuse.

"What we heard was they felt very safe in the building, but the overwhelming loneliness just haunted me," McMillan said.

She said the seniors she met had no activities to go to outside the apartment, and didn't have anyone to spend time with. They dreaded the thought of going into long-term care, she added, but they also weren't eating properly.

"One night I thought, you know, there's no big deal about a retirement home. I mean, they have meals and they have programs and they live together and they get to know each other," said McMillan. "I thought, I wonder if you could do that in an apartment building."

The Oasis program has since been expanded to several communities in Ontario, including in Toronto. And McMillan said she doesn't plan to give up on helping elderly populations.

"Seniors are demanding something that's different," she said, "and I think this is one of the good alternatives to what we have right now."

Donnelly agrees. She conducts research on the success of the Oasis program and said it represents an opportunity for leveraging naturally occurring retirement communities in a different way.

"It's thinking about how we can bring services to older adults, to where they're already living," Donnelly said. 

"But most importantly, as Christine alluded to, it's [about] how ... we empower seniors to articulate what they want … so they can come together."

Written by Kirsten Fenn. Produced by Joana Draghici and Ben Jamieson. 

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