BACKGROUND
As Canada’s population ages there is a need to explore community-based solutions to support older adults. Naturally Occurring Retirement Communities (NORCs), defined by Hunt and Gunter-Hunt in 1986 as buildings or areas not specifically designed for, but which attracts, older adults and associated supportive service programming (NORC-SSP) have been described as potential resources to support aging-in-place. However, while the body of literature on NORCs has been growing since the 1980s, no synthesis of this work has been done to date.
OBJECTIVE
The goal of this scoping review was to highlight the current state of NORC literature to inform future research and to offer a summarized description of NORCs and how they have and can support older adults to age-in-place.
METHODS
Using a published framework, a scoping review was conducted searching twelve databases (CINAHL, Ovid Medline, HealthSTAR, Embase, APA PsycInfo, AMED, Johanna Briggs Institute, REHABDATA, Sociofile, Education Source, ERIC, Urban Planning, and the Cochrane Library) from earliest date of coverage to July 2020. We included English peer and non-peer reviewed scholarly journal publications that described, critiqued, reflected on, or researched NORCs. Aging-in-place literature with little to no mention of NORCs were excluded, as were articles that recruited from NORCs but did not connect findings to the setting. A qualitative content analysis of the literature was conducted, guided by Greenfield et al.’s 2012 conceptual framework to examine the promise of NORC programs to promote aging-in-place.
RESULTS
From 762 publications, we included 61 articles. All publications were North American and most used a descriptive approach (49/61; 80.3%). Just over half provided a specific definition of a NORC (32/61; 52.5%); of those, almost half (14/32; 43.8%) used Hunt and Gunter-Hunt’s 1986 definition; yet there were discrepancies in the defined proportions of older adults that constitutes a NORC (e.g. 40%, 50%). Six articles (6/61; 9.8%) described processes for identifying NORCs. Thirty-seven articles (37/61; 60.7%) specifically described Articles about NORC SSPs, described both external partnerships with organizations for service delivery (30/61; 49.2%), and internal resources, including staff (19/61; 31.1%), volunteers (13/61; 21.3%), or neighbours (5/61; 8.2%). Identified key components of a NORC-SSP included activities fostering social relationships (24/61;39.3%) and access to resources and services (24/61;39.3%). Sustainability and funding of NORC-SSPs was described (25/61; 40.9%), particularly as challenges to success. Initial outcomes, including self-efficacy (6/61; 9.8%) and increased access to social and health supports (14/61; 22.9%) were cited; however, long-term outcomes were lacking.
CONCLUSIONS
This review synthesizes the NORC literature to date and demonstrates that NORCs with programming (NORC-SSPs) have potential as an alternative model of supporting aging-in-place. Longitudinal research exploring the impacts of both 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.
AMENDED 44 Social correlates of malnutrition risk in naturally occurring retirement communities in Ontario, Canada
