The elderly express a clear preference to remain in the community when they become frail. And recent legal decisions, such as the Supreme Court’s 1999 Olmstead decision, establish a right for the frail to receive care in community settings whenever feasible and reasonable. About one in five people with long-term care needs reports an unmet need for personal assistance.
This Topic Summary synthesizes work supported by the Robert Wood Johnson Foundation (RWJF) and described in Grant Results that is related to housing and supportive services for chronically ill and disabled elderly and adults. This work falls into the following categories:
Chronically Ill and Frail Elderly People
- Assisted Living—Assisted-living facilities offer an alternative housing arrangement for those who need extra help in their day-to-day lives but who do not require the 24-hour skilled nursing care found in traditional nursing homes.
The Foundation’s national program, Coming Home: Affordable Assisted Living for the Rural Elderly, is a $13-million program to develop affordable models of assisted living, with a focus on smaller and rural communities and low-income seniors. Grant Results also cover a feasibility study for an intergenerational assisted-living facility and an expert conference on barriers to expanding affordable assisted living. - Green House™—Green House is a group-home alternative to the traditional nursing home. Instead of a large facility with many elderly residents, a Green House has only six to 10 residents, each with a private bedroom and bath and a central area for cooking, eating, and gathering. Nursing assistants would play a much broader role in the care of patients.
RWJF supported the development of four pilot Green Houses in Tupelo, Mississippi, plus a replication program that since November 2005 has been working to spur the development of 100 or more Green House communities by the end of 2010. - Aging in Place—More than eight in 10 Americans over age 45 express clear preferences for staying at home when they become frail. RWJF has supported several projects that explored ways to help seniors do so.
Chronically Ill and Disabled Non-Elderly Adults
Supportive housing combines permanent housing with access to social, medical, mental health and substance abuse services for chronically ill low-income and homeless populations such as people with serious mental illness, HIV/AIDS and substance use disorders. This summary synthesizes work from six projects that provided services to these populations.