The Fight to “Age-In-Place” in New York
One out of every 10 older immigrants in the country live in New York City. As they age, can the City afford housing programs that will keep them in their communities?
By Emily Dugdale
Inside Isabella Senior Center’s modest storefront in Washington Heights, a group of seniors cluster in the waiting area escaping the rain, chattering idly away in Spanish. Older women periodically enter the center, shaking off soaked umbrellas and signing in for services at the small desk perched next to front door adorned with paper Halloween decorations and a prominent “ABIERTO” sign.
On a rainy Friday afternoon, Millie Almonte’s own office at the center is empty. A client services manager, Almonte works with local seniors — largely monolingual Dominican immigrants — to train them to accomplish routine financial tasks, job applications and more.
“Usually Mondays and Tuesdays are more packed,” she says laughing, gesturing around her vacant office.
New York’s senior population is booming — just under a million residents are 65 and older according to research from the Center for an Urban Future. The number of seniors is projected to increase by 35 percent in the next two decades to approximately 1.3 million in 2030, the Center reports. And almost half of seniors are foreign-born, bringing a new set of challenges for ensuring seniors are getting access to social services, health care and socialization.
But innovative housing/senior service programs called Naturally Occurring Retirement Communities — known widely as NORCs - may be the key to to allowing more immigrant seniors to stay put in their communities while providing the level of care they require. Isabella is one example — a six-year-old senior service center that provides free health, translation, advocacy and counseling services to seniors.
The city, however, places stringent requirements on neighborhood density to establish a NORC that can rule out some immigrant neighborhoods, and a more flexible criteria is being discussed by both activists and City Councilmembers.
For Dominican Republic native and longtime neighborhood resident Rafaela Mercedes, 83, who stopped by the center on Friday morning to chat with friends, the NORC program is one of the few positive things to happen in Washington Heights.
“It seems like the end of the world here,” she lamented in Spanish. “But these services truly value older people, and provide so many benefits I can’t access elsewhere.”
“It’s getting harder to ignore” older New Yorkers
Bobbi Sachman pauses mid-thought and brusquely brushes off a few people chattering in her office. A long-time senior services advocate in New York, she’s currently the director of public policy at LiveOn NY, an organization and incubator dedicated to expanding policies for senior services.
“It’s getting harder to ignore just about the fastest growing segment of people in not just the city, but the state population as well — people over 60 or 65,” she said, her voice saturated with annoyance.
Established in 1983, NORC communities are apartments or housing complexes that were not originally designated as retirement communities, but naturally developed a large concentration of residents over 60 either through the aging of existing residents or the exodus of younger ones.
A NORC is defined as “a residential location not originally built for seniors that have developed a “significant concentration” of older residents,” according to the City Department for Aging.
Federal law officially defines a NORC as a building where at least 50 percent of the units are occupied by a senior, or where at least 2,500 heads of households are an older adult. The majority of residents must also have low to moderate incomes.
Currently, the City boasts 41 NORC communities who partner with supportive service programs who provide the health, housing and social service components.
A 2012 survey from the American Association of Retired Persons (AARP) shows that 70 percent of older adults are concerned about being able to age in their communities.
Yet Bobbi Sachman, the advocate for services for seniors, said older immigrants living with family member who are unaware of the need or availability of professional caregivers and other services for their aging relatives at home, present a difficult challenge.
“They may come here at ages 60 and 70, [and then] the kids become Americanized and the adult children go out to work, And there’s grandma sitting at home who doesn’t know how to navigate more than a few blocks of [her] world,” Sachman said. “So it’s working to recognize that it’s not good for their families.”
Instead, NORCS offer seniors independent apartment living with the comfort of social workers, an on-site nurse and activities such as yoga and educational workshops in the same building. In place of of being whisked away to a retirement home, seniors can choose to live in the same neighborhood as their extended families — and stay within a familiar culture and language.
“Our goal is to provide comprehensive services to improve the quality of life for our members, enabling them to remain in their homes and lead independent, healthy and active lifestyles within their communities,” reads the mission statement from the Fort George Vistas NORC in Inwood.
To Sachman, senior services have been ignored for far too long in cities — and she’s not confident about the road ahead. “I just saw something about poverty, and on the program there’s not one mention of seniors. Really? How do you think you get to be poor and old? You start when you’re young.”
Problems arise for isolated immigrant seniors
Christian Gonzalez-Rivera speaks quickly, rattling off facts and statistics and pausing only to leaf through documents and fact-check his comments over the phone.
A researcher at the Center for an Urban Future, a non-profit policy think-tank, Gonzalez-Rivera interviewed dozens of New York residents, policy makers and experts for an expansive report in 2013 on the demographics and state of services for immigrant seniors.
By 2018, immigrant seniors are expected to become the majority of people aged 65 and older in the city, the report found.
Gonzalez-Rivera’s research also highlights that older immigrants more than any other group are largely dependent on the ethnic communities they live in.
“This is because seniors generally have a lot of barriers they face — decline in mobility, increased susceptibility for elder abuse, the problem of living on a fixed income,” he said, adding that a large number of senior immigrants are recent arrivals. As many as 60 percent of immigrant seniors report speaking English “less-than-very-well,” making routine errands and health check-ups not only a nuisance, but an almost impossible task without assistance.
NORCs work to address these issues by creating housing solutions that allow seniors to age close to their families and surrounded by those who speak their language and understand their culture.
“Their communities are their connection to the other world,” Rodriguez-Gonzalez explains. “It’s the only way that they have a connection to home — being able to age in the places where they are used to, eating the food and speaking the languages they are familiar with.”
Studies referred to a recent New York Times article also link isolation in seniors to cognitive decline, and even early death — a disquieting fact when grappling with whether to leave seniors alone in the house or whisk them away to a retirement home far from the familiar.
“In our world, we’ve been saying this for a very long time,” Sachman said. “Now there’s more information coming out that [socialization] is not just a nice thing, but it actually does impact your physical and mental health.”
However, NORCs do not yet reach all vulnerable immigrant populations. Gonzalez-Rivera also found the majority of NORCS are located in high-density moderate-income or public housing developments, where immigrants are less likely to live.
In fact, many neighborhoods in the city where older immigrants reside — and where their populations are growing — are low-density and do not meet current city NORC requirements stipulating that each apartment building must have a minimum of 500 seniors.
Gonzalez-Rivera’s report found that only four NORCs are neighborhood-based, while the rest are in high-density moderate-income or public housing developments.
Throw in factors such as long waiting lists, low turnover, and higher incomes, and many immigrants find themselves shut out.
“If you’re an advocate in the immigration rights movement — you need to really take a look at who is out there,” Sachman advised regarding NORC accessibility. “What is the full picture?”
NORC accessibility, services varies by location
A sudden splattering of rain doesn’t ruin Eileen Canty’s view of the Hudson from Eileen Canty’s her favorite seat in her 19th floor NORC apartment in Morningside Heights.
Grasping her walker, the 83-year-old plops herself down at the table in the apartment in a NORC building she’s lived in since 2009, and gazes skeptically at the increasing shower. She became a widow three years ago, and now lives alone in a community she repeatedly calls “truly enriching.”
“This kind of a setting precludes the need for people to go to nursing homes,” she says proudly. “Our goal is to keep people here as long as they can. We’re limited only by our own imagination.”
Canty is the president of the NORC-sponsored Morningside Retirement and Health Services (MRHS) NORC program, and also a resident in one of the multiple buildings that fall under the NORC umbrella. Tall brick buildings bordering shops on 125th Street house families with young children as well as older seniors who all participate in NORC events and services.
Canty counts 6,000 attendees on a program calendar of activities in the past year, including money management, dinner clubs, and foreign policy discussions.
“You see life here from the beginning to the end, which I think gives a richness that you can’t see in a nursing home,” she said.
Her Morningside Heights program was recently awarded a $500,000 New York State grant through Assembly member Daniel O’Donnell, according to a recent memo written by Canty. Contrasted to the few NORCs currently designated in immigrant communities, The program is relatively well-funded, with moderate-income residents who mostly own their apartments.
“A lot of recent immigrants would not come here because they would have to buy the apartment,” Canty said. “We just don’t have enough low income housing to start with.”
It’s a concern that Gonzalez-Rivera’s research points to as a signal for more NORCs to be established in low-income, immigrant neighborhoods.
It’s not a clear-cut situation Canty said. She remains prideful of her diverse community, where more established, higher-income immigrant families from the Caribbean and Asian countries play a vital role. “Which comes first, the chicken or the egg? Do you say, this is going to be a NORC, or is it a low-income building, and so on?”
Just a few train stops farther Uptown, one of clients at the Isabella Senior Center in Washington Heights this morning is Iris Morel, 73, who immigrated to New York alone from the Dominican Republic in 1974. She’s lived in her NORC building for over 40 years, and accesses senior services at the center often. Speaking softly in Spanish, she explains that she’s there to get help translating and mailing a letter.
It might seem like a simple request. But Gonzalez-Rivera’s research shows that about 37 percent of seniors live in “linguistically isolated households” meaning that no one in the household over the age of 14 can speak English well.
For Morel, the senior center is a lifeline for tasks both small and large. “They serve the community and the older people who need help. It’s very important to me,” she said.
Morel, who previously worked in a local factory, lives alone, as do the majority of senior immigrants. She’s made the short trek to the senior center dozens of times, but knows many who won’t.
“There are many reasons an immigrant might not come and receive help,” she explained. “Because of language barriers, or because they don’t have the right documents…”
It’s what makes Isabella’s team of bilingual social workers so important in a community where Millie Almonte estimates over 90 percent of the clientele are exclusively Spanish-speaking.
“Some of the most marginalized people in the city are poor seniors who don’t speak English,” Bobbi Sachman, the LiveOn housing activist said.
NORCS remain “critically underfunded” in New York
NORCs aren’t cheap. Over $5.6 million in city funding was granted to establish 28 new NORC contracts in 2015, according to the city’s Department for the Aging. And between 2003 and 2008, more than $22 million in federal funds through the United States Administration on Aging were used to establish the majority of the existing NORCs in the City.
But the federal Older Americans Act has not been reauthorized since 2006, leaving the future federal funding of NORC programs up in the air.
At a City Council hearing In February,, City Councilmember Margaret Chin (D-Manhattan),chairwoman of the Committee on Aging, proposed strengthening the role of NORCS, exploring locations for additional communities, and allowing more flexibility in the rules for evaluating the locations.
The year before, the council held a committee hearing on expanding access to senior services. Commissioner Donna Corrado affirmed that NORCs “provide services in a culturally competent way,” citing evidence of multilingual computer and cooking classes at NORCs in Manhattan and Queens.
“Aging in place, remaining in one’s residence or community, is the clear preference of the vast majority of older adults, yet in order to safely age in place, many seniors require additional services and accommodations,” the 2015 committee report noted. “Addressing these needs in NORCs can occur, in part, by organizing the provision of services at a localized level.”
Despite funding efforts, NORCS remain “critically underfunded,” Sachman said. There’s a shared sentiment that despite publicized committee hearings and reports, the City isn’t “putting the money where the mouth is”.
“There’s a level of negligence that a system is not well funded enough to service core basic services,” she said.
And time is ticking. By 2040, more than one out of every five New Yorkers will be over the age of 60. Designated NORC buildings in more low-income, low-density and isolated immigrant communities will only become more crucial. Senior policy experts agree that keeping seniors in the home and out of nursing homes and hospitals is the only option for the nation’s most rapidly graying metropolis.
“Once and for all, we need to recognize that this is a demographic shift — how are we going to treat those who are old now, and prepare for those who are coming up?” reiterated Sachman.
“As we talk about embracing diversity — especially in a place like New York — you don’t fall off the map when you’re 60 or 65.”