How to Avoid a Nursing Home

The group also helps members coordinate their medical care. "You get a care manager who is a registered nurse who will accompany you to the doctor and will be another pair of ears to hear what the doctor says. They will write it down and maybe send it to your family," says Carol Jubenville, founder of Sunset Neighborhood. "If the diagnosis is, say, Parkinson's disease, we will help you find support groups, find physical therapy that treats it, and start a plan for care."

The prototype for aging-in-place communities, Beacon Hill Village in Boston, is a member-driven concierge service that provides or negotiates reduced rates on everything from high-end health services like personal trainers and massage therapists to more essential geriatric care managers and home hospice care. "It is totally consumer-driven," says director Judy Willett about the high level of services offered by the 50-plus community. Beacon Hill has annual dues of $600 for individuals and $850 for households, with discounts available.

Perks for members, currently as old as 99, also include physical fitness evaluations, wellness seminars, classes at local fitness clubs, and vetting and discounts for local services. Beacon Hill, which is six years old, has been contacted by about 100 other communities interested in starting similar programs. It publishes a manual about how to start an aging-in-place nonprofit group.

Social interaction. Growing old in your own home can be very lonely if you don't have family and friends nearby. "One of the most important things these organizations do is provide social contact that helps members avoid isolation," says Rob Waldman, president of the nonprofit Center for Aging in Place Support. "These aging-in-place communities provide a great opportunity to make and meet new friends."

Nancy McCarthy, 65, goes to restaurants, university lectures, and a movie and book discussion group that she formed with other members of Community Without Walls in Princeton, N.J. The group of about 450 members was founded in 1992. It is organized into chapters of 100 people or fewer who meet at least once a month and also get together in smaller groups for activities. Annual dues are $30 or less.

"It's almost an investment in making your growing-older process as meaningful as possible," says McCarthy, who has been a member for five years. "A lot of us who live here don't necessarily want to move to Florida or South Carolina or into a retirement home as we grow older. We want to stay in our own homes and keep involved and active."