In 1994, Aging at Home I offered organizations in communities across North Carolina an opportunity to apply for funds that would help frail older adults age at home. Eighty-six letters of intent were received, thirty-six projects were invited to submit full proposals, and eleven sites, from the mountains to the coast, ultimately were funded.

The successful experience of the Aging at Home I initiative has been detailed in a publication issued by Duke LTC in 1996. See "Going to the Marketplace of Ideas" The Aging at Home I Program Experience, Vol. 7, No. 3, Spring 1996. Aging at Home I was characterized by diverse, viable ideas, from adult day health centers to care management to expanded hospice services, which were sustained after grant funding ended.

Most importantly, Aging at Home I kept its original promises by meeting its goal of serving substantial numbers of frail older adults who were at risk for institutional placement. Over the course of the two-year grant period, 2,726 referral were made to the eleven sites with 494 clients receiving ongoing packages of services and another 391 clients receiving other substantial services. Seventy-three percent of the clients receiving packages of services were "at risk" for institutional placement with "at risk" being defined by the widely accepted indicator of having three or more impairments in activities of daily living.

Lessons learned under Aging at Home I established the framework for Aging at Home II and III to come: Timely technical assistance leads to sustainable programs. Tracking the performance outcomes of projects can be done in a way that is useful for both sites and funding sources. Encouraging sites to share information with one another is a win-win endeavor. Involvement of diverse, experienced advisors, including key state agencies, was essential to the ongoing efforts of programs.

(See a map of Aging at Home Program.)