On the edge: Balancing health, participation, and autonomy to maintain active independent living in two retirement facilities Tetyana Pylypiv Shippee ⁎ Division of Health Policy and Management, School of Public Health, University of Minnesota, United States article info abstract Article history: Received 16 December 2010 Received in revised form 3 May 2011 Accepted 17 May 2011 This study examines how independent living residents in Continuing Care Retirement Communities (CCRCs) work to maintain a healthy, active community. Specifically, this paper elucidates how independent living residents, who have high status in CCRCs but also face transitions to more advanced care, manage their daily lives to build a positive sense of community against the backdrop of potential health and social declines. The researcher supplemented four years of observation in one CCRC and two years of observation in another with qualitative interviews with thirty residents from both facilities. Results indicated that shared sentiments contrasting the active social world in independent living with other living units, norms of mutual support balanced with autonomy, social participation as a source of belonging (or isolation), and definitions of deviance surrounding functional health and manners framed residents' understandings of daily life by reaffirming independent living residents' privileged status in each facility. © 2011 Elsevier Inc. All rights reserved. Introduction Several studies have examined how community life manifests in residential arrangements for older adults (Biggs, Bernard, Kingston, & Nettleton, 2000; Hochschild, 1973; Krause, 2006; Moss & Igra, 1980; Ross, 1977; Streib, 2002; Streib & Metsch, 2002). This topic is worthwhile, considering that robust communities are beneficial for social engagement, life satisfaction, and well-being (Jenkins, Pienta, & Horgas, 2002). These benefits may be particularly impor- tant for older adults, who face added challenges to well-being and social engagement due to role losses, selective survival of peers, declining health and mobility, and other age-related events (Heenan, 2010; Johnson & Troll, 1994). Age-segregated housing, combining group living with amenities attractive to older adults, is one potential mecha- nism for preventing declines in social engagement and personal activity as individuals age. One popular option for age-segregated living is the Continuing Care Retirement Community (CCRC), a facility with multiple levels of living that correspond to residents' changing needs. CCRCs typically include apartment or cottage independent living (IL), assisted living (AL), and skilled nursing care living (NL) in a campus- style setting. There are currently about 2000 CCRCs in the U.S. (Zarem, 2010), and the number of older adults in CCRCs has more than doubled in the last decade, with estimates of about 640,000 residents in 2010 (Association for Homes & Services for the Aged, 2010). Most CCRCs are not-for-profit (82%), and approximately half are affiliated with religious organizations (Zarem, 2010). A major benefit claimed by CCRCs is that residents can “age in place” within one facility (Matthews, 2002); among other things, this purportedly allows older adults to preserve their relationships and identities within familiar surroundings, making for a less disruptive experience. Residence in CCRCs is especially beneficial for IL residents, who report greater quality of life and social engagement after moving into the facility, and are generally healthier and more active than residents in other levels of care (Jenkins et al., 2002; Krout, Moen, Holmes, Oggins, & Bowen, 2002). Also, many IL residents feel that their apartments are their “homes” and that Journal of Aging Studies 26 (2012) 1–15 ⁎ Division of Health Policy and Management, University of Minnesota, 420 Delaware Street SE, MMC 729, Minneapolis, MN 55455, United States. E-mail address: tshippee@umn.edu. 0890-4065/$ – see front matter © 2011 Elsevier Inc. All rights reserved. doi:10.1016/j.jaging.2011.05.002 Contents lists available at ScienceDirect Journal of Aging Studies journal homepage: www.elsevier.com/locate/jaging