The implications of aging in place for community-based services for elderly people.

A study of 12 day care centers and luncheon clubs in London, England, found that, in response to changing client characteristics, many of the "clubs" were becoming formalized "centers." These agencies were expanding the number of days and hours of service, providing transportation, hiring professional staff, and renovating their premises to accommodate disabled individuals. The managers ascribed these changes to "aging in place" by the membership of the centers, and to new referrals of increasingly disabled people (who might once have been considered for institutionalization but who were now remaining in the community). These findings raise issues for providers of community-based services, and for case managers who are often the gatekeepers to these services.