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Date published: 12/27/2007

PROVIDENCE, R.I.--This time of year, it can take a stout heart to resist the phrase "home for the holidays." A certain frayed rug or sticky drawer can be essential to feeling connected to the world. The more we age, the truer this is.

Many Americans have incorporated nursing-home visits into their December routines. But often, it is not by choice. No matter how caring the staff or festive the decorations, families and residents alike typically wish for a better alternative--if not home itself, then something more like it. To those doing the wishing, these longings may feel hopelessly isolated. But quietly, like mounding snow, they are taking collective shape.

Consider: In Vermont, a new program called Choices for Care allows government dollars to pay for home care rather than nursing homes.

In more than 100 communities across the nation, neighborhoods are banding together to pay for services that can help older people remain in their homes longer. Such organizations charge dues to cover an array of services, from transportation to home repairs.

In Massachusetts, an association of nonprofit organizations has begun setting up small group homes for frail or disabled elderly people. The homes are in residential neighborhoods rather than attached to health-care complexes, and include a live-in aide who can assist with special needs. The residents are people who can no longer live on their own but who thrive with a degree of independence they would not get in a nursing home.

Gay elderly people who have felt themselves shunned in traditional nursing homes--and sometimes packed off to live with the severely disabled--are finding more adult facilities specifically geared toward them. In some places, caregivers are receiving special training in how to deal more sensitively with this population.

All of these efforts are in their early stages. But they are bound to pick up steam as baby boomers age and increasingly demand more humane setups for the aged. So far, their demands are being made on behalf of their parents. But soon they will be speaking up for themselves, and in the longer run, for their children.

Date published: 12/27/2007