North Carolina, like much of the United States, is experiencing a demographic shift as its population ages. This transition brings forth critical concerns regarding healthy aging, particularly in areas such as disability, accessibility, aging in place, and caregiver support. Addressing these issues is essential to ensure that older adults in the state can lead dignified, independent, and fulfilling lives.
As individuals age, the likelihood of experiencing disabilities increases, necessitating environments that accommodate their needs [1]. In North Carolina, efforts are underway to enhance accessibility for older adults. Programs like the Assistive Equipment Loan Program in Chatham County provide essential devices such as canes, walkers, and wheelchairs to support mobility and independence [2]. Additionally, initiatives that support accommodations like ramps and grab bars aim to make homes safer and more navigable for seniors.
However, challenges persist. Many older adults reside in homes that were not designed with accessibility in mind, leading to increased risks of falls and injuries. The Centers for Disease Control and Prevention reports that falls are the leading cause of injury-related deaths among adults aged 65 and older [3]. Addressing these concerns requires not only home modifications but also community planning that prioritizes accessible public spaces and transportation options. Sidewalk quality, public transit routes, and clear signage are all part of creating communities where older adults and those with mobility challenges can thrive.
The concept of aging in place—remaining in one’s home and community safely and independently—is a preference for many seniors. North Carolina has recognized this desire and has implemented programs to support it. For instance, Orange County offers services such as home safety assessments, emergency planning, and in-home assistance to help older adults maintain their independence [4].
Moreover, the North Carolina Department of Health and Human Services Division of Aging and Adult Services promotes initiatives that facilitate aging in place, emphasizing the importance of community-based support systems [5]. These efforts are crucial to ensure that seniors can continue to live in familiar environments, which is beneficial for their mental and emotional well-being. Aging in place reduces reliance on expensive institutional care and increases quality of life through familiarity, autonomy, and social connectivity.
Yet for aging in place to be a viable option for all, housing policies must evolve. Affordable housing is scarce in many parts of the state, and older adults on fixed incomes are increasingly at risk of displacement [6]. Communities need more investment in home repair and weatherization programs, tax relief policies for low-income older adults, and partnerships with nonprofit housing developers.
Family caregivers play an indispensable role in supporting older adults, often providing extensive care without formal training or compensation. Recognizing the challenges faced by caregivers, North Carolina has established programs like the Family Caregiver Support Program, which offers resources, counseling, and respite services to alleviate caregiver burden [7].
Additionally, Project C.A.R.E. (Caregiver Alternatives to Running on Empty) provides specialized support for those caring for individuals with Alzheimer’s disease or related dementias, offering education and connections to community resources [8]. These programs are vital to sustaining the health and well-being of both caregivers and care recipients.
Nonetheless, many caregivers still go without support. They often sacrifice their own health, jobs, and financial stability. Expanding paid family leave, providing caregiver tax credits, and funding community-based respite services would represent a long-overdue acknowledgment of the economic and emotional labor caregivers provide [9].
While North Carolina has made commendable strides in addressing the concerns of its aging population, ongoing efforts are necessary to meet the evolving needs of seniors. Investments in accessible infrastructure, expansion of in-home support services, affordable and adaptable housing, and enhanced caregiver assistance programs will be pivotal. By fostering an environment that values and supports older adults, North Carolina can ensure that its residents age with dignity, independence, and a high quality of life.
It’s not enough to meet the minimum standards of care; we must build a future where older adults are seen not as burdens, but as community assets. Planning for healthy aging is not just a social imperative. It’s a wise economic investment that touches all generations.
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Written by Guest Authors
Caroline Yoon
Student
Duke University Sanford School of Public Policy
Nathan Boucher, MS, MPA, DrPH
Director of Undergraduate Studies and Associate Professor of Medicine, Nursing, and Public Policy
Duke University Sanford School of Public Policy
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Guest posts represent the author's views and do not necessarily reflect those of the NCIOM.
1. NC State Aging Profile 2020. NC Department of Health and Human Services. Updated March 28, 2022. Accessed June 11, 2025. www.ncdhhs.gov/nc-state-aging-profile-2020pdf
2. Services. Chatham County, North Carolina. Accessed June 11, 2025. www.chathamcountync.gov/government/departments-programs-a-h/aging-services/services
3. About older adult fall prevention. Centers for Disease Control and Prevention. May 16, 2024. Accessed June 11, 2025. www.cdc.gov/falls/about/index.html
4. Aging. Orange County, North Carolina. Accessed June 11, 2025. www.orangecountync.gov/154/Aging
5. Division of Aging. NC Department of Health and Human Services. Accessed June 11, 2025. www.ncdhhs.gov/divisions/division-aging
6. Housing needs by state: North Carolina. National Low Income Housing Coalition. Accessed June 11, 2025. www.nlihc.org/housing-needs-by-state/north-carolina
7. Family Caregiver Support Program. NC Department of Health and Human Services. Accessed June 11, 2025. www.ncdhhs.gov/divisions/aging/family-caregiver-support-program
8. Project C.A.R.E. (Caregiver Alternatives to Running on Empty). NC Department of Health and Human Services. Accessed June 11, 2025. https://www.ncdhhs.gov/divisions/aging/project-care-caregiver-alternatives-running-empty
9. AARP. Credit for Caring Act. May 26, 2021. Accessed June 11, 2025. www.aahd.us/wp-content/uploads/2021/05/CreditforCaringActFactSheet-AARP_May262021.pdf