• PACE (Programs of All-Inclusive Care for the Elderly). Pioneered in San Francisco in the 1970s, the PACE model has now spread to about 50 sites nationwide. Run by community-based organizations and funded mainly by Medicare and Medicaid, PACE is open to those over the age of 55 who would otherwise be eligible for nursing home care but are able to live safely in the community with support.

By providing "wraparound" services including social support and medical care -- usually in a neighborhood day center -- as well as in-home meals and other care as needed, PACE programs aim to keep ailing older adults out of nursing homes and in their own homes. Participants have access to coordinated medical care as well as physical, occupational, and recreational therapy; nutritional counseling; social services; specialists such as dentists, optometrists, and audiologists; and home healthcare as needed.

Early research indicates that participating in PACE can slow the decline often seen in nursing home residents. If someone is not eligible for Medicaid, which is an income-based benefit, he may have to cover some of the cost of the program himself, but it's generally less expensive than nursing home care.

You can find a list of PACE providers all over the country at the National PACE Association's website or by calling (703) 535-1565.

• Elder villages. Another increasingly popular option springing up across the country, these are somewhat more loosely organized than the PACE model, but they also offer older adults communal support and services as they age. Members pay an annual fee (generally a few hundred dollars) to join, which gives them access to an on-call list of providers who offer everything from home repair and meal delivery services to transportation and in-home care, often at a discounted rate. Some villages also offer free services to members, such as daily check-in calls (especially valuable to older adults who live alone) and disaster preparedness inspections. Villages also hold recreational and social events.

One of the best-known villages is Boston's Beacon Hill Village, which publishes a newsletter and has produced a manual and DVD in an effort to help other communities replicate its model. Beacon Hill even has a concierge service, which will, for example, mail packages, take members' cars in for repairs, water plants, and pick up mail during a vacation.