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"This paper develops a conceptual model of the process of community change [in the United States] in response to elderly inmigration. Analysis of intra-regional variation in elderly migration patterns in Appalachia, and synthesis of an emergent literature on the benefits and costs of attracting elderly migrants, serve as a backdrop for case studies, based on field observations and interviews, of three contrasting Appalachian communities at different stages of development as retirement destinations."

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Over the duration of our lives, we each develop a rhythm and a routine in our use of space and in our relationships with the places of our lives that provide a sense of being in place. We gradually come to wear our environment like a glove, as, with increasing familiarity, it almost literally becomes a part of our persona. As we grow older or become increasingly frail, we adapt to reduced physical capabilities and changes in our environment in a manner that allows us to continue functioning effectively. This article explores the implications for occupational therapy of habitual use of the environment by older people and the sense of being in place that characteristically results. It is argued that sensitivity to the development and the maintenance of being in place provides a template for effective intervention when physical capabilities are compromised. Using the framework provided by complexity theory, and empirical observations from an ethnographic study of growing old in an Appalachian community, the article considers homeostatic adjustments that older people make in the use and the meaning of the spaces and the places of their lives as they accommodate to changing circumstances. By exploring the role and the uses of habituation (learning through repetition) in this process of gradual, often almost imperceptible, environmental adjustment, occupational therapists will be able to enrich their potential for developing strategies for intervention that effectively use a knowledge of habit in treatment.