In 1993, the Kate B. Reynolds Charitable Trust and the Duke Long Term Care Resources Program (LTC) collaborated to initiate the Aging at Home Program to serve frail, older North Carolinians and their families. The Trust was particularly interested in helping frail elderly who were at high risk of institutionalization. Duke LTC had already established itself as a credible base for technical assistance to both local and state Long Term Care programs in North Carolina. Building on their mutual interests, and after much deliberation and consultation with advisors from across North Carolina, the Trust established the Aging at Home Program to be developed and managed at Duke.

The Kate B. Reynolds Charitable Trust initially committed $1 million to be allocated to sites across North Carolina developing or enhancing home and community care programs to serve frail elderly who were at high risk of institutionalization. At its conclusion, Aging at Home was a successful three-pronged effort that extended the availability of those home-and-community-based Long Term Care services to North Carolina counties which identified gaps in services and proposed viable projects to answer those needs.