Rethinking senior living models
In the wake of the recent Great Recession our world has changed, specifically concerning the senior living industry. Capital has become largely unavailable and the next generation of seniors—the plentiful baby boomers—generally wants different services and housing models from those offered to their parents. To keep up with the changes, the ways in which existing communities operate and provide services must be reconsidered, and many organizations will need to rethink and realign how they meet their mission.
Outmoded communities can refurbish by simply splashing on a new coat of paint, installing new carpeting and ordering new furnishings. This type of facelift helps over the short term, but it does not specifically address the new realities that many face as senior living providers.
Communities can restore and renovate by adding a number of useful new spaces such as cafés, movie theaters and exercise rooms as well as altering unit plans by combining apartments and even relocating certain services for greater convenience among residents. This will make existing models more relevant and user friendly, but such changes fail to address the larger underlying issues.
Currently, senior living providers of continuing care retirement communities (CCRCs) only serve between 2 and 7 percent of the age- and income-eligible target market. According to AARP’s 2011 Boomer Housing Study, nearly 84 percent of those surveyed expressed a strong preference to stay in the places and communities they have called home. Whether this is a realistic expectation or denial of their future need for care is irrelevant. Our industry must find ways to serve the approximate 93 percent of seniors who do not embrace the traditional CCRC model. We must meet their expectations of aging in place, feeling at home and staying connected within a vibrant community setting.
NEW EXPECTATIONS
So what does the baby boomer generation expect and what models exist that can meet their expectations? While there is no single answer, this generation wants responses tailored to their needs. The good news is senior living providers can develop more options, think more innovatively and create more diverse market niches than ever before. There need not be one response; we need to think differently. We need to restructure our projects, develop new partnerships, think beyond our property lines and experiment with new concepts. Both existing and new senior living communities need to be connected in a multitude of ways to the life that exists beyond their walls.
The suburban model for senior living, self-contained on about 30 acres, is unsustainable and increasingly undesirable in many parts of the United States; most seniors want to be part of something interconnected. There are at least two viable options for shifting the existing CCRC model.
The first is to create an “inside-out community.” Take all the functions and features that are typically used exclusively by senior living community residents and re-situate them along the area’s perimeter, so that the greater community in which the CCRC is located can make use of key amenities as well. According to Maria Dwight of Gerontological Services, Inc., a specialty senior living market research firm, “Amortizing the fixed overhead of the facility and services costs to the broader community is a win-win for everyone. It reduces duplication of operating expenses, and infuses the CCRC with new energy and opportunities. It is good business and good marketing.”
This “inside-out” approach might involve turning the community dining hall into a full-service restaurant or the café into a coffeehouse that attracts more than just resident clientele. Perkins Eastman’s interior architecture for Baptist Housing Ministry does this with a new residential care facility in Saanich, British Columbia, Canada, called The Heights at Mount View. The facility’s ground floor will be dedicated to the neighborhood at large, replete with an Internet café, children’s play area and art gallery, community lounge and centralized town hall.
The second model is demonstrated by our work with Dallas-based care provider C.C. Young. Its community center serves both residents and the greater community. By partnering and working with more than 60 organizations, C.C. Young has created—from scratch, as opposed to enhancing and repositioning existing resources—a series of inviting programs within a senior center venue that attracts the broader community. This integration of the community with senior residents helps meet the socialization needs of all, while providing opportunities for more partnerships.
C.C. Young’s main building, developed on the edge of the community center’s campus, includes a library, art room, café, music hall and other amenities. The venue has benefitted from numerous program partnerships with organizations such as Big Brothers Big Sisters of North Texas and Faith Artists, which have helped provide relevant activities for seniors on campus and in the greater community.
ESTABLISH ALLIANCES
Partnerships can be more than just program oriented; they can provide capital, expertise and mixed uses that appeal to a broader set of interests. A common partnership might be with a local college, where seniors can enroll in classes, while younger college-aged students can take advantage of internship opportunities in fields like hospitality, healthcare and nursing. Overall, such a partnership constitutes an intergenerational approach that places seniors where the action is and provides people of different ages and interests with mutually beneficial opportunities.
A broader vision might include a collaboration among not-for-profit and for-profit developers. For example, a CCRC or rental senior housing might be a part of a larger master plan that includes retail development, family housing, an inn and spa and town commons, as we have with The Village at Crystal Spring in Annapolis, Md. Here, seniors will have a greater opportunity to become part of a vibrant center, where they can walk to the shops for necessities or just sit and watch the action.
All projects do not need to be large free-standing CCRCs. As the concept of walkable neighborhoods takes hold in suburban areas, we are seeing a resurgence of village community centers which identify as “age-friendly communities.” Whether expounded by the UrbanLand Institute (ULI), the World Health Organization, the Centers for Disease Control & Prevention or tracked by housing websites such as Trulia, walkable neighborhoods are increasingly recognized as being good for our well-being, and are important to seniors who may wish to rely less on cars to get around.
Infill projects like these can be small and need not have all the stand-alone program areas of a CCRC. In walkable neighborhoods, seniors can take a leisurely stroll, enjoy a choice of restaurants and interact with neighbors. For those seniors who opt to move from their existing homes, they now can live in a single-floor apartment, use all available services, and go to the same religious institutions they always have. The services, if and when needed, can easily be provided by a local organization. This model is more affordable for a modest, middle-class budget. What’s more, the residential site becomes even more attractive if it’s affiliated with or close to a public transit development project, extending the independent range of seniors who no longer drive.
NEW NICHES
Then there are entirely different concepts and market niches to consider. Perhaps a group of lifelong friends develops a shared home to live interdependently in an “intentional community.” Or, a developer assists two dozen or more seniors in creating a cluster of small, independent single-story homes with a shared community building, where residents cook and garden together in a co-housing model.
What if a resort is developed to focus on wellness and seniors’ needs on a time-sharing basis? Or what if we address specialized demographic groups of seniors, such as artists or LGBT (lesbian, gay, bisexual, transgender) communities? With new technology and universally designed homes, what if some people do choose to live at home, age in place and have the support of a village model? Indeed, we should only be limited by our imaginations when it comes to improving the communities and enhancing the services readily available to the growing senior population.
However, there are some limits in the regulatory and financial sectors that have adapted to serve the senior housing models presently in place and may not be suited to new development strategies. Ideally, regulatory agencies, investment banks and real estate investment trusts (REITS) will recognize the advantages of serving more people in housing with services that meet a broader market segment, and thus wish to capitalize on certain inevitable changes, and help communities propose new housing models, which will give baby boomers more choices for how to age in place.
CONCLUSION
Developers looking at the age wave demographic curve understand the opportunity at hand and the responsibility to serve this growing group. To paraphrase a recent ULI panel member speaking about the age wave, we have an enormous opportunity for which a solution has yet to be invented.
While we are repositioning ourselves in the post-Great Recession era, let us be the agents for change. We need not solve the whole issue with one solution, and, in fact, we should not. Rather, let’s attempt to understand our own local pieces of the market and adapt some of the strategies presented here, or attempt new ones to meet the growing need.
Leslie G. Moldow FAIA, LEED AP, is Managing Principal of the San Francisco office of Perkins Eastman. Contact her at L.Moldow@perkinseastman.com.
I Advance Senior Care is the industry-leading source for practical, in-depth, business-building, and resident care information for owners, executives, administrators, and directors of nursing at assisted living communities, skilled nursing facilities, post-acute facilities, and continuing care retirement communities. The I Advance Senior Care editorial team and industry experts provide market analysis, strategic direction, policy commentary, clinical best-practices, business management, and technology breakthroughs.
I Advance Senior Care is part of the Institute for the Advancement of Senior Care and published by Plain-English Health Care.
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