Posts Tagged ‘Assisted Living’

Seniors’ Housing Projects: Location, Location, Location–How Important is it Really?

Thursday, July 15th, 2010

Conventional wisdom suggests that for supportive seniors’ housing projects (meals, housekeeping, laundry etc), walking-distance proximity to stores and services is, if not essential, then at the very least extremely important. But without sitting down and doing the math, I would say that a minority of supportive seniors’ housing projects in BC are located close enough to stores and services so that people could easily walk to them. Some are in locations that are downright pastoral. Of course walking isn’t necessary for all people—many have scooters that enlarge their geographic boundaries. Scooters though are used by a small minority of seniors, meaning that walking distance is more important than scooter distance.

As well, many seniors’ housing projects have their own buses to take people around to shopping and doctors’ appointments, many have small tuck shops that sell various items, and in any case, most meals are provided on site. So why do people need to walk anywhere? I firmly believe that the answer to that question is this: even if people don’t have to walk anywhere, the fact that they could if they wanted to is an important psychological benefit. And for those people who actually do walk to the store or the bank, it’s more than just a psychological benefit—it’s a physical benefit as well.

Proximity to green space seems to be less important than proximity to stores and services. It’s always nice to have a park to walk through but half the time the weather may preclude the walk. But proximity to schools and other places where children play is almost always considered a decided advantage because it gives people something highly enjoyable to watch. Proximity to seniors’ centres is hugely advantageous, not just because it allows residents to participate in outside events and activities, but because it facilitates two-way interaction. It’s easy to invite people living in the community and using the seniors’ centre to come for meals and events at the housing project, which is one of the very best ways of keeping buildings full.  Easy access to public transportation falls into the “it goes without saying” category, whether or not people living in supportive housing projects ever actually take a city bus. Visitors might though and staff almost certainly will.

Of course finding sites that are close to stores, services, schools, public transit, and seniors’ centres is much easier said than done. When “affordably priced” is added to the list, finding a suitable site begins to verge on the miraculous, especially in centres where land is expensive.

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Disability Rates: Do they Mean Anything?

Friday, July 2nd, 2010

Understanding disability rates and how they affect housing market behavior, in particular moves to supportive housing or assisted living, is a very difficult thing to do. Statistics Canada tells us that 43% of the 65+ population in Canada have some degree of disability, primarily mobility, agility, pain, or hearing. Of those with disabilities, 60% are mildly or moderately disabled, while 40% have severe or very severe disabilities.  What “mild”, “moderate”, and “severe” mean is not easy to define. Statistics Canada uses a complicated rating system to categorize disabilities. At any rate, the question is how these disability rates affect housing market behavior.

To establish a context for his discussion, it’s useful to reflect on the fact that the huge majority of houses in Canada are neither “visitable” nor “accessible”, meaning they do not accommodate aging in place. So does this mean that when people become disabled in some way will they move to supportive housing? Maybe not all people, or even a majority of people, but some quantifiable proportion? Alas, no. We know that entrance into service-enriched housing such as supportive housing or assisted living is primarily need-driven, which means that people move into these types of environments not because they want to but because they have to. However that does not necessarily imply the presence of a disability—people may move because their spouse died and they are afraid to stay alone, or because they are isolated, or not eating properly, or because they have lost their driver’s license. And couples with disabilities are much less likely to move to supportive housing than individuals because they are able to help each other. If there were some way to quantify demand based on disability status we would have to adjust for the number of couples in a market area, which would further complicate an already suspect analysis.

As a result of all these confounding variables, in my view it is not possible to arrive at any conclusions at all about the demand for service-enriched housing in a community by applying national disability rates to the seniors’ population and assuming that some arbitrary proportion of that group will choose to move to service-enriched housing. Some market analysts do this I am sad to report. Be careful if you are working with one.

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US Occupancy Rates have Declined in 11 of 12 Quarters Since 2007

Thursday, June 24th, 2010

As we have often commented in this blog, the US is light years away from Canada in terms of the quantity and quality of available research on the seniors’ housing and health care industry. The mission of the wonderful National Investment Center (NIC) is: “To advance the quality of seniors housing and care by facilitating informed investment decisions through best-in-class data, research, networking events and professional education” and they do a great job of that.

One of the many useful things they do is track occupancy data by quarter for five categories of housing and health care—freestanding IL, combined IL, freestanding AL, combined AL, and CCRC. (Remember that AL in the US is almost exclusively private pay).

A recent NIC Newsflash points out that occupancy rates for all five categories have declined more or less continuously since the first quarter of 2007, when they reached a cyclical peak of 92.3% (on average). First quarter 2010 data indicates an average occupancy rate of 88.0%.

Assisted living performed best over the period (decline of 2.7%) and freestanding IL the worst (decline of 6.2%). CCRCs ended up in the middle with a decline of 4.1%.

This is not remotely surprising. The US housing market has been hammered over the last few years. People more able to postpone a move into service-enriched housing (i.e. potential IL residents) have done exactly that.

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Americans Moving to Canada in Search of More Affordable Seniors’ Housing and Health Care?

Tuesday, June 15th, 2010

I read a comment about this recently. The writer was hypothesizing that as costs for seniors’ housing and health care rise in the US, Americans might move to Canada or Mexico in search of more affordable alternatives.

In both cases (i.e. Canada and Mexico) the fly in the ointment for Americans actually contemplating such a move would be health care and immigration policies, but aside from that, are costs really cheaper in Canada? My first reaction was scepticism but upon re-reading a few brochures I picked up at the recent ALFA conference in Phoenix, I thought: “well, maybe it IS cheaper in Canada, at least for some types of housing and health care”.

For example, at the Forum at Desert Harbor, the daily rate for a private room in the long term care component of the campus is $280, which is to say just over $100,000 per year. There aren’t many private pay long term care facilities in Canada that are charging $280 per day.

But at the same time, the rate at the Forum for a two bedroom 922 square foot independent living apartment is only $2,868 per month (the meal package includes breakfast and one other meal). The Forum is an upscale project with lots of amenities including a lakefront location, a pool, and a grapefruit tree, to say nothing of that desert climate.

Americans would have a tough time finding a similar value in Canada. The trick at the Forum is obviously to stay out of long term care!

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What you could do if you had 808 units

Tuesday, June 1st, 2010

I toured Friendship Village in Tempe, AZ while attending the recent ALFA conference in Phoenix. It’s spread over 43 acres and has 575 independent living units (bungalows and apartments), 91 assisted living units, and 142 care beds. There’s a pool, a fully equipped fitness facility (very busy when we popped in at 10:30am), an auditorium, a library, woodworking shops, a billiards room, a 9,000 square foot recreation centre featuring rooms for dancing, weaving, ceramics, video editing, and stained glass, and three dining areas: a cafe that is open all day and looks exactly like a real cafe, a large buffet that’s likewise open all day, and a formal dining room that is open on a reservation basis at dinner time.

The first time I saw a buffet in operation at a new upscale project in Red Deer I was taken aback because of what I assumed would be the difficulty of dealing with a buffet if you had a walker or were just generally unsteady on your feet. But people at Friendship Village seemed to manage just fine – they put their food on the seat of the walker, or staff there was around to help. And it’s worth noting that at breakfast or lunch it’s the buffet or the café and that’s it – no table service is available, which is interesting in itself. Do people stay independent longer if you force them to retrieve their own breakfast and lunch from a buffet?

Aside from the array of amenities you can offer if you have 808 units, the other advantage is that there are people everywhere – in the cafe, in the buffet, in the pool, in the fitness centre. It’s lively! It’s hard to achieve the same ambience if you’ve only got 100 units or so and it’s impossible to offer the same array of amenities. But that doesn’t mean you have to resign yourself to sepulchral silence and meals in the dining room at precisely 11:30 and 4:30. Au contraire – stay tuned for ideas.

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Kitchens in Independent Living Communities

Tuesday, May 25th, 2010

I am in Phoenix at the ALFA conference. It takes a long time to get to Phoenix from Vancouver in spite of the fact that the two cities are in the same time zone (in the summer—Phoenix operates on standard time all year long). I spent part of the travel time reading Jim Moore’s latest book, Independent Living and CCRCs.  Chapter 11 discusses high impact design features for independent living communities. Number one on the list is full-function kitchens, even in places serving three meals per day.

Yesterday I toured three life care communities in the area and I will be posting more about these three over the next few weeks, along with highlights from the conference itself. All three had full-function kitchens in their independent living units. My tour guides were shocked when I told them that full-function kitchens in Canadian independent living communities were rare. One of the three is upgrading its units—it is 20 years old—and the new fridges are the two door type with ice and water dispensers on one of the doors. The contrast with Danby bar fridges could hardly be starker. The upgraded stoves are full size with burners that are flush with the surface.

American operators include full-function kitchens more for the impression they create than for their actual utility. Consumers associate the lack of full kitchens with nursing homes and they don’t want to go there!

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US Seniors’ Housing Conferences

Thursday, May 13th, 2010

I am heading off to Phoenix a week Sunday for the annual Assisted Living Federation of America (ALFA) conference. The last ALFA conference I went to was in San Diego in 2006. Since then I attended National Association of Homebuilder 55+ Housing Council conferences in Denver (2007) and New Orleans (2008). The NAHB conferences were focused exclusively on active adult housing for years but both Denver and New Orleans added a service-enriched stream. That was dropped in 2009.  The whole conference was dropped in 2010, presumably because things are so bad in the US seniors’ housing industry, at least from the perspective of the NAHB. So it’s back to ALFA.

I will be posting regularly from the conference itself. In addition I am touring three projects and will post about those as well.

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Lowering the Average Age of Entry into Supportive Housing (Reprise)

Thursday, April 29th, 2010

If I start getting boring on this subject please let me know! I had lunch with my 85 year old mystery shopper, Edna, today. Edna is well-suited to mystery shopping—she worked on the Enigma project in London during the Second World War. In an interesting twist, so did her father but because of the enormous secrecy shrouding the Enigma project, neither one of them knew about the other’s work until years later.

Edna lives independently and is in great health, although she had a scare a few months ago. Often we in the industry like to say that a scare is just the thing to drive people into the arms of the supportive housing industry, but not Edna! She’s got a pacemaker now and feels better than she has in years.

I asked her if she would consider moving into a project like the one we were touring if she had buckets of money but she said no. She said she was not interested in giving up anything she has now to move to “God’s waiting room”. By the way Edna highly recommends a British TV show of the same name.

That’s the problem in a nutshell—people don’t think of retirement housing as a wonderful carefree way to spend their golden years; they think of it as the last stop before death.

Can we change this view, even a little? Here’s Edna’s suggestion for an appealing tag line: “Have the freedom to do whatever you like. Join us for an endless series of adventures.” That sounds good doesn’t it?

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What’s new in Winnipeg

Monday, April 26th, 2010

I spent a few days in the warm sunshine in Winnipeg last week and toured several supportive housing projects while there.  If I were writing this in Manitoba I would say I had toured several assisted living projects, because the terminology is reversed in our two provinces. Manitobans describe projects that provide hospitality services and personal care as supportive housing; projects that provide only hospitality services are called assisted living.

One project in particular caught my attention—The Canoe Club, adjacent to what used to be a very popular recreational facility in Winnipeg years ago. The golf course is still there, but little else remains of the club’s former glory.

The Canoe Club is a 102 unit project, owned and operated by the Caleb Group. The Caleb Group, which is headquartered in Saskatoon, owns 12 projects across Canada and is busily developing others. Two of their projects are located in Winnipeg—Cathedrale Manor in St Boniface and The Canoe Club, in St Vital.

As all faithful readers of this blog know, I have toured a LOT of seniors’ housing projects all over North America but I was very impressed with The Canoe Club. It is quite beautiful—no other word will do. Interestingly, people can buy or rent any unit in the building, although the Caleb Group intends to retain ownership of a majority of the units, which will be offered on a rental basis. This is a smart move for the Caleb Group and for all The Canoe Club residents, owners and renters alike.

More on The Canoe Club in future posts.

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