8 trends shaping today’s senior housing

With more than 10,000 baby boomers turning 65 every day, the demographics are smiling on the senior housing market segment. Although the overwhelming majority of boomers will continue to live in their own (or someone else’s) home or apartment, 5-8% of them will ultimately opt for seniors-only multifamily housing, according to David Schless, President of the American Seniors Housing Association (www.seniorshousing.org). Americans born between 1946 and 1964 number 76 million, so that small minority adds up to as many as six million boomers needing generation-specific housing.

To clarify, ASHA classifies senior housing—residential settings with a minimum age requirement, usually age 55—in five categories: senior apartments, independent living (IL), assisted living (AL), nursing care (NC), and continuing care retirement communities (CCRCs). According to the “2012 NIC/ASHA Seniors Housing Construction Trends Report” from ASHA and the National Investment Center for the Seniors Housing and Care Industry (www.NIC.org), there are an estimated 2,099,616 seniors housing units in the top 100 metro markets and 2.9 million nationwide.

The senior housing segment fell off the cliff along with the rest of the housing market during the recession, but it has bounced back in the past couple of years. In 2011, this market had its best performance since its peak years of 2006–2007, with more than $25 billion worth of transactions closed, according to NIC.

As of March 31, 2012, a total of 25,369 units for independent living, assisted living, and nursing care were under construction, with another 17,272 senior apartments in the works in the top 100 metros, according to the 2012 NIC/ASHA survey.

Another indication of the market’s strength is recent investment by real estate investment trusts. “Three or four REITs have been purchasing multiple properties, in some cases paying significant amounts,” says the ASHA’s Schless. One of these was Toledo-based Health Care REIT Inc., which last August purchased Sunrise Senior Living for $844.6 million in cash.

Given the favorable demographic trends, senior housing is increasingly seen as a relatively safe investment. Nonetheless, it may take a few more years for demand to fully crank up. That’s because the target population may choose to stay in their homes longer than previous generations did. “Due to advances in health and technology, the new thought is that baby boomers will not need assisted living facilities until around the age of 75,” says Trey Sanders, Regional President in the Kennesaw, Ga., office of contractor Brasfield & Gorrie.

How to win in the senior housing market

1. Provide unique—or at least distinctive—amenities.
2. Overcome the negative preconceptions of senior housing.
3. Enable seniors to age in place.
4. Provide memory care services.
5. Integrate seniors into the larger community.
6. Accommodate ancillary services.
7. Play up the marketing value of sustainability.
8. Look into the Greenhouse Project model.

Simply because the sector looks favorable, however, don’t be fooled into thinking that means your firm can just keep churning out whatever worked in the past. Today’s seniors have a definite mindset about what they want in retirement communities. “It’s not a case of build it and they will come,” says Schless. “The project has to be well conceived, well located, and well operated.”

Following are eight critical points to address when programming and designing a senior housing project.

1. Provide unique—or at minimum distinctive—amenities.

Don’t underestimate the competitive nature of the senior housing market. Filling new or renovated independent and assisted living projects is no walk in the park. Average occupancy rates in senior housing have been hovering in the 90-93% range over the past few years, but owners would like to see those rates in the mid- to high-90s, says Schless. The more successful your development is, the more likely it will draw competitors—all the more reason why unique or distinctive amenities are absolutely necessary.

Sometimes a site comes with its own marketing edge—a location near a vibrant urban core or up-to-date suburban shopping mall. In such a case, adding a walking trail or sidewalk to connect to such an amenity may be all that’s needed. “In a perfect world, you would have a Panera Bread, a Starbucks, and a wellness center right in the neighborhood,” says Gene Guszkowski, AIA, Senior Principal with AG Architects, Wauwatosa, Wis.

Natural features are a big plus. For instance, Parkview Living, a new Los Angeles development built by Foursquare Foundation, is located across the street from Echo Park. “The park has a wonderful walking trail,” says Manny Gonzalez, AIA, LEED AP, Principal, KTGY Group. “Those sorts of nearby amenities are home runs.”

Hebrew SeniorLife, an affiliate of Harvard Medical School, was fortunate to acquire the largest piece of undeveloped land along the Charles River—162 acres of well-preserved woodlands and fields—for NewBridge on the Charles, in Dedham, Mass. Bordered on three sides by the river, the site is as close to a pristine natural area as you can get within 20 miles of Boston.

“In some ways, the site sold itself,” says Ruth Stark, Hebrew SeniorLife’s Corporate Director of Marketing. The project reached the 70% pre-sale goal it needed to obtain financing. Pitching the project to lovers of the outdoors, Hebrew SeniorLife preserved as many trees as possible and added walking trails that connect with public trails.

Opened in 2009, the development is now fully occupied, with 256 independent living units: 50 cottages (private homes grouped in clusters of two, four, or six units); 24 villas (large corner-unit apartments in small buildings); and 182 one- and two-bedroom apartments, ranging in size from 825 sf to 2,003 sf.

Projects not blessed with natural or man-made attractions have to create their own. In Portland, Ore., 12th and Burnside is a six-story, 132-unit development that lies several miles from downtown. The developer, Foursquare Foundation, added first-floor retail space, including a café, courtyard, and roof terrace, to make up for the lack of such amenities in the neighborhood.

Seniors housing property types

Senior apartments
Multifamily properties restricted to adults at least 55 years of age. Community rooms, social activities. No central kitchens or meals provided to residents.

Independent living
Central dining facility offering at least one meal a day. Housekeeping, transportation, emergency call, recreation, social programming.

Assisted living
State-registered properties that provide same services as independent living plus activities for daily living: medication, bathing, dressing, toileting, ambulating, and eating. Twenty-four-hour protective oversight. May include memory care.

Newer luxury and affordable senior housing projects are also adding interior common spaces for residents to pursue hobbies. “There’s been an explosion in amenities such as woodshops, arts and crafts rooms, and spas,” says David Hoglund, FAIA, Principal/Executive Director in the senior living practice at architecture giant Perkins Eastman, New York, N.Y.

At Heritage Oaks Senior Apartments, a 50-unit apartment community for low-income seniors in Oakdale, Calif., KTGY learned from focus groups it conducted in the pre-design phase that future residents—especially men—would miss the opportunity to tinker in their garages. So Gonzalez designed a hobby and craft studio that resembles a 1950s-era suburban residential garage. Adorned with workbenches, a dartboard, and a chrome table and chair set with 1950s-era Ford automotive logos, the garage, with its adjoining patio, has become a popular hangout.

Providing such distinctive elements could be even more essential to success as the senior housing market heats up. “Over the past 40 years, we’ve seen many different design themes used in the market—Tuscany, Williamsburg, Key West,” says AG Architects’ Guszkowski. He says he’s concerned that senior living could get commoditized––or what he calls “McDonald’s-ized.”

Innovation can provide a knockout punch to a project’s marketing efforts. For the Burbank (Calif.) Senior Arts Colony, a 141-unit apartment complex with affordable and market-rate units, KTGY came up with a unique offering to serve its local population of retired TV and film industry professionals—a studio where residents can make their own independent films.

“Having an identity is critical,” says KTGY’s Gonzalez. “Get the owner, the interior designer, the landscape architect, and the rest of the team together and spend a day brainstorming to come up with something different from what the competition is doing.”

2. Overcome the negative preconceptions of senior housing.

The stigma associated with traditional nursing homes, with their clinically stark semi-private rooms and shared bathrooms, continues to loom over the senior housing sector, particularly for assisted living. “Older people’s greatest fear is having to share the most vulnerable time of their lives with a stranger,” says L. Bradford Perkins, FAIA, Chairman and CEO of Perkins Eastman. “There are a couple of million skilled nursing units out there, and 80-90% of the existing stock is obsolete.”

Like traditional nursing homes, today’s assisted living facilities provide senior residents so-called activities for daily living (ADLs), such as bathing, dressing, and preparing meals. Unlike nursing homes, however, they offer more privacy, comfort, and home-like aesthetics.

Design can help erase some negative preconceptions. Conveying a non-institutional look through the building’s design vernacular and finishes is a must. Designers also have to tailor spaces to meet the demands of seniors who want to keep fit—in body and mind. For example, Michael Tague, Design Director in A/E firm Nelson’s Boston office, suggests creating a public space on a floor close to living units that can be used for yoga or exercise classes.

Says Hebrew SeniorLife’s Stark, “There’s a profound interest among seniors in staying physically and mentally healthy. That’s why our programming philosophy is ‘Try something new.’”

3. Enable seniors to age in place.

In general, today’s seniors want to stay in their own homes or apartments for as long as possible. “It used to be that people retired at 65, and you would live independently as long as possible, and then go to a nursing home,” says Guszkowski. With people living longer, there is a gray period that could last decades when seniors can live semi-independently. This factor has altered the makeup of 55+ developments in recent years. “You’re seeing a decline in the percentage of units dedicated to assisted living, since assistance is provided with ADLs in independent living units,” says Perkins.

To support the goal of aging in place, units are being built with larger bathrooms to give attendants plenty of room to aid residents with their ADLs. Windows need to be easy for arthritis sufferers to open. Factors like these can determine whether existing buildings, such as an old hospital, can be converted to senior housing. If the existing bathrooms are too small and can’t be opened up, that white elephant building may not be suitable for modern senior housing, no matter how cheap the asking price.

4. Provide memory care services.

As seniors live longer, more of them will become susceptible to cognitive disabilities. As a result, senior housing projects increasingly must provide memory care units for those with Alzheimer’s disease and dementia. In the past, memory care units were dark, claustrophobic spaces, says Michael E. Liu, AIA, NCARB, Vice President and Principal in Charge of Design with The Architectural Team, Chelsea, Mass. “Now, we raise window heads and increase window sizes so residents can see the sky.”

Don’t do senior housing? Some questions to ponder about your current work

Even if your firm doesn’t specialize in senior housing, this article raises questions that could apply to your work in other building types:

How closely is your firm following changing demographic trends—age, race, ethnicity, language, gender, mobility—that could be impacting the geographical markets and building types you specialize in?

Should your firm be conducting its own research (online surveys, focus groups, individual interviews, etc.) to gain insight on end-user/occupant attitudes and needs—proprietary data you can take to current and prospective clients?

What additional services or components—preferably those that would produce additional revenue for your clients—should you be incorporating into your specialty building type? Could your next library include a café—or even an adjacent brick-and-mortar bookstore?

What are the “negative perceptions” about your firm’s preferred building types, and how can you overcome them? If these negatives result in neighborhood opposition to your projects, what strategies can you develop to gain the community’s support?

In early design, is your Building Team taking into account the long-term operations and maintenance of the building? What about the ongoing service needs of its occupants and visitors?

Which marketing-related factors are truly crucial to your firm’s success in its specialty markets? Client service? Professional reputation? Performance record? Sustainability leadership? How do you know these factors still hold true?

Designers also have to take into account the so-called “sundowning effect,” the agitation that dementia sufferers can experience at sunset. Large windows can bring this on, so adjustable shades and lighting have to be used to mitigate that impact.

Memory care facilities need to provide a wide range of safety features; in particular, they must prevent patients from leaving the grounds unattended. “The reasons for cognitive frailty vary, but many memory care residents have the urge to wander,” says Liu. “We try to design memory care so there is direct access to the outside, but in a protected, enclosed area such as a courtyard.” Screening parking areas from residents’ view also helps reduce the desire to roam, he adds.

One bold experiment in memory care is the House for Betty, a multi-year research project being conducted by the Perkins Eastman Research Collaborative. Daniel Cinelli, FAIA, Principal and Executive Director at Perkins Eastman, has been leading this initiative after experiencing his late mother-in-law’s Alzheimer’s condition.

With input from the spouses of dementia patients and experts at the Alzheimer’s Association, Cinelli’s team has designed a model single-family home that addresses more than 300 elements that make it possible for a healthy spouse or other family member to provide care with minimal outside assistance. For example, the design calls for a secure, double-sided doorway that would allow medical supplies to be delivered without the doorbell being rung—something that can agitate a person afflicted with dementia. A light signals the spouse that a delivery has been made.

The first House for Betty is on hold, pending the resolution of some site infrastructure and zoning problems. Once these matters are settled, the model home will be constructed in Gaithersburg, Md.

5. Integrate seniors into the larger community.

One way senior housing developers are weaving seniors into their surrounding communities is to open up the amenities within senior housing developments to the general public. For security purposes, these facilities—eateries, wellness centers, meeting spaces, etc.—should be designed with separate entrances, one for the public, one for residents. They can also be equipped with reconfigurable furniture to accommodate various types of events—lectures, musical programs, films, and so on—that create opportunities for residents to meet and mingle with their neighbors from the surrounding community.

Some developers feed the drive for lifelong learning. The Kendal Corporation, Kennett Square, Pa., a Quaker-inspired senior housing developer, has built several such communities near colleges and universities, including those at Cornell University (Ithaca, N.Y.), Oberlin (Ohio) College, and Denison University (Granville, Ohio).

Lasell Village, on the campus of Lasell College, Newton, Mass., is not a Kendal community, but it plays a similar role. It houses 225 residents in its independent living apartments and dozens of others in assisted living and skilled nursing units. Residents participate in hundreds of on-site courses, lectures, cultural events, and physical fitness classes each year. Intergenerational activities for residents, faculty, and Lasell College students are encouraged.

If you can’t bring the seniors to the students, bring the students to the seniors. That’s what NewBridge on the Charles did. Hebrew SeniorLife built a K-8 day school on its site that offers multi-generational programming. “Kids learn from seniors, seniors learn from kids,” says Hebrew SeniorLife’s Stark.

Building Teams and their clients in the senior housing field must keep foremost in their minds that the great majority of today’s seniors—and the millions that are coming online every year—are looking for a vibrant lifestyle that keeps them active and engaged and thereby healthy and happy.

6. Accommodate ancillary services.

In addition to memory care, senior living communities are adding new services to fill specific needs and, not incidentally, create new revenue streams. Short-term rehabilitation is one of these. Assisted living facilities already have the expertise to provide such care, so adding rehab units could be a natural extension for them. These units are likely to be segregated from other parts of the facility, but they can be designed as additions to existing structures or connected with other units via walkways or footbridges.

Experts predict short-term rehabilitation facilities will get a boost from federal healthcare reform. The Affordable Care Act calls for penalties for hospitals that readmit patients for the same or related conditions. “Hospitals are going to want to send patients to bulletproof rehab facilities,” says Perkins Eastman’s Cinelli.

Another potential revenue stream for senior housing communities: expanded rehab space that can be leased out to physical therapy providers, whose services would be made available to residents and nonresidents alike.

7. Play up the marketing value of sustainability.

Prospective senior residents have an increasingly sophisticated understanding of sustainability and take an active interest in how their housing impacts the environment. NewBridge on the Charles is heated and cooled using 400 geothermal wells; it also has vegetated roofs for reducing urban heat-island effect. These measures, and the effort to preserve the natural state of the site during construction, are like marketing gold stars. “People are drawn here by our environmental sensitivity,” says Hebrew SeniorLife’s Stark.

This does not mean that senior communities must be LEED-certified. As green as NewBridge is, management chose to forgo certification. Whether certified or not, sustainably designed senior housing developments should play up the health and indoor environment benefits of sustainability, as well as the positive impact on utility bills—even if the residents are not paying directly for utilities.

8. Look into the Greenhouse Project model.

The Greenhouse Project, a model of assisted senior living featuring small, shared dwellings with a high level of care, is growing in popularity. Groups of 10 to 12 seniors share kitchen, dining, and common areas but have their own bedrooms and bathrooms. “Residents are taken care of like they’re a big family,” says design firm Nelson’s Tague. Staff members attend to the residents’ activities for daily living and cook meals within the Greenhouse living unit. “Residents can eat when they’re hungry, instead of just at a prescribed meal time,” says Tague. “It makes the setting seem less institutional.”

The newly opened phase of the Cottages at St. Martins in the Pines, near Birmingham, Ala., consists of three-story buildings, each 22,875 sf in size. Perkins Eastman is designing an urban high-rise in Manhattan’s Upper West Side for Jewish Home Lifecare. Eleven floors of the 20-story structure will have two 12-bed units per floor, with cooking facilities in each unit.

The Greenhouse concept has earned high marks from residents and staff on projects across the country. It’s an age-in-place strategy that balances independence with just enough support for seniors to be able to stay where they are as they become frailer with age, rather than having to enter a traditional nursing home. +

Additonal resources

“2012 NIC/ASHA Seniors Housing Construction Trends Report,” National Investment Center for the Seniors Housing & Care Industry (NIC) and American Seniors Housing Association (ASHA). $150. http://www.nic.org/store/Products.aspx?ProductCategoryID=4.

Design for Aging Review 11: “Insights and Innovations: The State of Senior Housing,” Perkins Eastman Research Collaborative, on behalf of the American Institute of Architects. http://www.aia.org/aiaucmp/groups/aia/documents/pdf/aiab096294.pdf.

Recurring themes from 50 projects submitted for this biennial report: 1) connectivity to the greater neighborhood and natural surroundings; 2) designing for capability, not disability; 3) affordability-driven innovations; 4) holistic wellness; 5) blurred boundaries.

“10 Top Design Trends in Senior Living,” by Bradford Perkins, FAIA (January 2010). http://www.BDCnetwork.com/10-top-design-trends-senior%C2%A0living-facilities.