Housing an Aging Nation

BY PHILIP LANGDON

IN RECENT YEARS builders, developers, and many others have been tantalized by visions of an aging America with plenty of money to spend. Though a fifth of the population sixty-five and older is poor or near poor, most elderly people have a considerably more comfortable style of life. The average aftertax income of the elderly is actually nine percent higher than that of the rest of the U.S. population, according to the Real Estate Research Corporation. Since 1962, when Michael Harrington’s Other America was published, the median cash income of households headed by someone of retirement age has increased by 75 percent in constant dollars. Thirty-one percent of America’s elderly households have an annual income of at least $20,000. In addition, nearly three quarters of retirement-age people own their own homes.

The result is that despite remnants of old-age subsistence living, a considerable number of the country’s elderly can presumably sell their houses, collect their equity (averaging $60,900 in 1985), and move into something better suited to their current needs. In reality most older people stay put. But the very knowledge that there are 30 million people sixty-five and older, many of them with sizable assets, is motivating a wide range of builders—from local companies to Cardinal Industries, the largest modular-housing manufacturer in the United States—to focus on retirement housing. As they do so, the housing choices offered to older people are expanding quickly. In no segment of what is called the senior-living industry is there now more diversification than in housing for the older elderly—people in their late seventies and up who need services that they didn’t need at sixty-five. Across the country there are now several hundred “life-care” complexes, which guarantee housing and services to their residents for the rest of their lives, even if their health deteriorates markedly.

In Bloomfield, Connecticut, in the rolling countryside north of Hartford, I visited an elaborate life-care complex named Duncaster. Moving into it is like buying a very expensive insurance policy. Life care is rarely for those with meager resources. The religious and nonprofit organizations that have built most of the nation’s life-care communities (Duncaster was built by a nonprofit corporation) usually demand both a hefty entrance fee for the right to occupy an apartment (not for ownership of it) and a substantial monthly charge. A person who moved into a one-bedroom apartment in a median-priced life-care development today would pay $55,000 plus a monthly charge of $740, according to Laventhol & Horwath, a Philadelphiabased accounting and consulting firm whose clients include developers of housing for the elderly throughout the United States.

Duncaster is near the top of the line and is priced accordingly. For a one-bedroom unit, entrance fees start at $77,935 and monthly charges start at $1,699. A resident who stays no longer than three months can get back all of the entrance fee, but after that the potential refund declines each month; after forty months the entire amount belongs irrevocably to Duncaster. Many life-care complexes are experimenting with a variety of financial arrangements—some permanently offering full refunds, others 70 to 90 percent refunds—but a sliding scale that moves toward no refund at all is still commonplace.

In return for their money the residents of Duncaster’s 216 apartments receive services that are typical of life-care developments—transportation, regular apartment cleaning, lunch or dinner every day in a group dining room, emergency medical attention at the pull of a cord in the apartment, and, if needed, unlimited eare at no extra charge in a nursing center on the premises. Duncaster’s higher-than-average costs are dictated by its lavish setting—seventy-two acres of woodland, grassy knolls, and ponds—and by the generous amenities it offers. Almost every life-care development offers a beauty salon, a doctor’s office, and places for social activities, but Duncaster also has some less standard amenities, such as a bank branch, a professional-quality greenhouse, an auditorium, a woodworking shop, a library with a collection of large-print publications, and a complete suite for visiting physicians. There is even a “gentlemen’s club,” although three quarters of the residents of Duncaster are women. (Nationally, there are twice as many women as men who are seventy-five and over.)

Duncaster’s buildings—gable-roofed threeand four-story structures in brick and a stucco-like material called Dryvit—are linked at such varied angles that from a distance they seem a jumble. As I drove down a winding entrance road, I wished that the designers, Stecker, LaBau, Arneill, of Hartford, had given the complex a more orderly configuration, like that, say, of the University of Virginia, where Thomas Jefferson artfully lined a central lawn with a series of connected buildings, making their organization clear and symmetrical, and the ensemble architecturally compelling.

A wish like this is in vain. The governing wisdom is that a life-care complex must not look institutional. Designers typically break big developments into smaller components, whose scale is more nearly domestic, even if this produces a fragmented appearance.

The apartments at Dunncaster, like those in many life-care complexes, have small kitchens, living rooms large enough for entertaining visitors, and private balconies or patios. Studio apartments are greatly outnumbered by oneand two-bedroom units, reflecting a general trend toward apartments with room for the furnishings and memorabilia that residents have accumulated over the years. As in a hospital, all of the common facilities and apartments arc connected by enclosed, weather-protected corridors. “There’s basically no place in the U.S. where a covered passage open on the sides is acceptable, because it’s either too hot or too cold at some time of the year,” says Carl H. Irwin, an architect in Huntington Beach, California, who is widely known for his work in retirement housing. The halls converge on a handsome courtyard ringed by the library, the dining room, the gentlemen’s club, and other common facilities. Irwin advocates this kind of layout, with the activity areas clustered at the hull and the apartment corridors radiating outward, because it minimizes the walking that residents have to do.

NOT SURPRISINGLY, the reservations that elderly people have about life care often pertain to money. “On average, only one in four residents ever needs nursing care on a permanent basis, and the elderly don’t necessarily want to subsidize someone else’s bill,” says James F. Sherman, a partner in Laventhol & Horwath. To lower prices and enhance the residents’ sense of independence, many life-care complexes are gradually converting included services into options. Residents pay only for what they need.

At the same time, a growing number of for-profit companies are entering the older-elderly housing held, and many of them are eliminating both nursing care and the entrance fees that the elderly have always been reluctant to pay.

Some are offering condominiums that the resident or the resident’s estate can later resell. Others are simply renting to elderly people. In these rental complexes (often called congregate living facilities), which offer residents such services as transportation, housekeeping, and one group meal a day, the median monthly cost is $825 for a one-bedroom apartment. Though rental developments generally lack nursing care, many of them help residents find a nursing home or hospital if their health deteriorates to the point where they have to leave.

The construction of rental projects is now booming, and that of entrance-fee developments is quiescent. Since 1982 Cardinal Industries, of Columbus, Ohio, has built seven rental retirement complexes, called Cardinal Milages, and has begun construction on six more. I spent a day at one of them—a rambling, low-slung wood-and-brick complex on just under ten acres in the Akron suburb of Cuyahoga Falls. The apartments there have small but complete kitchens, reasonably large living rooms, and private screened porches looking onto the grassy grounds. They also have a button for summoning emergency help and an “up-and-about” cord, which the resident is supposed to pull by 10:30 each morning; if it isn’t pulled, a staff member checks to see if there’s trouble. Corridors, which jog here and there to avoid monotony, connect the 119 apartments to the group dining room, beauty salon, combination library and game room, visiting-doctor’s room, and other common facilities, most of which are clustered near the entrance. There is no nursing care, no greenhouse, no gentlemen’s club. If the residents need an auditorium-sized area, they use the dining room. The result of these and other economies is that the rent is relatively low—$799 a month for a one-bedroom unit, including transportation, weekly apartment cleaning (the trend in the industry is toward less-frequent cleaning), some social activities, and one meal a day.

Inside Duncaster is an air of reserve much like that of an established wellto-do neighborhood. A Cardinal VilLage is less polished, but the relatively compressed common areas seem more lively with conversation and card-playing; the people I talked to at Cuyahoga Falls seemed as cheerful, in a just-folks manner, as could be expected in a complex where the average resident is an acheand-pain-prone eighty-three. After spending time at these two complexes and also seeing some depressingly blank faces in a congregate complex in Delray Beach, Florida, it was clear to me that although price, services, design, and amenities are important, what also greatly influences a resident’s degree of satisfaction is the overall tone of the place—the degree of vitality and the attitudes of the other residents and the staff.

THERE IS A PROBLEM in fitting even the best of these forms of housing into large new developments that attract younger, still-vigorous retirees. “If you put congregate housing at the center of a development, it becomes symbolic of dependency and turns off the people who don’t need congregate services,” says David B. Wolfe, an authority on marketing housing for older people. A former land planner, he founded the National Association for Senior Living Industries and operates Wolfe Resources Group, in Annapolis, Maryland. Some retirement communities are trying to deemphasize congregate and nursing facilities. When I visited Providence Point, a 180-acre retirement community in Issaquah, Washington, I discovered that both the congregate housing I was looking for and a nursing home had been built just outside the development’s boundaries, each under the auspices of an organization independent of Providence Point. Prospective buyers of Providence Point’s “empty-nester” condominiums inevitably learn that congregate housing and nursing care are close by—and available if they need either of them later—but this is not emphasized. The salespeople, according to Wolfe, might say, “’Oh, by the way, if you want your mother to move in, there’s a nursing home over there.’ It’s done in an offhanded, oblique manner.” Wolfe argues that one of the chief rewards of any discretionary purchase is the pleasure of being well thought of. In housing, Wolfe says, key questions in people’s minds are “Will my friends see my choice in an unfavorable light? Will they think that if I’m moving to a retirement community. I’m not what I used to be?”

Wolfe is involved in two retirementage communities—both just beginning construction—that will apply his theories about designing with “social reinforcement” and self-esteem in mind. One is Friday Mountain, a 550-acre development southwest of Austin, Texas, planned by Andres Duany and Elizabeth Plater-Zyberk, of Miami. The other is Worman’s Mill, a 224-acre project in Frederick, Maryland, designed by Wayne Williams, of the Smith-Williams Group, of Los Angeles and Washington, D.C.

“The congregate care at Friday Mountain is planned as a three-story facility that will look like an old-fashioned hotel, near a square in the center of town,” says Walter Reifslager, the chairman of Whitehawk Development Corporation, which, in partnership with SwansonDean Company, is developing Friday Mountain as a traditional small town containing housing, opportunities for employment, and a population composed mostly but not entirely of people over fifty. “Because of the facility’s location,” he says, “people can venture out and eat at other places.” The small-town format is expected to act as a kind of camouflage, making the congregate care less conspicuous and thus reducing the stigma attached to it. In a traditional town, David Wolfe says, people expect to encounter diverse kinds of buildings and activities, and are not put off by such things as businesses and nursing homes, as they likely would be in a suburban-style development. At Worman’s Mill, which is also conceived in terms much like a turn-of-the-century town, with a mostly retirement-age population and opportunities for work, there will be “a permanent-residence hotel,” says the developer, Robert K. Wormald. “We don’t call it congregate.” Whatever it is called, the hotel will have many of the same elements as congregate complexes, including rooms with small kitchens and access to services such as health monitoring and food delivery, which will also be available throughout the development.

The four-story hotel at Worman’s Mill will have a restaurant on the ground floor, facing a town square. The expectation is that people from throughout the community will eat there at least occasionally. Indeed, Wolfe argues, attracting outsiders into the building that houses somewhat dependent elderly people is critical to the elderly’s selfesteem. “It validates it as a desirable place to live,”he says. Residents, he says, draw satisfaction from knowing that the place they call home has an appeal for those who don’t live there, including younger people.

The advantages of Friday Mountain and Worman’s Mill, if they work as planned, lie in integrating the elderly into a more natural, balanced community. These developments aim to overcome the separateness that plagues most housing for the elderly—a separateness that deters most retired people from considering living in such places. “Everybody I know who’s older doesn’t want to go into what’s available,”Wormald says. “What people want,” Wayne Williams says, “is to be able to avail themselves of more services but not remind themselves that they’re getting old.” □