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August 26, 2011
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                                                                                                                         by Don Jacobs, FAIA

Like most 50+ professionals in the industry, I have been watching and tracking the demographics of the baby boomer generation for some time now, always anticipating a boom in all aspects of our industry, from active adult housing to Continuing Care Retirement Communities (CCRCs). We all know it is going to be huge and different, but so far it is not unfolding the way most of us expected it to.

While we are focused on the aging of America and all that implies, the rest of the world also is aging at the same rate, with similar statistics, and they are looking to America for ideas. Adapting our senior housing to other cultures might work, but there are many cultural differences that have to be considered. And there are some great solutions in other countries that we can learn from as well.

No matter the country, there are some common threads. The No. 1 issue is “wellness,” and No. 2 is “aging in place.” It should be noted that those areas of concern are affected by the fact that we have engineered longer lives for ourselves and, in most countries, families are becoming smaller.

Let's focus on China, Europe, India, the U.K. and Mexico/Latin America: all are very different markets, with different challenges.

China and India

In China, most couples have only one child, and the longtime familial pattern of the younger generation taking care of their elders has severely declined.

However, there is no law that restricts communities to persons of at least 55 years of age. Thus, the active-adult communities that have been developed have eroded after the first move-ins have passed away or moved to a higher level of care. The children have either moved into the facility or sold it to whoever wants to buy it, without regard to age.

Chinese builders have been very successful building market-rate units, so housing for the elder generation has not been a priority. That country has not figured out how to turn a profit as quickly with senior housing, so the development of CCRCs has fallen to insurance companies, which are looking for long-term investment results. But this situation may be changing. A senior housing conference in Beijing last May attracted quite a few of the country's top builders. Those great entrepreneurs are likely to figure out a way to make it work!

India faces many of the same issues that China does, but Indian families are not nearly as small. In India, the younger members of the family also help to provide care.

What makes India different is that access to education and a booming economy provide the younger generation freedom to make choices as to where they want to live. Like China, India is in the early stages of trying to figure out how to house the aging population — what works and how to implement it.

Considering that familial ties have played such an important role in both these countries, with multiple generations taking care of each other, this new approach to supplementing or replacing family care is a huge cultural shift that is not likely to be resolved in the near future.

After having designed residential communities for more than 10 countries, I think the challenge has always been this: "How do we best integrate the cultural issues into our designs?" Taking the person out of the familiar family unit just adds another layer of complexity to the design and planning process.

European Models

Vic Regnier, FAIA, has been studying the European model for decades. His description of the system in the Netherlands is a refreshing look at a viable solution that many countries can learn from. (See accompanying article)

England has approached housing for its aging population in an interesting way. Many facilities that we would classify as “congregate care” are expressed in a number of variations on the theme, from communities of cottages to mid-rise facilities. What the country has done well is create a guideline for all projects to follow that can apply to senior housing anywhere in the world. These Housing our Aging Population Panel for Innovation guidelines reflect what all of us would hope for as we look toward an ideal facility:

  • The new retirement homes should have generous internal space standards, with potential for three habitable rooms, and designed to accommodate flexible hours.
  • Care is taken in the design of homes and shared spaces with the placement, size, and detail of windows, to ensure plenty of natural light, and to allow daylight into circulation spaces.
  • Building layouts maximize natural light and ventilation by avoiding internal corridors and single-aspect flats, and apartments have balconies, patios, or terraces with enough space for tables and chairs as well as plants.
  • In the implementation of measures to ensure adaptability, homes are designed to be “care ready” so that the new and emerging technologies, such as telecare and community equipment, can be readily installed.
  • Building layouts promote circulation areas as shared spaces that offer connections to the wider context, encouraging such interaction, supporting interdependence, and avoiding an “institutional feel,” including the imaginative use of shared balcony access to front doors and thresholds, promoting natural surveillance and providing for “defensible space.”
  • In all but the smallest developments (or those very close to existing community facilities), multi-purpose space is available for residents to meet, with facilities designed to support an appropriate range of activities — perhaps serving the wider neighborhood as a community “hub”, as well as guest rooms for visiting friends and families.
  • Design measures ensure that homes engage positively with the street, and that the natural environment is nurtured through new trees and hedges and the preservation of mature planting, and providing wildlife habitats as well as color, shade and shelter.
  • Homes are energy-efficient and well insulated, but also well ventilated and able to avoid overheating by, for example, passive solar design and the use of native deciduous planting, supplemented by external blinds or shutters, easily operated awnings over balconies, green roofs and cooling chimneys.
  • Adequate storage is available outside the home, together with provision for cycles and mobility aids, and storage inside the home meets the needs of the occupier.
  • Shared external surfaces, such as “home zones”, that give priority to pedestrians rather than cars, and which are proving successful in other countries, become more common, with due regard to the kinds of navigation difficulties that some virtually impaired people may experience in such environments.

Elsewhere...

Most Mexicans and Latin American seniors continue to have strong family support. However, developers in those countries do want to build communities that will attract U.S. and Canadian clients who want to retire in a better climate and a less costly environment.

 I believe the opportunity is in CCRCs, or a variant of those that have been adapted to the specific culture. For example, in some countries there are no Skilled Nursing Facilities. In that situation, the CCRC might then be built around that missing component.

After working internationally for more than 15 years, I have learned that you can present clients with the most logical reason for doing something, but if it is not a part of that country's culture already, you have a real challenge on your hands.

While active adult communities of single-story homes for North Americans may work in Mexico and Latin America, I do not see them as an answer for solving the housing problems in China, India or Europe. There, the land is too valuable to do anything but high-density communities.

If you are involved in services for the aging population,  the world outside the U.S. might seem to be a scary place to venture, but there is a world of opportunity out there as the world’s boomers seek solutions for housing in the decades to come.

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Donald Jacobs, FAIA, is president of JZMK Partners, an architecture and planning firm in Irvine, Calif.

For more than two decades, Don has served as the principal in charge of numerous award-winning projects. His work is published in a variety of international architectural magazines and books, and he has been invited to speak in Poland and China and is working on projects in 10 countries.

Don has spoken extensively on high-density and senior housing at a number of conventions, including the ULI, NAHB, PCBC, NCOSH, and Multi-Housing World Convention. He is NCARB certified and is licensed in California, Texas, Illinois, Arizona, Florida, Nevada, Colorado, New Mexico and Hawaii.

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