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Nov. 14, 2012
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by Cornelia C. Hodgson


Couples playing tennis, friends lounging by the pool, a group sharing a ride to a local college — at first glance, it’s just a typical day at a retirement community, but is it a Continuing Care retirement community (CCRC) or an Active Adult community?  The distinctions are becoming increasingly blurry.

The demographic tidal wave that was predicted by Ken Dychtwald three decades ago is hitting full force as baby boomers reinvent yet another stage of life: retirement and aging.

The convergence of active adult communities and CCRCs is a direct result of baby boomers once again molding the market to meet their new and unique demands. Five key trends shape this revolution:

Trend 1: Universal Attention to Universal Design

Whether in an active adult community or a CCRC, room configurations and amenities reflect the design aesthetic and lifestyle of today’s older adult — open floor plans, one-floor living, master suites, high ceilings, ample views to the outdoors. Design-savvy boomers expect a high level of design, not the institutional look of the past, and are seeking universal design (UD) features.

While the origins of universal design are based on accessibility features, the principles encompass ease of living for people of all ages and abilities, and integrate well into a low-maintenance lifestyle.

The appeal of UD is demonstrated at Montgomery Place in Chicago, whose first approach to the apartment community’s renovation focused on giving kitchens and baths a style that reflected the urban location — a design-forward style with contemporary finishes and appliances. In focus groups, however, the owners found that renters strongly wanted accessibility features.

The resulting larger kitchens (left) include wall ovens and raised dishwashers — not just for looks, but to provide the space for accessible reach and maneuvering. Built-in glass door cabinets facing the dining area also provide easy visibility and access to stored items.

Another approach comes from Hummingbird Pointe in suburban Cleveland, which went through a dramatic repositioning from a modest-income 236-unit rental building into a wellness-oriented senior living community. Developer Forest City added services to a building that isn’t limited to older residents. While it caters to seniors, the apartment community also houses young couples, working professionals, and young families. In addition to a $6 million makeover that renovated apartments and an added 18,000-sq. ft. amenity center (right), the company brought in a home health care agency to provide residents with free access to wellness programs and an on-site nurse, as well as two exam rooms for physicians and therapists to use.


Trend 2: Blurring of Concierge/Clubhouse Services and Assisted Living

In active adult communities, clubhouse staff often help make make dinner reservations or handle registration for travel tours. Taking a cue from those communities, concierge desks at CCRCs have begun to add convenience services such as accepting delivery for packages, pharmacy orders and dry cleaning, as well as arranging transportation for shopping or doctor appointments. Many now offer personal care services through in-house caregivers. The concierge has become the “assistance-in-living” care coordinator, allowing residents to stay in their homes or apartments with the security of extra assistance to support their independence.

The blurring of concierge services and assistance-in-living services is an operational dilemma for both active adult communities and CCRCs, and they respond in various ways. 

A major renovation is under way at Harbour’s Edge, another Lifespace Community on South Florida’s Intracoastal Waterway (left). To stay ahead of coming lifestyle trends, the community's enriched wellness program includes redesigned concierge desks at each apartment entry where multiple staff stations offer not only traditional concierge services, but also provide a private desk for scheduling personal care services.

These trends are no longer unusual for many CCRCs. Almost all now offer fitness centers, auditoriums for lectures and performances, restaurants, beauty and barber shops, libraries and a post office. Most have spas, wellness programs, banking services, gift shops, convenience stores and other useful amenities.

Abbey Delray South, a Lifespace Community in Delray Beach, Fla. for 30 years, is beginning a $6 million renovation. Its residents were heavily involved in the planning process, weighing in on such operational issues as security and dining service options. The final plan included a new gatehouse at the community’s entrance, an expanded 5,000-sq. ft. kitchen, and three distinct dining venues, including a bistro and pub that add casual dining to the more traditional table service.

Offering a room service dining option at CCRCs is another example of melding concierge and assisted living services. Where some communities still wrestle with the “equipment code” issues of allowing walkers or wheelchairs in the dining rooms, the room service option can provide a convenient and comfortable alternative for many residents.

Trend 3: Shift from Entertainment-Only Programs to Lifelong Learning Activities

The stereotype of the retiree playing golf and shuffleboard are long gone. A holistic  active aging approach considers intellectual pursuits as part of the wellness platform, so communities are offering programs that help residents keep both minds and bodies engaged.

Theaters and auditoriums on community campuses are being reprogrammed as lifelong learning centers. At Friendship Village of South Hills, near Pittsburgh, the too-small auditorium is being rebuilt for more expansive programs, and will include new Hearing Loop technology. After the Harbour’s Edge remodel is complete, the theater will have greater capacity, as well as an addition that includes a new Media Center, classrooms and seminar rooms to serve conference center functions.

Many colleges and universities coordinate classes with CCRCs and active adult communities, offering classes at either the schools’ campuses or at the communities’ clubhouses and learning centers.

Kendal Corporation, a pioneer in this approach, has historically located its CCRCs near university campuses to take advantage of courses and the cultural and educational programs offered on campus.

Kendal at Granville in Granville, Ohio, shares a special bond with Denison University (right) in that the community not only leases 60 acres from the university, but residents also are welcome to attend classes, lectures, concerts, plays and athletic events.
 

Trend 4: Bringing Together Fitness and Wellness programs with Therapy and Rehabilitation

Although some very large CCRCs may have on-site medical centers, active adult communities are designed for independence and activity. While golf courses remain popular options for some of them, new residents also want other fitness activities such as bike paths, walking and jogging trails, and full-service health and fitness centers. Other amenities geared to active adults include spas, boating, game rooms, art studios, cafes and restaurants, as well as conference and business centers.

Just as the baby boomers have invented new ways of retiring, they also have developed a new disease — boomeritis. Efforts to stay fit and active sometimes generate the need for rehabilitation therapies for overly aggressive boomers, so there’s a need for both a fitness center and a rehab center — or a wellness center offering both services. When the tour director at the Boca West Clubhouse proudly points out that the latest addition to the fitness center is the rehabilitation therapy clinic, it’s clear that the world of active adult communities and CCRCs are blending.

The understanding that a philosophy of whole-person wellness means enabling activity for people of all levels — from a fit 70-year-old recuperating from knee surgery to a 90-year-old working on strength training for improved balance. Rehab gyms that look like fitness spas are becoming the norm.

Trend 5: Shift from Medical-Model Nursing Care Centers to Residential Households, with Care  

A remarkable cultural change has been taking place in nursing care. The Green House movement, first applied to nursing homes, is now spreading through the senior living continuum. Its premise is that quality of life for older adults can be greatly enhanced by replacing large nursing homes that use the medical model of care with smaller ones that put the resident at the forefront, and where medical care is just one component of a complete system.

Driving this effort is the Green House® model — homes that accommodate between six and 12 residents and give them a chance to create relationships with each other.  Designed to blend into the neighborhood, the homes have all the features of a traditional home — yards, large kitchens, dining areas large enough to seat everyone, living rooms, home offices, and private bedrooms and bathrooms. Medical equipment is well concealed — but staff is able to provide a high level of skilled care.

With its licensed Green House®, Porter Hills Communities, Grand Rapids Township, Mich., added non-traditional skilled nursing care through this residential household model (left). Many of the LifeSpace communities are exploring ways to integrate the Green House/Small House model into their campuses to replace some of the nursing home beds, and offer residents another choice in level of care.

Many developers are exploring the small house concept because it adapts to fit into an active adult campus, and blends well in a residential setting. The original concept of the Green House, offered by Dr. Bill Thomas, is one answer to the question: “How can we maintain our elders in the neighborhood, yet provide the requirements of a skilled nursing home?” 

This is a question that many active adult communities and CCRCs — and their prospective residents — are asking now.

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Cornelia C. Hodgson,
C.C. Hodgson Architectural Group

Hodgson is an industry leader in senior living, applying fresh thinking and innovative design to this fast-changing field. She creates innovative, insightful designs that address an array of options, from active adult independent living to Continuing Care Retirement Communities to settings providing specialized services for well-being.

Hodgson conducts workshops, seminars, and presentations on gerontological and universal design throughout the United States. and was the project executive for "Defining the Wellness Paradigm," the first study to track the state of wellness in senior living communities, and then followed as the co-principal investigator of "The National Whole-Person Wellness Study."

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