The Resurgence of Aging in Place

December 18, 2013  
Filed under Aging Parents

By Clara Rose Thornton

Between the early 1980s and the Great Recession of 2008, caring for senior family members in the home statistically lowered in America in favor of paying for assisted living communities and nursing homes. The culture of multigenerational dwellings also declined in middle and upper class America, as healthy, energetic seniors opted for independent living communities.

But with personal finances hit hard in the last few years, aging in place has experienced resurgence. Seniors and their families who opt for home care should be well informed on the ways to make their environments as functional, safe, aesthetically pleasing, stimulating and enjoyable as possible. The process does not have to be maddening or a severe financial burden. With lessened stress due to educated choices, the experience of togetherness can move to the forefront.

There are new, ready-made developments to ease aging in place transitions, namely MEDCottages and purpose-built multigenerational homes.

On November 27, 2012, The Daily Mail reported on MEDCottages, the pre-fab, high-tech living units for aging family members created by the Virginia company N2Care, which fit easily into standard backyards. “The $125,000 dwelling is being marketed as an alternative arrangement for people struggling to provide adequate care for the aging relatives since assisted living communities have become stigmatized and inviting an elderly relative a spot in the home can prove a squeeze. … The structure, which has earned the unflattering name ‘granny pod’, measures 12 by 24 feet, which is the size of an average master bedroom. ‘The inside maintains a comfortable home, using the space efficiently to create sleeping, living and bathing areas, ‘ the website describing the MEDCottage facilities explained.” Find more information at medcottage.com.

Some people are against the ‘granny pod’ model, feeling it’s akin to putting a loved one in a shed in the backyard. Blogger Ann Pietrangelo writes, “There are some really great alternatives to the ‘granny pod’ on the market. All of the biggest builders in the country now offer multigenerational floor plans that are meant to accommodate people of all ages. In some respects, it is now up to cities and towns to change their zoning laws in order to allow this type of housing and make sure that more seniors are able to age in place and be surrounded by their family members.” (“The ‘Granny Pod’ Alternative,” Care2Causes.com, August 23, 2010)

What about those operating in a traditional setting? What are major factors to consider for a home’s aging-in-place readiness?

For a healthy, independent senior remaining at home, or for a family remodeling a home, here’s a checklist and concerns from Certified Aging in Place Specialist Larry Dean, of Burlington, and from Vermont aging-in-place builder Tom Moore of Underhill Center.

Larry Dean completed his CAPS training prior to joining Wiemann Lamphere Architects, a firm that designs independent living and assisted living facilities.

“As a Certified Aging in Place Specialist, I’ve consulted privately for individuals with disabilities interested in buying a particular house and wishing to know if the house could be made accessible for current and future needs. I’ve worked with retrofitting existing homes to accommodate aging and/or disabled family members,” said Dean.

Dean explained how he evaluates a home. “A consultation can include the existing layout, noting the position and condition of rooms, stairs, plumbing, width of corridors and doors, and elevation changes. Learning the current and future needs of the client is very important. It is essential to listen and learn from the client that which is most significant; for one it may be an accessible kitchen, for another it may be an accessible path to the back yard, or keeping the bedroom on the second floor. Once the existing conditions and needs are known, the design consultation can begin.”

Dean stressed the importance of aesthetic and function, so that these homes increase universal livability and enjoyment.

“Accessibility is universal; everyone can use a ramp. Lever knobs and thick-grip tools are easier for everyone to operate. Wider doors and turning spaces can be more comfortable and should be thought about during the initial design of the home. Depending on the budget, there are wonderful products that can be seamlessly integrated into a home, such as attractive towel racks that are also designed as grab bars. I like the new push-pull lever doorknobs from Brinks that allow one with limited use of the hands to easily open a door. This would include someone with hands full with bags of groceries.”

And what did Tom Moore, who started his company Tom Moore Builder, Inc. in 1974, choose as one of the biggest precursors to a rewarding and enjoyable aging in place experience?

Quite simply, “organization —  a place for everything and everything in its place.”

FIT TO EAT: Time For An Oil Change

December 18, 2013  
Filed under Food

By Dr. Stuart Offer

Over the years, dietary fat has come in and out of fashion and at times been a dietary villain. In more recent years, nutritionists are agreeing that the right oils can be a welcome part of a healthy diet. Love fats or hate them, there will always be one consistent fact —  fats are very calorie-dense, having more than twice the calories as proteins or carbohydrates. Fat, particularly healthy oils, play a big part in my diet and cooking.

Since heart disease is the number one cause of death for both men and women, it is important to choose oils that support a healthy heart. There is no debating that we should be consuming natural fats and avoiding unnatural ones. Trans fats (partially hydrogenated oils) are manmade fats that are associated with an increased risk for heart disease. These should be avoided at all cost. If you see this as an ingredient in any product, be afraid, be very afraid and put it back. Saturated fat, also a contributor to heart disease, is another less than healthy choice and should be reduced as much as possible. These are fats found in the highest concentration in many animal products such as meat and dairy.

We should be choosing oils that are high in heart-healthy mono- and poly-unsaturated fat. These types of oils are associated with a reduced risk of heart disease because of their positive effects on blood cholesterol

Monounsaturated fats actually help to lower total and bad (LDL) cholesterol levels, without negatively affecting your good (HDL) cholesterol levels.

Polyunsaturated fats also help to lower total cholesterol, however some research shows they may also lower good (HDL) cholesterol in the process. Some polyunsaturated fats are also good sources of omega-3 fatty acids, which have been shown to decrease the risk of blood clotting and inflammation to help lower the risk for heart disease.

Knowing which oils are the healthiest is only half the battle. Pairing the right oil with the proper cooking method is important, as well. Some oils are good for high heat cooking, while others are better for salad dressing. One way to determine this is to look at the smoke point —  the temperature at which oil begins to smoke and break down, releasing carcinogens into the air and free radicals into the oil. When it reaches this point, you should discard the oil and start over.

Here’s a guide to the healthiest cooking oils and ideas for making good use of them in your kitchen:

1. Walnut Oil: A polyunsaturated fat and good source of omega 3s. With a smoke point of 400° F, this oil is good for baking and sautéing at low to medium-high heat or try it drizzled on a salad.

2. Flaxseed Oil: A polyunsaturated fat and good source of omega 3s. Due to its low smoke point of 225° F, it should not be used for cooking over heat. Try it stirred into dishes after heating or in salad dressings, salsa or smoothies.

3. Canola Oil: A monounsaturated fat with a medium high smoke point of 425° F, use it in baking, sautéing, stir-frying and in dressings.

4. Olive Oil: A monounsaturated fat with a medium smoke point of 325° F, use this flavorful oil for light sautéing, sauces like pesto and salad dressings.

5. Peanut Oil: A monounsaturated fat with a medium smoke point of 350° F, use this flavorful oil for light sautéing, sauces such as curry and salad dressings.

6. Almond Oil: A monounsaturated fat with a high smoke point of 495° F, this is a good oil for high heat cooking, like sautéing or frying. Its great flavor also works well in desserts.

7. Avocado Oil: A monounsaturated fat with a high smoke point of 510° F, this is a good oil for high heat cooking, like sautéing or frying, and tasty in salads.

8. Safflower Oil: A polyunsaturated fat with a low saturated fat level, this oil is a good all-purpose oil. Its high smoke point of 450° F makes it good for high heat cooking, like sautéing and frying.

9. Sunflower Oil: A polyunsaturated fat with a low saturated fat level, this oil has a high smoke point of 460° F making it good for high heat cooking, like sautéing and frying.

10. Grapeseed Oil: A polyunsaturated fat with a low saturated fat level, this oil has a high smoke point of 420° F, making it great for cooking and grilling of all kinds. It also has a very mild, nutty flavor that’s versatile enough to use in salads or virtually anything.

When outfitting my kitchen, I like to have two oils, one for salads and one for high heat cooking. My two go to choices are extra virgin olive oil and avocado oil.

Here is a simple recipe that could rival any Four Star restaurant. Use it for pasta, veggies or a sandwich spread.

Alzheimer’s Association 2014 Programs and Events

December 18, 2013  
Filed under Things to do

Program Educator Training – Jan. 8, Alzheimer’s Association Offices, Williston. Volunteer Community Educators and Chapter staff present community-based programs: Know the Ten Warning Signs; The Basics: Memory Loss, Dementia and Alzheimer’s; Living With Alzheimer’s series; and a new program, Conversations About Dementia. If you are interested in volunteering as a Community Educator e-mail Maggie.Lewis@alz.org or call 1-800-272-3900.

Monthly Program Series: Third Tuesday of each month starting in January, Alzheimer’s Association Offices, Williston. topics include: The Warning Signs; Disease Basics; Resources to Support and Guide.

50-Plus and Baby Boomers EXPO – Jan. 25, Sheraton Hotel and Conference Center, Burlington. Learn more about Alzheimer’s disease and area resources, volunteer, try your luck in our 50/50 raffle, or bid on one of our exciting silent auction items.

Program Educator Training: Jan. 2014.

Camels’ Hump Challenge: Feb. 23, Camel’s Hump, Huntington. Backcountry ski event raises funds for the the Vermont Chapter. Visit http://www.camelshumpchallenge.com/ for more information or to register.

Living with Alzheimer’s Mid-Stage Part 1 and 2: Feb. 27 and March 6. Northern Vermont Regional Hospital, St. Johnsbury.

Dance to Remember 2: March 22, Brookline Event Center, Brookline, NH. 2nd Annual Dance to Remember line-dance event. Visit http://www.denisebrault.com/ for more information or to register.

Alzheimer’s Association Advocacy Forum: April 7-9, Washington, DC. Join fellow advocates bring our key legislative priorities to Capitol Hill.

Alzheimer’s Awareness Day at the Vermont Statehouse: April 29, Help raise awareness for Alzheimer’s disease and its impact on Vermonters. Email Martha.Richardson@alz.org for more information.

Reason to Hope Dinner: Spring 2014 – details coming soon.

The Longest Day – June 21

Vermont Walk to End Alzheimer’s Kick-off, Summer 2014

Vermont Walk to End Alzheimer’s – Fall 2014

For more information, call 1-800-272-3900.


Growing the Perfect Christmas Tree

December 18, 2013  
Filed under Business

Christmas tree farming is a year-round industry that culminates in flurry of the winter holiday season. (Courtesy photo)

By Phyl Newbeck

Some of you may still be wondering where you’re going to get your tree this year. Thankfully, the folks who grow those trees are way ahead of you. They get started with their tree farms in the spring, working through the summer and fall to give you the centerpiece for your holiday joy.

One of the first jobs for a tree farmer is getting rid of last year’s stumps. Marcia Urie of Urie’s Tree Farm in Williston begins that process as soon as the snow is gone from the ground. Both she and Mike Isham of Isham’s Farm, also in Williston, start planting in early May. In Morrisville, Tom Paine of Paine’s Christmas Trees starts even earlier. Paine plants his seedlings at the end of April, as soon as the ground has thawed, with the belief that wetter ground gives them a better chance of getting established.

Those seedlings need tender loving care so most growers use a little bit of fertilizer and then some light herbicide, while mowing the rows as often as once a week in the height of the growing season. Isham, Urie and Paine all try to use the least invasive products possible to prevent weeds from taking over the trees. While some growers also use insecticides, Isham believes his location in an open field with the wind blowing across the land has helped keep him free of insect problems.

Even Charlie Brown’s Christmas tree had one solitary branch on top, which is known as a leader. Since not every tree grows that way, farmers go from row to row, shaping them into the conical figure most people prefer. Paine gets started early, often beginning his trimming the first week of July and sometimes finishing up by the end of September. Isham also starts his pruning in July but Urie, who has the smallest operation of the three, admits that if it’s really warm during the summer months she waits until September to shape her trees with a machete.

After the tops of the trees are shaped, there’s work to be done at the bottom. A process known as basal pruning provides trees with a “handle” which allows them to be easily carried and put in tree stands. Isham said basal pruning is generally not done until a tree is four years old because in younger trees, the branches grow back. Basal pruning has the added advantage of providing growers with material for wreaths, which explains why Urie does it as late in the season as possible.

Even with all this TLC, not every tree survives long enough to be decorated with tinsel and family heirlooms. This May was so hot and dry that Urie had to haul water to her trees; something she’d never done before. Then the rains came and she lost a number of firs due to the saturated ground. The constant rain caused Isham to lose almost a third of his new plantings and close to 50 of his older trees.

“When I first started I thought I could use marginal soil,” he said “but I’ve learned the hard way that it has to be well drained.” In 2012, Isham’s problems were at the other end of his trees. Birds —particularly crows—landing on the top branches broke many of the leaders. Urie hasn’t had much trouble with birds, but deer have been known to munch on the tops of her trees.

Isham and Urie favor Fraser firs while Paine is partial to balsams. Balsams have a stronger aroma while Frasers hold their needles better and are harder to grow. Paine is able to grow Frasers because his land is mostly sand and gravel; Frasers aren’t fond of wet soil. Urie also grows some spruce trees but found there isn’t much demand for them.

Farmers say it’s hard to figure out how many trees to plant, given their uneven mortality rates and the fact that most people are looking for trees in the eight- to 10-foot range. Last year, Isham closed his stand on Dec. 9 to make sure he would still have mature trees to sell this year.

“I didn’t want a reputation for just having four or five foot trees,” he said. “I’m fortunate that I live in a good community where people support local agriculture. The public allows farms like mine to stay in business, which, in turn, allows us to keep the land open. Vermonters are great that way; they’re willing to support local farms.”

Those agri-friendly Vermonters are what keep these farmers going.

Holiday Gifts for the Older Adults in Your Life

December 18, 2013  
Filed under Aging Parents

By Alexis Abramson, Ph.D.

It can be particularly difficult to find appropriate gifts for our older relatives, friends or clients. So what’s the secret to success when shopping for the senior in your life? Do you go with practical or fun? High-tech or low-tech? Here are some great ideas that will hopefully help you as you begin to tackle your gift list for the seniors in your life.

The RuffGrip® Dog Leash – This leash makes walking a dog easier for people with gripping or dexterity problems due to arthritis in the joints of their hands. The extra padding and no-slip grip is lightweight and provides extra control, while the super soft leather lining makes the leash extremely comfortable to hold. www.Ruffgrip.com

Chef’n® PalmPeeler – For those folks in your life who have hands that are aching or shaky, this peeler is amazing. All you do is slip your finger through the soft rubber ring on top for a natural feel and extremely easy peeling. The user’s hand force is also minimized due to the unique design. www.chefn.com

VTech CareLine ™ – Want the senior in your life to stay socially connected? Seniors are empowered to maintain active lifestyles and close relationships with this home telephone and personal communication system. This product was designed to answer seniors’ daily communications needs and support hearing, dexterity or vision challenges. Features include large displays, photo speed dial, reminder capabilities, volume boost and a wearable pendant with one-button dialing that directly calls those pre-selected people who seniors communicate with most or for emergencies. www.vtechphones.com

Easy Grip Slant Tip Tweezers – These tweezers are specifically designed for those with gripping and dexterity challenges. They are ready to use, right out of the easy-to-open package. The rounded back rests in the palm of the hand for stability and control. The comfortable, soft rubber finger and thumb grips make the tweezers easy to hang on to while they are being used. They also have precision tips with a unique gripping surface to tweeze fine and tiny hair. www.riteaid.com

The Magellan Maestro 5310 – This portable GPS-based navigation system is specifically geared toward seniors who are on the road. It features a larger screen and improved readability. This is a great gift for the older adult in your life who likes to seek out and experience new places but might need a little direction. www.magellangps.com

Tee Pal Pro – Having a bad back doesn’t mean that your aging loved one needs to give up golf. In fact, the low-impact nature of the sport makes it an ideal physical activity for mature adults. However, there are still challenges, including bending over to tee up the ball. The Tee Pal Pro is a unique, lightweight and ergonomic golf ball-teeing device, allowing users to remain upright so they don’t have to bend over to “tee up the ball.” www.teepalpro.com

EasyWear Jacket and Pocket Cape – This versatile, practical and super soft Janska’s EasyWear Jacket and Pocket Cape is a wardrobe staple. The minimalist design and thoughtful details, such as oversized buttons and generous armholes, can make getting dressed easier for people with gripping, dexterity, bending or reaching challenges. This unique clothing line was actually created by a caregiver who was frustrated with the scarcity of functional, stylish clothing options available to those with limited mobility. www.jankskawellnesswear.com

Easi-Grip Cheese Slicer – The contoured handles of this product were re-molded in a soft feel plastic, which gives a firm comfortable grip in either hand. The stainless steel tools are set at 90 degrees from the handle, keeping the hand and wrist in a neutral stress free position. Easi-Grip Knives and Kitchen Tools are super comfortable for everyone to use, but will be particularly beneficial for those with gripping and dexterity issues. www.lifewithease.com

The Radius Trowel – This lightweight senior-friendly gardening tool features an innovative curved handle (called the Natural Radius Grip), making it user-friendly and comfortable even for people with arthritis of the joints in the hands. Intuitive and easy-to-use, this grip helps enable digging, even in tough soil, without putting excess strain on the hands or wrist.
www.radiusgarden.com

Bathtub Steps – These steps add a great deal of safety and stability when getting in and out of the bathtub. The product provides a four-inch boost with a slip-resistant textured top and rubberized feet, enabling users to confidently climb over the tub wall, even in wet conditions. www.easycomforts.com

Two Handle Coffee Mug – This mug features extra large handles that allow for multiple gripping and lifting options for those with decreased dexterity. The two handle ceramic mug has a curved rim that helps prevent drips, and can be used with hot or cold beverages. The mug was designed to provide drinking independence for those with limited strength or other challenges that might prevent them from holding a traditional mug. www.caregiverproducts.com

FiNIS SwiMP3 Headphones – Swimming is one of the best activities a senior can do for their body! It’s easy on the joints and works nearly every muscle….all the while taxing their heart and lungs. But…no doubt – even swimming can get boring at times. Thankfully, there are these fully submersible headphones that transmit music through ones cheekbones and are said to provide a meditative rhythm to the swimmers stroke. www.finisinc.com

Hall to Lead CVAA

December 18, 2013  
Filed under News

CVAA recently announced that John Michael Hall will be the new executive director, effective in July. Hall is currently the Senior Director for the National Association of States United for Aging & Disabilities. Previously, he was the Director of Integrated Health Systems at the Center for Medicare & Medicaid Services and served as Secretary of the Department of Aging and Office of Long-Term Living in Pennsylvania.

Hall has long-standing connections to Vermont, having held a number of senior positions at Vermont’s Department of Disabilities, Aging & Independent Living and the Vermont Agency of Human Services under governors Dean and Douglas. Hall began his career in the Northeast Kingdom, working first as an elder law attorney at Vermont Legal Aid and later directing the Elder Law Project and Long-Term Care Ombudsman program.

Kathi Monteith, CVAA board president, led the national search for a replacement for retiring Executive Director John Barbour. “Mike Hall is the ideal person to lead CVAA in new directions in programs and services for seniors in Vermont. The board, staff and volunteers welcome Mike as the leader to take the organization into the future.”

Making Hard Decisions

December 18, 2013  
Filed under Mature Matters

By Sarah Lemnah

They say one of the hardest things to do is to move to a new home. Giving up a home that you loved, packing up boxes of things that for some reason you feel you cannot part with, and being in a strange new environment is a hard adjustment. Your home is your safe place — moving, even if you are moving up, is difficult to do. Most of us move because there is a change in our life: we got a new job out of townl; we expanded the size of our family; or we off to new adventures.

If moving in the best of times is stressful, how about moving in the worst of times? Or worse yet, how about having the conversation with a loved one that they need to move because they are no longer safe at home, but they don’t want to move. What do you say to a loved one?

As someone who works in senior services, I know the drill about difficult conversations: it is no longer safe for you to drive or you need supports to enable you to remain independent. I have written dozens of columns and talked to hundreds of people on the topic. All of that fades, however, when you personally need to look at someone you love and tell them the news that they are not safe at home, tell them they need to move where there are people around 24/7, and to tell them that they cannot keep their home or maybe even their pet.

My grandmother is 96 years old. She is independent and proud of it. She has been on her own since her husband died 42 years ago. She lives in a small apartment with her cat. It seems like it was only a few years ago that she was a foster grandparent and was driving from St. Albans to Williston to visit Walmart. However, a few short years can bring a lot of change when you are in your 90s. First there was a concern about her driving — that conversation did not go well. Then there was a fall and a broken hip. Against all odds, she recovered well from hip surgery, made it through rehab and was soon back home knitting dish cloths, over-feeding the cat, baking holiday cookies and living her life. Her life was smaller, but she was still independent and making it work.

Over time, she needed more help. Family members took on their roles. There was someone to pay the bills and go through the mail, set up her medications, clean the house, buy the groceries and do the laundry. It can take a lot to keep someone independent, but you do what you need to do. However, sometimes there comes a point when no matter how much help someone receives, it is just not enough.

What do you do when someone’s mind starts to fade and the simple things in life they used to enjoy they can no longer do? What do you do when they start exhibiting dangerous behaviors? It is sad when a loved one no longer remembers you, it is sad when they can no longer knit or bake. It is sad when the memories of their husband and children fade. But it is scary when someone forgets to eat, starts to burn baking pans (nearly starting fires), when they don’t take or overtake their medications, when they no longer understand how to use the phone to call for help, when they forget how to cook and call and say they are hungry. Sad things happen, but scary things are dangerous.

My grandmother went to the hospital because she stopped eating — while there, we found out she had a small heart attack. She is now in rehab and the family is trying to find the best option for her to live with independence and dignity, but be safe and well cared for. I have learned a huge lesson in all of this. Telling people what options they have and telling them how to have difficult conversations is easy. Being the one to make difficult decisions and have difficult conversations with your loved one is heartbreaking.

Dementia robs us of so many things and one of them is the ability to be able to live the life we had planned. When you are no longer able to make sound decisions for yourself, your family is left trying to figure out what is the best option and what you would want to do.

Finding a good assisted living facility, especially if you are not able to private pay, can be challenging. Find facilities that are close to family and friends. Visiting people with diminishing physical and mental abilities can be depressing as we want to remember loved ones as they once were. However, the emotional attachment to family is still there even after the memory is gone. People may forget names and faces, but sensing they are loved is never gone. Find homes that offer good care and well maintained facilities. Remember this will be your loved one’s home — their last home — so find a place that they can be as comfortable as possible. Many assisted living and nursing home facilities today offer excellent food, activities and outings to make the residents stay as happy as possible. Your loved one will adjust to their new surroundings and you will have to adjust to the new normal with your loved one.

Guilt is a tricky thing. We make ourselves feel bad for doing what we know we have to do to keep our loved ones safe. Remember when you were raising your children, being your child’s parent was more important than being his or her friend. You need to look out for your loved ones no matter what age. As you go down this path with your parents and grandparents, let it remind you that life is short. We all need to enjoy every minute and we need to plan for our future so we do not put our loved ones in the position of making these difficult choices. You are not alone. There are case managers who can help your family with these difficult transitions and there are workshops to help family caregivers. Ask for help as you maneuver down this emotional path.

Sarah Lemnah writes on senior issues for CVAA. For more information on services for seniors call the Senior HelpLine at 1-800-642-511.

Senior Living Trends

December 2, 2013  
Filed under Feature Stories

Rick Grimes, president and CEO of Washington-based Assisted Living Federation of America.

By Clara Rose Thornton

 

I found myself watching “Cocoon” (Ron Howard, 1985), again after all these years. Its initial scenes of retirement community life seem to jump from the screen, its colorfully clad men and women joking and dancing and flirting. Two men engage in locker room humor as they stroll down a hallway to see a friend; a few ladies roll their hips in mock seduction as they burn calories to pop music behind an instructor.

Despite the 1980s Hollywood chic, what came to mind was a real-life sentiment from Rick Grimes, president and CEO of Washington-based Assisted Living Federation of America, who I’d interviewed the day prior.

“When (people) move to a senior living community, their life changes. They become socially active, make friends, and start to take better care of themselves,” he said. “People often live at home by themselves in a house too big for them after their spouse has passed away,” he said. “They become socially isolated, may not take their medications properly, and often live in potentially dangerous situations — for example, trying to go up and down stairs. They might live a poor quality of life, and can get depressed.”

In the culture of senior living options — independent living communities, retirement villages, nursing homes, memory care or continuing care — the peer group looms tantamount to medical assistance. For a family that can no longer look after an ailing loved one in their home, or a single senior or couple for whom an isolated environment isn’t ideal, the daily energy and support offered within community is life-giving. And of course, as with the “Cocoon” coterie, opportunities for dancing and flirting are therapeutic at any age.

Yet in 2013, as we continue to clear the smoke of the Great Recession, the senior living industry faces setbacks and concerns manifesting in new trends. Medicare and social security cuts at the federal level, combined with facility funding cuts at the state level; a dip in occupancy numbers while creative solutions for aging in place increase; and efforts to meet evolving technological standards lie among top concerns.

On April 10, the New York Times article, “Health care and military spending bear the brunt of proposed cuts,” reported that President Obama’s “budget would require $57 billion in higher payments by Medicare beneficiaries, cut $306 billion in projected Medicare payments to health care providers and squeeze $19 billion out of Medicaid, the program for low-income people.” [As of this writing no official budget has been approved.] In Vermont, cuts that took effect on Oct. 1, 2012 precipitated the loss of $16,000 in state funding and more than $50,000 in federal funding for senior care, according to an August 17, 2010 Brattleboro Reformer article, “State, federal budget cuts threaten senior services.”

Industry leaders are optimistic

Journalist George Yedinak at Senior Housing News writes, “After almost four years of economic challenges, the United States is starting to show further signs of recovery, but increasing costs and funding cuts are the ‘new normal’ for senior living. The senior living industry feels that this shift is not a new normal but is just the business reality of caring for aging Americans. With these signs and the slowly improving housing market, providers, communities and consumers are finding confidence as a new foundation congeals.” (“Top Ten Trends for Senior Housing 2013,” January 7, 2013)

“We are not struggling. Business is growing,” Grimes said.

“Yes. The recession did impact the ability of some seniors to move to an assisted living community because, in part, they couldn’t sell their home or it was reduced in value,” he said. In 2009, the national average for a private room at a nursing home was $219 daily, or $79,935 annually, while a semi-private room was $198 daily, or $72,270 annually. A one-bedroom apartment or private room with private bath in an assisted living community averaged $3,131 monthly, or $37,572 annually. Many were unable to meet costs. Seniors stayed in their homes longer, and attractive alternatives to the standard housing model emerged, such as “granny pods,” or MEDCottages, which at an $85,000 to $125,000 one-time fee is a fraction of ongoing facility rates.

But in late 2009, America’s real estate market began a steadying ascent due to interest rates being historically low, and senior housing construction and investment increased.

Building Design and Construction reports, “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.” (“8 trends shaping today’s senior housing,” January 3, 2013) ALFA cites 2008 as a peak year, showing figures that assisted living construction activity in 2013 has surpassed. (“Housing Fundamentals and Trends in Senior Living,” Assisted Living Surpasses Prior Peak graph, May 7, 2013).

Given re-invigoration of investment and the rise of supply to meet demand—10,000 Americans turn 65 every day— how are these new facilities envisioned, how will they deal with federal cuts, and how will computer and Internet technologies and natural wellness trends be integrated, cultural developments that push older buildings and standards toward obsolescence?

The future of affordability may look something like the new Dana Strand Senior Living Apartments in Los Angeles. Designed by KTGY Architects for ROEM Development Corporation, the Leader in Energy and Environmental Design Gold-standard, 100-unit complex repurposed an underutilized urban infill site. Its one-bedroom apartments measure 540 square feet. The $22.3 million community features wellness programs, a computer center, media room, lending library, and a common room. Residents can take ESL and computer classes. ROEM Development Corporation works with low-income seniors receiving project-based Section 8 rental subsidies. Variations of this model can fit both independent and assisted living.

Said Grimes, “Everyone wants to live at home. But these communities are purpose-built for seniors and are thus inherently safer, with, non-skid flooring, handrails, no stairs. Note the use of ‘community’ instead of ‘facility’. A facility implies institutional care, and no one wants to live in an institution. The community becomes home.” Here’s wishing for affordable and functional homes in 2014 and beyond.