How are senior living communities evolving?
This article appeared in the 2020 Spring issue of Urban Land on page 62.
ULI MEMBER-ONLY CONTENT: Experts in real estate development for the age-qualified and service-enriched housing sectors discuss changing consumer preferences in senior living, the impact of new technologies, the growing interest in wellness, and other trends affecting operators of senior living communities.
What is changing about what consumers want and need from housing for seniors?
Lori Alford: Twenty years ago, our consumers were people who had lived through the Great Depression, and their expectations were very different. They didn’t have the luxuries of life, and they weren’t eating out and traveling a lot. Now, members of that generation are a minority of our residents. The consumers coming in today are more educated and more well-traveled. More women have worked outside the home. With all these factors comes a different level of expectation.
Marco Vakili: In the past, senior living communities were primarily focused on providing care, and the physical plant—the building itself—was considered ancillary. Today’s consumers expect that the care they receive will be exceptional, and they also want the physical environment to promote a healthy lifestyle, psychologically and physically, while providing safety and security and promoting socialization.
Dale Boyles: Residents are expecting better food, better dining venues, and a variety of dining venues, from formal to casual. They want better-designed bars and amenities spaces as well. And we are starting to see the “silver tsunami” arrive, as baby boomers start to consider senior living communities. Those 65- to 75-year-olds don’t tend to want the full-service model: they don’t need three meals a day and transportation provided. They want a great location and premium amenities while cooking and driving for themselves.
Kathryn Burton Gray: Affordability is also becoming a bigger issue. In the last five years, there was a big influx into urban communities, but land costs have become so high in cities ranging from San Francisco to Birmingham that I think we will see a return to suburban communities. Consumers are interested in housing with smaller footprints. They’re looking at co-op communities, where a group of people create housing around a shared common space and they don’t need an operator to run the community.
Dave Mazurek: Compared to the silent generation, the baby boomers are working longer and saving less, and they have more debt. They’re more tech savvy and they have a higher educational attainment, and they have had a longer time to be exposed to senior living communities, not just from their own experiences but also those of their loved ones. I think consumers are going to become more likely to embrace communities that provide lifestyle conveniences and holistic wellness.
How are new technologies changing senior housing communities?
Vakili: One of the first questions adult children ask when considering a community for their parents is, “How will my mom or dad be safe, especially with visitors and caregivers coming in and out?” New technologies are allowing us to provide our residents with enhanced safety and security. We’re also considering adoption of Mirror technology, which allows a resident to go to a fitness room and take an interactive fitness class customized to their interests and abilities. The program remembers who they are, it will ask if they want to do the same kind of exercise routine as last time, and it allows them to be independent rather than having to take classes, if that’s their preference.
Boyles: Younger seniors and adult children of residents are definitely more comfortable with technology and expect to see it in a senior living community, but the older seniors may struggle a little. The challenge for operators is integrating technology in a seamless, easy-to-use platform that will also maintain privacy. If we have cameras in rooms now, we have to consider privacy issues, both for residents and caregivers. So technology will rapidly enhance our industry, but there will be some bumps along the way as we figure it out.
Burton Gray: I expect more senior living communities to implement technology, such as solar panels, to reduce environmental impacts. And I think we’re going to see a lot of smart houses. I can do everything on my iPhone: I can set the temperature of the house, I can turn the lights on. And because baby boomers and millennials are very interested in having a lot of choice, I can see residents using their iPhone or iPad to order groceries or even meals: they can order what they want for lunch, when they want it, and it will be delivered.
Alford: Technology allows us to have better communication and more disclosure and transparency. Take medical records, for example. We can keep them electronically now, and when a resident goes to a hospital, we can share that information digitally rather than just printing out a one-page fact sheet. Doctors can log into our systems and see what the resident has been going through since they started living here and get a better glimpse of their lifestyle. Technology can also help operators track where residents are in the building, and with RFID [radio-frequency identification] keyless entry, our residents don’t have to fumble with keys.
What are some of the most exciting ways you’ve seen for incorporating wellness into senior living communities?
Vakili: The wellness aspect has grown beyond just having a gym with exercise equipment. Seniors can be lonely and suffer from depression. So communities are creating spaces now for meditation and mental health classes. We also are taking a page from the hospitality industry and raising the bar for landscape design to create peaceful, inspiring places where residents can sit by themselves or with family members and be in nature.
Boyles: The old days, when senior living communities had an exercise bicycle and a treadmill in a corner of a building, are over. People understand the value of exercise in promoting physical and mental well-being. As a result, gyms are being placed closer to the front of the building so people can easily see and access them. Golf simulators allow residents of all abilities to engage. Also, in the old days we relied solely on caregivers to observe if a resident was declining, but technology platforms can monitor residents and identify if, for example, they aren’t sleeping well. They allow us to have hard data.
Burton Gray: We have more information nowadays about aging and health, and we now know that food is medicine. Senior housing providers will no longer be serving hot dogs and food laden with fat and salt to aging residents. Also, 60 is not what it used to be: I have friends in their 60s and 70s who are running marathons. Consumers will be demanding more and better exercise equipment, better nutrition, and better testing—even genetic testing and analysis. That’s the future.
Mazurek: A more holistic approach to wellness is becoming more common, with senior living communities creating programs that give residents support in the key areas of mind, body, and soul. An example is Senior Resource Group’s new wellness initiative Zest, which is evidence-based and takes into account fitness and social connection and dining. There is also more integration between senior housing providers and health care providers, such as Welltower’s collaboration with CareMore Health. This type of collaboration can enhance information sharing and programming to improve resident wellness.
Alford: There is a greater focus on providing not only more fitness options, but also healthier food options. For instance, we don’t offer any fried food in our buildings. Every single menu has healthy choices. The industry is evolving in response to society’s changing expectations. People in general are more health conscious—for instance, smoking less, taking vitamins, going vegan, and meditating—and senior living communities need to take these changes into account for the aging population.
What innovative models of senior living are you seeing emerge?
Vakili: Twenty years ago, senior living communities were built in areas that were quiet and out of the way. The thinking has changed 180 degrees, and we now know it’s much better to incorporate senior living into larger communities so residents can interact with members of different generations, ranging from kids who are still in school to middle-aged adults. This is a great trend that we should be continuing.
Mazurek: A variety of partnerships are unfolding. Senior housing providers are partnering with medical systems, such as Welltower with CareMore Health, or Belmont Village Senior Living, which is partnering with Baptist Health South Florida. Other providers are partnering with universities to enable residents to take lectures and use college fitness facilities. And there are what I would call resident partnerships, such as co-op programs or co-living spaces. For example, Garden Spot Village Cooperative Living House, created as part of Garden Spot Village Retirement Community in New Holland, Pennsylvania, is a single-family home where five unrelated residents share private living quarters.
What other trends are affecting senior living communities?
Vakili: The vision of those of us in the industry is that soon residents will live in senior housing communities not because they have to but because they want to. It has been a need-based decision in the past, but we can make design enhancements and help raise awareness of the benefits that senior living communities provide compared to a more isolated life spent alone in a house.
Boyles: One of our goals is to create environments that anyone would be excited to live in and that don’t feel and look like grandma’s house, but instead look more sophisticated and hospitality focused. The buildings should cater to people’s needs but still speak to lifestyle and dignity and amenities and family and community. Another trend is that the hallmark for service-enriched senior housing is the people who care for residents. It can be more difficult to find people who are both technically qualified and motivated to care for seniors. We can build amazing buildings, but it all depends on passionate people bringing these communities to life.
Mazurek: Employee retention is a challenge for every operator of senior living communities. With overall low unemployment and many states increasing the minimum wage, existing and prospective senior living employees have a variety of employment options. They might make the same amount of money at a non–care providing position, and have the same benefits, without the difficulties that can come with being a care manager. The senior living community operators that create great corporate cultures with excellent benefits programs are going to have a competitive advantage.
Burton Gray: The new Latitude Margaritaville active adult communities in Florida and South Carolina are an interesting trend. The developers noticed the group of people who love going to Jimmy Buffett concerts, and so they built Jimmy Buffet–branded communities. Units there are selling like hotcakes. The residents love feeling like they live on a Caribbean island. If you can create a specific experience for people, that can really catch on. I’m also interested in the trend toward very high-end senior living communities in New York City. Is there a market for units that cost $20,000 a month and up? The services they provide would have to be off the charts.
Alford: Consumers want larger rooms than they did 20 years ago. And multipurpose rooms are changing. Instead of having one big room for a theater, one big room for an art studio, and one big room for a dining space, providers are converting these rooms so they can be used for several different experiences over the course of a day. Providers are also offering multiple types of kitchens and dining venues. They may be smaller, but they offer variety so people don’t feel like they are going to the same location for three meals a day every day.
RON NYREN is a freelance architecture and urban planning writer based in the San Francisco Bay area.