LA Assisted Living Centers Coming On Strong After Prior Lags

SLIDELL, LA (AP) — For Margaret Grannan's family, the question of where their aging mother would live boiled down to safety. At 93, she was at risk of falls, and small lapses in memory had her family worried about things like her using the stove. Her doctor told her she could no longer live alone in her own home.

         But when her children started discussing which of them she would live with, Grannan, a self-reliant sort, had her own ideas. She had raised seven children and, at 50, had started a career with Reily Foods Co. in New Orleans, handling product complaints.

         "I told my family, 'No, I don't want to live with one of you. I'll find myself a nice place to live, and you can come see me,' " she said.

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         That place turned out to be Azalea Estates, an assisted living center in Slidell, where Grannan, now 96, has a studio apartment. She retains a measure of the independence she cherishes, and her family knows that someone has an eye out for her.

         The assisted-living choice continues to grow in popularity nationwide as older consumers, who often have financial means, demand a range of options for their post-retirement years. It's also on the rise in Louisiana.

         Assisted living centers, which have been around since the 1980s, provide help with daily living tasks from bathing to dressing and, increasingly, with memory care for residents with dementia.

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         They are almost exclusively private-pay facilities, according to Arthur Mora, a professor of global health management and policy at Tulane University's School of Public Health and Tropical Medicine. That's in stark contrast to nursing homes, which are almost exclusively paid for by Medicaid.

         Assisted living centers tend to have a smaller number of residents than nursing homes. According to the federal Centers for Disease Control and Prevention, the average of beds in nursing homes nationally is 106, compared with 33 for assisted living centers.

         Assisted living centers, also known as residential care facilities, tend to attract older seniors, often those 85 and older, according to the National Center for Assisted Living. Members of the so-called silent generation, like Grannan, and even some older baby boomers already are part of the market for assisted living.

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         Their numbers are only going to swell with the advance of what one retirement community marketing representative calls the "silver tsunami." The population of people 85 and older is projected to nearly triple between 2015 and 2050, according to the CDC.


Louisiana lags behind


         Louisiana, like the South in general, has lagged behind other parts of the country when it comes to assisted living centers. Nursing home care has long been the dominant care model in Louisiana, although the number of those facilities fell from 288 homes in 2005 to 266 this year.

         In 2012, the AARP ranked Louisiana 50th in the nation for its number of assisted living facilities. The bottom five states — Louisiana, Mississippi, Nevada, West Virginia and the District of Columbia — averaged 11 units per 1,000 residents 65 or older, compared with 62 units for the top five states of Minnesota, Oregon, Idaho, Wisconsin and Washington. The national average is 31 units.

         But Louisiana is trending upward, as more providers are drawn to the state by the unmet demand. In 2010, the state had 86 assisted living centers. As of this year, there are 138, according to the Louisiana Department of Health, though the state doesn't track the number of beds in those facilities.

         And more are coming. Five assisted living centers are planned or under construction in the Baton Rouge area; two are being built in St. Tammany Parish and another two in Lafayette.

         Developer Prescott Bailey sees a definite uptick in such projects in Louisiana, including the one that's part of the Settlement at Shoe Creek that his Lafayette-based company, Southern Lifestyle Development, is building in Baton Rouge.

         This master-planned community in Central will include a 100-bed assisted living center that's being developed by CR Properties, a Mississippi company that's also building another assisted living center east of the Mall of Louisiana.

         Bailey said the assisted living center is a major selling point for the Settlement at Shoe Creek "traditional neighborhood development," which is designed to be a walkable community with multi-generational housing options.

         Prospective single-home buyers like the idea that they can find a place for parents or grandparents in their community, he said. Older homebuyers are attracted to the notion that they won't have to move out of familiar surroundings when they no longer are able to live on their own.

         His company plans to include assisted living centers in all of its developments going forward, he said.


'Sexy senior living'


         Provident Resources Group will break ground this fall on a 92-unit assisted living center in Zachary's Americana, another traditional neighborhood development. President Debra Lockwood said the company conducted extensive market surveys, and being part of a multigenerational development was a decisive factor in deciding where to build the center.

         Avanti Senior Living, based in Texas, broke ground on its first assisted living center in Louisiana in May, at Watercross at Nord du Lac in Covington, and it has plans to put a centers in Lafayette as well.

         Chief Operating Officer Lori Juneau-Alford touted the project as modeled on boutique hotels and offering resort-type amenities, calling it "sophisticated" and "sexy senior living." The $15 million facility will have 50 assisted living units and 40 memory-care units.

         Sherif Ebrahim, a Tulane professor of strategy and innovation who is executive director of the Albert Lepage Center for Entrepreneurship and Innovation Education as well as a former White House health policy adviser for two presidents, said assisted living is part of a new model for aging in place.

         These "continuing care retirement communities" don't replicate nursing homes but allow people to get increasing levels of care as their needs dictate. For example, a resident might begin in an independent living unit and then progress to an assisted living or memory-care unit.

         Assisted living is less expensive than having a 24-hour in-home caregiver, Ebrahim noted. But it comes at a cost, and the target market is seniors who have financial resources. Many owned their own homes and may receive pensions as well as having 401(k) accounts, all of which helps them afford this type of care.

         The continuing care model is also more expensive to build, staff and maintain, Ebrahim said. But the businesses may be more stable and sustainable because there is a longer relationship between the provider and the resident.

         As for the amenities that some facilities offer, Ebrahim described them as part of a consumer-focused trend. "The average consumer is more educated and better informed, and this has an effect on the consumer strategy and product/service offerings in most industries," he said.

         Assisted living centers also are addressing needs specific to aging residents, he said, with especially strong growth in memory care.


         More memory-care units


         Mora said the growth in memory-care units was strong even during the recession, when assisted living projects nationally felt the pinch of tight financing and reluctant consumers delayed making housing decisions because of concern about drops in the value of their homes and investments.

         With people living longer and with Alzheimer's and other forms of dementia on the rise, the need for memory services will continue to grow.

         All of the projects underway in Louisiana offer some memory-care units — as many as half in some cases. All 48 units at The Pearl at Jamestown, a $5.2 million facility that will open in October in Baton Rouge, are for residents with dementia, Executive Director Karen Jacobs said. She predicts that earlier diagnoses will mean younger residents will be seeking that level of care.

         Overall, the demand for choices isn't being driven only by those who need care now, Mora said. Baby boomers who've had to deal with aging parents, often with limited options, are looking ahead to their own "final years" — which could last for as many as 20 to 30 years, he said. They want to spare their children difficult decisions they've faced, but they also want a greater degree of control and want to avoid nursing homes.

         Mora sees the new model of continuing care retirement communities as more appealing to those consumers because they offer nice amenities, resort settings, a community of people at a similar point in life and the reassurance of knowing that the level of care will increase as they need it.

         It's a question of supply and demand, he said. One in five Americans will be older than 65 in the next 15 years, and the oldest of the old are the fastest-growing segment. But their strength isn't only in numbers. Half of all discretionary spending in the United States comes from that population, he noted, and they hold 70 percent of U.S. financial assets.

         Sexy senior living, indeed.

         – by AP/ Reporter Sara Pagones with The New Orleans Advocate

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