Not so long ago, the words retirement home conjured all-too-familiar images: starched uniforms and linoleum floors, wheelchairs and dinghy corridors, listless patients and antiseptic smells.
Today, the retirement home has matured, gracefully, into something altogether different: the retirement community, with apartments rivaling the most posh condos, landscaped sites that resemble small college campuses complete with health clubs and aquatic aerobics, putting greens and restaurants.
As Maryland and the nation as a whole gray at a faster pace than ever, more and more seniors have chosen these communities as an alternative to big, empty houses that can quickly become too much to handle after the kids have left the nest.
"If you look at the people who make up the senior population, most are homeowners and will tell you they want to stay right where they are -- and most succeed," said Ilene Rosenthal, chief of housing and long-term care for the Maryland Office on Aging. "But for many, a time comes when it's impractical to do that."
Developers with expertise in real estate, construction and hotel management, in turn, have joined nonprofit groups -- the traditional providers of senior housing -- in building retirement communities in recent years. And with residents moving in as much for the promise of long-term security as for the amenities, developers have increasingly built in some type of personal or medical care to cater to more than just the active senior.
The number of continuing-care communities -- which charge entrance and monthly fees that include access to health services -- has grown from 11 mostly run by nonprofits in 1980 to 28 today, according to the Maryland Office on Aging. Other types of retirement communities -- which do not charge entrance fees or offer health care directly -- have sprouted as well; the state does not regulate or track these.
In the past five years, developers have built hundreds of apartments and individual homes, including rentals, for-sale units, cooperatives and those requiring entrance and monthly fees, in communities such as Brightwood in Lutherville, North Oaks Life Care Community in Pikesville, Blakehurst Life Care Community in Towson, Vantage House in Columbia, Heron Point of Chestertown, Aspenwood Retirement Center in Silver Spring and the Classic Residence by Hyatt in Chevy Chase. More are on the way: Londonderry Retirement Community in Easton, Maplewood Park Place in Bethesda, Oak Crest Village in Parkville.
Their goal: Tap into the ever-growing demand for retirement housing among seniors like Fran Jacob.
Mrs. Jacob, a slender, seventysomething widow, found just what she was looking for -- which is to say a home, not a nursing home -- in May after selling the Towson rancher where she had lived for 25 years.
When she moved a few miles away to Blakehurst, many of her home's contents did, too. Her antique furniture -- a roll-top desk and marble-top bureau her husband refinished -- sits in the living room of her one-bedroom apartment. In the kitchen, Mrs. Jacob proudly shows her apothecary jars and prepares meals for friends who stop by to play bridge.
the year-old community set on 40 acres south of Joppa Road, with manicured lawns, private balconies and a well-stocked formal library, Mrs. Jacob says: "You don't feel like you're in 'the home.' You really start living again. It's not like the old days where you put Grandma in a home, and there she sat. I could have taken care of my house for several years, but I would like to be free of that. This way I can live just as graciously and be waited on."
It will cost you
But luxury senior living and pampering don't come cheap. Residents at the 177-unit Blakehurst pay entrance fees starting at $149,500 -- 90 percent of which is refunded to the resident or his estate after death -- for private housing and, when needed, care in the on-site health center. Monthly fees, which cover one daily meal in the dining room, maintenance, housekeeping, laundry service, utilities, transportation and activities, start at $1,646.
Seniors, who have the most per capita disposable income of any age group, have proved more than willing to shell out that much and more to be freed from the burdens of homeownership yet preserve their independence in communities offering activities and companionship.
Three and a half years ago, Judith DeBuys sold her home of 40 years in Ruxton because her four children live out of state. "It was no fun rattling around in a big house. I was having problems keeping up my house," she said.
She moved to Brightwood, which had just opened. Now 80 percent sold, the community has drawn mostly from nearby neighborhoods where older residents have opted to sell their large, paid-off homes and buy one of Brightwood's single-family ranchers or apartments. Unlike continuing-care communities that charge entrance fees for "life care," Brightwood sells condominiums and charges monthly fees starting at $1,463. Fees include one meal a day, a staff nurse, housekeeping,
laundry, maintenance and 24-hour security but no health care. Instead, Brightwood's developer sold an adjacent piece of land to Meridian Healthcare, which offers residents first priority.
"It was a great relief not to have to worry about the septic system or those problems and a great relief to my children scattered around the country," Ms. DeBuys said. "Here, I own my house, and I'm not paying for other people's health care."
To her $325,000, two-bedroom, two-bath apartment, modeled after Thomas Jefferson's brick dormitories at the University of Virginia and set similarly around a grassy square, Mrs. DeBuys brought her cookie sheets and roasting pans. They have sat unused in her kitchen cabinets, since she walks over to the dining hall most days. "When you get used to someone fixing your dinner, you don't do it yourself," she said.
The demand for retirement homes shows no sign of abating as the state's elderly population continues to grow. The number of seniors over age 85 is expected to double in the next two decades. Maryland residents over age 60 accounted for 15 percent of the state's population in 1990; that will grow to 23 percent by 2020, the Office on Aging projects.
New choices
That rapidly growing older population has driven the intense demand for alternatives, said Eric Belsky, senior economist with the National Association of Home Builders.
Today, seniors have choices their parents never imagined: Congregate housing, where seniors live in independent homes but can share meals and transportation; assisted living, where seniors get help with personal care up to, but excluding, nursing care; and continuing-care communities, with a spectrum of independent apartments, homes and nursing units for seniors both active and frail.
It is still unclear whether the market for the "active senior," a discretionary spender, will remain strong, Mr. Belsky said. But nationally and in Maryland, demographic trends show that much of the senior housing industry's future lies in reaching the needs-driven senior over age 75, who may require more than the traditional "golf course" communities offered in the past.
Some retirement villages -- designed years ago for active seniors -- have added health or assisted-living services to stay competitive. Initially, they may have focused on independent living, providing meals, transportation and activities, "but they didn't deal with the fact that seniors get old and sick," said Janet Henry, senior associate with Legg Mason Realty Group Inc., who tracks the retirement housing industry.
For example, the 163-unit Heartlands Retirement Community in Ellicott City opened seven years ago as a mix of mid-rise apartments and one- and two-bedroom cottages, all rentals, for independent-living seniors.
"As the community aged, we saw a need for a type of living arrangement for people who couldn't bathe themselves or needed help getting dressed," said Curtis Grothmann, executive director.
The developer, apartment builder Henry Knott Jr., converted a wing to assisted living four years ago.
"It is 100 percent occupied all the time," Mr. Grothmann said. "That's the trend of our industry."
Rather than building large-scale continuing-care centers -- huge financial undertakings that rely on seniors desiring lifestyle changes -- more and more developers will steer toward assisted living, Ms. Henry predicted.
Assisted living
One is Steven Cohen, vice president of Annapolitan Care Center Inc., who is building a 60-bed, assisted-living home on U.S. 50 in Annapolis for seniors who need minimum levels of supervision. For monthly rents from $1,875 up to $4,000 for those with Alzheimer's, residents get rooms with bathrooms, three meals a day and help with personal needs and medication. "There weren't alternative services for the well, frail elderly," said Mr. Cohen, who says more than a quarter of nursing home residents have no medical reason to be there.
The assisted-living industry is just beginning to alter the face of .. senior housing, Ms. Rosenthal said.
The availability of both assisted living and a nursing home attracted Donald Macleod, an ordained Presbyterian minister, to private apartment at Charlestown Retirement Community in Catonsville three years ago.
"Once you get to be 70, you have to look down the road," said Mr. Macleod. "Who's going to take care of you? My children don't have to worry about me here. If I become incapacitated, I'll be taken care of. It takes the weight off their minds."