Beyond assisted living: As Boomers age, there’s a boom in memory-care facilities

Aug. 09--Sandy Miller remembers when it became clear that her mother couldn't live alone anymore, even with Miller living next door.

"She just wasn't in tune anymore," she said. "She had trouble making a meal. If I wasn't there, she'd stay in bed all day, or she'd take a shower and go back to bed still wet."

So she moved her mother, 84-year-old Irene Samaras, into an assisted-living facility. But deterioration continued and a few weeks ago, Miller moved her into the memory care unit of The Windsor at San Pablo.

The Windsor opened just a few weeks ago on San Pablo Road, joining a growing list of facilities for seniors who no longer can live alone. The Windsor at Ortega, also a part of the 26-facility Legend Senior Living chain, opened in June.

Others have opened recently on Roosevelt Boulevard, Timuquana Road and Bartram Park. One is under construction on Palm Valley Road. Others are planned for San Jose Boulevard, St. Augustine Road and Skinner Parkway.

Some have both assisted living and memory care, which is for residents with Alzheimer's and other dementia, while others are only memory care.

It's the first big building boom in those type of facilities since the 1990s, said Tim Cassidy, owner of Senior Consulting and Senior Living Management, which is based in New Jersey but does work all over the country.

"New assisted-living facilities almost shriveled up because there was no financing," he said. "Now there's lots of money available, and people want to invest in this segment."

Assisted-living and memory-care facilities require licensing, but not the same state certificate of need that nursing homes do. There was actually a moratorium on new nursing home beds for more than a decade. It was lifted this year.

Whitehall Partners of Jacksonville recently entered the business after a background in multifamily development.

Last year, they opened Arbor Terrace Ortega on Timuquana Road. Arbor Terrace Ponte Vedra is under construction on Palm Valley Road with 64 beds and is expected to open next summer.

They expect to break ground on a third facility, Arbor Terrace San Jose, off St. Augustine Road early next year.

But while many facilities open with both assisted living and memory care -- typically about 75 percent assisted and 25 percent memory -- Whitehall's facilities are strictly memory care.

"What we're seeing is that memory care is a specialized kind of care," said John Carey of Whitehall Partners. "What's happening over the last 10 years so is that the industry has developed different engagement activities that are very specific to memory care, that are better for people with dementia.

"Arguably, they're better delivered in a standalone facility."

GROWING NEED

Carey said he first starting thinking about developing memory-care facilities when he and his wife were looking for a facility for a family member. He thought the market was under-served at the time and the need isn't going to go away.

According to the Alzheimer's Association, 5 million currently have the disease.

"That's expected to triple in the next 25 years," he said. "Short of a cure, there's going to be a lot of people suffering from it. And the demographics are all of us. The number of people who are going to be rolling into that age group is growing quickly."

Ryland Lucie and Bill Long, both of Jacksonville, have been looking at the same numbers -- the leading edge of baby boomers is now 68 years old.

The pair formed Starling Senior Living and have an assisted-living/memory-care facility under construction in Tampa. They expect to break ground soon just south of Goodbys Creek on San Jose Boulevard for a 90-bed facility that includes 24 memory care beds.

And they hope to start work on another on Amelia Island early next year.

"When you take a step back and look at the demographics," Lucie said, "we are still several years before the boomers start hitting 80."

He also pointed to the last rush of facilities that were built in the '90s.

"All of that product has a more institutional feel, it doesn't have amenities that people want now. Our memory care is built with two secure courtyards, a separate salon.

"When you look at where we wanted to place our bet over the long term, you just couldn't ignore this."

THE COST

Cassidy said the national range for assisted living is $2,500 to $6,000 a month, while memory care is $3,500 to $8,000.

But newer facilities, with those increased amenities, are often at the high end of the range.

At Windsor at San Pablo, for example, assisted living can range from $3,950 to $6,325 a month, depending on the size of the apartment and services needed. Memory care ranges from $5,295 to $6,295, said Dani Brashear, director of sales.

At Whitehall's Arbor Terrace Ortega, which is all memory care, the cost is $4,000-$6,000, depending on rooms and the care.

If a nursing home resident runs out of money, there is Medicaid funding available to pay some or all of the bills. But there is little Medicaid for assisted living or memory care.

"Assisted living is private pay," Carey said. "There is reimbursement for some rehab and there are some VA benefits. But many times, they've sold their homes and can use that money.

"But after two or three years, without assets from a home or elsewhere, you can go bankrupt. Families garner their resources, that's just how it works."

Miller said her mother has long-term care insurance.

"It doesn't cover everything," she said, "but she's in good shape. I don't know what other people do."

THE FUTURE

Cassidy said a recent spate of new facilities has filled some of the need that developed over the last 10-15 years. He recently did a study of 10 markets in one state which he didn't want to name. Two of the 10 had a need for more assisted living facilities, but five needed more memory care.

If the current building trend continues nationally, he said, the market will be full of assisted living facilities in another year or two.

Memory care, he said, will take several years longer than that.

But as more developers get involved with assisted and memory care, Carey had a warning for them.

"They can't be thinking this is a real estate play," he said. "It's about operating a business, not just developing it. You'll have people who get in and don't realize that, who haven't carefully thought through it."

So Whitehall partnered with the Arbor Co. of Atlanta, which runs each of their facilities.

Starling has contracted with Watercrest Living Group to operate its San Jose facility.

And both Whitehall and Starling plan to keep growing. Lucie said Starling is looking for other sites, but hasn't chosen any beyond the three in the works now.

Carey said Whitehall wants to stay within three or four hours of Jacksonville, meaning Charleston, S.C., to Tampa.

"Our business plan doesn't have us going all over the country."

FAMILY

In addition to a population that lives longer and the large group of boomers coming along, there are other forces at work.

"You've got changing family dynamics," Lucie said. "There's more divorce, fewer kids, fewer caregivers. All this is combining for this industry."

Families still struggle with the decision to place a parent in facility.

Even though they had condos next to each other, Miller said it was simply too much for her to work and to care for her mother.

"You do feel like you've kind of failed, like you should do more," she said. "But I was running myself into the ground. In the morning, I'd make lunch for myself and my husband, then I'd go next door to my mother's to get her up and make breakfast for her.

"I couldn't go anywhere because my mom depended on me.

"I'm in real estate and I see families who want a bigger house so they can take care of a parent. I get that, but I don't know if they understand what they're signing up for. It can be all-consuming.

"I don't think my mom would want me to spend all my time taking care of her. So you pick and choose where to put your parents and hope the staff gives her what she needs."

Roger Bull: (904) 359-4296

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