Expanding Senior Housing Options: Building Outside the Box

When it comes to hot button topics related to the aging population, elders’ choices about where they live ranks high on the list.  The idea of traditional facility living makes many older adults uncomfortable; no one likes the idea of losing independence or feeling as though they have been “put away” by their families.  While there are many excellent assisted living facilities and nursing homes in the community, some folks simply aren’t ready to make the move yet or are too put off by the negative stereotypes to ever willingly consider such a move.

That’s what was in Cindy Bradley’s mind when she sketched out her Golden Girls house on a napkin several years ago.  A fresh concept for the Knoxville area, Golden Girls, trademarked as LifeShare Homes, is a newly-constructed, well-appointed home with ample and comfortable common areas for visiting, preparing meals, etc.  It has four private single-person suites, each with its own sitting room, bedroom, and fully handicapped-equipped bathroom.  Cindy’s background in real estate helped her hone in on just the right property, but she says it was her desire to have this kind of option available for herself that inspired her to construct what she refers to as a “project of the heart.”  Cindy emphasizes that “the Golden Girls house is not a stopping point.  It is a practical, cost-effective alternative for seniors who want to still be out there taking advantage of all life has to offer.”  As more baby boomers consider housing and care options for themselves, it is a given that thinking outside of the traditional nursing home or even assisted living boxes will be essential.

Another less-known care option is the Medicare program known as PACE, or Program of All-Inclusive Care for the Elderly.  The PACE concept is best described as one that offers comprehensive intensive case management that incorporates medical care, support services, and/or the living environment that keeps the frail elderly as independent as possible and avoids nursing home placement.  In Tennessee, Alexian Brothers in Chattanooga is a non-profit PACE provider.

In addition to providing in-home services and adult day care, Alexian Brothers also operates traditional assisted living and long-term care facilities.  Until a little over a year ago, only non-profits were eligible for the PACE program.  Now that PACE dollars are available to private equity, it is hoped that more PACE providers will add to the housing/care choices going forward.  With private investors, it remains to be seen whether PACE will prove be a profitable endeavor.  When local real estate agent LaVance Davis, who opened one of the first assisted living facilities in the Knoxville area in 1992, contacted potential developers she learned that “at this point the feeling is the investment required is too great for the anticipated returns.”

On the more creative and exotic side, some have chosen to make a go of it in a hotel or even on a cruise ship for their later years.  While these options are not appropriate for the truly physically frail or the cognitively impaired, there is no doubt that the adventure and amenities this lifestyle offers will appeal to some with ample resources.

None of these non-traditional options can do it all for the entire aging population.  Non-medical in-home care, adult day care, independent senior living, retirement communities, continuum of care campuses, traditional nursing homes, and living with friends or family are all parts of the complex housing/care-as-we-age puzzle.  The exciting note is that the options are expanding.  In the senior housing market, it is more likely than ever that if you build it, they will come.

Amelia Crotwell, JD

Amelia Crotwell, founder and managing partner at Elder Law of East Tennessee, has guided families through long-term care and special needs challenges for nearly two decades. Specializing in Life Care Planning and special needs trusts, Amelia also collaborates across all areas of elder law, including wills, trusts, Medicare, Medicaid, probate, and veterans benefits planning. Certified as an Elder Law Attorney since 2011, she is president-elect of the Life Care Planning Law Firms Association and co-chair of their strategic planning committee. Amelia is deeply involved in the Special Needs Alliance and a prominent member of the National Academy of Elder Law Attorneys. She played a key role in founding the Tennessee chapter of NAELA, serving as its first president. A member of the Tennessee Bar Association and past chair of its Elder Law Section Executive Council, Amelia also dedicates time to pro bono work and community education. She earned her J.D., summa cum laude, from the University of Tennessee College of Law and teaches Elder Law there as an adjunct professor since 2018.

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