Asian retirement older male loneliness sit on wing chair with walker feel Lonely in old-age home staring out of a window as he longs for his family and friends. Rehabilitation healthcare concept.
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Teresa Stephens told stories of older adults leaving in tears because their incomes were too high for affordable senior housing but not high enough to cover a move to Givens Communities’ life plan communities. 

Those stories, she said, convinced banks and philanthropists to fund Givens Gerber Park, the organization’s first middle-market community in Asheville, NC. It opened in July 2018 with 82 independent living units.

“It’s a compelling story to be told to funders about the middle market,” said Stephens, vice president of Givens Affordable Communities. “They are an incredibly vulnerable group of people, and they deserve to be served.”

Stephens was part of a panel at the recent LeadingAge Annual Meeting + Expo in Denver, offering insight into how to successfully design, build and run a middle-market retirement community. 

Episcopal Retirement Services President and CEO Laura Lamb shared information on River’s Edge, a 20-acre middle-market campus in Perrysburg, OH, that includes 122 “patio homes” — single-family homes that share at least one wall with another home. River’s Edge welcomed its first residents in June 2020. 

Lamb said that the success of Episcopal Retirement Services’ model depends on partnerships. The organization entered a joint venture with other organizations that share ERS’ passion for the middle-market mission. Lamb said that shared passion is critical to the success of any project. 

River’s Edge offers a dining space and a fitness center on a 1950s-esque streetscape. Units appear to be single duplexes but actually range from two- to 10-unit dwellings. 

Middle market is untapped

“We spent years looking for a model to replicate and couldn’t find one,” Stephens said.

The company’s solution was to scale up its affordable housing model. The model for middle-income individuals has minimal staffing and amenities, but has a social worker — akin to a service coordinator — embedded in the community.

Staff members also are informed during the hiring process that they may be called on to be universal workers at any time.

“We say we are a team and you have to be willing to do anything if you’re going to be part of a team,” Stephens said. “It actually made our team stronger and reduced turnover, because they feel so supported by one another.”

An all-inclusive resident fee includes utilities, internet, telephone and cable TV. Residents also receive a monthly stipend to spend in the café, which is open to the general public.

“We look at housing as a platform for creating community and supporting them as they age,” Stephens said, adding that the community focuses on social engagement by creating spaces for gathering and undertaking activities and being enriched.  “We are there to connect them with what they need to age in place, but we don’t provide what they need to age in place.”

River’s Edge, similarly, does not “lay hands on residents,” Lamb said. 

“We had to adopt a plain approach. We needed to be comfortable in being the conveyor of service,” Lamb said, adding that the organization’s middle-market model adds value through service coordination similar to that in affordable housing.

“This is the future of life plan communities,” Lamb said to session attendees. “Don’t you want to be a part of solving our national crisis for folks stuck in the middle? It’s compelling.”

Stephens agreed, saying that the middle market is the “biggest segment of the senior market.”

“When you start telling real-life stories about turning them away and the hardships they have, when you know stories of middle-market seniors aging in their homes in isolation — tell those stories. It’s pretty compelling,” Stephens said. 

Givens also went to funders armed with data from a market study that said the company’s middle-income project “hit a completely unserved, untapped market.” 

Sharing lessons learned

Leaning into its mission to serve older adults, Lamb said, Episcopal Retirement Services’s next middle-market project will be an age-restricted community. 

River’s Edge is not age-restricted; residents range in age from 21 to 85, a fact that was not well-received by some older adult residents, she said. The turnover in residents experienced by the community was not from deaths or transitions to nursing homes but rather a reaction to living alongside a younger population.

“They don’t want the family environment,” Lamb said. 

Breaking through barriers

Both Lamb and Stephens said that middle-market projects have significant barriers but that they are not insurmountable.

Among the challenges they’ve seen are resistance at the leadership level, a belief that middle-market properties are divergent from an organization’s mission; an organization’s capacity and bandwidth to take on a different project; and elevated construction costs.

Middle-market projects, they added, also come with misconceptions, including a mindset that they are scaled-down life plan communities — they advised using affordable senior housing as a frame of reference instead — and that prospective residents cannot pay and are undeserving. 

Lamb said the potential resident market is filled with service providers — teachers, firemen, friends. 

“Get in their shoes and think about what it’s like to age in community without support, without all you have to offer,” Stephens said. “How can you meet them where they are?”

The panel included other speakers from SFCS Architects, which has invested over 10 years into solving the middle market challenge.

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