A place to age in grace
Elder-care innovators make senior citizens a vital part of the urban experience

What if we couldn't wait to be old and wise, just like kids can't wait to be teenagers and drive? Nader Shabahangi believes becoming an elder is something to be celebrated. Instead of accepting old age as a sentence of doddering obsolescence, he believes our elderly have a lifetime of experience and skills that make them vital contributors to society.

Shabahangi is the visionary behind AgeSong, a company that has built two elder-care communities and has more on the way. They are a far cry from your grandfather's old-folks home, and not only because they are located smack in the middle of San Francisco's thriving Hayes Valley. If you didn't know better, you might assume AgeSong's newest community, Laguna Grove Care, which opened in August, is a loft space for Hayes Valley hipsters.

AgeSong's business model is based on two simple ideas: Older people will thrive in an assisted-care home if it's built to resemble living in their own house; and when elder-care communities are designed to be good architectural neighbors, they will be readily welcomed into mixed-use urban settings.

So far, both are proving true.

The accidental developer

Becoming caretakers for the elderly happened to Shabahangi, and subsequently, his two brothers, more than they consciously chose it. In 1994, he was finishing his doctorate in humanities at Stanford University when some friends enlisted his skills as a contractor to help them expand their board-and-care home for the elderly.

"It was a beautiful, older San Francisco building that overlooked the Pacific Ocean," he says. When he began visiting other care homes to research design ideas for the expansion, he was disturbed by what he discovered: "warehousing of the elderly" in conditions that were often grim and institutionalized.

"That experience really shocked me and it became my mission to do something about it," says Shabahangi. He gathered with his two brothers, Ali and Amir, in their tiny Mission District apartment and shared his desire to change Western society's view of aging and the elderly. This discussion, and the many that followed, became the impetus for the creation of Hayes Valley Care, a 47-bed assisted-living community for elders.

Together, in 1995, the three brothers funded its design and construction with their meager savings and "lots of credit card debt." They paid $625,000 for the property and more than $2 million in remodeling costs. "We wanted Italian tile and high ceilings. We didn't skimp," says Shabahangi. "We believed, and still believe, that attention to detail and the quality of our building materials directly reflects on the quality of care we provide."

Two years later, they were admitting their first residents, which they got solely by word of mouth. "We opened our doors at 1 p.m. and by 4 p.m. we had our first two residents. By 6 p.m., it dawned on us that we needed to feed them. We didn't have a cook -- it was just Ali, Amir and I. So we became their caregivers, cooks and cleaners in addition to running the business end of things," Shabahangi says.

Within another year, the brothers had created a community that answered their vision and became a successful business -- one that included partnering with a Brazilian couple to open a restaurant on the ground floor that also served as a place friends and family of the residents could gather.

In 2000, joined by their sister Elke Tekin and fifth business partner, Chad Lewis, they created AgeSong. Five years later, they opened Laguna Grove Care and now have two more AgeSong community projects in the works -- 88-bed AgeSong Boulevard at 580 Hayes St. and 145-bed AgeSong Emeryville, at 4050 Horton Ave, just a stone's throw from Pixar and the Bay Street Marketplace.

AgeSong Boulevard is estimated to cost $10 million in construction and will break ground in the fall. AgeSong Emeryville is estimated to cost $25 million and will break ground this winter. Meanwhile, the company is looking for opportunities to expand in the South and North Bay.

A modern approach

AgeSong bought what is now the Laguna Grove Care community in two parcels. The corner building was purchased in May 2002 with the intention of creating a 20-bed extension of Hayes Valley Care.

Six months later, when the team realized the building next door was leaning onto their property, they bought it, too, and then tore both buildings down.

The team was divided between wanting a traditional design and a more contemporary one. "Design is a very subjective thing, and at times we had fireworks," says Leila Bijan, the architect. The fight between square corners and round began.

"A lot of love, care, and arguing went in to the creation of our newest building -- not to mention countless family-therapy hours and an exploding budget," Shabahangi says. Construction costs totaled $3 million.

Located at Laguna and Ivy streets, Laguna Grove Care's architecture is surprisingly modern. Stucco towers on the facade alternate between ironwood-slatted columns of large, bay windows. The spacious, light-filled entryway welcomes residents and visitors from the street, visually connecting the building with the outside world.

Bijan describes the lobby and the dining rooms and common areas on the floors above as the "transparent core" of the building. "These areas invite the city inside and help integrate elders into their urban surroundings," she says.

In contrast, the residents' rooms that radiate from the core are kept more private, with their solid wood doors, skylights and floor-to-ceiling windows. This clear delineation between public and private space is one of the core concepts of her design.

The windows throughout Laguna Grove Care are placed so that all residents can comfortably look outside from their wheelchairs or while sitting in a chair or on their bed, encouraging an immediate and ongoing connection with the outside world. "The use of natural light throughout the building was very important," Bijan says.

Limestone flooring, decorative tiles, cherry cabinets and glass bathroom tiles reflect a home, rather than an institutional space. "We chose materials that feel good under your feet and against your hands," Bijan says.

Dining rooms and lounges on each floor eliminate the need for long hallways. The high ceilings -- 11 feet in the residents' rooms and common areas and 18 feet in the lobby -- are practically unheard of in other elder-care facilities.

A roof deck provides outdoor space for residents to take in city views and tend to flowers and vegetables in their own private patch of soil.

A double room runs about $200 a day, while a private room can cost as much as $360 a day for residents who require more specialized care. There are three levels of assisted care that range from $40 to $80 a day. These prices include everything from utilities and linens to bedroom furnishings and weekly housekeeping visits. The only supplemental fees are outside transportation, caregiver attendance for medical and dental appointments, and incontinence supplies.

After eight months, the new community is at 75 percent capacity. Last month, AgeSong received the American Society of Aging's 2006 Business Award for best small business in the aging industry.

Family dynamics

Decision making among five strong-willed, opinionated family members (Bijan is a cousin) is no easy feat. Especially when they've come to AgeSong from such disparate disciplines.

Nader Shabahangi, the philosopher, is AgeSong's president of program development; Ali Shabahangi, the lawyer, is president of development and general counsel; Amir Kia, the businessman, is CEO; Elke Tekin, the marketing guru, is vice president of community relations; and, Leila Bijan, the architect, is, well, still the architect. Throw in Vice President of Operations and Development Chad Lewis, a former publisher and editor, and the only non-blood-relative business partner, and you have an impressive mix of approaches, processes and communication styles.

As Tekin tells it, each of them came from jobs that were, "OK, but maybe not the most fulfilling."

Therapeutic environment

AgeSong is an acronym for awareness, growth, excellence, spirit, openness, nurturing and giving back, which are the values that guide it. It emphasizes caring for its residents' emotional, spiritual and psychological needs in addition to their physical health.

At AgeSong communities, residents mingle for afternoon tea, choose their own daily activities, such as yoga and dance, and pursue hobbies, such as painting and pottery. But they also struggle with the mundane and often unspoken facts of aging: disability and dementia, changing relationships and shrinking independence.

The goal of AgeSong's caregivers is to help residents feel safe and supported, regardless of their age, health or present mood. "As we age, there is often a loss of hope. We stop communicating our dreams," says Tekin. "We've created a therapeutic environment where people can be who they really are." Pictures of the Shabahangis' grandparents hang on the wall to "keep an eye on us, and make sure we're doing it right," she says.

The company seeks out urban settings for its communities that encourage interaction between its residents and the outside world. "When you're old, you want the world to come to you," Shabahangi says. "This is why building in urban communities is so important. It brings the young and old closer together and empowers our elders with a sense of purpose."

Shabahangi and his brothers all own residences in Hayes Valley and are often on-site at the communities. "Hayes Valley has been very welcoming of our business," he says.

Robin Levitt of the Hayes Valley Neighborhood Association thinks AgeSong has brought depth to the neighborhood. "All age, socio-economic, educational and racial groups are represented here. Seniors have an important place in this community," she says.

The AgeSong caregiver team is made up of physicians, nurses, social workers, licensed mental health professionals and nutritionists. It offers residents interdisciplinary programs in assisted living, dementia, memory improvement, behavioral health care and a hospice program in partnership with the Zen Hospice Project.

Residents can join current events discussions, poetry and life-story writing groups, and flower arrangement classes. There are also barbecues, movie nights, and field trips to Las Vegas and Tahoe, as well as to the symphony, opera and local museums.

This kind of therapeutic, holistic care doesn't come cheap. AgeSong falls on the upper end of the elderly care spectrum, although 20 percent of residents are Supplemental Security Income (SSI) recipients who are referred through and subsidized by the San Francisco Public Health Department.

The value of aging

In keeping with its mission to challenge stereotypes about aging, this summer AgeSong will present "Faces of Aging," a photography exhibit at Laguna Grove Care featuring portraits of the elderly. "We want to promote the idea of loving people for who they are at every age," says Shabahangi.

"Society teaches us to see each new crease or sag as a personal failure. We don't look in the mirror and say, 'Shucks, I wish I knew less,' so why do we wish we were younger?"

This sentiment supports AgeSong's holistic view that wisdom comes with life experience, which naturally means getting older and -- despite what makers of Botox and $200 face creams would have you believe -- looking your age.

Source: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/04/23/REGJ9ID8RQ1.DTL

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The ABC’s of Aging
Dr. Donna Benton discusses the best ways to provide care for elders

By Athan Bezaitis

“If I’d have known I was going to live this long I would have taken better care of myself.” – Dean Martin

Prophetic words from one of America’s most prominent 20th Century icons, who in spite of a magnetic voice and an even more impressive frock of curly, dark hair, succumbed to emphysema at the relatively young age of 78.  What if Martin hadn’t boozed the way he did?  He’d be 88 years-old this year, and according to Dr. Donna Benton, professor of gerontology at the USC Ethel Percy Andrus Gerontology Center, still young.

“In the next twenty to twenty-five years, people will start to live into their hundreds and beyond with far more frequency,” said Dr. Benton, in her presentation Aging Parents 101: The ABC’s of Aging, held at USC’s Andrus Gerontology Center Auditorium on Thursday, April 14, 2006.  Her lecture was part of a free monthly discussion sponsored by the Los Angeles Caregiver Resource Center (LACRC) entitled Take Care Series.

About 60 people attended the discussion, from community members of all ages to USC faculty and staff, mostly curious to learn about available resources to help provide care for aging family members and friends.  “It gives participants a starting point to take care of their loved ones,” said Patricia Rivera, LACRC program specialist.

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Dr. Jon Pynoos Reports to USC faculty and students on the 2005 White House Conference on Aging

By Athan Bezaitis

On Thursday, April 6, at the University of Southern California’s Hamovitch Research Center, The California Social Welfare Archives presented a synopsis of the 2005 White House Conference on Aging (WHCoA).  Held every ten years, the WHCoA took place from December 11 -14th in Washington D.C. 

Representing the USC Ethel Percy Andrus Gerontology Center was Dr. Jon Pynoos, one of the three speakers at Thursday’s presentation who attended the Conference.  Dr. Monika White, president and CEO of the Center for Healthy Aging and Community Activist Marvin Schacter were the other two panelists.  The Hamovitch Center was crammed with about 50 people, composed mainly of concerned seniors from the community, faculty members and students eager to learn the details of the Conference.

Entitled, “The Booming Dynamics of Aging,” the main theme of the WHCoA was the coming of age of the baby boomer generation.  An American now turns 60 years-old at a rate of 330 people per hour and 50 years-old every seven seconds.  According to Dr. White, those numbers represent a huge demographic shift that will greatly impact future policy. 

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Homes can adapt to change as quickly as families do
Concept includes movable walls

Our lives are forever changing. Our homes can't always keep up.

Just about every household experiences the sort of change that calls for rapid response: the birth of a child, perhaps, or the arrival of an older family member who needs round-the- clock, in-home care.

Maybe the change is a professional one, necessitating the conversion of a den into a home office. Or sometimes an aging house simply gives out on us, forcing us to make major structural changes at great expense.

Houses don't always seem sympathetic to their owners' plight. Sometimes, they seem downright antagonistic. But a new partnership between the private and public sectors hopes to tip the scales in favor of homeowners. The fruit of this collaboration is a house designed to anticipate and accommodate exigencies, such as the sudden need for a new bedroom or updated electrical system.

Welcome to the PATH Concept Home, a "house of the future" designed - and soon to be constructed - under the aegis of the Department of Housing and Urban Development. The program was conceived by the department to catalyze change in the housing industry, which, according to one official, is generally slower than other industries toadopt innovations.

"In every other industry, improvements in productivity and technology have led to better products and better services," says David Engel, director of affordable housing research and technology in HUD's Office of Policy Development and Research. "Housing should be subject to the same forces."

The PATH, or Partnership for Advancing Technology in Housing program, was conceived as a way to unite builders, engineers, architects and policy-makers to encourage innovation in housing design. The plans for two Concept Homes - one a traditional house that evokes an Arts and Crafts style bungalow, the other a contemporary urban townhouse - incorporate such innovations as flexible floor plans, movable walls, "utility cores" that make it possible to relocate kitchens or bathrooms, and easy-to-access mechanical systems and wireless networks that control lighting and other household functions.

Construction on the first home, the bungalow, will begin this summer in Omaha and should be completed a year from now. Engel hopes the house will prove to home builders (and home buyers) that such innovations are not only attractive but affordable.

Of the Concept Home features, perrhaps the most captivating is the flexible floor plan. According to James Lyons, a mechanical and environmental engineer at Newport Partners, a Maryland-based technology consulting firm working on the project, it "allows interior spaces to be reconfigured much more easily." Thus a large single bedroom can be turned into a pair of smaller bedrooms by adding a wall that has already been built and can simply be slid into place - perfect for the arrival of a new family member, or for siblings who have outgrown a shared space. Should the homeowners wish to return the room to its original dimensions, the wall slides back out again.

In a nod to universal design trends, both Concept Homes have been designed so that elevators can be installed without structural upheaval. In one of them, Lyons notes, removing a floor panel from a second-story closet reveals a shaft built to accommodate the specs for a standard-size home elevator.

Other innovations in the Concept Homes will include wiring that is easily accessed through removable baseboards, so that the act of servicing the electrical system - or installing an entirely new one - will require no demolition. The "utility core" will consolidate the plumbing system in a central space ("like a big tree trunk in the middle of the house," says Engel) so that pipes can radiate from it in any direction, making the moving of one's kitchen, or the addition of a new bathroom, much less daunting.

Liza Bowles, Newport Partners' general manager, imagines a near future in which it will become standard practice for new houses to incorporate such innovations. "As new products and systems come along, it will then be that much easier to switch out systems within a house, and to get the latest and greatest of something rather than be stuck with something that's old simply because it's too expensive to change it out," she says.

For more information: http://www.denverpost.com/ci_3651750?source=rss

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Lifetime Homes Community set to be built in Rockford

ROCKFORD, IL – 77 home community comprised entirely of Lifetime Homes are set to be built by Gambino Realtors Home Builders according to Frank Gambino, President of Gambino Homes, LLC, and leaders of RAMP, Inc.

Lifetime Homes is a type of housing that allows aging-in-place – living in one’s home safely, independently and comfortably, regardless of age or ability level.

Founded in 1923, Gambino Realtors Home Builders, Inc. is one of the oldest and largest real estate firms in the area. Gambino Realtors is a full service company, and can handle any real estate need from residential to commercial. They also offer a complete home building division.

RAMP, Inc. is a non-profit, non-residential Center for Independent Living whose mission is to promote an accessible society that allows and expects full participation by people with disabilities. RAMP serves and advocates for people with disabilities in Winnebago, Boone, DeKalb and Stephenson Counties.

For more information: (“Gambino Homes and RAMP Come Together to Provide Rockford with the First Complete Lifetime Homes Community” Thursday, March 23, 2006.) Kim Montgomery, Education & Advocacy Coordinator (815) 968-7467 and Frank Gambino, President of Gambino Realtors Home Builders, Inc. (815) 637-0113

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Universal Design Helps People of All Ages

Universal Design is more widespread among homeowners because it provides an enhanced safety and comfort that benefits everyone. The alterations that can turn a regular home into a UD home are extremely simple.

The problem is that the traditional American home is not created according to the principles of universal design and lacks many of the features that make aging –in-place possible.

Universal design is a multi-disciplinary design principle aimed at creating products and environments usable to all people, without the need for adaptation or specialized features. It applies to everything from ergonomic pots and pans to stair-less homes.
Aging-in-place is one of the benefits of universal design. Aging-in-place means living in one's home safely, independently and comfortably, regardless of age, income or ability level.

The best place to evaluate a home's aging-in-place potential is in the bathroom due to hard, slippery surfaces and sharp edges are everywhere.

The first addition for any bathroom modification should always be grab bars. Solid, 250-pound capacity supports provide needed stability around the shower, tub and toilet, and are a mainstay of any aging-in-place design. Grab bars in colors that contrast with the walls are even better. Beyond grab bars, the options for making a bathroom easier and safer to use are nearly endless and dependent largely on an individual's needs, pocketbook and taste.

A simple transfer bench costing less than $150 helps people get in and out of tubs, but tub cuts (where a portion of the tub is sliced away, making it, in essence, a walk-in shower), tub lifts, replacing a tub with a curb-less shower (no entry to step over, and possibly trip over), and a variety of methods for raising toilet height are other options.
One caveat: What may be suitable for one person may actually make it more difficult for another. A 6-foot man with arthritis might enjoy the comfort provided by a higher toilet bowl, while a 5-foot woman with osteoporosis might find it more difficult that a traditional toilet. There is no single comprehensive aging-in-place checklist, but experts in the field do pinpoint certain areas where homeowners can take action now to make their lives easier and safer not only for the short term but also well into the future.

• Avoid slip-ups. Non-slip surfaces on stairs, in bathtubs and on slick floors help prevent falls. “Fall-related injuries are the leading cause of death in people over 65. Reducing fall risk is a huge effort,” says Mack.
• Sit on it. A workstation in the kitchen - chair and all, just like a computer workstation - helps reduce back strain while preparing meals. A bench in the shower not only helps prevent slipping, it conserves a person's energy, which becomes more necessary to conserve with age.
• Abolish knobs. Lever door handles are especially useful for a person with poor hand strength or anyone who has his arms full with a bag of groceries.
• Lighten up. Ed Brown, Progressive Home Solutions, Gainesville, Fla., gives his clients compact fluorescent bulbs that not only provide more light (“as seniors age they need more light,” says Brown), they last 10 times longer than a regular bulb. “They're really good for seniors who can't get up on ladders and chairs to change bulbs,” he says.
• Keep it level. Adapting thresholds so that they are flush with the floor removes another tripping hazard and facilitates wheelchair or walker movement. Eliminating the front steps either with a ramp makes entry easier.

Few people want to think they will have difficulty with stairs or lifting their leg over the side of a tub without falling. But the consequences of falling just once could be severe. Too often people save for retirement, but do not equip their house to enjoy it.

For more information: “Keeping pace with aging-in-place” by Paul Rogers, Content That Works (http://myopr.com/articles/2006/03/24/special/realestate/68content.txt)

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State Denies Needed Funds for Disabled Girl

The state of IL recently denied a Grundy County couple funding to modify their home in order to assist their adopted daughter Andi whose wheelchair is too big to fit into the bathroom and bedroom doors.

The couple turned to the state for $110,000 to help to modify their home by enlarging doorways and improving floors but they were denied without an explanation. They are able to cover some of the cost but in order to modify the host to best accommodate their daughter they will need help from the state.

 In 1993 the couple from took in twin girls from Chicago -- special-needs babies so small, they had to wear Cabbage Patch doll clothes. One twin, Lexi has severe emotional disabilities, they were told, and Andi is a spastic quadriplegic with cerebral palsy. The state told them that as their foster parent they will be able to get financial help to care for the twins. Three years later in 1996 the couple adopted the twins.

Andi, now 12, is unable to access the bathroom in her family's home; her toilet sits next to her bed. W hen the girl needs a bath, her parents have to carry her, naked, to the bathroom and place her in the tub. All this is due to the fact that her wheelchair is too big to fit into the bedroom and bathroom doorways.

Now, Ken and Denise C. -- not identified by their last name for privacy reasons -- have filed suit in Cook County Circuit Court against the Illinois Department of Children and Family Services, hoping a judge will reverse that denial and allow their daughter a little more freedom.

“The state does provide funds for post-adoption home modifications for those in need, but it is a multi-layered, paperwork-driven process that the family says it has followed since asking about funds in 2001.

While not speaking directly to the family's situation, DCFS spokeswoman Diane Jackson said requests are considered "on a case-by-case basis, with no hard and fast criteria," though the agency does ensure the request is based upon "medical needs or needs that would benefit the child."

"For special-needs kids, a lot of their needs come up post-adoption," said attorney Darcy Bielema, who once represented the family, though they are now represented by attorneys Amy Peterson and Sarah Price, of the civil rights group Equip for Equality.

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