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"The assisted-living movement has really changed the way people age," says Karen Wayne, president of the Assisted Living Federation of America (ALFA), an industry trade group. "We've proved that people don't want to be in institutional settings." The facility provides each resident with a room or suite; meals, usually in a common dining room; and round-the-clock staff members who help with the no-big-deal chores of the day that can still defeat the mostly capable elderly--bathing, dressing, taking medication. Assisted living gives the elderly some measure of independence, a chance to socialize and needed privacy. Privacy for all sorts of things--sex has hardly disappeared from these seniors' lives. A survey released this month by the American Association of Retired Persons revealed that a quarter of those 75 or older say they have sex at least once a week.
The widening flood of Americans into later life--Tina Turner turns 60 this year!--guarantees that elder care will be a 21st century growth industry. The market, which was $86 billion in 1996, is expected to reach $490 billion by 2030. That potential is attracting such big developers as the Hyatt Corp. and Marriott International hotel operators. The 3,300 units of senior housing that Hyatt operates in 16 communities around the country are worth an estimated $500 million.
The old people that assisted living caters to are usually able to get out of bed and walk around. But their average age, estimated by ALFA, is 83, so they can also be frail. Almost half have Alzheimer's or some degree of cognitive impairment. (Alzheimer's patients tend to have their own, more closely supervised areas.) John Knox Village, in Pompano Beach, Fla., is a not-for-profit continuing-care operation on a landscaped campus with meandering walks and duck ponds. In an arrangement typical of such places, the elderly buy a residence--studio apartments are $48,500; two-bedroom "villas" are $142,500--and a continuing-care contract that sets a monthly maintenance fee covering all services. While they may begin life there in a mostly independent mode, taking an apartment with meals, they can later move to assisted-care rooms or even the on-campus nursing home for about the same monthly maintenance fee, usually a fraction of what a regular nursing home demands.
Carl Kielmann, 73, is a retired banker and the second generation of his family to live at John Knox in the Health Center. He and his wife Lillian moved there in 1985, joining his mother, who was also a resident. His mother's contract with Knox allowed her to spend her last six years in the village medical center without eating up her savings. "In a lot of ways," says Kielmann, "this type of place is your ultimate insurance policy."