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The demographics of America’s aging population are inescapable.  The number of increasingly frail older people (older than age 65 with any disability) is projected to increase from 11 million in 2010 to 18 million in 2030*, due to the fact that 10,000 Americans are turning age 65 every day from 2011 to 2029**.  Consequentially, by any standard, demand for services on behalf of this aging cohort are and will be increasing exponentially.  Not least, will be demand for housing for aging boomers; housing specifically designed to support the lifestyles and quality of life that this generation of aging adults increasingly insists on. 

Today, the concept of assisted living (AL) as a solution is the fastest growing long-term care option for seniors.  It’s not hard to understand why, with a wide array of services, assisted living combines flexibility with convenience enabling individuals and couples to age more easily in place, without having to sacrifice lifestyle independence until they absolutely need to.  At which point, the next phase of more intensive care can made available seamlessly where they live, or at worst, very close at hand.  In many cases the AL concept involves what’s called a “community living package,” offering complete continuity of care from fully independent older adult residency to assisted living, and on through residential care, all supported by easy access at any point to skilled nursing and rehabilitative services.  As such, the assisted living concept provides a manageable path for negotiating the aging process by making graduated use of more intensive care for adults only when they can’t entirely live independently, but may intermittently and gradually require some and/or more assistance as they age.

With demand at these extraordinary levels, the supply of specialized assisted living housing is now doing its best to catch up.  Indeed, it’s meant that a new construction industry has emerged in order to affordably scale what could easily be a very costly process of delivering custom solutions on a basis that’s efficient enough to control such costs.  Because at their best and most sophisticated, assisted living facilities involve building accommodations that include a host of services much of which call for substantial interactive, highly complex, communications. 

On the surface, assisted living facilities look like more or less conventional condominiums but with a deeper array of universally available common elements.  Depending on the design, these can seem like a true hybrid of single family units with standalone kitchens and bath facilities tied into institutionally organized common dining and recreational areas with nearby access to skilled nursing and rehabilitation services.

In short, the challenge to builders in the assisted living marketplace has been how to bring maximum customization on a turnkey basis, so as to deliver a very high quality residential experience at an affordable price to individuals and families looking to optimize their “golden years.” 

The solution for builders and owners has meant turning to innovative team-building concepts in construction, featuring highly collaborative, interdisciplinary contracting models using many of the means and methods of lean construction to deliver the complexity needed on a basis that can scale effectively without sacrificing quality or raising prices beyond the practical reach of the senior market. 

The combination and collaboration between disciplines is indispensable to operations, as is a compensation methodology that favors simplicity to the owner while collectively rewarding efficiencies and maximizing high-value deliverables and customer value.  Joint ventures in which the participants share risk and reward have become standard.  Making abundant use of the latest building information modeling (BIM) technologies, interdisciplinary teams are able to interact successfully, working efficiently and fast to control costs and maintain aggressive schedules—all of which contribute to profitability and customer value. 

Meanwhile, features that used to be available only in the most advanced hospitals and clinical settings have migrated into residential environments.  Part of this, of course, is due to the revolution in digital systems design and development and the growth of ubiquitous wireless communications.  But it’s also a function of the ability to integrate what used to be disparate communications systems over a unified IP network.  The capabilities that come with this can range from advanced paging and nurse-call systems to interactive video monitoring systems, all the way to advanced IP based low-impact systems that can monitor individual vital signs at the individual bedside. 

Companies with this expertise are often construction specialists in healthcare systems installation. Their capabilities have honed by decades of hospital construction, which has led them to become practiced collaborators delivering the range of what’s called MEP (mechanical, electrical and plumbing) services—all of which are essential to the construction of sophisticated patient care facilities.  With the advent of design-build, and the growth contract innovations of integrated project delivery (IPD).  These specialists are able to join forces with advanced general contracting partners, visionary developers and owners to bring about what amounts to a revolution in the specialized residential construction needed to deliver assisted living on a basis that will be needed as the population across the nation ages.

*http://www.aarp.org/content/dam/aarp/research/public_policy_institute/ltc/2013/baby-boom-and-the-growing-care-gap-in-brief-AARP-ppi-ltc.pdf

**http://jamanetwork.com/journals/jama/fullarticle/1733726

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