The United States is currently home to over 30,000 licensed assisted living centers with an estimated population of one million residents. Research indicates that the demand for age-qualified housing will continue to increase in the near future as baby boomers enter retirement over the next few years. While the current economic downturn and real estate problems may delay retirement age for some, it is anticipated that there will be additional growth in continuing care retirement community construction as the increasing percentage of seniors in the country look for more options for their active lifestyle in their retirement years.
Those who choose continuing care retirement communities are generally in good health and capable of either living independently or living with minimal or moderate assistance, but anticipate an increased need for assistance with activities of daily living and/or healthcare in the years ahead. Successful continuing care retirement communities typically offer a range of living options such as independent cottage or apartment style units for the most independent residents, assisted living units for residents who need assistance with some activities of daily living, and skilled nursing facilities for those requiring nursing and personal care around the clock.
The successful development of a continuing care retirement community starts with the selection of an appropriate location for the facility. Selection criteria for determining the best geographic locations include demographics, population projections, potential competition, and nearby amenities such as hospitals, shopping centers, churches, banks and public transportation. It is typically more desirable to locate a new community near residential areas and away from major commercial development.
More specific concerns that need to be evaluated before selecting a site include zoning requirements, dimensional constraints, site grades, available utilities and limitations imposed by environmentally sensitive areas. It is not so much how large a site is, but rather how much of the site is usable. Land use restrictions such as minimum setback distances, allowable lot coverage, and open space requirements will limit the footprint of the facility that can be constructed. Due to accessibility concerns beyond typical Americans with Disabilities Act and Architectural Access Board guidelines, assisted living and retirement communities are generally less tolerant of excessive grade changes across a site. As "barrier-free" communities, steps are not acceptable. Therefore, retaining walls or other reinforced earth structures are often required to maximize the usable portions of a site, resulting in added cost for the development.
Open space and recreational considerations are also very important when developing a new continuing care retirement community. Today's seniors are staying more active than in the past and look for outdoor opportunities to exercise on walking paths or in garden areas. Often wetland resources or stormwater management infrastructure can be integrated into recreational areas to enhance the aesthetic value of the open space. Low impact development options such as rain gardens are a great way to provide functional stormwater management and aesthetically pleasing plantings and native vegetation. Stormwater control ponds can also be landscaped and maintained to give residents a safe place to enjoy the outdoors and view nature.
Layout of the different buildings and recreational areas on the site should take into consideration how the residents and employees utilizing the facilities interact and move throughout the day. Safe accessible routes with appropriate lighting and signage should be provided from independent living units to other buildings where meals are served or activities and healthcare are provided. Movement of staff and equipment between facilities should also be included in the planning stages of a project.
Traffic and parking design and planning should account for increased levels of pedestrian movement and adequate access for emergency vehicles. Increased turning radii and other considerations may be necessary to accommodate large fire apparatus if the development includes large multistory structures; however pavement widths should be minimized where possible to reduce speeds and provide traffic calming. Local ordinances and subdivision regulations should be consulted as they typically stipulate required pavement widths, curve radii and parking requirements for different types of development. Adequate parking in convenient locations should be made available to provide easy access for family members and friends to encourage visits. Sufficient staff parking must also be provided. If the development is located in a harsh winter climate, garage space is also typically required to meet resident expectations.

Jay Viamari, PE, LEED AP is an Associate with Tighe & Bond, headquartered in Westfield, Mass.