This PowerPoint explores sustainable environments for the elderly from a holistic point of view. First presented in Seoul, Korea, November 2009.

1. Sustainable Community and Architecture for the Aging Jeffrey Anderzhon, FAIA Fairfax, Virginia, USA

3. Income $35,825 median for family households 65+ in the U.S. $15,193 median for people 65+ reporting income in the U.S. Percent Distribution by Income: 2004 Source: U.S. Census Bureau Long-term financial stability is an issue of sustainability of aged facilities

4. Cost of Care $77,380/year U.S. National average rate for private nursing room $68,985/year U.S. National average rate for semi-private nursing room Avg. Length of Stay: 2.4 Years 2006 Met Life Market Survey

5. Cost of Care $36,372/year U.S. National average rates for assisted living $51,204/year U.S. National average rates for assisted living Alzheimer’s Care Average Length of Stay: 21 months 2006 Met Life Market Survey

6. Income 3.6 million elderly in US were below the poverty level in 2004 Another 2.3 million were classified as “near poor” Source: U.S. Census Bureau

7. 1.6 million people in U.S. are in 18,000 nursing homes Nursing Home Care in U.S. is a $111 billion business annually 2004 Met Life Market Survey Cost of Care

8. Cost of Care 46% of Nursing Home and Home Care Costs in U.S. are paid by Medicaid (U.S. Government reimbursed) 12.4% are paid by Medicare (Partial U.S. Government reimbursed) Medicaid 46% Medicare 12.4% Out-of-Pocket 27.9% Private Insurance 7.7% Other 6.1% 2004 Met Life Market Survey

9. Operating costs are the largest on-going capitol outlay

10. Sustainable staffing affects design Source: LeaderStat, Inc. 3.05 2.10 .23 .70 32 Beds Hours PPD 2.96 2.00 .46 .50 60 Beds Hours PPD 3.18 97.5 30 45 22.5 Total 2.06 .56 .56 40 Beds Hours PPD 67.5 22.5 30 15 Nsg. Asst. 7.5 7.5 LPNs 22.5 7.5 7.5 7.5 RNs Total Evenings Days Nights

12. Sustainability is holistic

13. In the U.S. the only sector that has experienced job growth is the healthcare sector

14. Staffing for aged care in developed countries will come from the younger aged group of undeveloped countries

17. Regulatory Challenges Difficult Devices for a Layman to Operate; Not as Easily Adjusted to Senior Needs Sophisticated HVAC Systems with Control System Design for Engineers Senior Friendly Energy Efficiency

18. Forest Side ALF for Dementia Washington, DC JSA, Inc. Architects Sustaining the Aged in an Adaptive Re-use Structure

26. Peabody Retirement Community North Manchester, Indiana, USA RLPS Architects Foulkeways Gwynedd, Pennsylvania, USA RLPS Architects The Royal Star & Garter Solihull, UK Scurr Architects

27. Sun City Ginza East Tokyo, Japan Perkins Eastman Architects Goodwin House-Bailey’s Crossroads Falls Church, Virginia, USA DHPY Architects The Mirabella at South Waterfront Portland, Oregon, USA Ankrom Moisan Associated Architects Sustaining the Aged in an Amenity-Rich Community

28. Marywood Center Grand Rapids, Michigan, USA Perkins Eastman Architects Sustaining the Aged in an Purpose-designed Sustainable Environment