STRAWMAN PROPOSAL
Here is a brief review of what we have examined during this series of meetings on Senior Assisted Living on Orcas Island and a strawman proposal to focus further discussion.
1. We have examined a
Needs Checklist for seniors in the context of how those needs might be met in
our community. The Needs Checklist is
available at: http://tinyurl.com/67mkpg
2. We looked at senior needs for three demographic groups:
S1 - Healthy, fit, but starting to slow down
S2 - Reduced abilities, unable to perform some functions, but otherwise capable of caring for oneself.
S3 - Needing assistance for basic functions including personal hygiene, getting out of bed, mobility, etc.
These three groups do not directly correspond to age. The only thing that we can say with some confidence is that S1 is the largest group and S2 and S3 are progressively (and mercifully) smaller.
While we can expect to have the following age demographics,
Age
2007 2018 2018
Min. Max.
65-69
298 308 542
70-74
212 272 460
75-79
181 262 371
80-84
128 184 295
85+
123 155 382
Total
942 1181 2050
A reasonable guess about the 3 groups in very rough numbers might be,
Group
2018 2018
Min.
Max.
S1
600 1200
S2
400 650
S3
150 200
3. We identified the
variety of Living Options for Seniors that other
communities have employed and visited the new projects on Lopez (LOHO) and San
Juan (The Village at the Harbor). A list
of Living Options may be found at: http://tinyurl.com/5cgzwd
4. Looking at the spectrum of senior needs, the demographic groups and comparing them to the variety of living options for seniors,
a. We might conclude that the services needed by S1 (with the single exception of emergency medical care) fall in the category of "nice to have, but not essential." We have a community of mostly independent people who enjoy their homes and their island, but who do not have an overwhelming desire to move into a senior community of any type. This is fortunate because this group is the largest.
This would suggest that services provided under an "aging in place" strategy, perhaps similar to the Beacon Hill Village example put forward by Helen Bee would be best. These services are and probably should be the concern of the Senior Center, but also suggest a number of promising businesses that could survive and even thrive here.
Proposals centered on the convenience of living within easy walking distance of everything in Eastsound, as appealing as they might sound, need to be weighed against the fact that most people in this age group have elected to live in rural areas. The size of this demographic group might make a commercial senior restricted housing project viable and we should carefully follow the LOHO cottages and The Village at the Harbor as good indicators of the local market. However, a subsidized effort to build something like this would use money that could otherwise be better used elsewhere.
b. We might also conclude that the services needed by S3 are the most critical. This care is now primarily provided by a spouse or other family member. Those who can afford it may hire help and the going rate is $30/hr and 24/7 coverage is out of the question for most people. In-home care for this group offers little economy of scale and for those who cannot afford it, the only alternative is to go to the mainland where costs are lower. Removing seniors from their familiar surrounds, friends, and local support structure is an option that we want to avoid if at all possible. Other than the Convalescent Center on San Juan Island, there is no local facility to provide this level of care.
This would suggest that services provided under something like a small nursing home, especially something similar to the Green House Projects might be best for Orcas Island. http://www.ncbcapitalimpact.org/default.aspx?id=150
This approach doesn't have the economy of scale that larger more institutionalized nursing homes have, but we are not likely to have a large enough S3 population to justify something more substantial. A Green House Project approach is recommended because it is closer than any of the others to our island culture: small, personal, and not institutional. There is one final and very important reason to select this approach. It can be started as a small project at low risk and replicated, either in Eastsound or at other places around the island as the need becomes more obvious. It is also worth noting that the reasons for locating a facility within the Eastsound core for this group are not compelling. Convenience to shopping, restaurants, entertainment, and other reasons for being in the Eastsound core are not the highest priority for this group.
c. We have no conclusions to offer about the S2 demographic, yet. It is certainly possible to use technology to help provide services to this group within the framework of Aging in Place. Alternatively, Continuing Care Retirement Communities, Adult Family Homes, or the specific example of the Village at the Harbor, while they address the needs of this group, they are generally not interested in providing services such as bathing, dressing, toileting, transferring (as into or out of bed), continence, or feeding (See Katz basic activities of daily living or Lawton-Brody instrumental activities of daily living). That is a problem. As someone mentioned at a previous meeting, these living options are increasingly being pressured to also provide care for those who have advanced to S3, and some do now offer a "pay-for-service" provision.
5. One thing that is very clear through all three groups is that providing medical care, especially emergency medical care, to our seniors across the difficult geography of our island is a serious problem. Given the population demographics, it is unlikely that we will be able to help solve this problem with any kind of housing project except at the margin.
DISCUSSION: At our March meeting, these topics were discussed and two issues were raised: