Aging in Oakland: Response to growing group

By Stacy Gittleman

On any given day, there’s a wait to play pickleball at Birmingham Next, the non-profit 50 and over senior center housed at the former Midvale School. As seniors wait their turn for the three indoor courts, they’ll chat with old friends or make some new ones. But don’t call them seniors – they’d rather be known as active older adults.

“At Birmingham NEXT, we have dedicated 25 hours a week to pickleball because it has become so popular," said Birmingham NEXT Executive Director Cris Braun. “There are always about 25 people lined up. They could go to other places, but they stick around here because of the camaraderie. So it's a little bit of fitness and a lot of friendship and fun.”

Birmingham NEXT looks forward to tripling its space to 30,000 square feet when it moves from its current location at the former Midvale School into its expanded digs in a renovated Birmingham Family YMCA building on Lincoln Avenue by the summer of 2026. Braun hears from current members that they are excited about the growth, just so long that the culture of camaraderie does not change. And they hope it has more of the feel of a premiere sports club and less of a nursing home or hospital.

The anticipated expansion of Birmingham's senior center is just one example of how Oakland County government and non-profit entities are trying to make the area as palatable as possible for the 65 and over demographic, which is fast becoming the largest segment of the population in the state.

The Baby Boom generation is notorious for being young-at-heart. Regardless of your political leanings, the leading presidential candidates from both parties are well at the top of this age bracket. Dolly Parton, at 77, was recently photographed attired in a Dallas Cowboys cheerleader outfit and the Rolling Stones, who are in their 80s, will be out on tour again in 2024.

Maybe we all can’t have the stamina of rock stars or presidential political candidates, but studies show that the age demographic who are 65 and over is growing larger and still carries political, economic and cultural clout.

Looking ahead to this shift in the age demographic where the old are outnumbering the young, the Area Agency on Aging 1-B (AAA 1-B) wrote a document in 2010 titled "Preparing for the Silver Tsunami: A Wave of Opportunity.” The agency pointed out that seniors spend 92 percent of their monthly income, rather than saving it, as younger demographics need to do, and that they typically spend it locally. In 2009, seniors spent $5 billion in Oakland County, making them a very strong economic force.

So what happened to the momentum of action and planned services spurned from the Silver Tsunami report?

Oakland County Commissioner Marcia Gershenson (D-Bloomfield Township, Bloomfield Hills, West Bloomfield, Orchard Lake), herself a senior who has dedicated her career to championing the needs of older adults, said like many projects, sometimes things get reprioritized depending on who is in office.

And then came the COVID-19 pandemic.

“After the tsunami report came out, there was about a two or three-year frenzy when we had a great group of people working on all sorts of initiatives for seniors,” recalled Gershenson, who also worked on the 2010 report as well as the subsequent 2021 Blueprint for Successful Aging, and has served in the county for years on the Senior Advisory Council. “And then, as things usually happen, there is an election and things get shelved.”

Eleven years later, the 2021 Profile on Older Americans revealed that almost 2.5 million out of 10 million residents in Michigan are over the age of 60. Of that population, there are a half million between the ages of 75-84.

The median income of older persons in Michigan in 2020 was $26,668. Men had a higher median income overall: $35,808 compared to $21,245 for women. From 2019 to 2020, the average income (after adjusting for inflation) of all households headed by older people decreased by 3.3 percent. Households headed by persons 65 and older reported a median income in 2020 of $68,067. About five percent of family households with an older adult householder had incomes less than $15,000, and 79 percent had incomes of $35,000 or more.

The Healthy Aging Oakland County Ad Hoc Committee was formed in March of 2021 by the Oakland County Board of Commissioners. In December of that year, the committee, working with the AAA 1-B, released the Blueprint on Successful Aging in Oakland County.

The Blueprint revealed that since 2015, the county’s senior population has been growing at a more rapid pace than its population of children, a trend projected to continue through 2045.

While stating the urgency of providing resources to this growing demographic in Oakland County, the Blueprint noted that the county lacked an overarching program that assists older people with benefits counseling to ensure they are utilizing all available benefits, and a point person in the county administration who could listen to their concerns.

The Blueprint also revealed that while a significant portion of older adults felt like they were missing out on entitled benefits, they also may be reluctant to enter their information into a computer or handle the paperwork disclosing personal information and felt the application might not be worth the effort.

Of those age 65 and older, according to the Blueprint 70 percent will need long-term supportive services such as personal care or homemaking assistance during the remainder of their lifetime. Most older adults prefer for this care to be provided in their homes rather than moving to an institutional setting. However, many families struggle to afford in-home care services.

The Blueprint also reported on the dire shortage of healthcare and home healthcare workers in Oakland County. This is because it is difficult to attract and retain these workers, who are perennially underpaid and find few training and advancement opportunities. Many leave the workforce due to conflicting childcare responsibilities, lack of transportation, or to find a higher paying job. The Blueprint recommended that the county develop partnerships with community colleges to provide credit and tuition assistance for direct care workers seeking career advancement and to remove barriers to these workers by offsetting childcare and transportation costs.

The Blueprint reported that 28 percent of older adult households in Oakland County are paying more than 30 percent of their monthly income toward housing costs, such as rent and mortgage payments. Spending too much of one’s income on housing-related costs reduces the amount available for items such as healthy food, healthcare and/or transportation. These spending trends can negatively impact one’s health into a negative cycle for older populations.

The drawback of living in one’s home on a fixed income is the high cost of home maintenance, from replacing a furnace or roof to mowing the lawn in the summer or plowing the driveway in the winter. The Blueprint reported that in the face of inflation and rising labor and material costs, not many contractors are willing to come in below at-market rates. Chore services that were once available in some municipalities have been rendered unsustainable. The AAA 1- B historically funded county-wide chore services (lawn and snow care) until September 30, 2019.

Oakland County Executive Dave Coulter said although there is a significant number of seniors in Oakland County who have enjoyed financial stability, between 30 to 40 percent of seniors face some housing insecurity – even in wealthier suburbs. This is because those who were used to a certain lifestyle now must contend with the upkeep of a home and housing expenses on a fixed income.

“The fact that there is a high incidence of housing insecurity right here in Oakland County raises a lot of eyebrows,” Coulter said. “The issue of affording home improvements doesn’t just affect low-income communities. It has become a top challenge for me when I was elected in 2019.”

After creating an Ad Hoc Senior Advisory Council, it was determined that a standalone position needed to be created to see to older adult issues in the county. So Coulter appointed longtime Royal Oak Mayor and state legislator Jim Ellison to the new position in January 2023. Rather than duplicating programming that already may be available at the municipal level, Ellison, himself a senior, circulated in the county talking with people at senior centers and residents of independent and assisted living communities and non-profit agencies such as the AAA 1-B.

According to Katie Wendel, Michigan’s director of planning and advocacy for AAA 1-B, in comparison to the Blueprint, the 2010 Silver Tsunami report was lacking in actionable objectives. “Not as many direct investments were made in response to the Silver Tsunami,” Wendel said. “It's been substantially different with the Blueprint.”

Wendel explained that the Oakland County Board of Commissioners at the Blueprint’s suggestion made several financial investments for senior resources, including creating Ellison's position. It approved $5 million in grants to senior centers for capital technology and infrastructure improvements. It allocated $3 million to fund the development of a county chore pilot program, reserving up to $50,000 in grants for nonprofit organizations to support volunteer management and $5,000 to help with administrative costs for the reinstatement of the Oakland County Safe Elder Abuse Prevention Coalition, which is back up and running again.

Wendel continued: “These are tangible programs that are meeting benchmarks. We will continue to see increased focus on the needs of the older adult population, and how we can support caregivers. In the Blueprint, we created an actionable list of ideas for the county to focus on. And I think we're seeing the fruits of that in those really targeted investments but brought more broadly an increased focus on older adults.”

As of this January, Wendel said AAA 1-B shook off its bureaucratic name and rebranded itself as AgeWays Nonprofit Senior Services.

“When we look at the rising demand for senior services, several factors come into play,” explained Wendel. “The aging of the baby boomer generation is the nation’s fasting growing demographic. But this generation also had fewer children than previous generations, and those adult children, who most commonly are the primary caregivers, tend to live farther away. So, these are some difficult dynamics as there is a lack of available caregivers."

The first step in AgeWay’s mission, Wendel said, is to educate seniors through their families and caregivers about entitlement benefits for seniors. These classes are often offered through the senior centers throughout the county. Wendel said people need not wait for a crisis to take advantage of these informational classes. “Most people don't interact with aging services until that day when they really need it, such as when a loved one experiences a fall or gets a serious health diagnosis. And then that’s a lot of information to learn all at once.”

To offset caregiver burnout, AgeWays in October 2023 launched through a grant from the Ralph C. Wilson Foundation $575 respite care vouchers, where, through its network, family caregivers can have the ability to select and pay for a respite care worker found through their online platform or pay a trusted neighbor or relative.

As another leg of support for caregivers, AgeWays initiated a caregiving coaching program. Volunteer caregiver coaches, steeped in knowledge from their own caregiving experiences, serve as coaches to those just beginning to grapple with an aging loved one, connecting them to resources, teaching stress management techniques and other tools to navigate the complexities of caregiving.

“Our core programs are a critical component to supporting the goal of aging in place,” Wendel said. “We are all about the home and community-based settings. We highly value our seniors, as they have the strongest and most enduring bonds to our local community. These are the people who are the drivers of our local economy as well as volunteer efforts. There are several things that we can do as a community to make it more attainable for people to reach their goal of aging in place. Having supports and services set in place, helping people identify ways to modify their homes are important components of fulfilling that goal.”

Oakland County's Coulter and Ellison determined that the highest priority need for seniors is accessible transportation. Changes and enhancements are on the horizon now that Oakland County is a fully opt-in county, meaning that public transportation is going to reach every community countywide thanks to a transportation millage that passed in the November 2022 election. Coulter said that main bus routes will be expanded with micro-routes to reach the outermost and northern reaches of the county. Seniors can even get picked up and given door-to-door service starting at $2 a ride.

“In the year since the millage passed, we've seen a 20 percent increase in ridership in the outer county micro transit routes,” explained Coulter. “These are pick up services that take seniors and others with disabilities to run errands and go to doctor’s appointments. We are hearing all the time what a game changer this is giving seniors and others the freedom and independence that they needed. And you need not be at a lower income level to benefit from this.”

And once they have a ride, Coulter said the report revealed the destinations seniors desire the most are visits to senior centers where they can exercise and socialize.

“Our seniors want a much more active lifestyle than those generations in the past, so we would like to lean in and learn how we can help communities that offer senior fitness and recreation centers and programming,” Coulter said. “And this falls in line right up to what (Governor Gretchen Whitmer) is saying: we want to build up the amenities and quality of life that they want and expect here in Michigan to keep our seniors here and attract and maintain our younger generation. What seniors want now is very different from just a couple of decades ago. They are more active and tend to have more disposable income. They don’t want to stay home and watch TV – they want to get out, socialize, play pickleball and travel.”

Using the Blueprint as his guide, Ellison said so far he has spent the first year on the job assessing needs while visiting with staff and participants at every senior center across the county. He has found there are groups of active, healthy seniors who may have retired early, who are looking to keep busy and social and make the most of their pensions and retirement savings. He has talked with senior center staff members who have known and worked with members for years. Challenges for these seniors, Ellison says, are transportation issues in a car-dependent society, finding affordable home repair and other financial management resources.

“Transportation is one of the first tasks we are going to tackle,” Ellison agreed with Coulter. “Another big one is home ownership. A lot of seniors would like to downsize and move out of their larger homes, but they feel tied in because of the way state property taxes are structured. Even if they move into a smaller house or condo, they still might wind up paying high property taxes so that is a problem that needs to be addressed.”

Echoing on Ellison’s sentiments about seniors being locked into their homes is Wayne State University’s Thomas Jankowski, associate director for research at the WSU Institute of Gerontology. A large part of his position involves working on older adult issues with local municipalities as well as AAA 1-B.

Jankowski said that about 25 percent in Birmingham and West Bloomfield aged 65 and over are “house rich and cash poor.” The current inhospitable housing market for sellers find seniors locked into a big house and capped at lower property taxes – which would become high property taxes if they move as they desire so downsizing is something that the market is not making available to them.

The Institute of Gerontology collaborated on numerous state and Oakland County research projects on aging, including the Silver Tsunami with the AAA 1-B and the 2019 statewide needs assessment reports.

“From this work, we learn that the older adult population is by no means monolithic,” said Jankowski. “While there is a fair amount of Oakland County older adults who are well off, retire early and can afford to do what they want to do, there are a significant portion of them who struggle to get by, who need to decide between paying rent or paying for prescription medication, even in wealthier areas.”

At the same time, Jankowski pointed to the buying clout and economic vitality of this population. Nationwide, they spend billions in their local community with revenues from outside sources, meaning Social Security, Medicare and retirement pensions that flow into local shops and restaurants they’ve patronized for years. They also would rather avoid e-commerce.

“Another thing is that seniors are not savers,” Jankowski said. “They've already spent a whole lifetime saving, so 95 percent of older adults spend all of their income on a range of things from housing to medicine to trips to the Caribbean.”

Demographically speaking, Jankowski said Michigan’s 65-and-over population is growing and will continue that trajectory for the next 10 years, as will the population of those 85 and older. At that point, those will be the people who will tend to suffer from chronic disease, mobility and cognitive decline who will need more support to either age in place or move to independent or assisted living with step-up care, if they can afford it.

Jankowski said there is a growing trend of seniors hitting the books again and going back to college. While some are enrolling for the sake of lifelong learning, others are considering a late-in-life career change. Jankowski said Wayne State University is the third institute of higher learning in Michigan that has embarked on a partnership with the Age Friendly University Global Network, making classes more accessible to older learners.

“The age of retirement has been creeping up since the 1980s and that is because people are living longer and they want to work and have different careers in their lives,” Jankowski said. “I can’t tell you how many students I have spoken to who are in their sixties. A year or so after they retired, they realized they were not going to make it (financially) without at least some part-time work or consulting. They want to work, but they also want to have much more control of their schedule.”

Last November, Birmingham voters approved support of senior resources with a new, three-year 0.33-mill levy which will collect about $1,053,750 in revenue per year for interim improvements and a sinking fund for a new senior center. This was well supported because Birmingham, Beverly Hills, Bingham Farms and Franklin expect households with older adults to jump by 50 percent by 2045.

Birmingham NEXT's Braun said that the plan to relocate the senior center and renovate the existing Birmingham Family YMCA 400 E. Lincoln Street is also made possible by a mosaic of funding revenue that includes fundraising, sponsorships and grants to keep base membership at $55 a year for members. The current center has 2,500 members and welcomes about 1,600 visitors per week to participate in a variety of classes, lectures, courses and resources such as a computer lab and a library.

Once the YMCA is renovated for greater accessibility, such as ramps and an ADA-compliant elevator, Braun said there is great excitement over how they can deliver enhanced senior programming in the new building that will triple its footprint from its current location.

“We provide so much at Birmingham NEXT so I can’t wait to see how much more we can do once we are in the new building,” Braun said. “It already is like a tale of two (senior) centers. On one hand, we have very active members who like to exercise, go on trips and learn at our lecture series. Then we have others in the community who come in looking for support, whether they are having technical problems with their cell phones or tablets, or if they are looking for someone who can help mow their lawn or shovel snow. In Birmingham, we have worked hard to provide services like this to our seniors.”

In 2022, Bloomfield Township voted to renew a millage for senior services that was created in 2004. The current senior services millage of 0.2273 mills was set to expire in 2024, but since the proposal passed, there will be an increase of the senior services millage by 0.1027 mills, for a new total millage rate of 0.3300 mills for 10 years. The renewed millage and increase will be levied in December 2024 and will result in the authorization to collect $1.673 million in the first year.

Bloomfield Township Senior Services Director Christine Tvarhoa said the millage pays for over 50 percent of the cost to run the township’s senior center, located on 4315 Andover Road. The rest of the revenue comes from grants, donations, fundraising, program and membership fees.

According to Tvarhoa, the senior center was growing in popularity in the years before the pandemic. In 2019, there were about 70,000 visits to the center, which was open six days a week at 65 hours per week. The center boasts a walking track, a pool for swimming and aquatic classes, and a gym with dozens of pieces of weight machine equipment, and about 51 classes per week.

After shutting down in-person programming for nearly 15 months, Tvarhoa said the center in 2023 was climbing back out of the pandemic phase to find a shifting preference from senior clients. They may have moved away or are still hesitant to gather in person. Tvarhoa is hoping that the many offerings this winter, such as lunch and learn lectures, the reformation of a jazz band, and planned day trips can coax seniors out of the winter doldrums.

“Above all, we are focused on building social networks that gather in person as we take a holistic approach to our seniors,” Tvarhoa said. “This winter, we offered a slew of complementary programs to draw people in, even though we all have the urge to hunker down in cold, dark weather. From playing poker or billiards to book club and fitness classes, we are encouraging people to come in and reconnect to the community.”

To alleviate transportation barriers, in 2012 the center kicked off a transportation program and hires its own private drivers and mini-shuttle routes to pick up members and bring them to and from the center. And asking for a lift is not limited to those who are permanently no longer driving.

“No one likes to say, ‘I’m never driving again.’ Our transportation program is here for the times that seniors may feel hesitant about driving, or if they are recovering from surgery and temporarily cannot drive. There is a wide range of people who benefit from our transportation program and many more could benefit from it if they were aware of it.”

Essential to our physical health as we age – so we can continue playing sports or even remaining independent at home, is maintaining balance and learning how to avoid falls. According to the Centers for Disease Control and Prevention, falls are the leading cause of injury and injury death for those 65 and older. One out of four older adults will fall each year in the United States.

Proper, prescribed strength coordination and balance exercises have been proven the best way to maintain balance and prevent falls, and this has been a focus within the physical therapy department at Oakland University.

Chris Wilson is an associate professor of physical therapy at Oakland University who has been board certified in geriatrics since 2008. His department launched a community program called Home-Based Older Persons Upstreaming Prevention and Physical Therapy, or Hop-Up-PT, which has been piloted at senior centers at Auburn Hills and hopes to be expanded and available to other senior centers in the county.

The study was made possible by a partnership between Oakland University and the Michigan Health Endowment Fund with a contribution of $900,000. There is also additional grant funding of over $400,000 to build a statewide online portal where seniors and their caregivers can locate nearby fall prevention programs. The program will be developed with the Michigan Department of Health and Human Services and Michigan 2-1-1 to find a nearby fall prevention program.

“Much of a senior’s ability to stay independent, safe and active in the community depends on their ability to stay physically and medically healthy,” said Wilson. “That's why we've been very excited to work on this Hop-Up-PT initiative that has a community focus.”

Wilson said what typically happens is that an aging person injures themselves or falls and then in their recovery process they are prescribed physical therapy and strength training. But Hop-Up-PT turns this way of thinking on its head.

“Instead of waiting for something to happen, like a fall, we have learned that in our seven-month study, conducted by working in the field with 144 participants at six area senior centers, Hop-Up-PT participants were eight times less likely to fall than their counterparts who did not do the exercises,” Wilson said.

He said the study pointed out important lessons as we all age: that preventative exercises that intervene the course of aging can address predictable issues before they happen.

Most seniors want to stay in their homes as long as possible, but that may involve receiving extra support. The Program of All-Inclusive Care for the Elderly (PACE) is a model of care that integrates Medicare and Medicaid benefits for eligible beneficiaries. It provides comprehensive medical and social services to seniors and individuals living with disabilities that enables them to live in their homes and communities rather than receiving care in an institutional setting.

On December 5, 2023, Michigan Congressman John Moolenaar (R-Midland) and Congresswoman Debbie Dingell (D-Ann Arbor) reintroduced the PACE Expanded Act, which is legislation that would strengthen the Program of All-Inclusive Care for the Elderly (PACE). PACE is a model of care that integrates Medicare and Medicaid benefits for eligible beneficiaries who are 55 and over and can live independently in their own homes with extra support provide by the program. Available in 31 states and with 25 centers in Michigan, PACE offers comprehensive medical and social services to seniors and individuals living with disabilities that enables them to live in their homes and communities rather than receiving care in an institutional setting. Stephanie Winslow, executive director of the PACE Association of Michigan, said the program is perhaps the best-kept secret and a remedy to Michigan’s “perfect storm” of older people living longer and staying put within the state while their younger counterparts are moving away. This creates a multi-layered conundrum of less local caregivers and a shrinking tax base to provide these services, Winslow said.

“Michigan is one of the top 15 oldest populations in the US, and Michiganders 85 and older, are the fastest growing group of everybody,” Winslow said. “Between 2012 and 2022, PACE has seen participation increase in its Michigan program by over 470 percent. That’s because it’s really the best kept secret to this perfect storm.”

PACE payments are capitated, meaning that when a senior needs specific in-home care after they are released from a hospital or emergency room setting, health care providers or organizations will receive payments through PACE as a predictable, upfront, set amount of money to cover the predicted cost of all or some of the health care services for a specific patient over a certain period of time.

Winslow said that 70 percent of senior consumers would rather be cared for in their home, and seniors living at home are hospitalized 24 percent less than living in another setting. Those enrolled in PACE can be provided with age-in-place amenities in their home such as handrails in hallways and showers and ramps for better accessibility.

PACE enrollees can also visit one of their centers in southeast Michigan from a few times a month to a few times a week, either on their own or picked up by a PACE shuttle, said Winslow. At a PACE center, seniors can take a supervised bath or shower, have their laundry done, have a meal, be seen by doctors, nurses and physical therapists have prescriptions filled, take part in social activities and have a meal. Winslow said because PACE is both the health insurance provider and the healthcare provider, this model is the “Cadillac” of care.

“While hospitals and nursing homes grapple with staffing shortages, we at PACE are nimble, quick and tend to have better staff retention,” said Winslow. “Because we are both the insurance and the healthcare provider, our trained staff, from our physicians to physical therapists and nurses, tend to stay with us longer because they can provide care without their hands tied behind their back. For example, in a traditional insurance situation, a patient may use up their physical therapy hours in a certain allotted timeframe. But at PACE, if we see that patient is and can improve and remain living independently in their own home, we have that flexibility to give them more therapy to get them to that level of being able to live independently.”

When living on one’s own or moving in with a relative are no longer options, people may choose to explore senior living communities. According to the website seniorliving.org, Michigan has over 500 independent living and over 1,200 assisted living facilities.

The Birmingham-Bloomfield area has seven living communities for senior residents, including All Seasons, American House Village at Bloomfield, Baldwin House, Cedarbrook of Bloomfield Hills, Sunrise of Bloomfield, the Avalon of Bloomfield Township and The Sheridan at Birmingham.

An independent living community can offer maintenance-free one and two-bedroom apartments, small condos or patio homes. They feature on-site minimal medical care as needed by residents. Residents have a private living space as well as community-based services and facilities, such as a community entertainment space, a dining plan, a meeting room, and a community garden. In addition to providing the built-in assurance that seniors will be living in a secure environment with a supportive staff always on call, residents can expect a lifestyle that is full of social and recreational activities, including happy hour nights several times a week.

According to the website aplaceformom.com, the average monthly cost for independent living in Michigan is $2,635. The costs are out of pocket. Additional care by a home health aide may be financed by Medicare or Medicaid.

For those who need more care with taking medication, dressing and mobility issues, assisted living residents get help from trained healthcare aides that are not necessarily registered nurses. Memory care is available in some assisted living homes and some facilities are known as continuum care models where the staff can increase care for a person as they age and their needs change. According to memorycare.com, the cost of this level of care is on average $5,313 per month, $300 less than the national average.

Some independent and assisted living communities offer temporary, respite care arrangements for those who may need extra support when recovering from an illness or surgery.

Many officials from places like Baldwin House, American House and All Seasons began their careers in the hospitality industry and treat their businesses as such. Many who work in this industry have stayed for decades and were introduced to it when it was time to look for living arrangements for their parents. And many say their clients, who felt lonely and isolated living on their own, wish they had moved in sooner.

“Aging in place is the preferred option for most folks,” said Baldwin House Chief Operating Officer Tina Marzolf. “If people are no longer able to do this, the next best thing is to age within the community they are most comfortable and familiar with. It’s where their church or pharmacy is located, where they have nearby family and friends. And an independent living community like what we have at all of our Baldwin properties is one of the most common choices.”

Marzolf said all of the Baldwin House properties in Oakland County, from independent living apartments in Birmingham, stand-alone cottages in Hazel Park and apartments in Auburn Hills by the Great Lakes Crossing, are intended to improve and maintain the active, independent senior quality of life through social connection.

“Isolation is at epidemic levels in our country, while we see other cultures like in Asia where communities are more closely connected, people live longer and healthier lives,” Marzolf said. “It can be assuring to know you can move to a place where you can see people all the time. You don’t have to rely on far-away family members who may only see you once a month. And in our common areas there is happy hour, there is music and people are having fun.”

Marzolf said if people are unsure about making a permanent relocation, they can rent an apartment on a trial basis.

While all of the units at Baldwin House are designed for active, independent living, a caregiver may need to reassess and consider assisted living if memory impairment issues or acute mobility issues arise.

“Trying to care for loved ones in one’s home who have acute needs can become expensive and exhausting, and that is a big reason why people seek out assisted living,” Marzolf noted. “Once home and community-based care options have been exhausted, that is the time when families consider assisted living, where there is access to around-the-clock care and tending to personal care issues like taking medications, dressing, and bathing.”

Also in downtown Birmingham is All Seasons independent apartments on Elm Street. At the high end of independent living, All Seasons is adding to its housing options this year with a 55 and over boutique housing with 24 luxury two-bedroom apartments. Each will feature high-end kitchen appliances, vinyl hardwood floors, balconies and private terraces as well as high-tech security door locks and temperature controlling.

“The demand for senior living just keeps climbing and I don’t see any signs of it slowing down because the longevity of our lives keeps growing,” said All Seasons Director of Sales and Marketing Rita Zhao.

Zhao comes from a decades-long career in international hospitality and previously worked for the Hyatt Corporation. She enjoys her work at All Seasons because of the dedication of the staff and their respect for residents shown by the quality of care and attention they give. Everything from a resort-like dining selection and housekeeping services are included. Amenities include shuttle transportation to shopping and appointments, programming from concerts to dance performances to the “senior prom” each year.

“All Seasons has created a community that is not only set in a beautiful and loving environment but has created an attractive lifestyle for our residents who love it here because they have so much to do. As one ages, unfortunately, one’s social circle begins to shrink. Friends pass away, and it gets harder to get out and about and see friends and family. But when they are here, they are surrounded by new people to meet and have many things to do, both here at All Seasons and through planned trips to Detroit to visit the DIA or take in a performance at the DSO.”

American House CEO Dale Watchowski and President Jeff Floyd say they are committed to the quality of life for their residents, some of whom are their own parents who all lived in Oakland County their whole life and had no desire to move away as they made their transition to independent and assisted living. Altogether the company has six independent, assisted, memory care and respite care sites in Oakland County and 60 communities in the Midwest, New England, and Southeast. American House is in the Top 20 of the largest senior housing company in the country.

“People’s desires to stay locally is the reason for us developing our housing community in West Bloomfield and Bloomfield Hills,” Watchowski said. “In some cases, retirees may downsize and move to more rural areas of the state. Then, a health issue arises, they are far from family and the quality of doctors they need, and a decision needs to be made. Unfortunately, making a move to assisted or independent living happens reactively, and many who ultimately move in with us in retrospect wish they’d done it sooner.”

“Many families seniors fit into three categories,” explained Floyd “They either plan for the future, procrastinate and push it off as long as possible, or they are a crasher – they wait until a health crisis forces a decision. It is unfair and stressful to everyone, especially the senior resident.”

Watchowski said this is why it is important to speak with loved ones to plan for the future as much as possible how to move forward with life as we become more frail and dependent, and consider where we want to be once we reach this stage.

An area senior living community most known for its attention to the continuum of care is Cedarbrook of Bloomfield Hills. With three locations in southeast Michigan, the community in Bloomfield Hills also offers nursing home care. According to Erin Ottenbreit, Cedarbrook's Senior Vice President of Operations, the staff takes the time to build relationships with the residents as well as their family members. If a resident starts to show a decline in health, staff members start the conversation about solutions and/or next steps. It may be as simple as coordination with rehabilitation therapy services or as important as meeting with the resident and their families about transferring to another area of the community that can better provide the appropriate care and support.

“The senior industry can be confusing a times because communities offer several different types of services and living options,” Ottenbreit explained. “As an example, some communities offer licensed assisted living and memory care; others may offer independent living with or without some connection to home healthcare, which will not have the same government oversight. It is important to have Cedarbrook in the community where people have lived because it is familiar, close to friends and family, and full of memories.”