HomeMy WebLinkAbout1996 SAIL Ltr Forwarding 1995-2010 East Metro Senior Housing Market • East Metro SAIL
Counties Served:
11 Dakota
Ramsey
Washington
s,,,L C on Board
Navigating
the Future Seniors Agenda for Independent Living
Together
October 3, 1996 1996
Northwest Associated Consultants
5775 Wayzata Blvd
Suite 555
St. Louis Park, MN 55416
Attention: Oak Park Height Planners
Dear Sirs:
Enclosed is a copy of a report on the senior housing market in the East Metro area.
This report was produced by Wilder Research Center for the East Metro Senior Agenda
for Independent Living (SAIL) Project. East Metro SAIL serves the counties of Dakota,
Ramsey, and Washington.
The report identifies demographic projections, needs for increased housing options, and
raises questions and issues for policy makers and housing developers to consider as the
aging population continues to grow and new services are developed.
Please feel free to share the information with others. East Metro SAIL would like this
document to be well circulated and utilized.
If you have questions, want more information about the contents of this document, or
need more information about SAIL, feel free to call Nan Just, East Metro SAIL
Coordinator at (612) 552 -3111.
Sincerely,
'
Nan J
Eas Metro SAIL Coordinator
Dakota County Public Health
161 N. Concord Exchange #450 — South St. Paul, MN 55075 — (612) 552 -3111 or (612) 552 -3100 — Fax: (612) 552 -3130
For TDD, contact Minnesota Relay Service at (612) 297 -5353 or 1- 800 - 627 -3529.
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• AUGUST, 1996
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• A REPORT PREPARED FOR:
• EAST METRO SENIOR AGENDA FOR INDEPENDENT LIVING PROJECT
• SERVING DAKOTA, RAMSEY, AND WASHINGTON COUNTIES
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• A REPORT PREPARED BY;
• VERONICA M BENNETT, Ph.D., SENIOR RESEARCH SCIENTIST
• WILDER RESEARCH CENTER
• 1295 BANDANA BOULEVARD NORTH
• SUITE 210
• ST. PAUL, MN 55108
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• EAST METRO SAIL HOUSING WITH SERVICES COMMITTEE
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• Rick Buechner, Regina Medical Complex, Hastings, MN
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• Judy Fairbrother, DARTS, West Saint Paul, MN
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• Roberta Guidry, Wilder Residence West, Saint Paul, MN
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• Nan Just, East Metro SAIL, South Saint Paul, MN
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• Carole Lohmar, Ramsey County Public Health, Saint Paul, MN
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• Maribeth Lundeen, Dakota County Community Services, Apple Valley, MN
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• Daisi Martin, Human Services, Inc., Stillwater, MN
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• Jeanette Metz, Amherst H. Wilder Foundation, Saint Paul, MN
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• Therese Richard, Ramsey County Human Services, Saint Paul, MN
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• Heidi Sandberg, Dakota County Community Services, West Saint Paul, MN
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• Barb Schommer, Ramsey County Public Health, Saint Paul, MN
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• J. F. Wallace Todd, Consumer, Cottage Grove, MN
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• Deb Tulloch, Washington County Community Services, Stillwater, MN
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• Kathy Wick, Dakota County Public Health. South Saint Paul, MN
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• Marcia Wielinski, Washington County Community Services, Stillwater, MN
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• For more information, contact Nan Just, East Metro SAIL Coordinator (612) 552 -3111.
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• ACKNOWLEDGMENTS
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• This report is based on published and unpublished information reviewed by the East Metro
• SAIL Housing with Services Committee. References consulted include:
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• Consumer's Guide to Housing Options for Older People, Met Council, 1988
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• Census of Population and Housing 1990 Summary Tape Files on CD -ROM, Bureau of the
• Census, 1992
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• Minnesota's Changing Counties: The Next Thirty Years, Minnesota Planning, October
• 1993
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• 1995 Senior Housing Directory, Minnesota Senior Federation, 1995
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• Senior Housing Inventory, Minnesota Health and Housing Alliance, 1995
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• Directory of Nursing Homes and Alternative Housing for Older People in the Twin Cities
• Metropolitan Area, Metropolitan Area Agency on Aging, 1996
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• East Metro SAIL is indebted to the organizations that produced those reference sources and
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• to their staff, volunteers, and informants.
• Likewise, it would not have been possible to produce this document without the
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• contributions of many people with special expertise in the areas of demography, geography,
• planning, housing and development and particularly senior housing. We would like to express
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• special appreciation to the following individuals:
• Ron Abato, Adult Services Specialist, Minnesota Department of Human Services, Aging
• and Adult Services Division
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• Elaine Anderson, Program Services Manager, St. Paul Public Housing
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• John Baer, Survey Project Coordinator, Washington County Surveyor's Office
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• Wes Butler, Special Project Manager, Washington County Housing and Redevelopment
• Authority
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• Deb Cook, Clerk Specialist, Washington County Health, Environment, and Land
• Management
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Jessica Cook, Program Development Director, Dakota County Housing and •
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Elliot Graham, Program Evaluator, Ramsey County Community Human Services •
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LaRhae Knatterud, Policy Planning Coordinator, Minnesota Department of Human •
Services, Aging and Adult Services Division •
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Diane Sprague, Senior Policy Analyst, Minnesota Housing Finance Agency •
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Ann Thibault, GIS Specialist I, Dakota County Survey and Land Information Department •
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Our sincere thanks also go to Marilyn Conrad, Administrative Services Manager, Louann •
Graham, and Darlene Zappa, Word Processing Operators, and Kent Treichel, Research Associate •
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I, at Wilder Research Center for their assistance in the development and production of this report. •
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Just, P I ( •
East Metr. SAIL Coordinator •
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• TABLE OF CONTENTS
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• Page
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• Acknowledgments i
• Glossary v
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• Executive Sununary vii
• Introduction 1
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• The Older Population in the East Metro SAIL Region 2
• Distribution by County 4
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• Geographic Concentrations Within Counties 6
• Projected Growth in the Older Population 8
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• Frailty Among Older Adults 10
• Risk Factors for Poor Health and Functional Impairment 12
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• ADL and IADL Impairments 14
• Frailty and Housing Tenure 16
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• East Metro SAIL Area Senior Housing Supply 18
• Numbers of Units 20
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• Projected Senior Housing Needs 22
• Service Enriched Housing 24
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• Summary and Issues to Consider 26
• Summary of Conditions 26
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• Issues to Consider 28
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Conclusion 32
• Appendix 34
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LIST OF FIGURES •
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1 Estimated Distribution of Population by Age - 1995 3 •
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2 Estimated Distribution of Population Age 55 and Older by County - 1995 5 •
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3 Density of Older Adult Population 7 •
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4 Projected Population Age 65 and Older 9 •
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5 Percent of Persons 65 and Older with Self -Care and/or Mobility Limitations 11 •
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6 Distribution of Persons 65 and Older at High Risk of Frailty 1990 13 •
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7 U.S. Noninstitutionalized Population Age 65 and Older Percent with •
IADL Difficulties and Percent with ADL Difficulties 15 •
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8 Profiles of Homeowners and Renters Age 60 and Over by Housing Tenure 17 •
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9 Distribution of Senior Housing Facilities by Type 19 •
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10 Senior Housing Units as of March 6, 1996 21 •
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11 Additional Beds/Units Needed for Older Adult Population: 1995 -2010 23 •
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12 Housing Units with Services 25 •
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• GLOSSARY
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• Activities of Daily Living (ADL) - Everyday tasks associated with personal self -care, (e.g.,
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• bathing, dressing, eating and transferring). Gerontologists measure functional independence
• in terms of a person's ability to perform these tasks.
• Adult Foster Care (AFC, Homes Plus) - Foster care homes licensed by the Minnesota
• Department of Human Services to serve up to five residents, if all residents are 60 years or
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• older. Included in this category are corporate adult foster care settings run by paid staff 24
• hours a day.
• Aging in Place - Continuing to live in one's established residence despite physical frailty and
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• functional limitations that may occur as one grows older.
• Boarding Care Homes - Health care facilities licensed by the Minnesota Department of Health
• that provide only personal or custodial care and related services for five or more aged or
• infirm adults.
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• Board and Lodging - Establishments licensed by the Minnesota Department of Health (or by
• the local Health Department) to provide room and board to residents.
• Board and Lodging with Services - Board and lodging establishments that provide support
• services, such as assistance in making appointments, or health related services, such as
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• medication reminders and personal care services. These establishments must register with
• the Minnesota Department of Health.
• Condominium - Ownership housing in an apartment -style building or townhouse -style complex.
• Condominium residents hold title to their own living unit and share ownership of the
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• common areas with other owners in the development. (Townhomes are classified in this
• category).
• Continuing Care Retirement Community (CCRC) - Campus - style developments offering a
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• range of housing and long -term care services to the residents. Residents pay an entrance fee
• as well as a monthly fee for a package of services specified in the resident's long -term
• contract, which includes a residence, services and nursing care.
• Cooperative (Coop) - Ownership housing in a multifamily building or complex. The
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• development is owned by a corporation on behalf of the occupants, who buy shares in the
• corporation in exchange for the right to occupy a specific living unit.
• Housing Unit - A generic term that may refer to a bed, a room, or a rental, condominium or
• cooperative apartment, depending on the kind of housing facility under discussion. For
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• example, one bed in a double nursing -home room is referred to as a housing unit, and a two-
• bedroom market rate apartment is also one housing unit.
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Instrumental Activities of Daily Living (IADL) - Complex everyday tasks, such as shopping,
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using the telephone, handling personal finances, and preparing meals, which are necessary to •
live independently in a modern society. Functional independence is measured in terms of a •
person's ability to perform IADLs and ADLs without assistance. •
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Low/Moderate Rental - Rental projects that serve low or moderate income elderly but do not •
have any direct federal rent subsidies. Such projects may have been developed through tax •
increment funding or some other local subsidy, or through federal tax credits. •
Market Rate Rental - Rental housing that has no government subsidy; rent levels are •
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determined by the real estate market. Those offering services are included in this category. •
Mobility Limitation - Difficulty going outside the home alone for activities such as shopping or •
visiting a doctor's office that is due to a physical or mental health condition that persists for 6 •
or more months, except for conditions like a broken bone that is expected to heal.' •
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Natural Break - Ranges "created according to an algorithm that uses the average of each range •
to distribute the data more evenly across the ranges. It distributes the values so that the •
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average of each range is as close as possible to each of the range values in that range. This
ensures that the ranges are well- represented by their averages, and that data values within •
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each of the ranges are fairly close together.i2 •
Nursing Home - Facility licensed by the Minnesota Department of Health to provide active •
restorative treatment of an individual's disability or disease. The treatment plan is designed •
to lower the level of dependency. •
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Self -Care Limitation - Difficulty in taking care of personal needs such as dressing, bathing, or •
getting around inside the home that is due to a physical or mental health condition that •
persists for 6 or more months, except for conditions like a broken bone that is expected to •
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Subsidized Rental - Privately -owned rental buildings that serve qualified lower - income •
households. These projects have been developed under federal programs such as Section •
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202, Section 236, Section 8 new construction, and Farmers Home Administration 515.
Transferring - Getting in and out of bed. •
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U.S. Census Bureau, 1990 Census of Population and Housing •
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2 Mapinfo Professional (1992- 1995). Users Guide. Troy, NY: MapInfo Corporation, p. 128. •
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3 U.S. Census Bureau, 1990 Census of Population and Housing •
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• EXECUTIVE SUMMARY
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• Increasingly, mature adults want to grow old in their own homes and communities, even if
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• they become unable to function independently. Meeting elders' desire to age in place in the least
• restrictive environment possible is a particular concern for the East Metro Senior Agenda for
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• Independent Living (SAIL) project. East Metro SAIL is one of six multi - county projects that are
• part of the State of Minnesota's 20 -year SAIL initiative. The goals of the SAIL initiative are to
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• make high quality home care services easily accessible to seniors, foster the development of
• other community -based alternatives to nursing homes, and help shape long -term care policy and
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• spending decisions for the future.
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• In 1995, the Housing with Services Committee of the East Metro SAIL project began an
• effort to identify current service - enriched housing options for seniors in Dakota, Ramsey, and
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• Washington Counties. They authorized this report to provide information that community
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• planners and developers of housing and services for the elderly can use to plot their future
• activities. This document links data about the current and projected size and characteristics of
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• the older adult population in the East Metro region with information about the area's senior
• housing supply. It projects the number of senior housing units that the region will need over the
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• next 15 years. It also includes information about the prevalence of functional disability in the
• older population and estimates of the numbers of area residents who will need help with
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• everyday activities over that time. This information will help determine the future need for
• service - enriched housing.
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• THE AGING POPULATION IN THE EAST METRO REGION
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• Persons aged 55 and older comprise about 17 percent of the region's total population.
• Older adults are more likely than the general population in the East Metro SAIL Region to reside
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• in Ramsey County. However, the other two counties are making substantial gains. Between
• 1980 and 1990, absolute numbers of older adults increased in all three counties, but the
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• proportion of all East Metro elders who live in Ramsey County fell 17 percent. The proportions
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• living in Dakota and Washington Counties increased 39 percent and 50 percent, respectively. In
• the next 15 years (1995 - 2010), Ramsey County's 65- and -older population is expected to grow
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only 10 percent. Dakota County can expect its older population in 2010 to be 86 percent larger •
than it was in 1995. Washington County's projected growth rate for the 15 -year period is 95 •
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percent. By 2010, a slight majority of East Metro seniors (52 %) will live outside Ramsey •
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The trend in Ramsey County is for slow growth in the 65 -and -older population. Virtually •
all of that growth will be in the oldest old segment (age 85 and up). This implies that most •
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Ramsey County seniors who are 70 and older today and survive the next 15 years will age in •
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place. By 2010, oldest -old seniors will comprise 17 percent of Ramsey County's projected
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67,520 elderly population. In contrast, Dakota and Washington Counties will experience •
approximately as much growth in the young -old segment (ages 65 -74) as they will in the oldest- •
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old. Thus growth in these counties will come from immigration of elders who now reside in •
Saint Paul and other places, as well as from current residents' aging in place. Most of the elders •
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who move into Washington and Dakota Counties will be in the 65 -74 age range. In 2010, about •
eleven percent of Dakota and Washington Counties' 65- and -older populations will be oldest -old •
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adults, while 57 percent and 60 percent, respectively, will be between the ages of 65 and 74. •
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FRAILTY AND THE OLDER POPULATION •
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Frailty in the older population is a function of age, gender, race, and income. National health •
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studies have consistently shown that •
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▪ Functional impairment increases geometrically with age. •
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▪ Females are more likely than males to have health and functioning problems. •
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Persons of color are more likely to have problems than Caucasians. •
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▪ The prevalence of poor health increases as income declines. •
Nevertheless, census data did not indicate that the prevalence of mobility and/or self -care •
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problems was substantially different for any of the three counties in the East Metro region in •
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1990. About 16 -17 percent of persons aged 65 and older reported having difficulty getting •
around outside or performing personal care activities because of a chronic health condition. •
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Among persons age 75 and older, the prevalence of self -care and/or mobility limitations was 27 •
percent in Ramsey County, 28 percent in Washington, County, and 29 percent in Dakota County. •
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• The expected relationships of gender, age and income with functional limitations are
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• apparent, however, when data are aggregated by housing tenure rather than by county. The
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• concentration of persons with high risk characteristics is greater among renters, as is the
• concentration of older adults who have difficulty doing everyday activities. For example, Wilder
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• Research Center's 1989 statewide study of Minnesotans aged 60 and older found that women and
• persons age 75 and older were much more likely to be renters (75 -84 percent female, 45 -54
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• percent 75- and - older) than homeowners (59 percent female and 25 percent 75- and - older). The
• study also showed that the prevalence of functional problems was higher among renters (40
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• percent for market rate renters and 44 percent for subsidized) than among home owners (31
• percent with functional problems). The difference in prevalence of functional problems between
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• subsidized and unsubsidized renters is consistent with research that shows that poverty is a risk
• factor. Because of income eligibility requirements, elders with low per capita incomes were
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• more likely to reside in subsidized rental units (94% < $10,000) than to rent at the market rate
• (45% < $10,000).
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• EAST METRO REGION SENIOR HOUSING SUPPLY
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• As of March 1996, the East Metro SAIL Housing with Services Committee had identified
• 280 facilities in the three - county area that provide housing for seniors. These include
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• • 74 adult foster homes
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• 11 boarding care homes
• • 11 board and lodging facilities
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• • 17 low /moderate rent apartment buildings /complexes
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• • 39 market rate apartment buildings /complexes
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• • 52 nursing homes
• • 73 subsidized rental apartment buildings /complexes
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Together, these facilities have more than 18,000 beds and/or apartments. On average, there •
are 196.4 beds /apartments per 1,000 persons age 65 and older. Ramsey and Washington •
Counties both have more than 210 beds /apartments per 1,000, but Dakota County has only 147 •
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per 1,000. •
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Aside from those located in nursing homes, boarding care homes, and adult foster care, few
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of these beds /apartments are located in service - enriched housing environments. The Committee •
was able to identify
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• 4768 beds /apartments with meals programs •
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• 4,301 beds /apartments with transportation services •
• 3,296 beds /apartments with emergency response systems •
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• 2,592 beds /apartments with housekeeping services
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• 2,462 beds /apartments with personal care nursing services
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In many instances, these services involve additional fees to the residents. They are not included
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as part of the rent. •
Considering projected population shifts and growth rates, almost 7,000 new •
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beds /apartments will be needed by 2010 to maintain the present 1.96 per thousand ratio in the •
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East Metro region. For each county to maintain its present ratio, there will have to be 2,661 new
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beds /apartments in Dakota County, 1,287 in Ramsey County, and 2,303 in Washington County. •
Also based on projected population growth rates, East Metro SAIL estimates that almost 18,000 •
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area elders will need help with everyday instrumental activities like shopping and money •
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management and 6,700 will need help with self -care activities if they are to continue to live in
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their communities. Thus, service - enriched environments may become a hallmark of future •
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housing facilities for the 65 and older population.
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• ISSUES TO CONSIDER
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• As the size of the older population increases and as this population becomes more widely
• dispersed over the three- county East Metro SAIL region, policy issues such as whether and
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• where to encourage senior residences, who should meet seniors needs for help, how those needs
• can best be addressed, and how to prevent age - related functional disabilities, will emerge and be
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• addressed. Planning and spending decisions of communities and developers will affect the
• policy outcomes. Therefore community planners and developers and operators of senior housing
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• facilities and senior services will want to consider these issues from the outset of their projects:
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• • HOW WILL THE PROPOSED PROJECT AFFECT THE GEOGRAPHIC DISTRIBUTION OF THE
• AGING POPULATION? Will the resulting concentration or dispersion of older adults
• alleviate or exacerbate age segregation, social isolation and/or intergenerational
• conflict? Will residents have access to needed ancillary services like public
• transportation and amenities like shopping and recreation outlets?
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• • HOW WILL THE PROPOSED PROJECT AFFECT THE WAY OLDER ADULTS RECEIVE SERVICES
• AND THE COST OF DELIVERING SERVICES TO THEM? Will it encourage frail elders to
• congregate in limited areas and allow paid providers to deliver their services more
• efficiently? Will it encourage ongoing family participation in seniors' care? Will
• it encourage more dispersion of the elderly who are frail and require the
• community to become more involved in voluntary elder care?
• • HOW WILL THE PROPOSED PROJECT AFFECT EFFORTS TO REDUCE THE INCIDENCE OF
• FUNCTIONAL DISABILITY AMONG OLDER ADULTS? Will the resources needed for the
• project take away from the resources available for prevention efforts? Will the
• design of the proposed project encourage elders' participation in preventive and
• therapeutic exercise and social activities?
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• • HOW WILL THE PROPOSED PROJECT AFFECT THE DEMAND FOR AND AVAILABILITY OF
• ELDER CARE RESOURCES IN THE EAST METRO SAIL REGION? How can the strengths of
• the project be leveraged to benefit all East Metro SAIL participants? How can it
• capitalize on existing resources in the region? How can East Metro SAIL
• participants contribute to the project's success?
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• INTRODUCTION
• More than seventy thousand East Metro householders age 55 and older (75 %) were home
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• owners in 1990. Assuming that they were like most older Americans, the majority of those
• homeowners had no desire to move. Aging in place is becoming an increasingly desirable goal.
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• According to the American Association of Retired Persons, the proportion of older adults who
wish to remain in their current residences as they continue to age rose from 78 percent to 86
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percent between 1986 and 1989. However, increasing frailty can make maintaining a private
• residence difficult and cause older persons to seek new housing.
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Housing the frail elderly is a particular concern for the East Metro Senior Agenda for
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• Independent Living (SAIL) Project. East Metro SAIL is one of six SAIL projects that are part of
• the State of Minnesota's 20 -year SAIL initiative. The goals of the SAIL initiative are to make
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• high quality home care services easily accessible to seniors, foster the development of other
community -based alternatives to nursing homes, and help shape long -term care policy and
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• spending decisions for the future.
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In 1995, the Housing with Services Committee of the East Metro SAIL Project undertook
an effort to identify current housing - with - service alternatives for seniors in its region. This effort
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• is a precursor to working with local leaders in the field of senior housing to identify priority
• housing needs. Efforts to date have included enumerating the current supply of senior housing
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• units with and without services, identifying the size and characteristics of the population age 55
• and older in the East Metro region, locating areas where elderly residents concentrate, and
• estimating the growth in the older adult population as an indicator of future senior housing needs.
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• In June, 1996, the East Metro SAIL Project engaged Wilder Research Center to prepare this
• interim report on the results of the Housing with Services Committee's work. It summarizes the
• information that the committee has accumulated, reviews other published information on the
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° U.S. Census Bureau, 1990 Census of Population and Housing.
• 5 American Association of Retired Persons. (1990) Understanding senior housing for the 1990s. Washington,
• DC: American Association of Retired Persons. Cited in Golant, Stephen M. (1992) Housing America's
• elderly: many possibilities, few choices. Newbury Park, CA: Sage Publications.
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health and functional status of elders, and refines the estimate of the future needs. It is presented
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in four sections. The first section describes the distribution and demographic characteristics of
the elderly population in the East Metro region and projections of that population's growth. The • •
second section presents information about frailty among older adults. The third section describes •
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the existing supply and projected demand for senior housing and housing with services in the •
East Metro region. The fourth section presents issues for consideration by the East Metro SAIL •
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Project and area senior housing providers in developing their plans for the future. •
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THE OLDER POPULATION IN THE •
EAST METRO SAIL REGION •
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Dakota, Ramsey, and Washington Counties comprise the East Metro SAIL region. The
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graph and chart on the facing page are based on population estimates made by the State of •
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Minnesota. They show the age distribution of the combined populations of the three counties.
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• Almost 975,000 persons resided in the East Metro SAIL region in 1995. •
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• About 162,000 persons, 17 percent of the region's population, was 55 or older in 1995. •
• Almost 94,000 persons (about 10 %) were 65 or older.
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A comparison of the 1995 population estimates and the results of the 1980 Census indicates
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that the number of older adults in the East Metro SAIL region grew substantially. •
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• Between 1980 and 1995, the 55- and -older population grew 22 percent. •
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• Between 1980 and 1995, the population age 75 and older increased by 40 percent.
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Nevertheless, the proportion of the total East Metro SAIL population that was age 65 and •
older in 1995 (10 %) is lower than the comparable figure for all U.S. Metropolitan areas, which •
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was nearly 12 percent.
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6 U.S. Bureau of the Census. 1996. Current Population Reports, Special Studies, p. 23 -190, 65+ in the United
States. U.S. Government Printing Office, Washington, DC.
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Figure 1
• East Metro SAIL Region
• Estimated Distribution of Population by Age
• 1995
•
•
/ ' / r 55 and Older
• .r'• %. %.. % % .% 17% • • Y f f.r• / r•i 'r.'': . .
• .t � �� ^�� � � r is � � `` i !'.i •!''!: %.r'.r'• %.r'• %.i'r� r''!:
• a E ,�..: �,.,..�t'x,.^ $r, �' ,� r r! r r r r f! r r r f/ !' f
s+s .ra.. " ti :.� � � � r !' !' i • f • r •'i� %� %� f i � f •' / '• / •'i 'i �/'
• ,. � f �y i .l..i . f .. f .. r •' f •' i ' i ' i '; ' i 'i 'r•' /.'!.' %.l..
�
•
"� -� ..., i • • r• i r r• z r r r r f r i i i r f
•
•
•
•
•
•
•
•
Under 55
• 83 %.
•
•
•
• Estimated Distribution of Population by Age -1995
•
•
• Total
•
• Age Number Percent
•
• Under 55 812,600 83%
•
• 55 to 64 68,060 7%
•
•
• 65 to 74 50,870 5%
•
• 75 and Older 43,080 5%
•
• Total 974,610 100%
•
•
• Source: Minnesota's Changing Counties: The Next Thirty Years, Minnesota Planning, October 1993.
•
•
•
•
•
•
•
•
•
•
•
DISTRIBUTION BY COUNTY •
•
The older adult population is not distributed proportionately among the three counties that
•
make up the East Metro SAIL region. Figure 2 shows that in 1995 an estimated 60 percent of the •
55- and -older population resided in Ramsey County, 25 percent resided in Dakota County, and 15
•
percent were Washington County residents. Following is a comparison of the distributions of the •
1995 total and elderly populations for the three- county region. •
•
•
•
% of East Metro's % of East Metro's 55 and •
County Total Population Older Population •
Dakota 32% 25% •
•
Ramsey 51% 60% •
Washington 17% 15% •
1
Proportions are based on population estimates prepared by the State of Minnesota from 1990 Census data. •
•
Compared to each county's share of the area's total population, the population aged 55 and •
•
older is substantially under represented in Dakota County, substantially over represented in •
Ramsey County, and slightly under represented in Washington County. Nevertheless, •
•
considerable diffusion has occurred over the past 15 years. Ramsey County's share of the 55- •
•
and -older population in the East Metro region was 72 percent in 1980 compared to 60 percent in
•
1995. That difference represents a 17 percent decline over the past 15 years. In contrast, Dakota •
County's share of the region's older adults rose from 18 to 25 percent, a 39 percent increase, and •
•
Washington County experienced a 50 percent increase from 10 percent of East Metro region's •
older population in 1980 to 15 percent in 1995. Thus, relative to their 1980 populations,
•
Ramsey County's share of the region's elderly population fell by 17 percent, Dakota County's •
share grew by 39 percent, and Washington County's share increased 50 percent. •
•
•
Finally, we note that in the East Metro SAIL region, the older adult population is also •
aging. In this area, the proportion of seniors in the 55 -64 age group fell from 46 percent in 1980 •
•
to 42 percent in 1995, while the proportion aged 75 and older rose from 23 to 27 percent. •
•
•
•
•
v
-4- •
•
•
•
•
•
Figure 2
East Metro SAIL Region
• Estimated Distribution of Population Age 55 and Older By County
• 1995
•
• Washington
• 15% Dakota
•
•''•' • •' • 25%
•' '♦♦'♦♦♦♦ ♦ ♦ ♦ ♦ ♦♦ ♦r
• 1f r ♦ r ♦ ' r ' ♦
• : «.. •
•
•
•
•
•
•
•
•
• Ramsey
•
• 60%
•
•
•
• Estimated Distribution of Population Age 55 and Older by Age Group -1995
•
•
Dakota Ramsey Washington Total
•
• 55 to 64 19,970 48% 36,150 37% 11,940 51% 68,060 42%
•
• 65 to 74 12,140 30% 31,860 33% 6,870 29% 50,870 31%
•
• 75 and Older 8,900 22% 29,550 30% 4,630 20% 43,080 27%
• E b '° 4, t 8 F .8 .1i g .y Il (C :. g 3
•
• Source: Minnesota's Changing Counties: The Next Thirty Years, Minnesota Planning, October 1993.
•
•
-5-
•
•
•
•
•
•
•
GEOGRAPHIC CONCENTRATIONS WITHIN COUNTIES
•
The density of the aging population also differs for each county. Ramsey County is the •
•
smallest of the three geographically. It covers only 170 square miles. At the same time, Ramsey •
County has the greatest number of persons aged 55 and older, 97,560. Thus, the average density y
•
of the older population in Ramsey County is 574 per square mile. In contrast, Dakota County a
covers 585 square miles and has an older population of 41,010, or an average density of 70 older •
•
persons per square mile, and Washington County has only 56 older adults per square mile on •i
average. By age group, population densities are: •
•
•
Persons per Square Mile •
•
Dakota Ramsey Washington
•
55 -64 34 213 28 •
65 -74 21 187 16 •
75 and older 15 174 11 • •
•
In actuality, the older population is not distributed evenly throughout each county. 0
•
Typically, older residents tend to live in older, more established areas, having moved there when •
they were younger and aged in place. Figure 3 displays the concentration of seniors in East •
•
Metro area census tracts by persons per square mile grouped according to naturally occurring •
breaks (see glossary for definition of natural breaks). Because of the differences in population •
•
densities, the average number of seniors per square mile in Washington and Dakota Counties are •
in the first group for the East Metro region, while the average number of seniors per square mile •
0
in Ramsey is in the third group. Thus, in Dakota and Washington Counties, census tracts in the v
second through fifth concentration groups all have senior population densities that are greater •
•
than the counties' averages. •
•
Above county- average concentrations of seniors are found as follows: •
•
▪ Dakota County - West Saint Paul, South Saint Paul, Inver Grove Heights, Eagan, •
Burnsville, Apple Valley, and Hastings •
▪ Ramsey County - City of Saint Paul and first ring suburbs, New Brighton, and White •
Bear Lake •
•
. Washington County - Stillwater and Oakdale, City of Forest Lake, White Bear Lake, •
Woodbury, and Cottage Grove •
•
-6- •
•
•
•
•
•
•
• Figure 3
• East Metro SAIL Region
• Density of Older Adult Population
• (persons 55 and older by census tract)
•
• s�.•\
• 55 and Older per Square Mile "_,,.
■ 1,535 to 2,639
• I 990 to 1,518
• 0 507 to 934
• 0 183 to 492
• ❑ O to 173
•
•
0 kAllitiVi
• lit PPM
sc
,=::::-Arammweir 1 is-st 4
ki." ir -PA
•
• � � 7∎
TI: VIM . Val i
• AIM 0
•
• 111 )04 . .
• .lam
• r kw ,,,
• LA
It bill
ill is
•
•
• r
• i
•
•
•
• -
ID •-••••-•"",/ % .,...."
•
•
•
• Source: 1990 Census of Population, Summary Tape File 2
•
• -
•
•
•
•
•
•
PROJECTED GROWTH IN THE OLDER POPULATION
•
According to the state demographer's office the number of persons age 65 and older in the •
•
East Metro Region will increase 37 percent, from 93,950 to 129,060 between 1995 and 2010. •
Figure 4 shows that most of that growth will be in Dakota and Washington Counties. The •
•
number of older adults in Ramsey County is expected to grow only 10 percent in the next 15 •
•
years, from 61,410 to 67,520. The following table shows the percent change in the numbers of
•
seniors for each of the next three five -year periods in each county, as well as the growth rates for •
the entire 15 years in each county and for the East Metro SAIL region as a whole. •
•
•
Projected Percent Change in Population Aged 65 and Older •
•
1995 Population
Age 65 and Up 1995 -2000 2000 -2005 2005 -2010 1995 -2010 •
•
Dakota 21,040 +19% +22% +28% +86% •
Ramsey 61,410 +1% +2% +7% +10% •
•
Washington 11,500 +21% +24% +30% +95%
Total 93,950 : +8% r +40% +v16 %a ;= %
37�oxy
•
The differences in these growth rates emphasize the extent to which the elderly population •
•
in the East Metro SAIL region will redistribute itself in the years before the baby boom cohort
reaches retirement age. An analysis of growth rates by age groups is included in the Appendix. •
It shows that:
•
•
•
. In Ramsey County growth will occur almost exclusively in the 85- and -older cohort, •
with the growth rate for that cohort (38 %) being more than five times greater than that •
of the 65 -74 cohort (7 %). •
•
. Dakota County's elderly population will grow more than 85 percent from 1995 -2010, •
with the 65 -74 cohort growing at a 95 percent rate and the oldest old (85 and up) •
growing 101 percent. •
•
• The size of Washington County's elderly population will almost double during this •
period, with growth in the 65 -74 cohort (102 %) being slightly greater than growth •
among the oldest old (90 %). •
•
•
By 2010, Ramsey County is expected to house 47 percent, Dakota County 36 percent,
•
and Washington County 17 percent of the East Metro region's elderly. •
•
•
•
-8-
•
•
•
•
•
• Figure 4
• East Metro SAIL Region
• Projected Population Age 65 and Older
•
• Thousands
• 140
•
•
•
•
120
•
•
• 100 •
•
•
• 80 - — •
•
•
4. • 60 - - — — —
•
4 . .1, S °
•
40
/f
• 20 .. -_—
• I I / • f• • / • %• %/� • '
• f 3 / f . ,, • f • • /•f a
• 1995 2000 2005 2010
•
• V a Dakota Ramsey Washington Total J
•
•
• Source: Minnesota's Changing Counties: The Next Thirty Years, Minnesota Planning, October 1993.
•
•
•
•
•
•
•
•
•
•
•
• -9-
•
•
•
•
•
•
•
FRAILTY AMONG OLDER ADULTS •
•
•
•
Not all older adults are frail enough to require in -home services or housing with services.
•
Nationwide, forty percent of persons age 55 and older consider themselves to be in very good or •
excellent health.' Figure 5 shows that only 16 percent of Dakota and Washington County's non- •
•
institutionalized residents age 65 and older and 17 percent of Ramsey County's elders who live •
•
outside of institutions have mobility and/or self -care limitations. The table below provides detail •
on the proportions of elders who have mobility limits only, self -care limits only and both •
•
mobility and self -care limits by age. It is based on data from the 1990 census. The Census •
Bureau's definitions of self -care and mobility limits are included in the glossary (p.v). •
•
Prevalence of Mobility and Self -Care Limitations
•
Among Persons Aged 65 and Older •
Mobility Limits Self -Care Limits Both Limits •
•
number % number % number %
Dakota County •
65 -74 347 3% 269 3% 287 3%
_ 75 and up 852 14% 361 6% 531 9% •
'65 and 1 1'1 0 E' 7% , 630 •
�.:. .� , ':� .�- ; X4 /0 `818 5 %� � •
Ramsey County •
65 -74 1348 4% 982 3% 919 3% •
75 and up 3041 13% 1166 5% 2081 9% •
, 65. N .. 4 ,- ... , ., 8 % 'i : . - " 214 4% ., r? 3000, 5%a
•
Washington County
•
65 -74 183 3% 153 3% 146 3% •
75 and up 450 14% 122 4% 320 10% •
65 and u},r 4 ,:° 633 7%0\ ,275 .: f 3 %u 5%
_ X466 •
Source: 1990 Census of Population, Summary Table File 2 •
•
In short, older adults who need services are even more widely dispersed than elders in •
•
general. This makes providing community -based services difficult for public and private •
agencies. A widely dispersed target market makes it harder to schedule services efficiently. •
•
Home care workers who serve clients in private residences must spend more time traveling •
between their appointments, which leaves them less time to provide direct care. •
•
•
•
•
•
-10- •
•
•
•
•
•
•
Figure 5
• East Metro SAIL Region
• Percent of Persons 65 and Older with Self -Care and /or Mobility Limitations
• 1990
•
•
Self -Care and/or
• Mobility Limits
• 65 -74 9%
• 75 and Older 28%
• 65 and Older 16%
•
•
•
• Self -Care and/or
• Mobility Limits
• 65 -74 10%
• 75 and Older 27%
• 65 and Older 17%
•
• Ramsey
• Washington
•
•
•
•
•
•
•
•
• Self -Care and/or
• Mobility Limits
• 65 -74 9%
• 75 and Older 29%
• 65 and Older 16%
•
• Dakota
•
•
•
•
•
•
•
•
•
• Source: 1990 Census of Population, Summary Tape File 2
•
•
• -11-
•
•
•
•
•
•
RISK FACTORS FOR POOR HEALTH •
AND FUNCTIONAL IMPAIRMENT •
•
Seniors' needs for in -home services arise primarily because of functional impairments and •
•
poor health. Levels of functional impairment are associated with age, race, and gender.' •
According to the National Health Interview Survey (NHIS) 1986 Functional Limitations •
•
Supplement, among the population aged 65 and older, 32 percent of black females and 24 •
percent of black males have activity of daily living (ADL) impairments compared to 25 percent •
•
of white females and 18 percent of white males. ADLs include self -care behaviors such as •
•
eating, bathing, dressing, and so forth. The probability of impairment also increases with age
•
and poor health. Poor health, as used in this report, refers to self - reported health. The proportion •
•
of persons age 65 and older who rate their health as poor is higher among persons living in
•
poverty than among persons with incomes above the poverty line. Thus, members of the senior •
•
population are more likely to need supportive services as they grow older; and elderly women,
•
persons of color and members of low income households are particularly likely to need home •
•
care.
•
•
Figure 6 shows the proportion of adults age 65 and older in each county who were in each •
of these high risk demographic categories as of the 1990 census. The proportions of females and •
•
low- income households in each county are not substantially different. Ramsey County has a •
higher proportion of persons of color than Dakota and Washington Counties. The East Metro •
•
SAIL Project has prepared color coded maps that show the geographic distributions of persons •
by age, race, and income within each county. These maps are available for review at the East •
•
Metro SAIL offices in Dakota County. •
•
•
s
•
Prohaska, T., R. Mermelstein, and B. Miller. (1993) Functional status and living arrangements. Pages 23 -39
in J. F. Van Nostrand, S. E. Furner, and R. Suzman (eds.). Health data on older Americans: United States •
1992. National Center for Health Statistics. Vital Health Stat 3(27). 1993. •
Blesch, K S. and S. E. Furner. (1993) Health of older black Americans. Pages 229 -273 in J. F. Van •
Nostrand, S. E. Fumer, and R. Suzman (eds.). Health data on older Americans: United States 1992. •
•
m
National Center for Health Statistics. Vital Health Stat 3(27). 1993.
•
10 U.S. Senate Special Committee on Aging, American Associated of Retired Persons, Federal Council on the •
Aging, & U.S. Administration on Aging. (1991). Aging America: Trends and Projections (DHHS •
Publication No. 91- 28001). Washington, DC: U.S. Department of Health and Human Services •
•
-12 •
•
•
•
•
•
•
• Figure 6
• East Metro SAIL Region
• Distribution of Persons 65 and Older at High Risk of Fraility
• 1990
•
•
•
•
•
• 60% Female
• 1.3% Persons of Color
• 6.6% Below Poverty
•
• 64% Female
• 3.7% Persons of Color
• 8.8% Below Poverty
•
•
•
•
• Ramsey
• (pop. 65+ = 59,447) Washington
• (pop. 65+ = 9,480)
•
•
•
•
•
•
•
• 60% Female
• 0.8% Persons of Color
• _ 7.2% Below Poverty
•
•
• Dakota
(pop. 65+ = 17,352)
•
•
•
• - I
• �J
•
•
•
• Source: 1990 Census of Population, Summary Tape File 2
•
•
• -13
•
•
•
•
ADL AND IADL IMPAIRMENTS
•
•
Figure 7 displays the proportions of NHIS 1986 Functional Limitations Supplement •
•
respondents in high risk categories who reported having difficulty performing specific activities
•
of daily living (ADLs) and/or instrumental activities of daily living (IADLs). As the first table •
•
suggests IADLs are complex activities that must be done to support everyday life. The current
•
best estimate of the proportion of noninstitutionalized U.S. residents age 65 and older who have •
•
one or more ADL disabilities exclusive of walking and getting outside is between 5 and 8
•
percent. The tables show the extent to which the prevalence of functional limitations is •
influenced by gender, race, and age. •
•
Less published information is available concerning the relationship between income and •
•
specific ADL and IADL difficulties. One study found that the reported rates of difficulty with •
•
some activities were approximately twice as high among the lowest income quintile of
•
noninstitutionalized U.S. residents age 55 and older of all races except Black as they were in the •
highest income quintile.13 •
•
The data in Figure 7 indicate that the most frequently reported difficulty is an instrumental •
•
activity. However, three of the five activities that persons 65 and older are most likely to find •
difficult are physical ADLs. •
•
•
■ On average, 24 percent of older adults report having difficulty doing heavy housework,
like painting and moving furniture. •
•
▪ The second most prevalent limitation is in walking, which is difficult to about 18 •
percent. •
Other frequently reported difficulties are with shopping (13 %), getting outside (12 %), •
and bathing (10 %). •
•
•
•
•
" Prohaska, T., R. Mermelstein, and B. Miller. (1993). Functional status and living arrangements. Pages 23 -39 •
in J. F. Van Nostrand, S. E. Fumer, and R. Suzman (eds.). Health data on older Americans: United States •
1992. National Center for Health Statistics. Vital Health Stat 3(27). 1993.
•
•
' Weiner, J. M., R. J. Hanley, R. Clarka and J. F. Van Nostrand. (1990) Measuring the activities of daily
living: Comparisons across national surveys. Journals of Gerontology 45(6):229 -237. •
•
13 Kover, M. G., J. D. Weeks, W. F. Forbes. (1995) Prevalence of disability among older persons: United •
states and Canada. National Center for Health Statistics. Vital Health Stat 5(8). •
•
-14- •
•
•
O
O
O
O
O Figure 7
East Metro SAIL Region
0 U.S. Noninstitutionalized Population Age 65 and Older
•
II
ID Percent with IADL Difficulties in Specified Area
O Number of
• Race, sex, persons in Meal Managing Using Light Heavy
• and age thousands preparation Shopping money telephone housework housework
• Race Percent
•
• White 24,753 6.6 12.1 4.9 4.8 7.5 23.3
• All other 2,784 12.8 18.8 8.2 6.7 12.8 28.0
• Sex
•
• Male 11,357 4.5 8.1 4.1 5.1 5.6 13.0
• Female 16,181 9.2 16.0 6.0 4.9 9.8 31.3
• Age
• 65 -74 years 16,987 4.0 7.3 2.5 3.2 4.6 18.0
•
• 75 -84 years 8,552 9.9 18.1 7.3 5.9 11.1 29.5
• 85 years and
• over 1,999 23.4 36.0 19.5 16.1 24.4 48.0
•
•
• Percent with ADL Difficulties in Specified Area
• Number of
• Race, sex, persons in Getting
and age thousands Eating Toileting Dressing Bathing Transferring Walking outside
•
• Race Percent
• White 24,753 1.9 4.4 5.7 9.5 8.2 17.8 11.3
• All other 2,784 1.3 7.0 8.6 14.0 11.6 22.1 15.6
•
• Sex
• Male 11,357 1.7 3.4 5.2 7.1 6.4 14.9 7.5
• Female 16,181 1.9 5.6 6.5 12.0 10.1 20.6 14.8
• Age
• 65 -74
• years 16,987 1.5 2.8 4.2 6.3 6.2 13.5 7.0
O 75 -84
• years 8,552 1.8 6.3 7.3 13.9 11.2 23.4 16.9
O 85 years
• and over 1,999 5.0 14.0 15.1 24.8 17.1 35.9 30.1
•
• Source: Health data on older Americans: United States 1992. National Center for Health Statistics. Vital Health
• Stat 3(27). 1993.
0
• -15-
0
•
0
0
•
FRAILTY AND HOUSING TENURE
•
•
Increasing frailty contributes to older adults' decisions to move to rented housing. The •
•
table below shows how housing tenure and functional
g problems were related among •
noninstitutionalized Minnesotans age 60 and older in 1989. It is based on a statewide survey •
•
conducted by Wilder Research Center. The results of a later, 1994, survey of residents of
•
Public Housing Authority hi -rise residents in Saint Paul appear to be consistent with proportions •
•
displayed below. That study found that only 55 percent of those residents age 62 and older were •
fully independent with regard to physical and instrumental daily activities. •
•
•
Percent 60 and Older with •
Tenure of Housing Number Functional Problems
•
Own 1,849 31% •
Rent - unsubsidized 211 44%
Rent - subsidized 105 49% •
•
Other' 44 55% •
a Consists primarily of elders who live with other family members and pay no rent •
•
•
Demographic profiles of older Minnesota home owners and renters are shown in Figure 8.
•
•
• A majority of unsubsidized older renters (55 %) are under the age of 75, female (75 %),
•
slightly more likely to live alone (54 %) than to live with others (46 %), and only 9
•
percent have per capita incomes of less than $5,000 per year (1989 dollars).
•
• A majority of subsidized renters (54 %) are 75 or older, female (84 %), live alone (82 %), •
and only 6 percent have per capita incomes of $10,000 or more. •
•
• Only one out of five elderly home owners lives alone, 41 percent are males and 49 •
percent have per capita incomes of $10,000 or more. •
•
•
•
•
•
•
14 Fischer, L. R., D. P. Mueller, P. W. Cooper, R. A. Chase. (1989) Older Minnesotans: What do they need?
How do they contribute? Saint Paul: Amherst H. Wilder Foundation, page 44. •
•
15 Chase, R. A. (1994) PHA Hi -Rise Resident Survey Results. Unpublished report prepared for the Public •
Housing Agency of Saint Paul by Wilder Research Center, Inc. •
•
-16- •
•
•
B
1
1
•
•
Figure 8
• State of Minnesota
0 Profiles of Homeowners and Renters Age 60 and Over by Housing Tenure
•
O Rent Rent
✓ Own Unsubsidized Subsidized Other'
• Area (n =1804) (n =210) (n =100) (n =39)
O Metro Area (7 county) 41% 60% 36% 25%
• Greater Minnesota 59% 40% 64% 75%
•
O Age (n =1804) (n =210) (n =100) (n =39)
O 60 -64 28% 20% 10% 15%
• 65 -74 47% 35% 36% 15%
O 75 -84 21% 30% 41% 31%
•
. 85 and older 4% 15% 13% 23%
0
O Gender (n =1849) (n =211) (n =105) (n=44)
• Female 59% 75% 84% 77%
• Male 41% 25% 16% 23%
a Per Capita Income (n =1304) (n =149) (n =78) (n =27)
• Less than $5,000 13% 9% 44% 59%
•
0 $ 5,000 - $9,999 38% 36% 50% 22%
• $10,000 - $14,000 23% 28% 6% 7%
• $15,000 and over 26% 27% - -- 11%
• Living Arrangement (n =1849) (n =211) (n =105) (n=44)
•
Live alone 19% 54% 82% 16%
0
• Live with other 81% 46% 19% 84%
• a Consists primarily of elders who live with other family members and pay no rent
• Source: Wilder Research Center, Older Minnesotan's Study, 1989
•
•
•
•
•
•
•
•
•
•
•
•
• -17-
0
•
•
0
0
•
•
EAST METRO SAIL REGION SENIOR HOUSING SUPPLY 0
•
0
As of March 1996, the East Metro SAIL Housing with Services Committee had identified •
280 residential facilities for older adults in its region. Figure 9 indicates the locations of these
•
facilities by type. The glossary includes descriptions of each type of facility. The following •
table shows the number and percent distributions of these facilities by county and for the total
•
East Metro SAIL region. Separate maps for each county are included in the appendix of this •
report. •
County •
Dakota Ramsey Washington Total •
•
Facility Type Number Percent Number Percent Number Percent Number Percent •
Adult foster care 22 37 37 22 13 25 72 25.7 •
•
Boarding care
•
home 1 2% 9 5% 1 2% 11 3.9%
•
Board and lodging
with services 4 7% 3 2% 4 8% 11 3.9% •
•
Condominium 2 3% 2 1% 0 0% 4 1.4% •
Cooperative 1 2% 0 0% 0 0% 1 .4% •
•
Low /moderate
rental 7 12% 6 4% 4 8% 17 6.1% •
Market rate rental 3 5% 24 14% 12 23% 39 13.9% •
•
Nursing home 9 15% 38 23% 5 10% 52 18.6% •
Subsidized rental 11 18% 49 29% 13 25% 73 26.1% •
Count is of March, 1996.
•
Together, there are 60 residential facilities in Dakota County, 168 in Ramsey County, and •
•
52 in Washington County. The table shows that: •
•
• About a third (35 %) of Dakota County's facilities are rental apartment projects, •
compared to 47 percent in Ramsey County and 56 percent in Washington County •
• Washington County has no condominiums or cooperatives for older adults who want to •
•
own their congregate housing units. •
• Compared to the other two counties, subsidized rental facilities comprise a relatively •
small proportion of Dakota County's residential options for seniors. •
•
• Compared to the other two counties, a relatively large percentage of Ramsey County's •
facilities are nursing homes. •
•
-18- •
•
•
Ill
•
•
•
• Figure 9
• East Metro SAIL Region
• Distribution of Senior Housing Facilities by Type
•
• fl Adult Foster Care
t r • ® Boarding Care Home - .1_
• ® Board and Lodging with Services + x
• ° Condominium
• * Cooperative
• 0 Low/Moderate Rental x
• x Market Rate Rental x
• ° Nursing Home g
• ± Subsidized Rental
•
• + ❑ c
• x g
• ..
• x--F t *, -Fc ± X ®
III <> 0 lar <> Iw
• 4x °+^� ❑ fo,
• v ® + A-0 •• CJ
M 4
❑ O
• ° 0 x sic
• 0 ❑
• 0
• 0 g
• oo °
• g oo c+ ��o.
• - ❑ Q
• 0 °
• e
• °+ + +°
• x
•
•
• 4
•
• 4
•
•
•
•
•
- 19-
•
•
1
1
1
1
NUMBERS OF UNITS •
•
•
The 280 residential facilities for seniors that the East Metro SAIL Housing with Services
1
Committee identified contain more than 18 thousand housing units. Kinds of units ranged from 1
nursing home and foster care beds to rental, cooperative and condominium apartments. Figure
1
10 shows the numbers of beds /apartments for all facilities that provided this information. The 1
data are sorted by type. From this and the data on page 18, one can determine that:
•
• The 183 licensed adult foster care beds in the East Metro SAIL area comprise
•
only 1 percent of all units, even though a plurality of the facilities are adult
foster care homes.
. Dakota County has more nursing home beds than it has subsidized rental 1
apartments. 1
• The number of subsidized rental apartments are greater than the number of •
nursing home beds in Ramsey and Washington Counties.
•
Following are estimates of the numbers of beds /apartment units per one thousand persons 1
aged 65 and older in 1995 in the East Metro SAIL area. Overall, there were about 196. Dakota 1
•
County had substantially fewer than Ramsey and Washington Counties. While it is safe to say •
ta
that adult foster care, nursing homes and boarding care homes can accommodate one person per
•
housing unit (i.e., one per bed), apartments, can accommodate more than one person. Thus it is •
not possible to determine precisely how many older adults the housing units in the East Metro
•
region can accommodate. •
•
Number of Beds /Apartment Units
Per 1,000 Population 65 and Older •
•
Facility Type Beds /Apartment Units per 1,000 Population 65 and Older •
Dakota Ramsey Washington Total •
•
Adult Foster Care 3.6 1.2 3.0 1.9 1
Boarding Care 1.5 5.6 4.3 4.5 a
Board & Lodging w/ Services 10.6 2.9 4.1 4.8 _ •
Condominium 5.3 4.1 0.0 3.8 • •
Cooperative 0.6 0.0 0.0 0.1 •
Low/Moderate Rental 18.6 6.9 24.7 11.7 •
Market Rate Rental 16.7 21.4 52.8 24.2 •
Subsidized Rental 35.9 86.6 64.7 72.6 • •
Nursing Home 54.3 81.8 57.7 72.7 •
F a�'+, a r " k " `t - x 4 3 a f n , �� *41/.1 y x "�?a 5 f� Y
•
-20- •
•
•
r
s
•
•
Figure 10
• East Metro SAIL Region
Senior Housing Units (Beds /Apartments) as of March 6, 1996
•
• County
• Dakota Ramsey Washington Total
/► Type of Facility Units Units Units Units
• Adult foster care 75 74 34 183
Boarding care home 32 343 49 424
• Board and lodging with services 223 178 47 448
Condominium 111 249 * 360
Cooperative 12 * * 12
Low/Moderate Rental 392 421 284 1097
Market rate rental 351 1314 607 2272
-
Nursing home 1143 5026 663 6832
Subsidized rental 755 5321 744 6820
•
• X94 2,�: 2428 448
• * Data not available.
•
Sources: Consumer's Guide to Housing Options for Older People, Met Council, 1988; 1995 Senior Housing
Directory, MN Senior Federation; Directory of Nursing Homes and Alternative Housing for Older
• People in the Twin Cities Metropolitan Area, MAAA, 1996; Senior Housing Inventory, Minnesota
• Health and Housing Alliance, 1995.
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
• -21-
•
•
1
a
41
1
PROJECTED SENIOR HOUSING NEEDS
•
It appears doubtful that the present supply of beds and apartments for seniors greatly
exceeds demand. Data from a recent Dakota County survey suggests that 99 percent of all r
subsidized and unsubsidized independent living congregate housing in that East Metro county 1 *
41
are occupied. Washington County reported only two vacant units in all of the senior housing •
facilities that it owns." Telephone conversations with East Metro board and lodging facilities •
indicate that about 90 percent of dwelling units of this type are occupied. The occupancy rate for
•
nursing home beds in Area Agency on Aging Region 11, which includes Dakota, Ramsey and •
•
Washington Counties, is about 92 percent.' Only Adult Foster Care appears to have excess
•
capacity. The vacancy rate for family- operated facilities is approximately 50 percent in the East
Metro region. However, Adult Foster Care beds comprise only one percent of the area's total •
beds /units. Thus, the vacancy rate has little impact on the senior housing occupancy rate overall. • •
Based on current population projections, approximately 25,342 beds /apartments will be
•
needed in 2010 in order to maintain the estimated ratio of 196 per thousand persons aged 65 and
•
older in the East Metro SAIL region. Figure 11 shows that this will require the addition of •
almost seven thousand units, although the number of units needed would be only 6,253 if each •
county maintains its individual ratio.
•
It is virtually certain that the number of residential units per thousand seniors will not •
•
remain the same for each type of facility over the next 15 years. If nothing else, the statewide
•
moratorium on nursing home beds will result in a declining number of beds per thousand
•
residents. The Interagency Long -Term Care Planning Committee recommended in 1994 that the
moratorium be continued, noting that statewide, Minnesota had 80 beds per thousand residents •
aged 65 and older in 1982. This was well above the national figure of 53. In the three- county •
•
East Metro SAIL area, there were about 73 nursing home beds per thousand elders in 1995.
With the moratorium and the growth in the elderly population, we expect that figure to be about 1
53 by 2010. However, unless existing beds are redistributed Dakota and Washington Counties'
ratios will fall to about 30 per thousand in 2010, while Ramsey County's will be about 74. •
•
16 Dakota County HRA. (1996), [Inventory of Independent Living/Congregate Housing Facilities] Unpublished
raw data. •
•
17 Telephone conversation with Wes Butler, Washington County HRA, August 13, 1996. •
•
18 Silloway, G. and E. Opland. (March 1994). The 1993 Distribution of Nursing Home Beds in Minnesota.
Saint Paul: Interagency Long -Term Care Planning Committee, p.32.
•
•
-22- •
•
•
•
•
•
• Figure 11
• East Metro SAIL Region
• Additional Beds /Apartments Needed for Older Adult Population: 1995 -2010
•
•
• Thousands
• 8
•
• 7
•
• 6
•
•
• 5
•
• 4 - •
• 3 — — •
•
• 2 _ •
•
• 0
• Dakota Ramsey Washington East Metro Total
•
•
*1995-2000 2000 -2005 12005 -2010
•
•
•
• Additional Beds /Apartments Needed to Maintain Specified Ratios
•
• Dakota Ramsey Washington East Metro Total*
• (147 units/ (210 units/ (211 units/ (196 units/
• 1000 65 +) 1000 65 +) 1000 65 +) 1000 65 +)
•
• 1995 -2000 602 109 521 1,391
•
• 2000 -2005 798 240 703 1,942
•
• 2005 -2010 1,261 937 1,081 3,563
•
• 1995 -2010 2,661 1,286 2,305 6,896
•
• * Does not equal sum of units per county.
•
•
• -23-
•
•
•
•
•
•
•
SERVICE ENRICHED HOUSING •
•
The growing preference among seniors to age in place, the declining ratio of nursing home •
•
beds to older adults, and increasing numbers of frail older adults are portents of a growing need •
for senior housing with services and community based care in the East Metro SAIL region. One •
•
established model for projecting frailty among seniors takes into consideration gender, race, age, •
•
geographic region, and the level of poverty in the community. Applying estimators from that •
model to population projections for the three county area, we expect that in the year 2010, more •
•
than 6,000 noninstitutionalized East Metro SAIL area residents aged 65 and older will have •
difficulty performing one or more physical activities of daily living (ADLs) and 17,800 will have •
•
difficulty with one or more instrumental activities. A detailed table of estimates for each •
county is included in the appendix. •
•
The extent to which service - enriched housing is already available in the East Metro SAIL •
•
region is uncertain. In addition to the 52 nursing homes and 11 licensed boarding care facilities •
in the area, the Housing with Services Committee was able to identify •
• •
39 facilities with housekeeping services •
• 58 facilities with meals programs •
• •
35 facilities with arrangements for personal care nursing services •
• 48 facilities with emergency response systems •
•
• 55 facilities with their own transportation programs •
•
The number of housing units that these facilities represent and special access requirements (if •
specified) for the services that they offer are displayed in Figure 12. For the East Metro SAIL •
•
region, the number of service - enriched units per 1,000 persons age 65 and older ranges from 26.2 •
personal care nursing services to 50.8 for meals programs. Figure 12 also indicates that a •
•
majority of residents in service - enriched housing units must pay extra for housekeeping, meals, •
and personal care nursing. The appendix contains separate tables that show the number of •
•
service - enriched units in each county. •
•
•
19 Elston, J.M., G.G. Koch, and W.G. Weissert. (1991) Regression- adjusted small area estimates of functional •
dependency m the noninstitutionalized population age 65 and over. American Journal of Public Health, 81 •
(30):335 -341. •
•
•
-24- •
•
•
0
e
•
•
•
• Figure 12
• East Metro SAIL Region
• Housing Units with Services
•
• Type of Facility
• Board and Low/
lodging with moderate Market Subsidized
•
• services Cooperative rental rate rental rental Total
• Housekeeping
• additional cost * 12 * 537 1,048 1,597
• contact building * * * 30 * 30
•
• yes - access requirements
not specified 401 * * 564 * 965
• Total 401 s �1 f 12 % 1,131 1,048 2,59
• Meals Program
• additional cost * 12 * 955 1,048 2,015
• contact building * * * 99 * 99
0
• yes - access requirements
. not specified 401 * 182 326 1,745 2,654
� � _ a . 401 12 182 1,380 2,793 4,768
• Personal Care Nursing
•
additional cost 230 * * 556 863 1,649
•
• contact building * * * 30 136 166
• yes - access requirements
not specified 171 * * * 476 647
• Total 401 * * 586 1.475 2,462
• Emergency Response
•
• contact building * * * 83 * 83
• yes - access requirements
• not specified 391 _ 12 93 1,569 1,148 3,213
,
llgj 93-; z? A'„ W 4.1 , 148 € , -
•
Total s ) m " �
e Transportation
•
• additional cost 42 * * 208 237 487
• contact building 10 * * 30 852 892
• yes - access requirements
• not specified 349 12 59 1,295 1,207 2,922
•
Total 401 12 59 1,533 " ., „ x,296 4 ,301
• Count is as of March, 1996.
•
•
• -25-
•
•
•
•
•
•
•
SUMMARY AND ISSUES TO CONSIDER •
•
•
The State of Minnesota has charged East Metro SAIL and the other SAIL projects with •
the aging in place process and contributing to long-term care policy and spending
•
facilitating g g P P g g P Y •
decisions. As part of the process of meeting its charge, the East Metro SAIL Housing with •
Services Committee has examined the changing demographics in Dakota, Ramsey and •
•
Washington Counties, identified senior housing options for the county's residents aged 55 and •
•
older, and commissioned Wilder Research Center to prepare this report. Because frailty, •
particularly functional impairment, is a major consideration in older adults' housing decisions, •
•
WRC also reviewed 1990 Census data and data from several national health surveys conducted •
during the 1980s and developed projections of the number of East Metro SAIL area residents •
•
aged 65 and older whose ability to perform every day activities is impaired. •
•
SUMMARY OF CONDITIONS •
•
This report has addressed the question, "What are the conditions in the East Metro SAIL •
•
area ?" The answers have not been surprising. It is common knowledge that the size of the older •
population is growing, that frailty increases with age and poverty, that women and persons of •
•
color are particularly prone to frailty, that frailty is more prevalent in senior housing facilities •
•
than it is in the eneral population, and so forth. However, the
g P P purpose of this report has not •
been to discover new trends. The purpose has been to measure the extent to which these •
conditions exist in the three East Metro SAIL counties and to quantify such trends as the growth •
•
of the elderly population, the changing geographic distribution of older adults in the area, and the •
extent to which providers of residential services for seniors have responded to these changing •
•
conditions. In doing this, we have found that •
•
In 1995, 60 percent of the area's 162,000 persons aged 55 and older resided in •
• •
Ramsey County, 25 percent in Dakota County, and 15 percent in Washington •
County. •
The proportion of the 55- and -older population living in Ramsey County fell by •
• •
17 percent between 1980 and 1990 while the proportions living in Dakota and •
Washington Counties grew by 39 percent and 50 percent, respectively. •
•
•
-26- •
•
•
•
•
•
•
• ▪ Despite the redistribution of population that occurred during the 1980s, Ramsey
• County still has ten times as many older adults per square mile as Washington
• County and more than eight times as many as Dakota County.
▪ Almost 94,000 residents of the three- county East Metro SAIL region were 65 or
• older in 1995.
•
• • Between 1995 and 2010, the size of the 65- and -older population is expected to
• increase 86 percent in Dakota County and 95 percent in Washington County but
• only 10 percent in Ramsey County.
•
• • Virtually all of the growth in Ramsey County will be in the 85- and -older cohort,
• the oldest old.
•
• • In the three - county area, more than 13,500 noninstitutionalized persons aged 65-
• and -older had mobility or self -care limitations at the time of the 1990 census.
•
• • By 2010, more than 6,000 persons 65 and older will have difficulty performing
• one or more ADL and the number experiencing difficulty with at least one
• IADL will approach 18,000.
•
• • Including adult foster care, boarding care, board and lodging, condominiums,
• cooperatives, subsidized and unsubsidized rental facilities and nursing home
• beds, Dakota County presently has fewer than 150 housing units per 1,000
• persons age 65 and older, while Ramsey and Washington Counties have more
• than 200 units per 1,000 each.
•
• • To maintain the current ratio of housing units per 1,000 seniors, almost 7,000
• units will have to be added to the existing supply in the East Metro area between
• 1995 and 2010.
•
• • If the moratorium on new nursing home beds continues and existing beds are
• not redistributed among the counties, Ramsey County will have 73 nursing
• home beds per 1,000 persons aged 65 and older in 2010, while Dakota and
• Washington Counties will have only 30 beds per 1,000 each.
•
Excluding adult foster care facilities, the East Metro SAIL Housing with • • Services Committee identified 4,768 noninstitutional senior housing units with
• meals programs in the three - county area, 4,301 units with transportation
• services, 3,296 units with emergency response systems, 2,592 housing units
•
• with housekeeping services, and 2,462 units with personal care nursing services.
•
•
•
•
•
•
•
• -27-
•
•
•
•
•
•
ISSUES TO CONSIDER •
•
•
The moratorium on new nursing home beds is a manifestation of one of the State of •
•
Minnesota's long -term care policy objectives -- reducing Minnesotans' dependence on nursing
•
homes for the long -term care of older adults. Other objectives include: •
•
•
• Facilitating older Minnesotans' ability to age in place
•
• Assuring that frail and disabled older Minnesotans receive high quality care •
•
• Minimizing the cost of high quality care to the State •
•
These objectives and the foregoing statistics provide the context of planning and spending •
decisions for East Metro SAIL region long -term care policy makers and service providers. Issues •
•
that they may want to consider when making these decisions, include: •
•
• The impact that planning and spending decisions may have on the geographic •
distribution of the aging population in each county •
•
• The impact that planning and spending decisions may have on service delivery •
•
systems
•
• The impact that planning and spending decisions may have on efforts to prevent •
age - related disabilities as well as on providing long -term care •
•
• The impact that individual county planning and spending decisions may have on •
housing with services, resources and demand throughout the East Metro Area •
•
Housing Decisions And Population Distributions •
•
•
Policymakers' and program developers' housing- related planning and spending decisions
•
will influence how concentrated or widely dispersed the population of frail elders becomes over •
time. The numbers and kinds of housing units needed in a particular location may be determined •
•
in part by the size and composition of the existing population. However, the reverse is also true. •
Older adults will move to different neighborhoods and communities when necessary to get the •
•
kinds of housing they need. •
•
The way that policy makers address the issue of the geographic distribution of the elderly •
•
population may depend on how they define aging in place. The concept can be defined narrowly. •
It may refer to bringing services to elders in their existing housing units, regardless of where they •
•
-28- •
•
•
•
•
•
•
• are. Aging in place may also refer more broadly to facilitating elders' remaining in their same
• • neighborhoods or communities by making appropriate housing alternatives available to meet the
•
• needs of those who could not remain in their existing housing units without substantial help.
•
• The geographic distribution of the elderly population is a particularly relevant issue for
• Dakota and Washington Counties, where the number of older adults will almost double in the
•
• next 15 years. Growth in the elderly population will affect intergenerational relationships and
•
• the need for public transportation and other amenities as well as the need for senior housing and
• health and social services. Thus, policy makers may want to consider how much concentration
•
•
or dispersion is desirable in particular areas.
•
• Both concentration and dispersion have positive and negative implications. In areas where
• the older population is widely dispersed, elders may experience social isolation, and access to
•
• formal long -term care services (i.e., services provided by paid workers) may be limited and
•
•
costly. The problem of access can be exacerbated if providers and users make a distinction
• between services for the elderly and services for disabled children and younger adults.
•
• Bringing those who need formal services together in smaller geographic areas can improve
•
• service delivery efficiency. In addition it may alleviate the social isolation, of some seniors to
• have other members of their age cohort nearby. However, policies and programs aimed at
•
• increasing the concentration of the frail elderly also support age segregation, dependence on
• formal services, and possibly intergenerational conflict. Younger, healthy residents in a
•
• neighborhood or building may resist having significant numbers of frail and disabled persons
•
• housed nearby. Concentration may exceed anticipated levels if younger residents in the area
• move to different locations. Very heavy concentrations of older persons may prove burdensome
•
• if their need for public services grow and their contributions to a community's economy
• stagnates.
•
• Housing Decisions And Service Delivery Systems
•
• Formal Services
•
• Policy makers and planners may also want to consider how their senior housing decisions
• affect the way services are delivered to older adults. As noted above, policies that foster
•
•
• -29-
•
•
•
1
•
•
geographic concentrations of those who need or are likely to need help with instrumental and
•
physical ADLs work to the advantage of organizations and agencies that provide services •
•
formally. Formal service delivery systems are most efficient when few workers can serve many •
elders' needs. Efficiency gains may work to the elders' benefits when enough clients are located •
•
in close enough proximity to enable formal service agencies to provide care in short increments
or on an ad hoc basis. Assisted living programs and corporate adult foster care are •
•
manifestations of this strategy of having one or a few workers serve several clients during one •
shift. •
1
1
While formal service providers may achieve efficiency gains as a result of concentration,
an unanticipated influx of clients into a service area can also tax providers' resources. For 1
i
example, the local Meals on Wheels program may not have the budget or the human resources •
necessary to deliver an additional 20 -30 meals each day unless it learns about a new senior •
housing facility in time to incorporate the anticipated demand into its annual request for funding 1
under the Older Americans Act. Thus, it is important for housing developers and city planners to •
inform public and private social service agencies of new projects at the outset to be sure that
resources will be available when the new elderly residents that their projects are designed to 1
1
serve arrive. 1
•
Informal Services •
1
Policy decisions can also influence informal service delivery systems, in which frail older
1
•
persons receive the help they need from family members, neighbors, and friends. Family 1
•
responsibility laws are an example of using public policy to influence informal caregiving •
arrangements. Once widespread, state family responsibility laws were repealed as the American 1
population became more mobile. Family ties crossed state lines and the laws became •
increasingly difficult to enforce. While most informal care of frail elders is still provided by 1
family members, younger and distant family caregivers are increasingly likely to take a care •
management approach to caregiving. They fulfill their role by making arrangements for and
monitoring the quality of formal service for parents or loved ones. •
•
•
•
1
-30- •
•
•
•
•
•
•
• The extent to which public policy might influence elders' ability to obtain informal care
• from their peers and others in their communities and neighborhoods has not been ascertained.
• However, planners and policy makers in the East Metro SAIL area may want to consider
• fostering and funding demonstrations of community initiatives that support intergenerational
•
• exchange and intergenerational interdependence in the delivery of informal assistance to frail
• elders. Intergenerational exchange refers to younger, healthier neighbors helping frail elders
•
• with instrumental activities like shopping and transportation while retirees in the neighborhood
• keep an eye out for vandals and suspicious activities, supervise young children, and monitor the
•
• activities of neighborhood youth, and so forth. Intragenerational interdependence refers to
• coresidence, self - directed group homes and other mutual support arrangements in which older
•
• adults pool their complementary skills, functional abilities, and resources in order to meet many
of their needs without formal help. Some communities have established programs whereby
•
• volunteers who perform personal and household tasks for impaired elders earn credits for their
• own future care.
•
•
Housing Decisions And Prevention
•
• The foregoing strategies address the policy objectives of aging in place, reducing the use of
•
• nursing homes and minimizing the State of Minnesota's long -term care costs by helping frail
• seniors compensate for declining abilities. Another approach to the problem of caring for
•
• growing numbers of frail elders is to reduce the prevalence of functional limitations through
• prevention initiatives. This approach runs counter to the widespread concept of aging as chronic
• • disease. However, even though physical capabilities do decline inevitably with age, the body of
• evidence that age - related disabilities can be prevented or postponed is growing. Therefore,
• another policy question that must be addressed is how to allocate funds to prevention and care
• P Yq P
• programs in order to gain the maximum benefit. Putting all available funds into services for frail
•
• elders could perpetuate the image of aging as disability and discourage today's seniors from
• taking steps to prolong their ability to function without help.
•
•
•
• 20 Levitan, S.A. and E.A. Conway. 1990. Families in Flux: New Approaches to Meeting Workforce Challenges for Child,
Elder, and Health Care in the 1990s. Washington, DC: The Bureau of National Affairs.
1
1
• -31
1
•
•
•
•
•
•
Housing Decisions and Regional Implications
•
Finally, planners, policy makers and service providers will want to consider the impacts •
•
that their senior housing and service decisions may have on the East Metro region as a whole. •
This report makes clear the differences among the three East Metro Counties in terms of •
•
population growth and housing supply. These differences suggest that the three counties face •
•
distinctly different challenges. In responding to those challenges, policy makers and planners
•
can help improve the region's long -term care system efficiency and effectiveness by considering •
•
questions like:
•
• How can each county respond to the needs of its elderly population in ways that
will benefit the elderly in the other counties immediately and in the longer term. •
0
• How might the establishment of aggressive senior housing development programs •
in one county affect the demand for housing and services in the other counties •
over time? •
• What would those effects imply for the three counties' futures? •
• Under what conditions will a regional approach to the area's senior housing
•
challenges yield greater benefits than a county- centered approach.
• How can the region use today's challenges to prepare for the years after 2010,
•
when the baby boom generation begins to retire and need senior housing and
•
long -term care services?
•
0
0
CONCLUSION •
0
This analysis of conditions in the East Metro SAIL region has found that the need for 0
housing and services is likely to grow in Dakota, Ramsey, and Washington Counties. The pace •
of growth will differ for each county, however. Area policy makers and service providers must
take that reality into consideration in making their plans. Dakota and Washington Counties' 0
elderly populations are relatively small and widely dispersed at present. These counties may
•
have greater opportunities than Ramsey County to use their senior housing and other long -term
care policies to influence whether and where the older adult population will be concentrated in
•
the future. They must begin planning immediately however, because the elderly population is •
expected to grow rapidly. Dakota County may have to respond particularly rapidly. There the
number of senior housing units per thousand elderly is already 25 percent lower than in •
0
-32- 0
0
0
0
•
•
0
• Washington and Ramsey Counties. Ramsey County is expected to experience slower growth in
•
• the elderly population, which may provide the luxury of more planning time. However, virtually
•
all of Ramsey County's growth will be in the oldest old population, elders aged 85 and above. In
•
• addition, Ramsey County has a substantially greater number of minority elders than Dakota and
•
• Washington Counties. Research has shown that disability is more prevalent among persons of
• color and the oldest old. Therefore, the need for housing with supportive services may grow
• faster in Ramsey County than in Washington and Dakota Counties, where the growth rate of the
• young -old population (age 65 -74) will be about as high as the growth rate of the oldest -old
•
• segment.
•
• Dealing with issues such as these will require creativity and cooperation. Today's planners
• and policy makers must act without the benefit of knowledge gained through past experience.
• The aging of the population is unprecedented. No models from the past exist.
0
•
Under conditions of uncertainty, there is wisdom in joining forces and sharing risks.
•
• Fostering that collaboration is one of the goals of the SAIL initiative. By making the differences
•
in conditions in the three East Metro SAIL counties apparent and making the differences in the
•
• issues that confront each county more understandable, this study of senior housing with services
• in the East Metro area contributes to that goal.
•
0
•
0
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
• -33-
•
•
e
•
41
•
•
•
•
•
•
•
•
0
•
•
1
0
0
•
•
•
•
0
•
•
0
0
•
0
•
•
•
•
•
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• APPENDIX
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1 Seniors Ages 55 and Over
/
. Dakota County
1 Counts of Seniors
1 by Census Block Groups
1 N f / %= �
u lino w - .. E /� N Munciple Boundaries
, 4 !T O fall" N Block Group Boundaries
• s MEND • • • HBGH � , il i
1 trinwerti
1 ' 4 = " 4 - r less than 50 persons
. A 1 Vr 50 to 100 persons
101 t persons GAO '�i1(� 301 persons
• over 500 persons
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jt ill: ROSEM07NT 1 N/NINGER
Ild
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• O A
[.. I'
/ RAVENNA
6NPIRE V-, •N • .� - -
AN -
II — - I A • • NGTON 1 VERMILLION
B a s
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iR
lir
1 CASTLE ROCK
EUREKA HAMPTON D1 UGLAS
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1 - .
/' RANDOLPH NOTE:
This map is based on demogrphic
. GREENVALE WATERFORD SCIOTA data collected by the 1990 U.S. Census.
• The areas delinated on this map
1 represent 1990 U.S. Census block
• -_, - _ groups
1 The total population of Dakota County
. par the 1990 U.S Census was 275,227.
. The total number of persons over age
. 55 in Dakota County per the 1990
. U.S. Census was 33,882.
. The total number ea person in
Dakota County, age 55 -64,
Prepared by Dakota County Survey and Land Information Department par the 1990 U.S. Ceneue was 16,407
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1 - 3H-
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• RAMSEY COUNTY POPULATION
• AGED 55 AND OVER, BY CENSUS TRACT
• Total Ramsey County Population = 485,765. Total Population 55 -64 = 96,664. Figures based on 1990 census.
•
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• \ BLAINE .
410011 [40705 '•
10 OUNDS VI E ! _ - 1401
• = 1►[il:i 4 i WBT
_ 16
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1 [4087
X
• ' - . " ail 140603] m a w
• pawwi :mm:10m mu
• 1411061 ■ • - n .' (NA��iil_1:14
u
um G,,rLL!
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• Mi ra i
`, 2] uGI gin �1Ii1IIa•1_1►1t19L� 1423011
uoji • l :r•1 ' . - . . , --
• II
• Un " I MEI NI A►ac•1•1
c�c r G '7i1
• IIly_101•]►11:14Lel :11-1
•
• ka b
• [3091 : ° ' kW
. ��� 3141 ` •• �.
ii.„..,„,
• 32J32f t ��... nI `I j! r.. : ;:
I . 3 34I E ®
• III L
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• .11 1 1357�.. 361
ING:Ai
b10 11, Erd
• Ea [37-413-41 criza
• Count Aged 55+ kW
• ' n 0 to 406
• • Miles _
n 406 to 671
• 671 to 961
o s i
961 to 1896
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110 PERSO 1S OVER AGE 50
• 11
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• Number of Persons Over Age 55
II . (-10 -144
1 ( ( 145 -288
1 No J f 289 - 432
1 j 433 -576
10 . � Ik 1 577-72O
1 `1 110
1 NOTES:
.' This map is based on demographic
. � data collected by the 1990 U.S. Census.
• The areas deliniated on this map
• represent 1990 U.S. Census block
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to, groups.
• �j� The total number of persons in Washington • County over 55 years of age, per the 1990
. � U.S. Census was 19257 •
. • � . �� • �� '
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• prepared by:
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Washington County Surveyor's Office
• February 3, 1996
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Figure A -4
East Metro Sail Region Projected Growth in Older Population
• 1995 -2010
1995 -2000 2000 -2005 2005 -2010 1995 -2010
Pct. Pct. Pct. Pct.
• 1995 2000 Change 2005 Change 2010 Change Change
•
Dakota 65 -74 12,140 14,230 17% 17,490 23% 23,670 35% 95%
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• 75 -84 6,660 7,940 19% 9,340 18% 10,940 17% 64%
• 85 and Older 2,240 2,960 32% 3,720 26% 4,510 21% 101%
• • 65nd
. Older 21,040 25,130 19% 30,550 22% 39,120 28% 86%
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Ramsey 65 -74 31,860 29,950 -6% 29,700 -1% 34,150 15% 7%
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• 75 -84 20,980 22,210 6% 22,630 2% 21,570 -5% 3%
• 85 and Older 8,570 9,770 14% 10,740 10% 11,800 10% 38%
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Older , 5:516 , 1 , 4t 61,930 5.' 1 °.(61 5 63 2% 67 7% 10 %T*
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• Washington 65 -74 6,870 8,190 19% 10,240 25% 13,870 35% 102%
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• 75 -84 3,360 4,180 24% 5140 23% 6,140 19% 83%
• 85 and Older 1,270 1,600 26% 1,920 20% 2,410 26% 90%
65 and
• , ..._ Older 11,500 13,970 '4. - 21% 17,300 �. 4% � ... 0!Yp - 954
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• Figure A -5
• Dakota County
• Distribution of Senior Housing Facilities by Type
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• + ++
• 12 O o
• fl 00
• � n
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• ❑ g
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+ 4 O
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• Adult Foster Care (22)
• ® Boarding Care Home (1)
• O Board and Lodging with Services (4)
• A Condominium (2)
• Cooperative (1)
• ❑ Low/Moderate Rental (7)
• x Market Rate Rental (3)
• O Nursing Home (9)
• + Subsidized Rental (11)
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• Figure A -6
• Ramsey County
• Distribution of Senior Housing Facilities by Type
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1
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1 +
• ❑
• ❑ +
• x O x
• O x to
• + ra x
• 0 0
• ❑
• x
• 00
• x O Ox ❑
• 0 x + 4 x +
• x + x 4 ❑
• x
0 g g x ❑+
• 0 0 g 0 g
• 0 S
0
• + 0+
• A x g ° fl + g
x +
• O ® + x 0
+ + fl x
• + + + 0 + 0
• 0 x c c „0 o +
+
® 0 0 + + + g 0
• 4 g +
• o o +C C + +0 + + + ++ ® o x
• g c ® ® ® + O
+ +0 + +
• A +o +o + ++
• ® o
• x 0 ° o n
• + g • x g • dult Foster Care (37)
• ® Boarding Care Home (9)
• * Board and Lodging with Services (3)
• p Condominium (2)
• * Cooperative (0)
• ❑ Low/Moderate Rental (6)
• x Market Rate Rental (24)
• o Nursing Home (38)
• + Subsidiie Rental (49)
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Figure A -7
Washington County
Distribution of Senior Housing Facilities by Type
es
R og
o X+
1 + x
1
1
1
1 x
1
1 x
1
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1
1
1 g
1
1 4 Adult Foster Care (13)
1 ® Boarding Care Home (1) O
1 O Board and Lodging with Services (4) + x x xO +
p Condominium (0) ++ x
• * Cooperative (0) + x
1 ❑ Low/Moderate Rental (4) ❑ c
• x Market Rate Rental (12)
• O Nursing Home (5) c
• + Subsidized Rental (13) g +
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Figure A -8
Estimated Numbers of Non - Institutionalized Persons 65 and Older
With ADL and /or IADL Dependency Needs by County
1995 - 2010
1
Dakota Ramsey Washington Total*
1995
ADL Dependent 1,094 3,193 598 4,855
• IADL Dependent 2,904 8,475 1,587 12,965
2000
ADL Dependent 1,307 3,220 726 5,254
IADL Dependent 3,468 8,546 1,928 13,942
2005
ADL Dependent 1,589 3,280 900 5,768
0
IADL Dependent 4,216 8,704 2,387 15,307
2010
• ADL Dependent 2,034 3,511 1,166 6,711
IADL Dependent 5,399 9,318 3,094 17,810
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• * Counties may not sum to total due to rounding.
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III
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II Figure A -9
1 Senior Housing Units with Services: Dakota County
O
. Board and Low/ Market
S Lodging with Moderate Rate Subsidized
. Services Condominium Cooperative Rental Rental Rental
• Housekeeping
II additional cost * * 12 * 336 *
1 contact building * * * * * *
1 no * 55 * * * *
1 yes - (access requirements
not specified) 223 * * * 351 *
• Total 223 55 12 * 351 *
III Meals Program
• additional cost * * 12 * 351 *
• contact building * * * * * *
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no * 55 * * * *
II
• yes - (access requirements
. not specified) 223 * * 124 261
• 'otai ..k a 4 1 . � - 4 55`x ,_ 12 = 12 4 351 261
• Personal Care Nursing
• additional cost 52 * * * 143 *
• contact building * * * * * *
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• no * 55 * * * *
lb yes - (access requirements
• not specified) 171 * *
» n <L x m e 3 v x RAC <
T otal <,,., s ? 55yk , .'
• Emergency Response
• additional cost * * * * * *
• contact building * * * * * *
III • no * 55 * * * *
• yes - (access requirements
• not specified) 213 * 12 51 351 57
• T otal o,,,3 , . f,2 13 .. f, ' 55 12 51 351 57
Transportation
• additional cost 42 * * * 208 *
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• contact building 10 * * * * *
• no * 55 * * * *
• yes - (access requirements
• not specified) 171 * 12 * 143 338
• �• T ` o ., a F� < . e � �. r ,, � � � ' - : e , : ,,; 338
• * Data not available.
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• —44—
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• Figure A -10
• Senior Housing Units with Services: Ramsey County
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. Board and Low/ Market
• Lodging with Moderate Rate Subsidized
• Services Condominium Cooperative Rental Rental Rental
• Housekeeping
10 additional cost * * * * 201 964
• contact building * * * * * *
• no * * * * * *
• yes - (access requirements
• not specified) 178 * * * 433 *
• Total , 1'78 .* * * 634 964
• Meals Program
• additional cost * * * * 443 964
• contact building * * * * 99 *
• no * * * * * *
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• yes - (access requirements
not specified) 178 * * * 285 1,392
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• Total ir:' - 4 * :;,.4. ., * 4 4 y * 827 2,356
• Personal Care Nursing
• additional cost 178 * * * 413 779
• contact building * * * * * 136
•
no * * * * * *
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. yes- (access requirements
• not specified) * * * * * 476
r
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Total , !„ 178 ���' ; � _ , �. �.
• Emergency response
• additional cost * * * * * *
O contact building * * * * 83 *
II
O no * * * * * *
• yes - (access requirements
• not specified) 178 * * 42 998 964
• Total 178 * q �'
£� 1 42 �` 1 ,081 964
• Transportation
0 additional cost * * * * * *
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• contact building * * * * * 852
• no * * * * * *
• yes - (access requirements
e not specified) 178 * * 59 896 869
• Total 178 \, :a R , . ... . "
• * Data not available
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• -45-
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• Figure A -11
6 Senior Housing Units with Services Washington County
O
. Board and Low/ Market
• Lodging with - Moderate Rate Subsidized
. Services Condominium Cooperative Rental Rental Rental
. Housekeeping
additional cost * * * * * 84
• contact building * * * * 30 *
• no * * * * * *
• yes- (access requirements
not specified) * * * * 116 *
ID Total ,, w ,,-a „. , , A n t ,r *' * * 146 84
I/ Meals Program
• additional cost * * * * 161 84
• contact building * * * * * *
•
no * * * * * *
IP
. yes - (access requirements
. not specified) * * * 58 41 92
-',.:, b;:i"-'-'77:(-' -- ' ' 7 77 7 'Fix -i5; 3.6:.; - tx fr;;: -;---, '-, -- 47:7 - Vs ; - Ki - ',FIr $, , !.. ii eirp ---- -- -
. Personal Care Nursing
O additional cost * * * * * 84
contact building * * * * 30
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no * * * * * *
. yes - (access requirements
. not specified) * * * * * *
. Total 4
(4-
I ,, * * �3 * • a; * ; 30 84
Emergency response
• additional cost * * * * * *
contact building * * * * * *
no * * * * * *
• yes - (access requirements
. not specified) * 220 127
II T am '� . 4 „ , ' � .1 ' ... 4 220 i • 127
ID Transportation
additional cost * * * * * 237
• contact building * * * * 30 *
. no * * * * * *
0 yes - (access requirements
11 not specified) * * * * 256 *
fix t . i ti .94 o r 2 d , a. z � 4 L ` .
T otal $, t , �,. _ = ,,. .t t r, , , ; ?W. ° ,.41 �-
• * Data not available
0
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• REFERENCES
•
• American Association of Retired Persons. (1990). Understanding senior housing for the 1990s.
• Washington, DC: American Association of Retired Persons. Cited in Golant, Stephen M.
• (1992). Housing America's elderly: many ossibilities, few choices. Newbury Park, CA:
• Sage Publications.
•
• Blesch, K S. and S. E. Furner. (1993). Health of older black Americans. Pages 229 -273 in J. F.
• Van Nostrand, S. E. Furner, and R. Suzman (eds.). Health data on older Americans: United
• States 1992. (1993). National Center for Health Statistics. Vital Health Stat 3(27).
•
• Chase, R. A. (1994). PHA Hi -Rise Resident Survey Results. Unpublished report prepared for
• the Public Housing Agency of Saint Paul by Wilder Research Center, Inc.
•
• Dakota County Housing and Redevelopment Authority. (1996). Inventory of Independent
• Living /Congregate Housing Facilities. Unpublished raw data.
•
• Elston, J.M., G.G. Koch, and W.G. Weissert. (1991). Regression- adjusted small area estimates
• of functional dependency in the noninstitutionalized population age 65 and over. American
• Journal of Public Health, 81 (30):335 -341.
•
• Fischer, L. R., D. P. Mueller, P. W. Cooper, R. A. Chase. (1989). Older Minnesotans: What do
they need? How do they contribute? Saint Paul: Amherst H. Wilder Foundation.
•
• Health data on older Americans: United States 1992. (1993). National Center for Health
• Statistics. Vital Health Stat 3(27).
•
• Kover, M. G., J. D. Weeks, W. F. Forbes. (1995). Prevalence of disability among older
• persons: United states and Canada. National Center for Health Statistics. Vital Health Stat
• 5(8).
•
• Levitan, S.A. and E.A. Conway. (1990). Families in Flux: New Approaches to Meeting
• Workforce Challenges for Child, Elder, and Health Care in the 1990s. Washington, DC:
• The Bureau of National Affairs.
•
• Mapinfo Professional (1992- 1995). Users Guide. Troy, NY: Mapinfo Corporation.
•
• Metropolitan Council. (1988). Consumer's Guide to Housing Options for Older People.
• Minneapolis, MN.
•
• Metropolitan Area Agency on Aging, Inc. (1996). Directory of Nursing Homes and Alternative
• Housing for Older People in the Twin Cities Metropolitan Area. St. Paul, MN.
•
• Minnesota Health and Housing Alliance. (1995). Senior Housing Inventory. Minneapolis, MN.
•
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• Minnesota Planning. (October, 1993). Minnesota's Changing Counties: The Next Thirty Years.
St. Paul, MN.
Minnesota Senior Federation (1995). 1995 Senior Housing Directory. St. Paul, MN.
Prohaska, T., R. Mermelstein, and B. Miller. (1993). Functional status and living arrangements.
• Pages 23 -39 in J. F. Van Nostrand, S. E. Furner, and R. Suzman (eds.) Health data on older
• Americans: United States 1992. (1993). National Center for Health Statistics. Vital Health
• Stat 3(27).
1
• Silloway, G. and E. Opland. (March 1994). The 1993 Distribution of Nursing Home Beds in
Minnesota. Saint Paul: Interagency Long -Term Care Planning Committee.
1
• Telephone conversation with Wes Butler, Washington County Housing and Redevelopment
• Agency, August 13, 1996.
•
U.S. Census Bureau, 1990 Census of Population and Housing.
1
. (1996). Current Population Reports, Special Studies, p. 23 -190, 65+ in
• the United States. U.S. Government Printing Office, Washington, DC.
•
• U.S. Senate Special Committee on Aging, American Associated of Retired Persons, Federal
Council on the Aging, & U.S. Administration on Aging. (1991). Aging America: Trends
and Projections (DHHS Publication No. 91- 28001). Washington, DC: U.S. Department of
• Health and Human Services
1
• Weiner, J. M., R. J. Hanley, R. Clarka and J. F. Van Nostrand. (1990). Measuring the activities
• of daily living: Comparisons across national surveys. Journals of Gerontology 45(6):229-
1 237.
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