For Seniors, Assisted Living On Smaller Scale

Group Homes Offer Care To Mere Handfuls of Residents

From the curb, the large yellow house on Ipswich Road looks like one of many new homes in a Bethesda neighborhood dotted with tear-downs. It is a trim, two-story modern Victorian. But there's no garage. A wheelchair ramp inclines toward the porch.

The house is not one of the area's typical single-family dwellings. Inside live eight unrelated seniors, all ambulatory but in need of help with the activities of daily life. They are assisted by three professional caregivers during the day and by one at night.

The home, which opened in 2005, provides what developer and owner Lori Larson describes as family-style assisted living. Larson and her business partner, Lisa Max, plan to open a second home in Bethesda this month and have started construction nearby on a third. All will be part of the Eden Homes Group.

They aim for a growing niche market in upscale, high-amenity housing for older people who don't need nursing-home care but can't live on their own. Larson and Max consider their homes a hybrid between in-home care and larger assisted-living facilities.

"The demand and market for the high end has been growing," said Elizabeth Boehner, director of the Montgomery County Area Agency on Aging. "Our seniors and their families have greater affluence than in the past."

These group homes are an example of the increasing specialization in senior housing, according to Paul Williams, director of public policy for the Assisted Living Federation of America, a national association representing assisted-living communities.

Neighbor Katie Rivas approves of the Eden Home on her block. "To me it made sense to put a home in a neighborhood where they're still part of daily life and daily routines," she said. Rivas and her four children often visit the residents. The only possible growing pain with this addition to the neighborhood was parking, said Rivas, which Larson and Max have tried to manage by asking staff members to park unobtrusively some distance away.

The Ipswich Road house has a high staff-to-resident ratio and many appointments and activities. But it comes at a price: The all-inclusive rate for board and care is about $7,000 a month, at the higher end of the $3,000 to $9,000 price range for group facilities in Montgomery County, according to Boehner. The house is what is known as private pay: Residents pay their own fees; Medicaid is not accepted. Many private, long-term-care insurance policies will cover some or all of the cost of living in these homes.

Max, who lives in Bethesda, said the locations of the homes were selected for several reasons, including access to the Beltway, Wisconsin Avenue and Suburban Hospital. "We looked at places that we thought were, from a real estate investing standpoint, appreciating markets," she said.

Of the 140 group homes for seniors in Montgomery County, most are in existing structures, and the neighbors might not even know about them. Montgomery County zoning laws allow up to eight non-related people to live in a single-family house. Larson and Max, who both have many years of experience in real estate development and finance for national firms, created their own model.

"The secret of the business in my mind is not trying to jury-rig and kind of modify an existing house," Max said. "But when you start from the ground up, you really can do things that make it accessible but also [so it] feels like a home."

Her three group homes are each designed to include eight bedrooms on three living levels: five bedrooms on the upper floor, two on the main floor and one on the lower level. Each house has an elevator. A thick-slatted wooden stairway has safety gates to prevent tumbles. Two residents in each house have private bathrooms; the other six share the three remaining bathrooms. The bathrooms are wheelchair-accessible, and unlike the commercial feel of a nursing home, the toilets are oversize but not the handicapped models.