“We’re busting at the seams,” said Nancy Mastrofranceso, who chairs the city’s Senior Citizen Advisory Committee.
Every day since Jan. 1, 2011, some 10,000 people have turned 65, according to population projections by the Pew Research Center. When the last of that generation—the baby boomers—crosses the line in 2030, almost a fifth of the country’s population will be 65 and older.
It should come as no surprise, then, that the area has experienced significant growth in this demographic. From 2012 to 2016, Friendswood and Pearland saw this age group grow by more than twice the rate as the rest state of Texas, according to population estimates from the U.S. Census Bureau’s American Communities Survey.
Friendswood added 2,419 people to its total population—a 7 percent growth—with 1,240 older than age 65, a 30 percent increase in that demographic. Pearland as a whole grew about 18 percent, but its 65-and-older residents increased by 40 percent. Meanwhile, the state of Texas as a whole grew by 7 percent, while the state’s population over 65 grew by 17 percent.
That baby boomers are a significant part of the growth equation in the region is clear: For Friendswood alone, this population increase was responsible for half of the city’s total growth for that period. In 2013 alone, Friendswood’s population would have declined if not for baby boomers.
Health care professionals, agencies and service providers are feeling pressure to keep up.
“We definitely feel the population difference,” said Dr. Adam Bartsoff, assistant emergency center director at Memorial Hermann Southeast in Houston. Bartsoff previously worked at the Memorial Hermann Hospital in Pearland.
Falls are a leading cause of serious injury for older adults, according to the Centers for Disease Control and Prevention, sending many of them to nearby emergency rooms. The ER is being treated as a first step in a series to get older patients healthy again.
“It’s a multidisiplinary approach,” Bartsoff said, adding that social workers, case managers and other resources are increasingly becoming part of the treatment team. “We are trying to convert the emergency department from a safety net to more of a partner in coordinating their care.”
The range of expertise and resources needed to help seniors has prompted health care systems to adapt. Dr. Steffanie Campbell, an internist at the Kelsey-Seybold Clinic in Pearland, said the demand is affecting the practice of medicine nationally.
“As a workforce, we are not prepared for this growth. We don’t have enough primary care physicians, and we definitely don’t have enough people trained in geriatric care,” she said.
One of the reasons driving this is that once people reach 65, many opt for Medicare, which for doctors, pays out lower rates for services, making it a less lucrative practice, Campbell said.
The best approach is to work on keeping patients out of the hospital in the first place, she said, which can be challenging for a generation confronting diabetes, high blood pressure, high cholesterol and heart disease.
As people live longer, overall physical health can be managed, but the brain is a whole other story.
“It’s harder to preserve the brain, so memory care is definitely a need and a shortage, and it’s difficult to get into. It’s very expensive,” Campbell said.
The growth of hospitals, specialists and senior living options in the area is making it easier to stay put—if retirees and families can afford it.
An expensive situation
In Pearland and Friendswood, apartments and even entire neighborhoods catering to seniors are a familiar part of the real estate landscape. However, cost can be a barrier.
Dennis Rundell, 70, said he would probably not be able to live in the Gardens of Friendswood Lakes Apartments if his wife were not still working as a bookkeeper. The apartments were one of the reasons they made the decision to stay in Friendswood.
“It is a great place. It has all we need and then some,” Rundell said.
Developers—seeing the demand for apartments, nursing homes and other facilities—have taken note. Banfield Properties Inc., which owns The Bedford and the Village Square Apartments in Friendswood—both for seniors—is expecting to open its third Friendswood community for this population, The Beldon, this fall. And it is already 85 percent spoken for, which is unheard of, said Brett Banfield, president of Banfield Properties.
“That’s the market right now—senior housing, big time,” Banfield said. His company is planning its next project in Angleton. “We’re seeing an explosion of demand. We expect a strong market for senior housing for the next 20 years.”
Banfield, whose parents started the company in Friendswood in 1963, has seen the town flourish over the years.
“A lot of people come here and don’t want to leave,” he said. “Once they get tired of the big home and they want to downsize, they look for senior living.”
That said, retirement is starting later for more people. Curtis Cooper, who has been involved in the Houston-Galveston Area Council’s Agency on Aging for 30 years, has seen this trend unfold.
“You used to have young senior citizens going to the senior centers, but now, a lot of that younger population is going back to work or continuing their career. They’re putting off retirement,” Cooper said.
A nationwide survey in 2011 by MetLife found that in the Greater Houston area, for example, a year of living in an assisted-living apartment cost about $45,000 on average.
Another option is in-home care, which for the Greater Houston area, averaged $19 an hour in the Metlife survey. That comes to about $1,600 a month, based on a 20-hour schedule.
The demand for these services is increasing at a time when there is already a shortage of staff, according to the direct-care research organization PHI. It estimates the need for in-home caregivers will grow by more than 50 percent by 2026, compared to an estimated increase in nursing home staff of 1 percent.
To fill some of the unmet need, the Agency on Aging provides a wide range of services, such as supporting nutrition programs, placing in-home caregivers, advocating for seniors at various living centers and providing Medicare benefits counseling. It does this for anyone older than 60 who lives in one of its 12-member counties, including Brazoria and Galveston counties, regardless of need.
Unfortunately, as the need has increased—almost all of its programs have a waiting list—its budget, which comes from federal funds, has not.
“So, almost by attrition, it’s decreased over time,” Cooper said. “We serve fewer people than we used to.”
The trend of “aging in place” is expected to continue. In 2015, an AARP study found that almost 80 percent of people older than 45 want to stay in their home for as long as possible, and a similar percentage said their current community is where they will always live. That means typically suburban cities need to factor this into its planning.
“When we do needs assessments, the No. 1 issue that rises to the top is transportation—the lack of,” Cooper said. “It’s hard to get places because nothing is close together.”
It is an area in which Pearland has some room for improvement, surveys show. In both the 2015 and the 2017 National Citizen Survey of Pearland, the city received low scores for ease of walking and traffic flow.
Back at the Friendswood Activity Center, members of the advisory committee are hopeful the City Council will follow through on pushing for a new community center that can meet the growing need there.
A feasibility study in August identified options for around $7 million, which several council members agreed would have to come to a bond election.
The programming at the center keeps seniors active, engaged and connected, Mastrofranceso said. Like Pearland’s Knapp Activity Center, the Friendswood center has daily classes ranging from tai chi to balloon tennis to “Wii Sports” video games.
Mastrofranceso credits the staff for keeping up with the growth and providing critical services, such as shuttle trips to help seniors shop or host an annual health fair. Around 1,600 people visit the center every month.
“This place is excellent. It’s the best-kept secret in Friendswood,” Mastrofranceso said.