Assisted Living for Senior Citizens in Vienna

The study provides a summary the housing, care and nursing situation of senior citizens in Vienna. Various concepts of assisted living in Austrian regions are then analysed and tested for their applicability in Vienna.The final chapter documents existing approaches to assisted living in Vienna, followed by an analysis of barriers to the implementation.

Main Results

“Young” seniors and very old people are two different worlds
There is no generally accepted English terminology: In this study, the “young” seniors are people after they have left working life until their late 70s, the term “old” seniors refers to people from around 80 years of age. The two groups differ fundamentally in terms of their economic power, the need for care, mobility, etc., and require very different concepts for housing, care and nursing. In Vienna particularly the group of “young” seniors will grow in the coming years, but in the 2030s it will be the “old” seniors. For this population group, extensive and high-quality services are available in Vienna. In contrast, group-specific services are still lacking for the “young” seniors.

Assisted living as option between staying-at-home and a nursing home
Assisted living for elderly people (in according European standards, the term “sheltered housing” is applied) combines the "hardware" of a barrier-free apartment with the "software" of basic social care. It seems to be an ideal solution for seniors with little or no need for care, i.e., for all those who have found it difficult to remain in their home but who do not (yet) feel the need of entering a nursing home. Existing models show conceptual weaknesses that have so far prevented the spread of assisted living. The available options are often targeted to “old” seniors with primarily a nursing approach. But they can hardly attract “young” seniors who are vital and agile.

Successful approaches in the “Länder”
In almost all of the nine Austrian regions (“Länder”) – except Vienna – assisted living is established in the regional housing subsidy schemes. A wide range of models and approaches has emerged. Most models are aimed at LPHAs (limited-profit housing associations), and in some regions, also at commer-cial providers. Assisted living is often promoted in stand-alone buildings, while in several regions there are models in which assisted living units are mixed into the standard subsidized multi-apartment build-ings. In most regions, assisted living is defined in reference to “hardware” (construction-related) and “software” (services), in Vorarlberg only by requirements on basic assistance, while the construction-related demands on assisted living must be met by all subsidized housing. So, every subsidized apart-ment in that region can become an assisted unit and change back. This approach is seen as exemplary.

Assisted living in subsidized housing in Vienna
Assisted living has not yet been established in the Viennese housing subsidy scheme. The concept received a moderate boost with the introduction of the fourth pillar in housing subsidy evaluation (hous-ing developers’ competitions and Land Advisory Board), i.e., “Social” (alongside “Architecture”, “Ecology” and “Economy”). Since then, the Vienna Social Fund (FSW) provides subsidies for “senior shared apartments” and nursed studio apartments (“Garconnieren-Verbund”) for fully assisted living. Several limited-profit and commercial property developers have integrated such units into their housing estates. In addition, there are some assisted living units within the “residential home” subsidy scheme. In total, the stock of subsidized assisted living units in Vienna is estimated at 500. Several limited-profit and commercial developers have also built such units without subsidies. Excluding supply from the mu-nicipal entity for retirement and nursery homes (KWP, “Kuratorium Wiener Pensionisten-Wohnhäuser), the available stock of assisted living apartments for seniors is estimated at around 1,500. Various rea-sons for the comparatively low spread of this model can be identified. It is undoubtedly not due to a lack of demand.

Competition of social service providers
Many of the social service providers active in Vienna offer services of assisted living. The most important are Volkshilfe, Caritas, Hilfswerk, Arbeiter Samaritanbund, Johanniter, Diakoniewerk and Kolping, as well as the commercial providers SeneCura, Fortuna and SBZ Sozial- und Begegnungszentrum. The basic assistance package is typically offered at a flat rate of € 70-100 per month. Given the necessary staff on site, this amount only covers costs if project sizes are large and additional care services are sold to the clients.

New approaches face a difficult environment
New approaches to assisted living are confronted with a variety of challenges: demographic develop-ment with strong growth in the group of "young" seniors, the structural barriers in large parts of Vienna's housing stock, the orientation of existing facilities primarily to the “old” seniors, the obvious limits to care at one’s own home, care by relatives and 24-hour care and finally the mixed track-record of available services.

Mixed into standard multi-apartment buildings or stand-alone buildings
Existing models of assisted living are either single-use buildings or assisted living units are mixed into standard multi-apartment residential buildings. Both approaches have advantages and disadvantages. However, the advantages dominate in the mixed-in-model of assisted living, especially in terms of inte-gration, customer acceptance, flexibility of use and real estate sustainability.

Enhancement of SMART apartments into “60+ comfort apartments”
We propose a reorientation of assisted living towards a focus on the target group of "young" seniors. "60+ comfort apartments" should be easy to maintain and offer care services. As a result, they are considered apartments dedicated to older people in terms of tenancy law, which impedes entry rights for relatives in descending line and ensures that the units can be used permanently to the advantage of the target group. The well-established SMART housing program offers favourable preconditions: With only minor adaptions of the requirements on existing building standards, all newly built SMART apart-ments of types A and B (max. 40 or 55m²) are suitable for senior costumers. During the subsidy granting procedure (both, developers’ competitions and Land Advisory Board), objects can be identified that should in parts be geared towards assisted living for elder people. SMART apartments are currently being offered for a gross rent of only € 7.5/m², with tenant capital contributions of max. € 60/m². Even if the costs of the basic care package are included, this is well below € 500 per month for a single house-hold. This is affordable for the vast majority of "young" seniors without further demand-side subsidies. For all others, of course, targeted income-related subsidies must be applied. We recommend an expan-sion of housing benefits or the adjustment of existing FSW (Social Fund Vienna) subsidies.

Obligatory structural criteria
A few measures that go beyond today's building and subsidy standards are indispensable for senior citizens' apartments: inside the apartments, these are a combined bathroom/toilet, floor-level shower, wall reinforcement for the later installation of handles, entrance doors with electronic combination locks and barrier-free accessibility of terraces/loggias and their shape, which should be as square as possible. Corridors and stairwells are to be dimensioned and designed with a high design quality, heavy fire pro-tection doors should open automatically; Common rooms should be sufficiently large and of high quality (kitchenette, public toilets). At least two open-use rooms are required in the entrance area (head quarter “care” and nurses/doctors' room). Common open spaces and green space are to be designed to be inclusive. At least 25 "60+ comfort apartments" should be clustered in close proximity to ensure the economic feasibility of providing care services.

Basic care package
Basic social care must be tailored to the target group of “young” seniors. It includes a qualified caregiver with a background of social work on site. The more apartments for seniors, the more time on site should be factored in. With 40 "60+ comfort apartments" it should be 20 hours per week. The caregiver is available for providing information in all situations, helps in crisis situations, for example after returning from the hospital, arranges health and care services, organizes smaller events, helps with community life in the house, helps with the use of the common areas, makes sure that “something is going on", encourages the residents to engage in activities, supports the founding of associations, settles conflicts, helps with social networking of the residents, is a kind of outpost for property and asset management, etc. At the same time, it must be clearly defined what the employee is not responsible for, in particular individual care, reception, technical services and cleaning (services which may be arranged).

Extensive advantages of the model
The proposed model of "60+ comfort living" combines extensive advantages: For comparatively little money, high-quality housing and care is ensured. This contributes to a high standard of living of the elderly and protects the public budget. Moving before the necessity of care is overall much cheaper and has less of a negative impact than moving house later. The low down payments at the beginning of the rental period and the tenancy law classification as senior citizens' apartments ensure that the apart-ments are not misused through the establishment of ownership or the entry into contracts by younger relatives. The well-established SMART housing program only needs to be adapted in minor areas. Fur-thermore, apartments for elder people contribute to the social mix in neighborhoods.

FSW and KWP
The Vienna Social Funds (FSW), as the central clearing house between customers in need of care and social service providers, as well as the Kuratorium Wiener Pensionisten-Wohnhäuser (KWP), with its 30 "houses to live in" in almost all districts, are undoubtedly key institutions in the development and implementation of new approaches to assisted living as part of subsidized housing.