In 2009 when Bob Zook's mother, suffering from dementia, needed more care than his father could give, she was hospitalized for a bit, then entered a nursing home.
She wasn't happy there.
Bob and his wife, Carolyn, brought her home under hospice care, and six weeks later, she died.
“It was a wonderful experience. We had a hospital bed set up in front of the big picture window at our house. As they lowered her in the bed, when she touched the bed, she said, ‘I’m home,’ Bob said, his voice cracking with emotion. “That’s what it’s all about. That was a very meaningful experience for everyone. As tough as that time is, to be in a home situation… and as good as some of these places are, it’s not the same.”
Later, Carolyn's father moved in with the Zooks for six months.
“Just his interaction with our kids that would come in, and his interaction when we were cooking, the banter back and forth, you could just see that make him light up," Bob said. "Just being part of the family was huge.”
The Zooks are planning to bring Goshen a new housing option for seniors who can no longer live alone but don't need the level of care provided by nursing homes. They will continue to live in a home-like setting, surrounded by neighbors of all ages.
The Zooks are building an "elder care" home at 309 Nebraska Drive, a residential street lined with modest brick ranches, that will house as many as six seniors. The Zooks also will live in the home, and they'll employ staff to assist residents with everything from cooking, cleaning and laundry to helping with medication reminders, getting dressed and other daily tasks.
The contractor recently poured the basement foundation for the 3,100-square foot home. It will have six bedrooms, each with their own full bathroom.
The Zooks are aligning the home with Eden Alternative concepts. Eden Alternative is a Rochester, N.Y.-based senior advocacy nonprofit that stresses elimination of the three "plagues" of aging: loneliness, helplessness and boredom. While they haven't copied the Eden Alternative assisted living floor plan, the Zooks have borrowed three of its main features for the home: a central "hearth" or fireplace, a large dining table where everyone shares meals, and a kitchen that has visibility of all common areas of the home.
“We can address loneliness by constant interaction with other people, with pets," Bob said. "The boredom will be addressed by having spontaneous activity. We may sit down with the elders in the morning and say, ‘What do you want to do today?’ They might say, ‘Well, we want to go on a picnic,’ or, ‘We’d like to go for a drive.’”
Helping to prepare meals, run errands, or sharing in other household tasks can help prevent feelings of helplessness, Carolyn said.
The Zooks and their staff will receive training from Eden Alternative this summer.
Bob is a corporate pilot for Biomet, the Warsaw-based medical device maker, and he'll keep flying, partly out of financial necessity. The couple is dipping into their retirement savings to fund the $400,000 project, which includes a $17,000 fire suppression system.
Carolyn will quit her job as finance coordinator at Goshen Home Care and Hospice, an affiliate of IU Health Goshen, and focus full-time on running the home when it opens in September.
She said her work leads her to believe there is nothing comparable being offered in the area.
The couple's corporate name, Family Care Homes of Indiana LLC, hints at their long-term vision. If this goes well, their commercial lender has told them it will provide capital to build more homes around the area, Bob said.
The Zooks are allowed to give personal care but are not licensed to provide medical care. Families who feel their elder loved one needs daily medical care can arrange to have a home health care provider come into the home, an option that would still cost less than a nursing home, Bob said.
The Zooks said they were surprised by the lack of information the state of Indiana could provide about setting up this type of home. The couple instead had to turn to Michigan for guidance, which calls such homes "adult foster care" and has licensed 4,343 throughout the state. Michigan Medicaid does pay for some adult foster care services.
The Elkhart Senior Housing Study, a market analysis recently commissioned by the city's redevelopment department, identified this type of housing, which it called "senior co-housing," as one solution to a projected senior housing shortage as the Baby Boom generation ages. Tammy Friesen, executive director of the Council on Aging of Elkhart County, said the Zooks' home will meet a need for many seniors, and she called the Eden Alternative "an incredible model which allows residents to set their own schedules for rising, eating, medication, etc."
But Friesen noted it's only a private pay option, meaning that unlike in Michigan, it won't be available to low-income seniors because it cannot be paid for with Medicare or Medicaid. The Zooks hope the day will come when the state will allow Medicaid reimbursement. Until then, they'll set their fees at assisted living market rates, where 80 percent of residents are private pay.
With about 200 homes within a mile of the site, Bob expects most of the residents will come from the immediate area.
Carolyn noted the biggest challenge could come in finding seniors who are the right fit. They'll be interviewed to ensure they can get along with others, and are comfortable with their housemates' families visiting.
“We think the home setting will provide a place where children and neighbors will be welcome, and relationships can be strengthened in that setting," she said. "If a grandchild wants to stop by and make cookies with grandma, it will be a welcome home setting.”