An Interview with Amir Kia: Ideas on Beauty & Affordability in Senior Housing

One of the people I interviewed for this project is Amir Kia, who serves on the Board of Directors for my graduate school – Starr King School for the Ministry. Amir Kia is one of the principal owners for Spirit Living Group, a company that acquires and runs senior living facilities throughout California.

Photo E Principals Page Amir

Amir came to the field of senior housing from the ground up. When first working at a small six bed board and care facility in the Richmond district of San Francisco, he was was struck by the big difference between the way elders are cared for in the US versus in his home country of Iran, where elders are the center of the family and where he had been raised by his grandparents. He felt like there could be a big shift in the US, so he combined forces with his brothers and went out to the community and got involved with more hands on care, as well as doing assessments of other facilities. “It became clear that there was so much room to be creative and make to a difference.” Although Kia’s senior housing facilities are all private pay at this point, there are some key concepts around the environmental design that he brings to the conversation that I also feel are essential.

 Spirit Living Groups’ mission statement has some bold and radically-stated ideas that I find liberating to see named as core values: 

 The mission of Spirit Living Group is to build community, value and beauty. The Company is guided by values of Self-Expression, Presence, Intuition, Relationship, Initiative, and Trust.”

 Although SLG’s communities are all private pay at this point, Kia would also love to see them handle a diverse population – specifically people with few financial resources. “The biggest challenge to senior housing and care is affordability. Amir sees that this will have to be dealt with inevitably. “It’s going to require partnership with community resources and agencies to make it happen.”

San Francisco’s “Patch” Program

Kia tells of a successful pilot program with San Francisco’s Department of Public Health to provide housing for the most impacted low income residents. “At Hayes Valley Care we set up a pilot program with Health Services where we took the most high risk elders who were typically placed in locked facilities for lack of better placement, seniors who hadn’t received the attention for proper diagnosis and treatment and had been medicated with psychotropic drugs. We took them and placed them in our community with the interns and the staff and were really able to bring them to life again.”

 These people receive a ranking with the city, and those who used the most amount of city resources were brought to the Hayes Valley community. They received their SSI of around $700 as well as a “patch” payment from the city that helped to cover their costs at the community. The patch was less money than what the city would have spent with other city-run services, so in the end it was a cost-saving plan for the city. At one point they had maybe 15-16 people. “Some of the most memorable moments I have had have been with these people…. From the moment they walk in and see how beautiful the place is, they realize that they are being cared for. There is an energy of the space caring for you, so you begin to see yourself differently and begin to take care for yourself as well. I saw people come to life over and over again.”

The DPH program started in 2000 and continues today with many senior housing communities. Eventually, budget shortfalls made it hard for Hayes Valley to compete with other senior housing projects using the patch program where their patch cost was lower for the city. Hayes Valley would have had to cut other programming to supplement the patch program. They realized that they could no longer continue in a competitive way.

Architectural Features

I asked Amir what were his dream components that he envisions for the physical space of a senior community. His list is inviting:

 Light and space are core, where you walk into a space and immediately you feel the spaciousness and the openness  – and the joy and energy that comes from light.

 Floor to ceiling windows allow you to look out into a garden as well as bring in the light

 High ceilings

 Activities areas that are connected to common spaces – i.e. being able to see into the wellness center or art studio.

 Public cafes in the building.

 Playful colors, inviting again the open feeling.

 Flooring would be radiant floor heating – good for their feet.

 • Not long, boring hallways, but niches with art and color.

 • In memory care areas having kitchens and activities areas completely open so when the resident comes out of their room they want to come out and engage.

 [This interview was held November 7, 2012]

 Home Page Picture 3 Bayside Park

Re-purposing and Infill Site Ideas

In my dream vision I would build an entirely new facility based on Frank Lloyd Wright’s economical usonian architecture. May this someday be so, and good for another blog discussion down the road. In the meantime, I suspect a realistic approach would be to convert existing skilled nursing facilities (SNF) or to convert just about any large inner city building that has the needed elements and has an undeveloped area that can be worked into the garden.

“Keep listening to what the space wants and do it. Don’t keep whittling it away or else nobody is happy.”

– Don Houston

Conversion Example #1: A converted SNF might be developed from an existing large (100+ occupancy) for-profit facility that gets sold to the NNN Non-profit. In this instance, some of the building would be vacated and converted into the children’s nursery school. More common areas would be part of the remodeling. Since the staff would be reduced and therefore the parking needs reduced, some of the parking lot would be torn-up and re-landscaped for the garden.

 Conversion Example #2: Another option would be to re-purpose an existing building that could adequately serve the needs of the intergenerational commnity. Infill projects are a way of recycling a well-built building and saving on planetary resources. A multi-floor building is an intriguing consideration, where the administration offices and nursery school could be on the upper floor(s) and the elders and nursing care on the ground floor.

A space that goes up several floors could also allow for some other very creative and potentially income-bearing uses: office spaces could be rented out to other community and non-profit organizations, making the care community even more engaged as a hub of activity. Loft-style space could be offered to artists (and gardeners/horticultural therapists) who in turn work with the elders and children for their rent. Again, if the facility was big enough or had the kitchen and dining space to support it, low-cost dining programs could be offered to the general public or at least for the children and live-in resident artists and employees.

In an interview with architect Don Houston (where we discussed the Pattern Language  approach to architecture and systems), he offered some cautions with the infill approach. He encouraged thinking of these building as “permeable membranes”. “Don’t let the structure stop you – you can do anything you want to do. In Pattern Language you always leave some of the old to give complexity, richness.” He also encouraged to “keep listening to what the space wants and do it. Don’t keep whittling it away or else nobody is happy.” And – “It may cost more.”