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Intro ..................................................................................................................................................... 4 Highlights ............................................................................................................................................. 4 Limitations of Research ....................................................................................................................... 5 1.0 BACKGROUND ............................................................................................................................... 6 1.1 Long-Term Care in Ontario ............................................................................................................ 7 1.2 Retirement Residences ................................................................................................................. 8 1.3 Guiding Principles .......................................................................................................................... 9 2.0 PLANNING CONTEXT ................................................................................................................... 10 2.1 Policies ......................................................................................................................................... 10 2.1.1 Provincial Policy Statement, 2005 .................................................................................... 10 2.1.2 Places to Grow Act, 2005 .................................................................................................. 10 2.1.3 Growth Plan for the Greater Golden Horseshoe, 2006 .................................................... 11 2.1.4 Durham Regional Official Plan .......................................................................................... 11 2.1.5. Ajax Official Plan .............................................................................................................. 12 2.2 Guidelines .................................................................................................................................... 15 2.2.1 Long-Term Care Home Renewal Strategy, 2009 ............................................................... 15 2.2.2 Other Guidelines ............................................................................................................... 17 3.0 MARKET ANALYSIS....................................................................................................................... 19 3.1 Community Profile Demographics ............................................................................................. 19 3.1.2 Population ......................................................................................................................... 19 3.1.3 Density .............................................................................................................................. 21 3.1.4 Education .......................................................................................................................... 21 3.1.5 Employment ...................................................................................................................... 21 3.1.6 Income .............................................................................................................................. 22 3.1.7 Housing ............................................................................................................................. 22 3.1.8 Families ............................................................................................................................. 23 3.1.9 Language, Ethnicity & Immigration .................................................................................. 23 3.1.10 Crime ............................................................................................................................... 24 3.1.11 Dementia and Disease .................................................................................................... 25 3.2 Market Definition – Who is the Customer? ............................................................................... 26


3.2.1 Geographic ........................................................................................................................ 26 3.2.2 Demographic ..................................................................................................................... 27 3.2.3 Rent Pricing Range ............................................................................................................ 28 3.3 General Market Trends for an Aging Population ....................................................................... 29 3.3.1 Employment and Labour Force ......................................................................................... 29 3.2.2. Ethnic Market Trends....................................................................................................... 30 3.2.2 Homeownership................................................................................................................ 31 3.2.3 Migration: Retirement in Urban and Rural Environments ............................................... 35 3.2.5 Push Factors: Problems that Create the Market .............................................................. 37 3.2.6 Pull Factors: Responding to the Market Trends ............................................................... 38 3.3 Demand ...................................................................................................................................... 40 3.3.1 Capture Rate ..................................................................................................................... 40 3.3.2 Vacancy Rate ..................................................................................................................... 41 3.3.3 Waiting Lists for Long-Term Care Homes in Ajax ............................................................. 44 3.3.4 Absorption Rate ................................................................................................................ 46 3.4 Supply ......................................................................................................................................... 46 3.4.1 Current Supply .................................................................................................................. 46 3.4.2 Competitive Market Analysis ............................................................................................ 49 4.0 SITE ANALYSIS .............................................................................................................................. 50 4.1 Historical Context ....................................................................................................................... 50 4.2 Site Location and Neighbourhood ............................................................................................. 50 4.2.1 Site Photos .......................................................................................................................... 0 4.3 Zoning and Land Use .................................................................................................................... 0 4.4 Area Context................................................................................................................................. 1 4.5 Environmental Considerations ..................................................................................................... 1 4.6 Proximity to Services and Amenities ............................................................................................ 1 4.7 Transportation.............................................................................................................................. 4 4.7.1 Employee Demand .............................................................................................................. 4 4.7.2 Existing Transit Infrastructure............................................................................................. 4 4.7.3 Existing Road Networks ...................................................................................................... 5 ...................................................................................................................................................... 5 4.7.4 Wheel Trans ........................................................................................................................ 5


4.8 Opportunities and Constraints ..................................................................................................... 7 5.0 MOVING FORWARD .................................................................................................................... 10 5.1 Vision .......................................................................................................................................... 11 Appendix I - Maps ................................................................................................................................. 13 Appendix II – Tables .............................................................................................................................. 14 Figure 1.0 ........................................................................................................................................... 14 Figure 2.0 ........................................................................................................................................... 15 Appendix III – Site Photos ..................................................................................................................... 16 GLOSSARY.............................................................................................................................................. 17 REFERENCES .......................................................................................................................................... 19


Intro This interim report is prepared for Chartwell REIT (Chartwell) as a precursor to a redevelopment proposal for its Ballycliffe Lodge Long-Term Care and Retirement Residences property. This property has been identified as an underperforming asset within Chartwell’s portfolio and the Notorious BLG Ltd. Group has been tasked to research the current conditions of the site with the goal of optimizing value and transforming it into an asset. The goal of this report is to (1) establish conclusively whether a demand exists for a long term care and/or retirement residence; (2) evaluate current supply in the market; (3) set the stage for redevelopment by highlighting opportunities from the site, government legislation (specifically planning policies and policies related to such development), and the market; and (4) identify constraints that would inhibit certain redevelopment options and see if they can be overcome.

Highlights 

Ballycliffe Lodge site is currently zoned Downtown Central Area – Institutional, but designated Downtown Central Area - Mixed Use.

Vacancy rates of Retirement Residence by unit types in Durham Region were the lowest for two-bedroom units (9%), highest for private/studio (15%)

Long-term care homes in Ajax have waiting lists of typically two years, the lowest being 3-6 months for semiprivate accommodation for senior women in Ballycliffe Lodge.

Services and amenities in the surrounding neighbourhood are very limited in catering to seniors.

Winbourne Park is the only other long-term care home competitor in Ajax.

There is no specific ethnic group that an Ajax senior home would have to specifically gear its services and amenities towards, given the demographic breakdown.


Public transit is severely limited. Automobile is the main method of travel, with convenient access to Highway 401.

 Existing site conditions are in need of rehabilitation.  Notorious BLG Ltd. recommends the procedure of redeveloping the Ballycliffe Lodge site given the facts established by the interim report.

Limitations of Research It is important to acknowledge the limitations of the information gathered in this report. One of the biggest challenges faced in attaining relevant data was the scope of research used by primary data researchers. The report tries to maintain consistency with data collected on lower tier municipality (Town of Ajax) and upper tier municipality (Durham Region) levels, as well as on a provincial level (Ontario). The report strives to use data based on the Central East Local Health Integration Network’s boundaries for topics regarding long-term care homes as this is the feed for that particular market. Retirement residences are devoid of this boundary as they do not apply. Provincial levels are used when deemed appropriate or a scope larger than Durham Region is necessary. National levels are used to note trends in senior behaviour, particularly from sources such as the Canada Mortgage and Housing Corporation.


1.0 BACKGROUND

As a person ages, a time may arise where independent living is no longer an option and various types of seniors housing must be explored. Although the decision may be quite difficult, it often arises out of necessity over desire, when physical or mental health deteriorates to a point that caregiver dependency is essential for survival. A sudden loss in caregiver support, or decline in health status can often trigger an urgent transition to some type of supportive living, with retirement housing and long-term care being two options available for seniors. In Ontario, the increasing cost of these facilities, coupled with a lack of available accommodations can often make the transition quite challenging. As a result, the Ministry of Health and Long-Term Care (MOHLTC) has attempted to overcome this by increasing bed availability and facility desirability through retrofit projects across the province. This study will focus on Ballycliffe Lodge Long-Term Care and Retirement Residences (Ballycliffe Lodge) in the Town of Ajax to determine the need for redevelopment and retrofitting at this location.


1.1 Long-Term Care in Ontario Long-term care provides housing for seniors with access to support services 24 hours a day. This support includes assistance with daily activities, nursing, and/or supervision in a secure setting. Long-term care facilities offer a higher level of care than is typically found in other retirement residences or supportive housing (MOHLTC, 2013). Long-term care beds in Ontario are governed by the Long-Term Care Homes Act, 2007 (LTCHA) with admissions and waitlists managed by 14 Community Care Access Centres (CCAC) across Ontario (MOHLTC, 2013). The CCAC boundaries follow those of the 14 Local Health Integrated Networks (LHIN) in place across the province. Access to these beds is only made possible through an application to the CCAC, which involves an Eligibility Assessment followed by a Resident Assessment Instrument – Minimum Data Set 2.0 (RAI-MDS 2.0). This is a standardized assessment tool for admissions, quarterly assessments, significant change in health status of residents, and annual assessments. Once a client’s care level is determined by this tool, a decision can be made by a Community or Hospital Care Coordinator if long-term care is then necessary (MOHLTC, 2013). Once a client is found to require long-term care, the waitlist process begins and up to five facilities can be selected within any Ontario LHIN. The majority of the homes in Ontario have very long waitlists with wait times ranging anywhere from 3 months to 7 years depending on the region and home of choice (Central East CCAC, 2013). Although all regulatory procedures that the CCAC’s are bound by, when managing the longterm care waitlists, are strictly regulated by the Ministry of Health and Long-Term Care Act, the local LHIN will also act as a regulatory body to ensure that occupancy standards are met and that vacancy rates do not drop below the ministry requirement of 97% (Central East LHIN, 2013). The Local LHIN collects data from the CCAC and reports it to the Ministry of Health and Long-Term Care to ensure that minimum standards are maintained. The decision to move into LTC must be made within 24 hours of a bed offer otherwise the clients file will close and the waitlist process begins again. A person can move as many times as they choose, however, client families are made aware of the adjustment issues that can cause detrimental health effects each time an elderly person is moved.


Funding for long-term care is subsidized by the government, with those applying to basic accommodations eligible for additional rate reductions based on income (MOHLTC, 2013).

1.2 Retirement Residences Retirement homes in Ontario differ in many ways from long- term care residences in the province. Retirement homes have no minimum level of care requirement for admission and provide accommodation for seniors who are able to manage and pay for their own care (MOHLTC, 2013). They are appropriate for people who do not require 24 hour nursing care that is provided by longterm care and often offer meals, housekeeping, and laundry, recreational and social programs. These services however, vary greatly, between different homes (MOHLTC, 2013). As of 2010, the care provided to retirement home residents became legislated by the Retirement Homes Act 2010. This act created the Retirement Homes Regulatory Authority (RHRA) which has the power to license homes and conduct inspections, investigations and enforcement, including issuing financial penalties or revoking licenses if necessary (MOHLTC, 2013). Tenancy, in retirement homes, is also governed by the Residential Tenancies Act (2007), since retirement homes are considered privately owned rental accommodations for seniors and the facility owner becomes the resident’s landlord upon tenancy (MOHLTC, 2013). Since the RHRA is not fully proclaimed, a register of licensed retirement homes is not yet available to the public (MOHLTC, 2013). At this time, clients are directed to the CCAC for listings of Retirement Homes. Applications for tenancy however are not completed through the CCAC but rather each home directly. Furthermore, Retirement homes are not subsidized by the government like long-term care homes so tenants are responsible for the full monthly cost which can range from $1500-$5000/month for a private room. The option to purchase additional services is often available and varies from home to home (MOHLTC, 2013).


1.3 Guiding Principles

1.

Enhance Community Structure & Character

2.

Invest in Sustainability & Efficiency through Built Form

3.

Promote Accessibility for Residents

4.

Provide a High Quality Centre that Exceeds Service Standards


2.0 PLANNING CONTEXT 2.1 Policies 2.1.1 Provincial Policy Statement, 2005 The Government of Ontario’s Provincial Policy Statement provides policy direction on matters of provincial interest related to land use planning and development. The Provincial Policy Statement is to be used as a guide for local and regional planning bodies, setting the policy foundation for regulating the development and use of land while supporting the provincial goal of enhancing the quality of life for citizens of Ontario. Any decision made in the province regarding land use planning matters must be consistent with the policies stated in the Provincial Policy Statement, 2005. Using the Provincial Policy Statement the province is able to outline good planning principles that encompass the interrelationships between economic, social, and environmental factors. The Provincial Policy Statement focuses on policies that meet a full range of current and future needs. For example, it directs local municipal authorities to provide for an appropriate range of housing types and densities to meet the social, health and well-being requirements of current and future residents, including special needs requirements as defined in section 1.4.3 of the legislative document. 2.1.2 Places to Grow Act, 2005 The Government of Ontario recognizes that in order to accommodate future population growth and achieve a high quality of life, planning must occur in a rational and strategic way. This act provides a balanced approach to decisions regarding growth challenges. To complement this Act, regions may create growth plan policies that contain population projections and allocations; assessment and identification of priority growth areas; growth strategies, policies, and goals and; criteria relating to intensification and density. Ballycliffe Lodge is situated within the boundaries of the Growth Plan for the Greater Golden Horseshoe, thus development on this site must be in compliance with the policies stated in the Places to Grow Act, 2005.


2.1.3 Growth Plan for the Greater Golden Horseshoe, 2006 The Greater Golden Horseshoe (GGH) is a densely populated sub-region of Southern Ontario for which a need for managing growth was identified. The Growth Plan for the Greater Golden Horseshoe is a 25-year framework for implementing Ontario’s Places to Grow Act as well as providing growth management policy for the GGH. The Growth Plan aims to: 

Provide housing options to meet the needs of people at any age.

Promote transit-supportive densities with a mix of residential and employment land uses.

Build compact, vibrant and complete communities.

Promote the intensification of existing built-up areas, with a focus on urban growth centres, intensification corridors, and major transit station areas.

Create an appropriate range of community infrastructure to meet needs resulting from population changes.

2.1.4 Durham Regional Official Plan The Durham Regional Official Plan defines the intent of the Regional Council in the guidance of growth and development in the Regional Municipality of Durham. Its purposes include: 

The provision of policies to ensure an improved quality of life and secure the health, safety, convenience and well-being of the present and future residents of the Region.

The establishment of future development patterns of the Region and articulate goals, policies and implementation mechanisms to achieve it.

The provision of guidelines for regional council and councils of the area municipalities (including Ajax) in the preparation of future amendments to this Plan, municipal official plans, zoning by-laws and other municipal actions and programs.

The goals of the Official Plan include but are not limited to: ●

Managing growth so that it occurs in an orderly fashion.

Establishing a wide range of housing opportunities in Urban Areas in order to accommodate the needs of present and future residents.

Creating liveable urban environments for the enjoyment of present and future residents

Providing opportunities for a variety of cultural, health and community services.


The Durham Regional Official Plan outlines policies that deal with the environment, economic development, housing, cultural, health and community facilities, and finance.

For

example, the Regional Council shall support alternative, renewable energy sources and green technology.

The Regional Council will also promote more energy-efficient buildings including

retrofitting existing development to meet energy-efficient standards. In addition, the Durham Regional Official Plan also provides policies that will enable a wide variety of housing types, sizes and tenure in urban areas. For example, under the Durham Regional Official Plan, Regional council shall promote the utilization of Federal and Provincial programs for the provision of assisted housing for families, seniors, and special needs groups. Finally, it is the intent of the Regional Council that the Regional Official Plan establishes a framework to guide the preparation of municipal official plans. For example, as outlined in the Durham Regional Official Plan councils of the area municipalities shall ensure the inclusion of provisions to implement: ●

Policies and implementation procedures required to meet the objective of the Provincial Policy Statement and this Plan, particularly with respect to housing types, density, intensification and affordability.

Policies for mixed use development in regional and local centres, as well as major corridors designated in the Plan.

2.1.5. Ajax Official Plan Under the Planning Act of Ontario, local municipal plans are to conform to the upper tier Regional Official Plans. Therefore, the Town of Ajax Official Plan must be read in conjunction with the Durham Regional Official Plan. The purpose of the Ajax Official Plan is to establish principles, goals and policies governing long-term growth in Ajax. For example, one of the guiding principles for development in Ajax ensures that development is designed to be sustainable, transit supportive, pedestrian-oriented, and accessible to persons with disabilities. This will be promoted through: ●

Green technologies and renewable energy systems.

Residential intensification in mixed use areas serviced by public transit.

Pedestrian access between residential uses and public transportation in the Downtown.


Trails, bicycle lanes and other active transportation infrastructure that will link communities and provide travel alternatives.

Building design that improves access and mobility for persons with disabilities.

The Ajax Official Plan also outlines unique areas of planning interest. These areas are known as Community Improvement Plan Areas under the Planning Act. Community Improvement Plans (CIP) are used as tools to encourage neighbourhood renewal and commercial area improvement. Ballycliffe Lodge is located in the CIP area known as the Downtown Central Area (DCA) in Ajax (see DCA map Appendix). The objective of the DCA Community Improvement Plan is to: 

To enhance the Downtown as a unique district and the heart of the Town.

To strengthen the Downtown in terms of vibrancy, diversity and economic viability by stimulating investment interest in the redevelopment potential of the Downtown.

To improve the image and appearance of the area (much of the development in the Downtown is aging and shows visible signs of deterioration).

To promote redevelopment and/or rehabilitation that supports the Downtown vision that includes the creation of an intensive, mixed-use, pedestrian-oriented and transit-supportive district.

This will be achieved through policies such as: ●

The creation of an interconnected network of sidewalks and urban squares is encouraged throughout the Downtown Central Area

All new buildings, including both public and private sector developments, shall be sited close to the street right-of-way to create a consistent street wall and an attractive and interesting public realm

All buildings shall present the primary pedestrian entranceways onto the public street

Parking, loading, garbage and any other servicing facilities shall be located in the rear yard, or, where that is not possible, shall be screened from public view to mitigate their visibility from adjacent streets


CIPs also allow for the Town to offer financial assistance to encourage and support the redevelopment of lands in the Downtown area. Programs relevant to Ballycliffe Lodge are: ●

The Rehabilitation Grant Program: intended to provide financial relief in the form of tax grants to property owners who undertake rehabilitation or improvement of their properties in the Downtown Community Improvement Plan Area that results in a revaluation and tax increase on these properties, for eligible residential and commercial/office development.

The Planning and Development Fees Grant Program: intended to stimulate new investment in the Downtown Community Improvement Plan Area through the provision of a grant to offset, in whole or in part, the cost of specific planning and development fees for residential and commercial/office redevelopment in the Downtown Community Improvement Plan Area.

The Development Charge Exemption / Grant Program: intended to encourage higher density, more intensive development in Ajax’s Downtown area. The program will offer development charge exemptions or reductions for all eligible residential and commercial/office redevelopment proposals within the Downtown Community Improvement Plan Area.

The Exemption from Parking Requirements Program: intended to provide relief in the form of a reduction in the number of parking spaces required to property owners who undertake improvement projects.


2.2 Guidelines 2.2.1 Long-Term Care Home Renewal Strategy, 2009 The Ministry of Health and Long-Term Care (MOHLTC) plans to redevelop 35,000 B, C and upgraded D class long-term care beds over 10 years to ensure the quality of long-term care home accommodations. Along with the Local Health Integration Networks (LHINs) the Ministry is now inviting applications from long-term care home operators of these types of beds for funding to support redevelopment. In order to benefit from this renewal strategy, operators must comply with the following policies and guidelines: â—?

Long-Term Care Home Design Manual, 2009 The design manual’s goal is to integrate design concepts that will provide a high level of quality resident care in an environment that is comfortable, aesthetically pleasing and as home-like as possible. Furthermore, it will support well-coordinated care for residents who have diverse care requirements. The design manual sets out standards that apply to Residents Home Areas (RHAs), which are smaller self-contained units within a long-term care home that have at least one kitchen, an outdoor area, a salon/barber shop and a place of worship. The consolidation of the 2002 Long-Term Care Retrofit Design Manual provides additional standards for retrofitting long-term care homes to accommodate flexibility in home design.

â—?

Leadership in Energy and Environmental Design (LEED) LEED is the premier green building certification system in Canada. LEED provides developers with guidelines designed to reduce the impact of buildings on the environment and its inhabitants. LEED certificate is granted to facilities that emphasize on eco-friendly features that promote energy and water efficiency, healthy buildings and the conservation of natural resources.


Policy for Funding Construction Costs of Long-Term Care Homes, 2009 This policy will alleviate costs of developing or redeveloping (including renovating or retrofitting) long-term care homes. Funding is provided for both capital costs and operating costs. In the case of newly constructed beds, $120,000 per bed must have been expended to receive the maximum available through base construction funding per diem, or funding will be pro-rated. Eligible costs include:    

Cost of actual construction furniture equipment building permit

 municipal development charges  architect (and other eligible professional) fees  related net taxes  and anything deemed eligible by the Ministry

Designs for construction projects must include plans to meet LEED Basic standards or will not gain approval from the Ministry. The degree to which LEED standards are met will affect the amount of funding received. Eligibility for this program is determined by the MOHLTC. ●

Transition Support Guidelines, 2009 The Transition Support program is intended to address expenses the operator will incur during the redevelopment of the home while maintaining the operations of an existing home. This policy will be beneficial for phasing. In addition, all Long-Term Care Homes are required to operate under all applicable

government legislation, regulation, operational and program standards. These include:  Long-Term Care Act, 2007 The Act ensures that residents of these homes receive safe, consistent, and high-quality resident-centred care in settings where residents feel at home, are treated with respect, and have the supports and services they need for their health and well-being. ●

Retirement Homes Act, 2010 This act contains care and safety standards and other requirements applying to licensed retirement homes in Ontario. Regulations under this Act provide additional standards and requirements for licensed homes, and requirements relating to the RHRA’s administration of the Act.


2.2.2 Other Guidelines Policies and objectives also contained in the Ajax Official Plan that will act as guidelines for any future development or redevelopment on the Ballycliffe Lodge site include: ●

Barrier Free Design: The Town supports maximizing accessibility for all people, including persons with disabilities

Built Form and Architectural Design: Any development or redevelopment must undertake a study to develop a Noise Wall Retrofit Policy that would establish, among other matters, eligible locations and parameters for the construction of new noise walls, the replacement of an existing wall, or other appropriate measures or actions

Green Building and Environmental Design The Town will support development proposals that will contribute to healthier, safer living environments. It will also support methods of energy self-sufficiency and energy sources that protect the environment. For example, green building technologies and construction practices such as renewable energy systems and green roofs

Special Needs Housing Special needs housing includes assisted housing, group homes, hospices, shelters, nursing homes and seniors housing. All special needs housing shall be appropriately integrated with the surrounding developments.

Mixed Use Areas Intensification Policies The Town shall generally not support the conversion of any land use that proposes development at densities below the current density minimums identified in the detailed planning policies within the Downtown Central Area. In addition, in order to maximize the efficiency of existing infrastructure, employment growth and housing production, council will encourage urban intensification in all of the mixed-use designations.


â—?

Site Plan Control The entire Town is designated as a site plan control area under the provisions of the Planning Act. All proposed development may be subject to site plan control, at the discretion of the Town. Therefore, no person shall undertake any development or redevelopment in an area designated under site plan control unless development or redevelopment implements: i.

Criteria contained in the Town’s Site Plan Review Manual

ii.

Policies of the Official Plan


3.0 MARKET ANALYSIS 3.1 Community Profile Demographics The demographic information presented in this report is taken from the Statistics Canada Census data from 2001, 2006 & 2011 (Statistics Canada, 2013). Ajax, Durham, and Central East Local Health Integrated Networks are considered appropriate scopes for analysis as these levels would sufficiently capture the target market. Their respective community profiles were analysed for comparison to determine the means within which the Ballycliffe Lodge redevelopment would be supported. 3.1.2 Population

Durham Population 2011

-10000

85 and over 80 to 84 75 to 79 70 to 74 65 to 69 60 to 64 55 to 59 50 to 54 45 to 49 40 to 44 35 to 39 30 to 34 25 to 29 20 to 24 15 to 19 10 to 14 5 to 9 0 to 4

Age Cohort (years)

Age Cohort (years)

Ajax Population 2011 85 and over 80 to 84 75 to 79 70 to 74 65 to 69 60 to 64 55 to 59 50 to 54 45 to 49 40 to 44 35 to 39 30 to 34 25 to 29 20 to 24 15 to 19 10 to 14 5 to 9 0 to 4 -5000

Population

0

5000

Female

10000

Male

-40000

-20000

0

20000

40000

Population

In 2011, the population of Ajax was 109,600, a 21.6% increase from its 2006 population of 90,167, and had the highest growth of all municipalities within the region. Durham’s total population for 2011 was 608,124, an increase of 8.4% from its 2006 population of 561,258, less than the 10.7% increase it saw between 2001 and 2006.


Population growth in Ajax between 2006 and 2011 was most prominent in the 60 to 64 year age group, with a 66.6% increase. This was followed by the 85 and older cohort with a 58.8% increase that same year. Notably all age groups over 50 saw significantly larger growth than that of their younger counterparts. This data is also consistent with that of Durham although the 85 and older age group led the bulk of the growth at 46.2%, followed by those 60 to 64 at 41.9%. This data suggests a rapidly aging population, indicating the imminent need for appropriate housing targeted at this cohort in this region. According to Stats Canada projection estimates for 2011, Durham’s population over 75 is expected to grow from 33,690 to 113,330. This indicates that those currently 55 and older are going to be more populous than ever before when they hit the 75 and older cohort in approximately 20 years (Ontario Ministry of Finance Population Projections, 2013). Durham Region is part of a GTA cluster, where the population growth of seniors is expected to exceed 150.0% between 2011 and 2036. (Fig. 1.1) This extraordinary

demand

provides a solid foundation to support the need for the

Durham Region Figure 1.1 (source: Ontario Ministry of Finance Projections

redevelopment of Ballycliffe Lodge, which is located in the heart of this cluster The Central East LHIN population data is also considered as a potential source for long-term care clients to Ballycliffe Lodge residing within the same LHIN. The total population of the Central East LHIN in 2006 was 1,432,695, which has increased by 6.3% since 2001, which is the same population composition as the rest of Ontario. In 2006 the population over 75 made up 6.4% of the population. Despite relatively similar male to female ratios throughout the age cohorts, the balance shifts significantly towards more females past the 55 to 59 year cohort. Data from Stats Canada for


the 2011 Ajax population shows the 55 to 59 age cohort had a 102:100 male to female ratio, a number which quickly drops to 86:100 for the 70-74 cohort, then 48:100 for the 85 and over cohort. This further verifies the fact that females live longer than males and thus consist of a bigger makeup of the senior population as the cohorts age. 3.1.3 Density In 2006, the density of the Central East LHIN region was 93.8 persons per square km. In 2011 Ajax had a population density of 1634.2 persons per square kilometer, compared with Durham regions 241.0 and Ontario’s 14.1. Ajax saw the greatest densification with a 21.6% increase since 2006 much greater than Ontario’s increase of 5.2%. Over the same time period, Durham saw a decrease in density of 8.4%. Evidently Ballycliffe Lodge is located in the denser portion of its geographic market. Following current trends and government intensification planning initiatives, Ajax’s density is projected to continue to increase. 3.1.4 Education In Ajax, 17.5% of the total population 15 years and over held a University certificate, diploma or degree in 2006, which exceeds Durham Region’s 14.8%. Population levels of those with no educational attainment (including any type of certificate, diploma or degree) are however lower in Ajax with 18.35%, compared to both Durham with 21.1%, however both fall short of the Ontario’s 20.49%.. Education can be an important indicator of economic growth within a community (World Bank, 2013). For the purpose of this study, there are no evident issues that would hinder the redevelopment of Ballycliffe Lodge, as Ajax remains on par for economic growth with the rest of the province. 3.1.5 Employment In 2006, the unemployment rate in Ajax was the same as the province of Ontario with 6.4%. In the same year, Durham had a slightly lower unemployment rate with 6.3%. This indicates that the number of people who are willing and able to work but unable to find employment is consistent with the rest of the region. It can thus be assumed there is no underlying factor specific to the town of Ajax that is hindering the unemployed from finding work. Ajax’s unemployment rate has maintained relative stability since 1996, with 6.7% dropping to 5.4% in 2001. This data also shows


that this geography is maintaining a stable workforce with no trends indicating any imminent risk to it. Increases in unemployment rates within a community may be indicators of declining income neighbourhoods that can often lead to social issues and homelessness. For the purposes of this study all employment data indicates Ballycliffe Lodge is located within a growing community where there is no eminent threat to redevelopment, which would likely thrive. 3.1.6 Income The 2006 median earnings of those aged 15 and over who worked full time was $49,860. This was very similar to Durham’s median full time earnings of $49,823. This is consistent with other data that shows a stable workforce within the study area, providing no indicators that would afflict this redevelopment project. The median family income in 2006 for all census families was $82,918 in Ajax. This is higher than the Durham median of $80,872, however higher than Ontario’s median full time earnings of $69,156. In Ajax, the median total income for males in 2006 was $40,879 per year (8.8% decrease from 2001). In the same time period for females, the median income was $25,637 (a decrease of 5.2%). In 2006, 10.9% of persons living in Ajax were categorized as low income before tax compared with 9.4% in Durham and 14.7% in Ontario. It is important to note from this study that the market area maintains average income earners. Accordingly, redevelopment plans should not be catered towards income extremes (affluent or impoverished). 3.1.7 Housing In 2006, 68.7% of the total occupied private dwellings in Ajax were single detached homes, similar to Durham’s 67.6%, but much greater than Ontario’s 56.1%. Semi-detached dwellings comprise 4.8% of the total occupied dwellings in Ajax compared with 5.8% and 5.7% in Durham and Ontario respectively. Row houses occupy 11.7% of the dwellings in Ajax and slightly less in Durham with 9.3% and even less in Ontario with 7.9%. In 2006, the median monthly payment for rented dwellings in Ajax was $959, which exceeded Durham’s median of $858. Similarly for owner occupied dwellings, the median monthly payment in Ajax is $1590, which exceeds Durham’s median of $1,372 and greatly exceeds the provincial median of $1,046 monthly. The price of long-term care and retirement rentals at Ballycliffe Lodge will exceed the median rental and ownership rates of the


regular housing stock for the town of Ajax. This added value must be reflected on the quality of care services and facilities that will accompany this type of dwelling. 3.1.8 Families In 2011, Ajax had 30,950 families in private households compared with 174,635 in Durham region. The town of Ajax saw a 22.0% increase in families between 2001 and 2006 which was the second largest increase, in Durham region, behind Whitby, over that time period. The average number of children at home per census family in 2011 was 1.4 in Ajax, which was higher than the Durham, and Ontario averages of 1.2 and 1.1 respectively. This trend indicates a growing community in Ajax, which will necessitate seniors housing in the near future. Durham region had a 21.0% increase in those over 65 living with relatives and a 19.0% increase in those living alone between 2001 and 2006. This is consistent with the aging population trend and the imminent need for appropriate seniors housing within the region. 3.1.9 Language, Ethnicity & Immigration In Ajax in 2006, 89.1% of the total population spoke English most often at home, compared with 93.2% in Durham and 80.3% in Ontario. In 2011, however, Ajax saw a decrease in English language spoken at home with only 85.5%. Durham and Ontario also saw a decrease with 91.9% and 79.0% respectively. This trend could be due to the increase in immigrants to Ontario. In 2006, 3.5% of Ajax’s total population had immigrated between 2001 and 2006. The change in racial composition of the population

can

be

referenced

below

(Fig.

1.2).

Only

Durham’s

1.8%

of

population

immigrated between the


same years. For context, Ontario had a 2001 to 2006 immigration population percentage of 4.8%. Durham and Ajax have more settled populations.

While the 2011 census data for Ajax shows a variety of cultures with numerous languages spoken at home, there is currently no predominant culture besides English within this geography. Tagalog has the highest number Figureof 1.2 mother tongue natives with 2.1%, whereas Urdu is the highest non-official language spoken at home with 1.3%. For the purpose of this study, at this time, it will not be necessary to cater to any specific ethnic group. This trend should be carefully monitored however, as unpredictable increases in immigrants over the next several years could drastically change the cultural composition of the area.

3.1.10 Crime The site on which Ballycliffe is located is in the West Division – Ajax/Pickering, one way of measuring crime in this region is through the use of police-reported data. In this study, data was compared between the years 2006 and 2011 (Fig. 1.3). In 2006, there were 625 assaults; 853 break and enter incidents; 390 drug charges; 6 murders; 2,941 theft under $5,000 charges; and 191 robberies. In contrasts, when compared to 2011 many of these figures decreased in number. In 2011, there were 603 assaults; 393 break and enter incidents; 3 murders; 2,479 theft under $5,000 charges; and 178 robberies (Durham Regional Police, 2013). In addition, in 2011 Durham region ranked 195 out of 239 for overall crime severity in Canadian police serviced communities, ranking 105th for violent crimes and 208th for non-violent crimes (Statistics Canada, 2011).

West Division - Ajax/Pickering Crime rates by Offence 2006-2011

2941 2479

# of incidents

3000 2500

For the purpose of this

2000

study, site

1500 1000

625 603

500

853

2006

752 393

390 6

3

191 178

0 Assualt

Break and Enter

Drugs

Murder Theft under Robberies $5000 Offence

2011

surrounding crime rates must be examined in order

Figure 1.3 (source: Durham Reg


to understand factors that could essentially influence potential clients within the senior housing market. Many seniors select facilities located in areas with lower crime rates as they fear for their safety. The area on which Ballycliffe is located has experienced a number of decreasing crime rates over the time period between 2006 and 2011, accordingly it was determined that the site on which the current facility is located would appear more desirable for seniors looking to purchase a unit. 3.1.11 Dementia and Disease As the proportion of the population aged 65 and older increases, trends in diseases related to aging should be anticipated to correlate. Dementia is a prime example of such a disease increasing rapidly (Hopkins, 2010). By 2015 the number of cases of dementia will increase by approximately 18.0% and by 2020 this increase will reach 37.0% (Hopkins, 2010). This increase means that by 2020 there will be approximately 181,000 cases of dementia in Ontario (Hopkins, 2010). Specifically in the Central East LHIN, where Ballycliffe Lodge is located, there will be 25,269 cases of dementia by 2016 (Ontario LHINs, 2007). This will have an impact on the need for specialized accommodation equipped to handle and care for dementia diseases.

However,

constraints exist that prevent dementia patients from receiving quality care. For example, the Alzheimer’s Society of Canada (2010) forecasts that by 2018 there will be a demand for dementia care in long-term care homes totalling 296,473 beds but only 249,268 beds will be available. This leaves an excess demand of 47,204 beds. If this excess is not met, more people suffering from dementia will have to seek community care options. These community care options cannot provide the complex care dementia patients require and can potentially place a strain on the national health care system (Alzheimer’s Society of Canada, 2010).

58.0% of long-term care Residents have

Dementia (Long -Term Care Innovation Expert Panel, 2012). In addition, caring for a person with dementia outside of an equipped long-term care home facility can have negative impacts on the caregiver’s psychological and physical health, life expectancy, quality of life and economic security (WHO, 2012). The effects of caregiver strain and the potential strain on the national health care system combined with the lack of supply of long-term care beds for persons suffering from dementia further emphasize the benefits of dedicating beds to dementia care within long-term care facilities.


3.2 Market Definition – Who is the Customer? Within the senior housing industry, there are many types of service provisions directed to different markets such as at-home care, care specific for dementia patients, or residents who require Alternate Levels of Care (ALC). As established in sections 1.1 Long-Term Care and 1.2 Retirement Residences, these two senior housing types cater to specialized seniors needs. Defining the target market for Ballycliffe Lodge will provide guide development and allow the project to accurately respond to the needs of these markets through appropriate service provisions and amenities. As a result, the scope for the development project will be refined and more comprehensive in its design. Ballycliffe Lodge will continue to operate as a long-term care and retirement residence for seniors. Subsequently, the target market for Ballycliffe Lodge long-term care is seniors that are 75 years of age and older living in the south western region of the Central East LHIN within the Durham Cluster’s Whitby branch. For Ballycliffe Lodge Retirement Residences, the target market is seniors that are 75 year of age and older living in Ajax. This criterion was identified by breaking down the market into geographic and demographic components. 3.2.1 Geographic Ballycliffe Lodge is within the geographical jurisdiction of the Central East LHIN, which is responsible for coordinating interdisciplinary health care services in the regions of Durham, Peterborough, and Haliburton-Northumberland-Victoria (Appendix I). The Central East LHIN is the 6th largest LHIN in land area in Ontario comprised of 7 subdivisions that are responsible for all health services within the community (Central Eat LHIN, 2013). As retirement residences are privately owned and regulated under different standards, Central East LHIN has no authority or accurate record of their operations. For this reason, retirement residences will generally pertain to a regional scope (Durham). Despite the site being situated next to a major Highway, the 401, residents in the Central LHIN such as those in the neighbouring Region of York are not considered part of the target market as they will be directed within their own network.


The site is located at the south western end of the Central East LHIN, towards the more urban GTA peripheries. Ageing in place has become a trend among seniors and is increasingly encouraged by the government due to issues of funding. For seniors in more desperate need of services and health monitoring provided by long-term care homes, this location will also unlikely be a first choice for them as they are more likely to select a home in a community with which they are familiar. Given these two realities, this rural constituency will likely consist of a smaller portion of potential Ballycliffe Lodge residents. Consequently, the target market for Ballycliffe Lodge will focus specifically on the Ajax area as its primary boundary, with the Central East LHIN and Durham Region as secondary boundaries for the long-term care and retirement home markets, respectively. 3.2.2 Demographic Within the geographic and demographic boundaries established, the customer base is further denominated by age. Technically, admittance to a long-term care or retirement residence can be granted to anyone 18 years of age and older. However, this strays far from the average age of senior residents in long-term care homes and retirement residences and thus their target markets. In Ontario, the average age of people in long-term care is 83, with only 6.7% being less than 65 years old (Ontario Long-Term Care Authority, 2012). The threshold for official senior status has been established by the Canadian Mortgage and Housing Corporation (CMHC) to be 55 years of age in their 2012 report, Housing for Older Canadians. This also reflects the age when seniors transition into retirement from work and begin considering retirement residence options. However, “seniors� is a general term which does not sufficiently reflect the diverse needs of those aged 55 and older. CMHC breaks them down into four comprehensive cohorts: Pre-seniors (55-64 years old), Younger seniors (65-74 years old), Older seniors (75-84 years old), and Eldest seniors (85 years and older). The mean age for a senior to move into a seniors housing development is 85 (Canada Mortgage and Housing Corporation, 2012), but it would be strategic to reach out to the market early as age of entry is a correlating factor for length of tenancy (Ontario Long-Term Care Authority, 2012). Although those aged 55 to 74 will define a target submarket, since they will be the largest market in 20 years, attention must be given first to


those 75 and older as the primary target market. This latter cohort will be used to calculate market statistics (e.g. the capture rate) as it ensures consistency with the available data sources such as Statistics Canada and CMHC. Additionally, consideration will be given for the higher female to male ratio in the 75 and older market. 3.2.3 Rent Pricing Range 3.2.3.1 Long-Term Care Homes Long-term care long stay co-payment rates as of July 1, 2012 are as follows: 

Preferred Accommodation – Private Room: $2274.9

Preferred Accommodation – Semi-Private Room:

Basic or Standard Accommodation – Various styles - $1674.1

$1947.9

Residents who are not able to afford this co-payment rate may apply for a rate reduction if they apply to a basic or standard accommodation. The Ontario Government provides the rest of the copayment at a rate of $152.9 per bed per day (MOHLTC, 2013), which approximates to more than half the costs. 3.2.3.2 Retirement Residences According to a 2012 survey by Canada Mortgage and Housing Corporation (CMHC), the average cost of a seniors’ retirement residence unit in Ontario was $3,066 per month, with bachelor/private units as the most expensive in Canada at $2,699. Rents also tended to be on the higher side, with only 2.8% of retirement residence units renting for less than $1,500 per month, while 69.8% of units had a rent of $2,500 or more per month (2012). In comparison, the average rent for overall retirement residences in Durham was $3,230, accounting for two-bedroom units ($4,653), one-bedroom units ($3,725), and private/studio units

Durham Region Average Rent ($) of Standard Spaces by Unit Type - 2012 Two Bedroom

$4,653

One Bedroom

$3,725

Private/Studio Figure 1.4 (CMHC, 2012)

Average Rent ($)

$2,885 $0

$1,000

$2,000

$3,000

$4,000

$5,000


($2,885)(Fig. 1.4). Retirement residences are evidently more costly living spaces than long-term care homes. This has much to do with the less regulated costs as retirement residences are more flexible in terms of the rates they charge. However, this is countered by the intensity of demand for the respective senior housing types, reflected in quantitative form by the vacancy rates.

3.3 General Market Trends for an Aging Population 3.3.1 Employment and Labour Force The current and future generation of Canadians are healthier, live longer, and as a result may remain in the work force until a later age. In previous generations, older seniors would transition out of the work force upon reaching 65, which is considered the age for retirement. The combined income generated from longer work periods, private family sources, and retirement pensions supposedly ensure that on average most Canadians can retire without worrying that they do not have enough money to retire (CMHC, 2008). Most working age groups indicate that they retire beyond the age of 65. Men are slightly more inclined to stay in the workforce upon reaching the age of retirement. Both genders will remain in the work force past the age of retirement, but males are seen to be more active in the labour force as they grow older. Possible explanations may include personal statuses of health, income, or debt accumulation (CMHC, 2012b). Household income is a prominent factor for an individual’s length of stay in the workforce; 63% of those with less than $40,000 indicated a desire in continuing to work beyond 65 years of age (CMHC, 2012b)(Fig. 1.5). Contrastingly, as

Figure 1.5 (CMHC, 2012)


household income levels increase, people show significantly less interest in working beyond 65. 3.2.2. Ethnic Market Trends By 2036, Canada’s population forecast is expected to grow steadily with migration entering into the country as being a primary factor for this growth (Statistics of Canada, 2010). From this, it is projected that by 2036, approximately 336,000 immigrants will be introduced into Canada. Figure 1.6 (net interprovincial migration observed 1981 - 1982 to 2008/2009) shows that nearly half

(166,300) of this new immigration population is forecasted to settle in Ontario alone (Statistics Canada, 2010). Long-term care and retirement residences in places that have a largely immigrant population may need to consider this to adequately plan for their needs and wants. Language barriers to desirable services and amenities geared towards the general English-speaking population will need to be addressed by researching the demographic makeup of the surrounding retirement and long-term care home. Figure 1.6

Furthermore, based on the period of immigration, seniors may be less likely to live on their own if sponsored by their family to migrate over. It is more common for senior immigrants to live with their relatives than entering a senior retirement home as multiple generations of family


members living together are common in many cultures (CMHC, 2012b). Immigrant families who choose not to move elderly members in to a long-term care or retirement residence will require more housing space to accommodate the larger family sizes. This cultural factor relates to the trend of aging in place as most retired immigrant seniors will want to stay close to friends, family, and relatives as opposed to moving to a retirement home that they are not used to. It should be noted that the site of Ballycliffe does not currently experience these ethnic market trends as there is currently no predominant culture with most recording in 2006 that their primary ethnicity is English, Canadian, Scottish or Irish. This can be seen in Figure 1.7 (Primary Ethnic Groups as a Percentage of the Total Durham Population). Ethical market trends will need to be monitored and analyzed in the event of significant changes in its ethnic population.

Figure 1.7

3.2.2 Homeownership A variety of home types will be required to meet the diversity and unique needs of an aging population. This also serves as a criterion for the creation of vibrant mixed use neighbourhoods and communities that can contribute to an overall healthy social and active lifestyle for older


generations. Compared to younger individuals and families, the senior population is much more likely to choose dwelling types with one floor due to mobility issues that are commonly experienced by certain older residents (CMHC, 2008). Staircases in living environments may make it an inadequate place to age and this may require them to make the move to a more suitable dwelling type as their health and mobility declines. Developers will need to provide a range of housing options to accommodate the diverse needs of seniors needing long-term care or special care to help them live long and prosperous lives. Homeownership preferences are largely dependent on the income levels or wealth accumulation of those wishing to retire. The trend of working longer and retiring later is partly fuelled by the desire or need to add to the personal funds generated for retirement. Combined with the fact that a higher percentage of elderly Canadians have paid off their mortgages and become homeowners, this constituency of seniors has more reason to age in place for retirement (CMHC, 2012b). The percentage of home ownership and mortgage free ownership households can be seen in Figure 1.8 (2006 Canadian Household Ownership and 2006 Canadian Household Ownership Mortgage Free)

2006 Canadian Household Ownership (%)

2006 Canadian Household Ownership Mortgage Free (%)

Pre-Seniors (55 - 64) 31%

35%

Younger Seniors (65 - 74) Older Seniors (75 84)

34% Figure 1.8

28% 43%

Pre-Seniors (55 64) Younger Seniors (65 - 74)

29%

Older Seniors (75 -84)


Government pensions and family support also add to the overall savings a senior will have for retirement. In this respect, demand for long-term care homes greatly exceeds that for retirement residences (see 3.4.2 Vacancy Rates for a comparison) as the government subsidizes approximately half of the actual rent.

Most seniors wishing to retire will want to stay in their current homes and not move unless financial, family or health issues force them otherwise. Their preference is encouraged by the government’s prioritization of aiding seniors who wish to age in place (with evidence from the publicly funded 2013 Living Longer, Living Well report by Dr. Samir Sinha). As per the chart below, the single detached dwelling is the most popular housing type among the 75 and older cohort. However, physical and mobility limitations stemming from health has made downsizing to more manageable (and less expensive) dwelling types a trend among seniors. Evident from Figure 1.9 (Structure Type by Age of Primary Household Maintainer) below, as seniors move into older cohorts, senior population starts to downsize from detached housing to apartments. The demand for rental units in condominiums, apartments, and retirement facilities will be expected to increase as many seniors will want to go from larger to smaller units as they may not require the excess space in their homes.

A guiding principle for their transition is the level of services, amenities, and transportation they retain in (CMHC, 2012c).

Figure 1.9


Life Lease A popular nonconventional retirement home tenancy choice for those deciding to age in place is a life lease. It is a legal agreement that grants the buyer the Right to Occupy a specific unit/suite for a price that is at fair market value. Monthly payments will cover maintenance and operating fees (water, electricity, cable) for the building, much like a condominium or apartment. This form of residency is popular as residents can submit a deposit and are sold life lease interests which can be used to generate equity in the development to secure construction financing. Once these units are complete, residents finalize the purchase of the units and the additional funds are used to pay off the construction loans borrowed during the development stages. As developers do not profit from such projects, they are usually non-profit groups. Upon the completion of the project and final buyer payments, developers are left with no financing on the property. These non-profit organizations can also build relationships with assisted-living or long-term care facilities. At any time, they can sell the lease (at market value) to receive 90.0 to 95.0% of what seniors pay for. They have exclusive use of their own property and share common facilities and benefits. Tenants are responsible for home repairs within their own units, property taxes, and expenses. As of 2007, Ministry of Municipal Affairs and Housing recorded at least 125 Life Lease housing arrangements (more than 8,500 units). One attractive aspect of life lease buildings is the different dwelling units that an aging population may want to retire into. Life lease projects in the past have included high and low rise apartment buildings, semi-detached/detached houses with prices usually comparable to that of a condominium (Ministry of Municipal Affairs and Housing, 2007). Operating budgets are set by the building owner and tenants have little input on how the building is managed (Ministry of Municipal Affairs and Housing, 2007).

Co-Housing Another aging in place tenure type is co-housing, which is a living arrangement between two or more individuals. They are usually unrelated and share a home situated in a small town community and tight knit neighbourhood. Residents have their own private space, but share a common area such as a kitchen or living room. This tenure type is for people who are unable to live by themselves, but would like to remain engaged and active in the community. Residents can also


assist each other and housing costs are often lower for a senior retiring in this tenure (McDonald, 2011). These growing trends of choosing to age in place accompanied with the new options of a Life Lease and Cohousing will provide alternative solutions to a retirement home or long-term care facility once an individual grows old. Developers have found a market in condominium projects with a focus on mid-rise buildings which targets a younger demographic that wants to live in close proximity to transit oriented services, parks, mixed-use, and walkable streetscapes that are safe, attractive, and well-connected to desirable areas of where they live. Mixing older generations into these neighbourhoods can keep the neighbourhood active and vibrant with a variety of activities and events that will keep them entertained. As well, this retired stay-at-home population is excellent for fostering a sense of community and keeping eyes on the street, which abides by principles of Crime Prevention Through Environmental Design (CPTED) that improve public safety. 3.2.3 Migration: Retirement in Urban and Rural Environments On average, 78.0% of older Canadians choose to reside in an urban community, while only 21% live in a rural community. The average Ontarian has similar preferences to the average Canadian as 83% prefer to retire in urban settings while only 21.0% prefer a rural environment (CMHC, 2012).This could be explained by the many amenities, services, and transportation facilities that typically make up the cluster of an urban core, contrasting isolated and limited facilities found in rural environments. Notably, rural environments have higher rates of ownership as well as limited opportunities for renting (Canadian Home Observer, 2011). Figure 2.0 (Mobility of Changed Place of Residence in Last 5 Years of Selected Age Groups) shows that as people age and move into an older age cohort, they are less likely to move or change their place of residence. The 2012 Canadian Mortgage and Housing Corporation shows an overall 41.3% of seniors in Ontario have changed residences within the last five years.


Figure 2.0

It was recorded in 2012 that a total of 47,200 senior residents lived in an Ontario retirement facility. This number has increased from the 2011 census by 2,400, a quarter of which were coupled residents (CMHC, 2012c). 56.4% of seniors 65 years and older lived as part of a couple in 2011, which has increased from 54.1% a decade before (Statistics Canada, 2011). Senior couples continue to grow as they contribute to the demand for retirement homes, translating to the need for larger units capable of accommodating them. Senior couples in Ontario are seen to be most concentrated in the Greater Toronto Area as it was recorded that 13.4% lived in these areas of Ontario (CMHC, 2012c). This senior couples submarket will mean that room sizes and floor plans in long-term care and retirement homes will need to be configured to accommodate this trend.


3.2.5 Push Factors: Problems that Create the Market Aging in place will become a reality for a large proportion of these seniors. Long-term care and retirement homes target those aged 75 and above, as this cohort has the largest need for support and assistance. Younger seniors on the other hand will opt to remain at home or downsize to more manageable units to retain their independence (CMHC, 2012b) with a lesser demand for long-term care or retirement residency. Push factors for the senior housing market include:  The need for constant health care or

A survey reveals that at least 85 percent of those who were 55 and older said they plan to remain in their current residence for as long as possible (CMCH, 2008).

monitoring for seniors. As people age, they develop more severe diseases that require medical attention and monitoring (e.g. physical inability, Dementia). Often this service cannot be provided by unqualified family members.  Family members who have taken upon the responsibility of looking after seniors may not have the time to continue this duty, either due to the rising demands it involves or to a demanding personal schedule.  Loneliness and isolation are psychological issues for retirees. They may seek social companionship unavailable at home as family members have their own schedules to attend to throughout the day.  The death of a family member or close friend is often overlooked as a cause for moving into a retirement home. This would explain the exponential increase of seniors moving into retirement homes as they enter new age cohorts.  Unfriendly environmental design of current homes (which includes the lack of accessible features such as handrails and elevators) could frustrate disabled or less able-bodied seniors.


Those aging in place expect their environment to be modified in order to help them do so (McDonald, 2011). Those who cannot afford retrofitting or other aging-in-place-related expenses and do have other sources of funding (be it from the government, family members, or a third party organization) may not be able to do so. Immune to issues of finance, other obstacles for homeretrofitting exist as a result of the location, structure, or dwelling type that residences choose to remain in. For example, certain dwellings may prohibit retrofitting, or the building design simply cannot accommodate it, or the age of the home itself would not support such installations or changes. Realistically there are many requirements that must be overcome in order for seniors to age in place, regardless of whether the environment is rural or urban. Although seniors have unique needs stemming from their economic, ethno-cultural, or personal backgrounds, certain limitations exist regardless of these factors. 3.2.6 Pull Factors: Responding to the Market Trends Transitions from working to retirement life will involve employment-related activities will be replaced with social entertainment and recreational activities that will allow for a healthier and more active lifestyle upon retirement. Residential surroundings and support services around the area are crucially linked to how desirable or sought after a location will be for those wishing to retire. When evaluating retirement residence options, seniors will not only look at the home itself, but also look in the broader area for: ďƒź A range of amenities, activities and services offered such as medical facilities and the need of being within close proximity to family and friends. Older Canadian lifestyles now demand more activity to keep them entertained and socially engaged with the community. Because Canadians are working until later stages of their lives, they are wealthier and more active than ever before. A mix of services and amenities within close proximity to where they retire will be required to satisfy and fulfill their desire of living healthier, happier and more sustainable lives. These will also include services and facilities to medical centres, religious institutions and other needs in a senior’s life.


 Locations which are safe, sound and secure. Well-lit environments promote community and social cohesion within the surrounding neighbourhood.  Variety of transportation options (walking, public transit, automobile usage) to support the variety of lifestyles experienced by a new breed of healthier retiring seniors.  Diverse range of housing options to address issues of affordability, mobility, and other needs that better the lifestyle of an aging population. They should be retrofitted to be suitable to an aging population’s diverse needs.  Living environments are tailored and customized to accommodate specifically for aging seniors with mobility issues (ramps for wheelchairs and handles bars along sidewalks/homes) or suffering from health problems such as guided signs. Height, doors, room sizes, and hallways should be carefully retrofitted to accommodate those with wheelchairs, mobility issues, and health concerns. Designs should not be institutional, but rather give residents a sense of homeliness and voluntary permanence.  Environmentally friendly alternatives such as green roof technologies will not only benefit the environment and entice seniors to choose a residence, but can also lower operation and utility costs.

Developers, investors and interested parties can benefit from the market generated by the needs of this growing aging population in ways that will benefit seniors as well. They must however, be mindful during the planning stages of development as the senior retiree market is greater than ever before and will continue to increase as long as the baby boom generation and its echo exists. Movement patterns, affordability, and preferred locations of retirement data should be analyzed in the face of healthy competition. An understanding of the background planning context of local community needs and wants will be important in the decision making process for creating facilities for an aging population.


3.3 Demand An estimate for long-term care demand, based on population, can be determined by approximating 90 to 100 beds per 1,000 people over age 75 in a given area (Central East CCAC, 2013). Currently there are 210 long-term beds in Ajax, according to the Central East Community Care Access Centre (CCAC) bed listing, and 3,975 people over 75 years of age in Ajax, according to the 2011 Stats Canada Census. From this data, it can be calculated that in 2011 there was a need for 147 to 185 more beds in Ajax, a number which will increase each year as the population over 75 continues to age. 3.3.1 Capture Rate The capture rate is the ratio of persons aged 75 and older living in a seniors’ housing type to persons aged 75 and older in the geographic market population (CMHC, 2012), expressed as a percentage. It will be important to monitor the capture rate over the next decades, as it will reflect the extent to which retirement homes capture the attention of the baby boomer cohort. Because long-term care homes and retirement residences are technically separate types of senior housing with different operational aspects. 3.3.1.1 Retirement Residences 

Greater Toronto Area o The capture rate in the Greater Toronto Area was 3.6% in 2012. o The total number of spaces was 15,405 within 157 residences. o The number of residents was 13,803 from an estimated population of 378,650 aged 75 and older.



Durham Region o The capture rate in Durham region was 5.4% in 2012. o The total number of spaces was 1,991 within 23 residences. o The number of residents was 1,873 from an estimated population of 34,770 aged 75 and older.


3.3.1.2 Long-Term Care Homes 

Ajax o The capture rate in the Town of Ajax was 5.2% in 2011. o The total number of spaces was 210 within 2 residences. o The number of residents was 208 from an estimated population of 3,975 aged 75 and older.

Ontario o The capture rate in the Province of Ontario was 8.5% in 2011. o The total number of spaces was 76,073 within 634 residences.

The number of residents was 75,312 from an estimated population of 874,060 aged 75 and older.

3.3.2 Vacancy Rate Vacancy rate is calculated as the percentage of all available units in the property that are vacant and ready to be rented, units that have been turned off upon the exit of a tenant, and units that are not currently rentable because they are in need of repairs or renovations. The vacancy rate does not distinguish between occupants with meal plans or medical services and those without. It is affected by supply and demand; the higher the supply or the lower the demand, the higher the vacancy rate. 3.3.2.1 Long -Term Care Homes Between 2010 and 2011, Ontario accommodated 99,341 residents to their 76,073 long-term care beds, and employed a 31.9% turnover rate. In 2011 bed occupancy was maintained at 99.0% throughout the province, with the average length of stay for a resident being 1144 days (OLTCA, 2011). Throughout the year, long-term care homes in Ontario typically only have a 1.0% vacancy rate, putting 19,000 Ontarians on the waiting list for long-term care placement in July of 2011. This reflects the high demand and low supply for long-term care beds (see 3.3.3 Waiting Lists for a quantitative breakdown of waiting lists).


Discharge Data from 2010 and 2011 show that 32.4 % of the residents living in long-term care in Ontario were discharged in the fiscal year.

Average wait time across the province is 76 days (OLTCA, 2011)

From this number, 45.9% died in the facility, 21.5% were discharged to acute care/other hospital, 19.8% were discharged home and 12.7% were discharged to residential care (OLTCA, 2011). This low number of discharges per year, coupled with the long waitlists, gives an indication of the high demand for long-term care beds that supports this study and the need for the redevelopment of Ballycliffe Lodge. 3.3.2.2 Retirement Residences

Senior retirement residences typically have higher vacancy rates than those of the average rental market. This is a result of higher rents and more frequent turnover, but services and amenities provided in seniors’ residences are also strong contributors. In the period between 2008 and 2012, the overall vacancy rates in Ontario rose slightly by 1.9%. In contrast, Durham Region’s vacancy rates fell by 0.4% in part as a result of a stronger economy that had a better ability to rent.

Ontario vs. Durham Region

Vacancy rate

Vacancy rates (2008-2012) 17% 17% 16% 16% 15% 15% 14% 14% 13% 13% 12%

Ontario Durham

2008

2009

Figure 2.1 (CMHC 2008-2012)

2010 Year

2011

2012


Below are the 2012 vacancy rates in both Ontario and Durham Region:  Ontario o Vacancy rates fell across all senior housing unit types; Priciest spaces (over $3,500 per month) experience the largest vacancy rate decline. o Fell to 14.4% from 15.7% in 2011 Assumptions: o Vacancy rate declined due to strong demand for newer supply in Ontario. o New demand for private/studio spaces (which are typically more expensive) outpaced the growth in supply causing a vacancy rate decline in the highest priced space.  Durham Region o Vacancy Rate remained unchanged from 2011 at 14.4%. o By Unit type: Lowest vacancy rate was the two-bedroom (9.0%); highest was the private/studio (15.0%) (Figure 2.2) o By Rent: Lowest vacancy rate was the $3,001 - $3,500 range (10.7%); highest was the $2,000 - $2,500 range (37.7%) (Figure 2.3) o Heavy Care Spaces: 1.4% vacancy rate with an average rent of $4,019. Figure 2.3 (CMHC 2012)

Figure 2.2 (CMHC 2012)

Durham Region

Durham Region

Vacancy Rate by Rent Range - 2012

Two Bedroom

9.0

Vacancy Rate (%)

0.0

5.0

10.0

15.0

20.0

$3,501+

15.0

$3,001-$3,500

Private/Studio

2012 $2,501-$3,000

14.4

2011 $2,001-$2,500

One Bedroom

40 35 30 25 20 15 10 5 0

Vacancy Rate (%)

Vacancy Rate by Unit Type 2012

Rent Range

Assumptions: o Vacancy rate remained unchanged in the past year; however, vacancy rates remain low due to strong demand for newer supply in Durham Region o Vacancy rate is the lowest in the two-bedroom category of unit types; this can be attributed to lack of two bedroom suites in Durham Region, or seniors’ preference.


o Vacancy rate is the highest in the private/studio unit type; this could be due to high supply in these unit types, or seniors’ preference to live in other types of units. o Vacancy rate is the highest in in the $2,000 - $2,500 rent range; this could mean seniors’ prefer a higher quality and size unit type which are more expensive. 3.3.3 Waiting Lists for Long-Term Care Homes in Ajax Wait times vary widely by across LHIN and are reduced for those who were admitted to their 2nd or 3rd choices (OLTCA, 2011). Long-term care waitlists are strictly legislated by the MOHLTC and managed by CCACs throughout Ontario. In February of 2013, Ballycliffe Lodge only offers an internal waitlist for admittance to a private accommodation bed (Central East CCAC, Personal Communication, February 14, 2013). Since wait times are approximate due to the impossibility of predicting actual discharges in the future, previous months’ turnover rates for particular accommodations are used in order to make an educated prediction (Central East CCAC personal communication, February 14, 2013). Wait Times

Basic Accommodation

Ballycliffe Lodge

Winbourne Park

Male

Female

Male

Female

2 years

1.5 years

2

2

2

2

Private Semiprivate Dementia-Care Ward

1 years

3-6 months

N/A

N/A

N/A

N/A

1.5

1.5

Figure 2.4 (Central East CCAC personal communication, February 14, 2013)

Wait times for the only other long-term care home in Ajax, Winbourne Park, were also found to complete the demand for long-term care and types of accommodations in Ajax (Fig. 2.4). This facility does not have any semi-private accommodations, however provides a secured ward for dementia clients, having a wait time of 1.5 years for these basic type beds (Central East CCAC, personal communication, February 14, 2013). The lack of available secure ward beds in Ajax , gives reason for a redevelopment at Ballycliffe Lodge to include this type of specialty care unit within its expansion.


The long wait times for long-term care homes can be attributed to a mismatch between supply and demand and a poorly designed system, however, many initiatives are underway to try and increase patient flow and reduce waitlists for long-term care in Ontario. These initiatives are outlined below, as taken from the current Five-Year Strategy for Innovating Ontario’s System of Care for Older Adults (OLTCA, 2011). 

Streamlining the assessment and placement process and making it easier for consumers to navigate and plan their own care

Rebalancing the long-term care bed mix to provide more short stay, respite and convalescent care thereby relieving pressure on hospitals, home care and frail Ontarians and their families.

Reserving long-stay beds for persons with the heaviest care needs and building capacity to look after higher need residents through new models of service delivery

Undertaking comprehensive service planning that works across LHIN boundaries and is responsive to emerging demand for, and supply of aging care ‘places’ and ‘spaces’ in a wider variety of settings including supportive housing, retirement living and day/night programs

Leveraging the redevelopment of 35,000 long-term care beds to meet emerging consumer preferences and system needs, including the needs of rural communities

Moving to a financial and regulatory framework that incents and rewards system-wide improvements in access, quality, cost and consumer satisfaction. This proposed long-term care Innovation strategy will not only reduce the wait times for

long-term care beds, but also intends to reduce the need for new beds. The outcome of this strategy includes a 36.0% increase in long-term care capacity through modest improvements in long-term care occupancy and length of stay and rebalancing of bed types (OLTCA, 2011). This is notable for the purpose of this study as only a modest improvement to occupancy will be required for the future as other initiatives are being implemented to accommodate the upcoming demand without a substantial increase in bed supply. According to the 2011 Walker Report, the estimated annual demand for long-term care will be approximately 112, 000 by 2016 (OLTCA, 2011).


3.3.4 Absorption Rate The Absorption Rate is used to measure a market’s internal supply and demand for senior housing facilities. It uses the current inventory of facilities that are up for sale and compares it to the recent history of sales (per month) to determine the market’s current sale rate. In Durham Region the total number of units is 2,780 units from a total of 19 facilities. In regards to retirement residence suites, the rate will depend on the amount of vacant units currently in the market. Assumed is a rate of 3 to 5 resident move-ins per month, allowing that there is a positive room in the market. In addition, 6 months prior to the opening of a retirement residence, it is assumed that 10.0% to 15.0% of the total suites will be reserved and occupied within the first month. In terms of long-term beds, current demands and waiting lists are strong therefore a new long-term care home could fill up within a period of 2 months.

3.4 Supply 3.4.1 Current Supply 3.4.1.1 Long-Term Care Homes As of 2012, Ontario’s supply of long- term care homes was recorded to be 634 with 77,863 Figure 2.5 (LTCIEP,2012)


beds across the homes. 97.0% of these beds were long stay beds (LTCIEP, 2012). Figure 2.5 shows the breakdown of long-term care beds and the number of beds used for long stay and short stay. As of July 2011, 99.0% of Ontario’s long-term care supply of beds was occupied with approximately 19,000

“The supply of [long-term

Ontarians waiting for a long-term care space. 60.0% were

care] beds varies substantially

reported to be in the high needs category and 28.0% were

within the LHIN. Supply is

in the crisis category (LTCIEP, 2012). These figures note

lowest in Durham Region.”

the importance of the large amount of long-term care (Sinha, 2012)

beds required by retiring citizens. Average wait times for a long-term care placement

in Ontario was recorded to be 76 days, but it should be noted that this varies from region to region. Place of residence such as those in hospital (64 days) will have shorter average waiting times than those coming from their homes or the community (132 days) (LTCIEP, 2012). 3.4.1.2 Retirement Homes From 2008 to 2012, close to 9,900 new spaces were added to the market (Fig. 2.6), representing an increase of almost 24 per cent (CMHC, 2008 - 2012). This increase in construction was driven by market expectations that demand for retirement homes will pick up with the aging of the population, despite the fact that vacancy rates have slightly increased between 2008 and 2012.

Durham Region

Ontario Supply (2008-2013)

Supply (2009-2012) 2,200

55,000

2,000

50,000

Supply

Supply

1,800

45,000

1,600

40,000

1,400

35,000

1,200 1,000 2009 Year

Figure 2.6 and Figure 2.7 (CMHC 2012)

2010 Year

2011

2012


In Durham region, the region experienced an increase of 40.0% with close to 574 new spaces (Fig. 2.7). This increase was mostly driven by a stronger market and demand, as well as decreasing vacancy rates. As of 2012, the total number of residences in Ontario increased to 671 homes,

Greater Toronto Area

supplying the market with a total of 51,300

Total Spaces by Unit Type - 2012

spaces (CMHC, 2012). Newer supply of large

3%

size residences brings up the total supply of

Semi Private & Ward

5%

Private/Studio

spaces in the Ontario market. Homes with 90 40%

or more spaces made up 57.0% of the total

52%

supply in Ontario. In the Greater Toronto Area,

One Bedroom Two Bedroom

the share of the total spaces by unit type (Fig. 2.8)

comprises

of

mainly

private/studio

Figure 2.8 (CMHC 2012)

(51.8%), and one-bedroom units (39.7%). For the year of 2013, total supply is expected to increase by 2.7% to a total of 52,700 spaces as a result of an addition of 14 new homes with 1,370 spaces opened in 2011. This is the lowest growth rate since 2007. The area that is said to capture the majority of these new spaces will be the Greater Toronto Area, with 540 spaces. In terms of what future supply can

Durham Region

Capture Rate

Capture rate (%)

a market area successfully accommodate,

5.9%

the current capture rate must be

5.3%

compared to the historical capture rates

4.7%

for Durham region. According to data Capture rate

4.1%

taken from CMHC, between the years 2009 and 2012 the capture rate has

3.5% 2009

Figure 2.9 (CMHC 2009-2012)

2010

Year

2011

2012

steadily increased (Fig. 2.9). This could mean that the current supply to the


market is a desirable one since the capture rate was in fact improved by about a 35.0% increase over a 3 year period. However, it must be noted that factors such as levels of home care available and/or rates of seniors living on their own could adversely affect the capture rate in the future, therefore altering the future necessary supply of senior housing to the market.

3.4.2 Competitive Market Analysis To set the stage for developing the Ballycliffe Lodge long-term care and retirement residences, it is important to identify the currently existing long-term care residences and retirement residences as they will be competitors. In Durham Region there are a total of 18 competitors, excluding Ballycliffe Lodge, defined as licensed and registered operators of long-term care and retirement residences. The two closest currently existing competitors are Winbourne Park and Bay Ridges (3.2km North West and 4.9km South West of the Ballycliffe Lodge site, respectively). By examining the number of available units, the future market supply and demand for seniors housing residences can be forecasted. Furthermore, in order to appeal to the evolving demands of today’s seniors, residences are offering a wide variety of services and amenities. This information will help provide a competitive advantage over nearby retirement homes and long-term care residences and will help attract seniors to the proposed development. According to the CCAC (2012), there are a total number of 2,780 units spread among 19 longterm care and retirement facilities within the Regional Municipality of Durham. There are 869 private, 891 semi-private and 984 basic units available. The breakdown of these units by private, semi-private, and basic room types is referenced in Appendix II (Figure 1.0)


4.0 SITE ANALYSIS 4.1 Historical Context Ballycliffe Lodge is located in Ajax and sits in an important historical part of this town. Originally, the land around this area was once a farmland from earlier pioneers. Before the war, the land expropriated West of Dufferin Creek, East of Pickering road, South of Lake Ontario and North of 401 Highway was used as a munitions manufacturing site named the Defense Industries Limited (Green, 1995). Development of the town was led by the Central Mortgage Housing Corporation (CMHC) that built houses in the area, surveyed new streets, laid lots and established sewers, hydro and water lines, opening up development for more settlers in the new town (Smith, 1995). In recent history, the site was known as the Carousel Motel, and provided conference and entertainment services (Town of Ajax, 2012). The Ballycliffe Lodge site is a brownfield as previous uses on this land included the manufacturing of munitions and dynamite testing. With knowledge of the long-term externalities of such uses on a site, an environmental assessment is recommended prior to pursuing development or redevelopment on the site. Measures must be taken to avoid potential repercussions that could endanger the future health of the environment or occupants.

4.2 Site Location and Neighbourhood Ballycliffe Lodge is a 141-suite senior housing development sitting on a lot that is approximately 16820.3 square metres or 1.68 hectares in size. It is within the jurisdiction of Ward 3 of the City of Ajax, within the Region of Durham in southern Ontario, and on the eastern portion of the Greater Toronto Area. Ballycliffe Lodge is situated at 70 Station Street just off of the intersection of Harwood Avenue South and Highway 401. The residence specializes in retirement living as well as long-term care incorporating “a long standing reputation for quality care, and sense of community” as well as a comfortable and customized lifestyle to suit senior’s needs. In addition to the residents, there are currently approximately 130 full-time and part-time staff members, yielding asite occupancy of typically 271 people. This number fluctuates to reflect visits from family members, physicians, and other guests.


Downtown Ajax is a designated Regional Centre, also known as the heart of the town’s concentration of civic and employment activity. Although the City of Ajax has a busy downtown in today’s world, there are plans underway to begin revitalizing its downtown area, also known as Ajax City Centre, to replace what is now a relatively rundown low-rise industrial and commercial area. Ballycliffe Lodge is included in this important area, as it is bound by Clements Road, (beyond the Rouge Valley Hospital) north to Highway 401 and centred around two main arterial roads: Harwood Avenue, a ceremonial route and the primary north-south road connection to the Uptown Centre; and Bayly Street - a main east-west corridor, providing access to Highway 401 and adjacent employment lands. In the future, Harwood Avenue and Bayly Street are planned to become an urbanized modern area, with high-rise condos, office towers and mixed-uses along landscaped streets. Currently, Ajax serves as a “bedroom community” to the City of Toronto, where many residents live and commute into downtown Toronto or other communities of Durham region. Ajax still principally consists of large single-family detached houses on separate lots and is extremely auto-dependent, resulting in much traffic congestion and little use of public transit due to a lack of realistic alternatives. The City of Ajax acknowledges that the downtown area (which includes Ballycliffe Lodge) “does not currently reflect the forward-thinking, progressive values and priorities of Ajax as a community. Although it is home to many landmark sites and historic roots, the Downtown as it exists today lacks identity, vibrancy and a true sense of place which is vital to engage residents, businesses and tourists.” (The New Downtown Ajax, n.d.) Site Quadrant

Description

West

The parking lot is not utilized close to or at full capacity. It is a typical concrete and asphalt parking lot but dilapidated cracking is apparent. It can be considered for other uses. Sound barrier and rear fences are in poor condition and require attention due to noise from heavy traffic on Highway 401. Rear greenery appeared overgrown and not maintained. Waste and recycling facilities are exposed in open space revealing piles of garbage and junk. The parking lot on this side of the property is heavily used by staff, visitors, and residents. Its condition is close to capacity. Narrow road in front of the housing complex serves as entrance to both facilities and provide limited parking. General landscaping fronts the property onto the street. There are no sidewalks or pedestrian crossings for users, visitors, and staff. Such pedestrian uses should be considered in redevelopment.

North

East

South


4.2.1 Site Photos

EAST QUADRANT (looking North)

NORTH QUADRANT (looking North)

SOUTH QUADRANT (looking West)

WEST QUADRANT (looking North)


4.3 Zoning and Land Use The site is currently zoned under the Town of Ajax Zoning Bylaw as Downtown Centre Area – Industrial (DCA/I) which permits uses such as nursing homes with a minimum density of 1.25 the area of the lot. The maximum permitted building height is 28 meters (8 stories). Permitted land uses in DCA/I districts include, with some requirements, a range of community uses from daycare facilities to community centres (Town of Ajax, 2013). Zoning Details for Downtown Centre Area – Industrial (Nursing Home) Zoning Front Yard Build and Exterior Side Yard Build Minimum Setback from Rear Lot Line Minimum Setback from Interior Side Lot Line Lot Coverage

Minimum and Maximum Height

2.0 – 4.5 m (6) 9.0 m 5.5 m 40.0% Min. - Buildings (including underground parking covered by landscaped open space, and above ground parking structures 15.0% Min. - Landscaped Open Space 30.0% Min. - Surface Parking / Driveways/ Loading and Service Areas (excluding private roads) Min – 2 Storeys/6.0 m Max – 8 Storeys/28.0 m

The Official Plan land use designation for 70 Station Street is Downtown Central Area – Mixed Use (Town of Ajax 2009). This translates to intent to eventually change zoning for the site. In effect, certain uses currently permitted will be prohibited. Conversely, a combination of retail commercial, office, and/or residential uses in the same building with non-residential uses at grade level will be permitted. Appendix II (Figure 2.0) shows industrial and mixed use permitted uses. Given these provisions, certain uses should be noted for their potential inclusion or consideration in the redevelopment of Ballycliffe Lodge. However, this list should not limit the potential of redeveloping Ballycliffe; uses not explicitly permitted may also be incorporated but may require a minor variance application.


4.4 Area Context Site Quadrant North South East West

Description HWY 401; further north is a low-rise residential neighbourhood. Low-rise industrial buildings exist south of the site. To the immediate east is a six-storey apartment building (social housing); further east is a Library. West of the site are low-rise industrial buildings.

4.5 Environmental Considerations The Ballycliffe site is not prone to environmental harm and there is no immediate danger or environmental considerations that need to be addressed. Its location within the Great Lakes watershed, soil types Guelph and Fox (Soil Research Institute, 1960) and existing natural species pose no threats or constraints to redevelopment on the site.

4.6 Proximity to Services and Amenities Ballycliffe Lodge includes amenities such as: common areas, a dining room, lounges, an activity room, hair salon, library area, and an outdoor enjoyment area equipped with landscaped grounds and a patio area with a garden. The home includes a range of support and wellness services such as: a variety of services to promote and maintain individualized independence and wellness; nursing and personal care is provided on a 24 hour basis; assistance with activities of daily living provided by and under the supervision of a RN or RPN; physicians visit weekly, healthcare monitoring, rehabilitation and Restorative Care services; all housekeeping and laundry services, including personal items, are included; professional on-site management; unlimited access to scheduled life enrichment programs in recreation, leisure, social arts, entertainment and fitness; and scheduled outings. Ballycliffe Lodge is accredited by the Canadian Council on Health Services. In terms of Dining services, three meals are served daily with snacks between meals. Ballycliffe Lodge accommodates special and therapeutic diets, dietary supplements and devices enabling residents to feed themselves. A range of restaurants, grocery and retail stores, and specialty food stores in the neighbouring area provide alternate food choices. Health and wellness services, banks, some recreational facilities are also available.


Although the neighbourhood appears to have a fair variety of services and amenities, these uses are largely incompatible with a senior’s lifestyle and daily needs; they are not catered towards seniors. The senior’s basic and essential care needs are met on a daily basis, so anything outside of the care home, if it can be reached, is added enjoyment to everyday life. The problem with this neighbourhood is that recreational activities and shopping availability is limited. The community centre, as well as the local church and library are the only available facilities for seniors to attend and feel comfortable. Furthermore, the neighbourhood itself is not pedestrian friendly, walkable or transit-friendly. The neighbourhood is mixed with big-box plazas and small businesses with large parking lots and busy roads that discourage pedestrian use. For those with the greatest need for a pedestrian friendly neighbourhood, it is likely that the seniors of Ballycliffe Lodge are not able to leave their home often. It is important that all members of a community feel safe, sound, healthy and at home in their neighbourhood. Thus far, the neighbourhood surrounding Ballycliffe Lodge is not one that supports residents of this senior home.) How could this situation be improved for the residents of Ballycliffe Lodge? An issue faced by the Ballycliffe Lodge site is the limitation in space, particularly green space. As mentioned previously, it sits in an extremely inaccessible and sprawled-out neighbourhood, ensuing that residents are unlikely to leave the home to pursue activities in the neighbourhood. One way to solve this issue is to bring new recreational services and amenities to the site itself. A retirement home incorporating new, mixed uses allows for diversity and vibrancy and excitement without the discomfort of leaving home. A complete community is connected, vibrant and complete. To allow those to experience this in the comfort of their own home will likely increase the value and enjoyment of life at Ballycliffe Lodge, making up for a lack green space and civic space surrounding the site. What services and amenities could be implemented in the neighbourhood of Ballycliffe Lodge to build a complete community that includes seniors? The neighbourhood surrounding Ballycliffe Lodge is planned by the Town of Ajax for revitalization, with the designation of a Downtown Centre Area. With a new community centre, library, and town hall nearby, there is room to improve and rebuild the remaining community that can bring vibrancy that is currently lacking to the area. Due to poor neighbourhood accessibility and


the lack of enticing amenities catered towards seniors, residents of Ballycliffe Lodge likely do not spend as much time as they would like to outside of the home. One way to improve this situation is to redevelop the Ballycliffe Lodge home with services and amenities attached on the ground floor of the home, much like new mixed-use developments that establish commercial and retail ground floors with residential uses on the floors above. However these ground floor uses do not necessarily have to be commercial. For residents of Ballycliffe Lodge that are willing and able to be mobile in the neighborhood, it is essential to make sure that there are services and amenities available to them that allow them to feel integrated in the community so as to feel empowered that their life is not limited to the home. Furthermore, the added services and amenities contribute to sustainable development and a complete community; these features can also be made open to benefit other members of the community. Added services and amenities attached to the redevelopment of Ballycliffe Lodge will ensure that residents will receive the level of independence they desire, without sacrificing health and security.


4.7 Transportation 4.7.1 Employee Demand There are approximately 130 full-time and part-time employees currently working at Ballycliffe long-term care and retirement residence. Out of these 130 employees the majority of them use their own vehicles as means of transportation and only five to ten employees take public transit. Currently, there are no employees that make use of GO Transit (personal communication, January 23, 2013). 4.7.2 Existing Transit Infrastructure Local and regional transportation services in the Town of Ajax are provided by Durham Region Transit (DRT) and GO Transit (iTrans Consulting INC. 2007). GO Transit provides both rail and bus service through Ajax. The Ajax GO Station located at Westney Road immediately south of Highway 401 and is the major north-south road west of the Ballycliffe site. Ballycliffe falls within the designated Downtown Ajax Transit hub which is where all local transit routes traverse. (iTrans Consulting INC. 2007). The DRT 218 bus services Ballycliffe and travels along Station St. and Harwood Ave. Service is every 30 minutes and goes through the regional centre area and back to the Ajax GO station (Durham Region Transit, 2013). DRT offers accessible bus service that enables passengers the flexibility of using conventional transit routes rather than depend on DRT Specialized Services (wheel trans) exclusively (Durham Region Transit, 2013). Access to scheduled transportation for local shopping is also offered for the residences of the Ballycliffe Lodge retirement home (Chartwell, 2009).


4.7.3 Existing Road Networks Hardwood Avenue is the major north south road east of the Ballycliffe Lodge site. Harwood Avenue is classified as a Type C Arterial road under the Town of Ajax Transportation Master Plan and has a designated right of way (ROW) of 26 metres (Fig 3.0). Station Street, on which Ballycliffe Lodge is located, is classified as a local road with a ROW of 15 metres (Town of Ajax, 2012). The Realignment of Fairall/Station Street is a notable transportation project affecting the Ballycliffe Lodge site. Works are currently underway to eliminate the jog that exists between Fairall Street and Station Street, which contributes to traffic congestion and hinders efficient flow of people and goods at the two intersections during peak traffic hours. This realignment will enhance this intersection to create a vital gateway to the downtown district.

Figure 3.0 (WHAT IS THE SOURCE???)

Fig.3 (Town of Ajax,2012)

4.7.4 Wheel Trans Wheel Trans is available within the City of Toronto and up to one kilometre into the adjacent regions of York, Durham, and Peel. However, the city has set up transfer points (locations) with other regional para-transit services, upon a required fare to Wheel Trans. Should the resident of


Ajax need to use Wheel Trans on a regular basis, the resident must arrange an eligibility assessment interview (Durham Region Transit, 2013). Transit in Ajax is under the jurisdiction of the Pickering Transit Authority. Pickering

Transit

Authority has DRT Specialized Services for temporarily and permanently disabled residents of Durham Region, which provides accessible door-to-accessible transit service for those who cannot board conventional buses or walk 175 metres (Durham Region Transit, 2013). A resident must meet the eligibility criteria and complete an application form to qualify for this service (Durham Region Transit, 2013). Contracted taxis (accessible vans and sedans) are used to enhance DRT Specialized Services (Durham Region Transit, 2013). Because of the lack of accessibility to those who are disabled or fragile within the region of Durham, especially senior citizens, Ballycliffe Lodge should consider providing its own Wheel Trans service for residents.


4.8 Opportunities and Constraints This section of the report provides a detailed investigation into the opportunities and constraints of the subject land to support and critically consider the future redevelopment of Ballycliffe Lodge. This planning tool is used as a way to record, evaluate and analyze a site area in light of either positive and negative existing or potential features of the site to inform the design and consequent development process.

Opportunities Municipal services have previously been installed to service the site, and can therefore be used to accommodate a development on it. The sound barrier between the retirement home and the highway is in need of rehabilitation/replacement.

Existing Site Condition

Senior residents living in the facility may want to walk to nearby areas but feel restricted. Unfortunately, there are no accessible sidewalks or pedestrian crossings leading to the facility.

Constraints Seniors in the target market will prefer low-rise. To better accommodate seniors and respond to demands, a multi-storey may be the better option. This disconnect must be addressed. Proximity to nearby highway and railroad create noise pollution and disturbance for the site. Existing infrastructure and utilities may need to be retrofitted or/and renewed to accommodate a larger facility in the future.

Parking on the West side of the facility is observed to be underutilized and vacant.

Transportation

Area Amenities and Services

DCA/I zoning permits uses such as nursing homes with a minimum density of 1.25 the area of the lot. The maximum permitted building height is 28 meters (8 stories) and will allow for redevelopment of the home. Close proximity to Highway 401, and other major arterial roads such as Harwood Ave. Neighbouring GO station can be used to connect residents, staff, and visiting family to broaden variety of transportation choice. Redevelopment is an opportunity to catalyze the provision of strategic amenities and services that can be used by residents and general community. Redevelopment can improve the level of activity in seniors lives by

No transit stops accessible to Ballycliffe Lodge, disabling seniors unable to drive from leaving and coming to the site. Potential assets to staff could be excluded from working at Ballycliffe.

Limited site area allows for less room to create green space and civic space. Lack of sidewalks and wheelchair accessibility make it difficult getting around the neighbourhood without a car.


including new uses attached to the building Discount stores and thrift shops nearby can cater towards seniors (Ex. Salvation Army, Dollarama, Curvaceous, Consignments).

Weak sense of community completeness or vibrancy could be contributing to low quality of life. Limited services and amenities catered towards seniors could contribute to a sense of disconnectedness and alienation in the community; residents may feel restricted to their home. Routine isolation from their neighbourhood could inhibit current residents from embracing community integration.

Planning Context

CIP grants or loans may be provided to pay for a whole or part of the eligible costs. Programs that are relevant to the redevelopment of the site are: Rehabilitation Grant Program Planning and Development Fees Grant Program Development Charge Exemption / Grant Program Exemption from Parking Requirements Program Policy for Funding Construction Costs will soften costs of constructing long-term care beds. Followed properly, the project will also be more sustainable. Eventual DCA/MU will permit a wider range of uses. As aging and health problems are inevitable, there will definitely be a demand from the 65 to 74 year age cohort that will move into a seniors housing home. Certain existing environmental health and mobility issues can be addressed with retrofitting.

Limited religious or recreational establishments for seniors to participate in. A development charge for the construction of each individual lot includes fees for services such as transportation, police, and; infrastructure such as roads and sewers. There are also institutional building charges which are based off of: water supply, sanitary sewerage, roads, and transit. The specific requirement for zoning and setbacks exist for CN railway, the electrical easement, and interior side and rear lot lines and may limit the desired size capacity of the site. Section 2.5.2.2 Built Form and Architectural Design, Section 3.2.2 Mixed use Areas Intensification Policies. A large portion (85.0%) of the 55 and older population has the intent to remain in their current residence for as long as possible. Aging in place will normally require 3 people (2 full time support staff and 1 part time) for one senior resident who chooses to age at home.

Demand for rental units are expected to increase as many seniors will go from owning to renting due to repairs and maintenance require; they may be unable to do so due to do health problems or inadequate income.

Difficult for some families to take care of those seniors with dementia/Alzheimer’s disease need to be constantly supported and taken care of. Families could spend $1700 as opposed to $60 dollars a day at the home care facility which have support workers (Cohen - L’Chaim Retirement Homes Inc, 2013).

Senior couples continue to grow as they drive the demand for

Primary competitor Revera Winbourne Park long-term care home


Market Analysis

retirement homes meaning larger units will be required to accommodate these needs. This is due to the growing amenities and services that exist alongside retirement homes. ---Couples comprise of 12.7% living in retirement homes and 12.0% compared to total residents. New trends for specialized care treatments such as the Montessori Method used by L’Chaim Retirement Residences can be learned from to help enable older residents with dementia in living healthier, safer and more active lives. Vacancy rates are the highest in for seniors units in the $2,000 $2,500 rent range. This could present an opportunity for developers to come in and build facilities that safe, attractive, and wellconnected.

is 3.2km away from Ballycliffe Lodge location. Longstanding preference for certain unit types (e.g. in Durham Region the lowest vacancy rates were for two-bedroom units) which have been nurtured through regional/cultural attitudes towards home types. Compared to younger individuals and families, the aging population is more likely to choose dwelling types with one floor due to mobility issues that are experienced by some at an older age. Currently the market is in a slow stage of growth. Proposal for number of units to be added into this market’s supply especially for retirement residences must be made with caution and in depth research.


5.0 MOVING FORWARD Ballycliffe Lodge is at the intersection of opportunities. This interim report has established that redevelopment is capable of a spectrum of positive change. Further, it can serve as a catalyst and inspiration for the surrounding community for which the ideas of community vibrancy and completeness come alive using the guiding principles. New, vibrant development can be initiated to create a complete community, as outlined in the objectives of Places to Grow (2005). Planning is for people.

As we advance into the 21st century, people are becoming older and there is a growing need to support our aging citizens. Ballycliffe Lodge is situated in a neighborhood that does not reflect planning guided by principles of sustainability, vibrancy or completeness. It is important to plan to meet the needs of every resident and to successfully integrate all members of the community to allow for each resident of the community to feel a sense of place as well as a sense of belonging. The site, market and planning analysis conducted in this report has allowed for the establishment and creation of the five integral and vital guiding principles that will facilitate the Ballycliffe Lodge long-term care and Retirement Residences redevelopment project. Guiding principles are shared standards that guide an organization or project throughout its life that aid in achieving particular goals, objectives, or strategies and ensures that the planning and implementation process moves forward in a predictable manner and that remains consistent with the shared vision.


5.1 Vision A vision in an urban planning context refers to the kind of place in which the residents of a community foresees their community evolving optimally into. The redevelopment of Ballycliffe Lodge long-term care and Retirement Residence is envisioned to:

1. Enhance Community Structure & Character The community of Ajax, particularly the downtown area which has been designated as a regional centre, is currently a low-rise commercial and industrial area that severely lacks vibrancy, completeness and identity. We envision the redevelopment of Ballycliffe Lodge to act as an inspirational catalyst for the revitalization for the surrounding community, which will connect the site to the surrounding community and therefore create a sense of place as well as a neighbourhood where the residents of Ballycliffe Lodge are easily integrated. Along with the creation of a sense of place as a neighbourhood, we envision recreational and leisurely activities to be incorporated by nearby facilities, as well as cultural programs and intergenerational amenities for an age-friendly place. A mixed use building will attract community members outside of the home to the building to encourage this community amalgamation. Seniors would not have to leave their home to make use of these added services and amenities, while still integrating the surrounding community in order to create a neighbourhood of convenience and familiarity. Furthermore, we envision a turn in neighbourhood atmosphere and aesthetics that will foster innovative urban design tactics.

2. Invest in Sustainability and Built Form In order to adopt forward-thinking and progressive values, Ballycliffe Lodge can set a standard by designing in an innovative, sustainable and ecologically friendly manner thatwill make the most out of its new form. LEED certification will be a goal stemming from this vision, to be achieved through the inclusion of initiatives such as green roofs and community gardens that connect with an indoor courtyard. Mixed-uses will also be used as a means to integrate the interior and exterior of the Ballycliffe Lodge building through ground-floor commercial space. The building is also envisioned to include high levels of advanced safety and security to make residents and related family members feel as comfortable as possible


with the home, especially those in long-term care and dementia care. Such design measures will provide peace of mind. Strategies to implement sound barriers into the site and building to aid in potentially noisy traffic and trains that will come in close proximity with the residence.

3. Promote Accessibility & Building Efficiency Design for Residents Redevelopment of the home is envisioned to go in an upward direction to increase the density of the site without sacrificing residents’ private and communal spaces. Adding floors will accommodate a greater number of aging citizens and those that need special care, specifically dementia care. With added floors, common living and meal areas will be given an extra dimension for strategic design that will make such that are accessible to all residents on each floor. Because the lot area is limited, it is important that the building makes the most out of its square footage by not only creating a smart building design that is accessible and convenient for its residents but one that incorporates other uses on the ground floor, so that seniors are able to live and play in one building. This will work towards supporting those who are unable (or unwilling) to explore the surrounding neighbourhood. This intensification will produce a building and a place that makes the most of its spatial resources.

4. Provide a High Quality Centre that Exceeds Service Standards The purpose of the redevelopment of Ballycliffe Lodge is not only to accommodate more seniors in need, but also to create a building that integrates the people and the place into the community and immediate neighborhood. This will be done by (1) creating effective services and amenities that support seniors lifestyles; (2) creating a building with top of the line safety and security features protecting residents from inside and outside of the home; (3) integrating new, modern technological features; (4) creating healthy living routines and strategies to improve everyday life, social amenities including recreation, leisure, entertainment, interaction with the surrounding community, and intergenerational activities. Furthermore, the home will feature continuing care for independent living, assisted living and nursing care that will be strategically located on multiple levels. Finally, the home will be accredited.


Appendix I - Maps


Audley Rd.

Salem Rd.

City of Pickering

Westney Rd.

Church St.

TOWN OF AJAX Official Plan

Lake Ridge Rd

Schedule 'A' to Recommended Official Plan Amendment No. 38

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As identified in Section (4)1 of Amendment No. 38 to the Town of Ajax Official Plan, the key changes to Schedule ‘A’ of the Official Plan are to re-label Schedule ‘A’ (Land Use) to Schedule ‘A-1’ (Land Use); and amend the boundaries of the Environmental Protection, Open Space, and Rural Area land use designations. Refer to Recommended Official Plan Amendment No. 38 for further details.

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See Schedule 'E'

Lake Ontario

Residential Areas

Mixed Use Areas

Employment Areas

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Environmental Protection

Low Density Residential

Downtown Central Area

Prestige Employment

Open Space

Medium Density Residential

Uptown Central Area

General Employment

Rural Area

High Density Residential

Village Central Area

Employment Policy Area 1

S

Secondary School

Local Central Area

E

Elementary School

Mixed Commercial Corridor

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Secondary School Multi-use Campus

Community Improvement Area

Greenbelt Boundary

Sources: Teranet Inc., 2009 Region of Durham, 2009 Town of Ajax, 2009

Water Supply Plant Town Boundary Urban Area Boundary Special Policy Area Special Study Area

500

250

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500 Metres

June 14, 2010

99


Central East CCAC (9) CSAC du Centre-Est (9) Legend / Légende Cities / Towns " Communities CCAC Offices

Communautés CASC Bureaux

Former CCAC Boundaries !

HaliburtonNorthumberlandVictoria

Oxtongue Lake

D

Villes

Les anciennes frontières de CASC

Major roads

Routes principales

Minor roads

Routes secondaires

Kennisis Lake

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Muskoka East Parry Sound

Fort Irwin

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Eagle Lake Little Hawk Lake ! ! West Guilford

Halls Lake!

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Harcourt

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Ironsides Highland Grove ! Wilberforce Cardiff ! Tory Hill !

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Carnarvon

Haliburton

Ingoldsby

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Minden

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Irondale!

HastingsPrince Edward Counties

Gooderham Glen Alda

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Apsley ! Catchacoma !

Norland

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Burnt River

Lake Dalrymple!

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Peterborough

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Simcoe County

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Janetville

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Haliburton-Northumberland-Victoria

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! ! Haydon Myrtle Station! ! Raglan ! ! Precious Corners! ! Baltimore ! ! Wicklow Colborne ! ! Kirby Enniskillen Tyrone Creighton Heights Grafton Welcome Ashburn ! Myrtle! ! Solina ! Orono " Columbus ! ! Hampton ! ! " Claremont Brooklin Taunton! ! Mitchell's Corners ! ! Port Hope Cobourg Greenwood ! Newtonville Bowmanville ! Brougham ! ! Kinsale Whitby ! ! " " Newcastle Village Courtice ! " " ! Green River ! Whitevale Oshawa Port Darlington Cherrywood Ajax D ! ! " " 0 10 20 " Pickering Village Pickering

York Region

40 KM

Scarborough

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Published May 2006 ©2006, Queen’s Printer for Ontario

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Pubilée mai 2006 © 2006, Imprimeur de la Reine pour l'Ontario


Appendix II – Tables Figure 1.0 Total Beds

Private

SP

Basic

Ballycliffe Lodge Bay Ridges Bon Air Nursing Home Community Nursing Home Pickering Community Nursing Home Port Perry Extendicare Oshawa Fairview Lodge Fosterbrooke LTC Facility Hillsdale Estates Hillsdale Terraces Lakeview Manor Marnwood Lifecare Centre Reachview Village Strathaven Lifecare Centre Sunnycrest Nursing Home

100 124 55

14 100 4

68 16

18 24 35

Retirement Home attached (pall care programs) psychogeriatric care Retirement Home attached

233

83

110

40

Retirement home attached, complex care and dementia care

107

30

36

41

175 198 88 300 200 149 60 100 199 136

7 18 6 180 56 35 7 3 14 13

142 180 18

8

Village of Taunton Mills

120

72

48

The Wynfield Thornton View Winbourne Park LTC Centre

172 154 110 2780

103 34 90 869

69 66 20 984

CE CCAC LTC HOMES

Notes

Whitby Branch

Whitby Branch Total

72 54 18 24 50 49

54 891

64 120 72 60 35 73 117 74

Retirement home next door, specialized complex, dementia care, hemodialysis Hemodialysis Secure Unit, Dialysis, psychogeriatric, wound and skin care Secure Unit, Peritoneal & Hemodialysis, Hemodialysis, Veteran beds Secure Unit Retirement home attached Retirement home attached Dementia Care, young adults unit, functional abilities program, wound care Secure unit, complex care unit, medical services onsite Dementia and younger adults unit Dementia Care, Complex Care


Figure 2.0

DCA/I          

Community centre Crisis Care Facility Day Care Facility Library Place of Worship Recreation Facility School Sports Arena Nursing Home Minor variance for retail store

Official Plan Land Use Designation: DCA/MU  

  

 

Residential apartments Street, block and stacked townhouses, back-to-back townhouses, back-to back stacked townhouses, double-front townhouses, live-work units and A broad variety of retail and service commercial activities All types of office uses Public and institutional uses (public health facilities, places of worship, and all types of special needs housing) Cultural, entertainment and social facilities Community facilities such as a Transit Hub, day care facilities, public parking facilities, parks, urban squares and open space linkages Public utilities


Appendix III – Site Photos


GLOSSARY Age in Place - A term that ensures an older person the opportunity of staying in their own home as he or she ages (Barbara & Duncan, 2008). The success of aging in place can be attributed to the distribution of social services within communities, the built environment in and the number of social interactions and personal connections one has to the outside world (Barbara & Duncan, 2008). Aging in place can also be defined as living within the same community, but in a smaller unit or renting an apartment to avoid having to move into a long-term care facility. Aging in place is often seen as a personal and social symbol of one’s continued ability to be independent, an attribute highly regarded in our society (Sixsmith&Sixsmith, 2008). Community Infrastructure - refers to lands, buildings, and structures that support the quality of life for people and communities by providing public services for health, education, recreation, socio-cultural activities, security and safety, and affordable housing (Places to Grow, 2005). Complete Communities - Complete communities meet people’s needs for daily living throughout an entire lifetime by providing convenient access to an appropriate mix of jobs, local services, a full range of housing, and community infrastructure including affordable housing, schools, recreation and open space for their residents. Convenient access to public transportation and options for safe, non-motorized travel is also provided (Places to Grown Act, 2005). Intensification - The development of a property, site or area at a higher density than currently exists through:  Redevelopment 

The development of vacant and/or underutilized lots within previously developed areas, or infill development

The expansion or conversion of existing buildings. (Places to Grow, 2005)


Redevelopment – the creation of new units, uses or lots on previously developed land (Town of Ajax, 2012). Renewable Energy Systems - means the production of electrical power from an energy source that is renewed by natural processes including, but not limited to, wind, water, a biomass resource or product, or solar and geothermal energy (Town of Ajax, 2012) Retrofit – applies to spaces located within the existing long-term care building or to additional floors added to an existing long-term care building (MOHLTC, 2009a). Special Needs - any housing, including dedicated facilities, in whole or in part, that is used by people who have specific needs beyond economic needs, including but not limited to, needs such as mobility requirements or support functions required for daily living. Examples of special needs housing may include, but are not limited to, housing for persons with disabilities such as physical, sensory or mental health disabilities, and housing for the elderly (Provincial Policy Statement, 2005) Standard Space - A standard space is one that is occupied by a resident paying market rent and who does not receive heavy care (defined as 1.5 or more hours of care per day). A nonstandard space is one in which the residents are receiving heavy care, spaces being used for respite and non-market spaces. This term does not include long term care homes. Supportive Housing – Clients of Supportive Housing live in a specially-designed building, or in a cluster of adapted apartments within an ordinary apartment building, including shared houses or apartments, and self-contained apartments. The buildings are owned and operated by not-for-profit corporations such as municipal governments, housing cooperatives, or non-profit groups including faith groups, seniors' organizations, service clubs, cultural groups, and service providers. Clients of supportive housing do not require the medical monitoring or supervision that would be provided in long-term care, however staff are in the building 24 hours a day and are available to help residents on a scheduled basis, or as-needed. Services provided include attendant services, personal care, essential homemaking and an emergency response system (MOHLTC, 2013).


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Long Term Care Innovation Expert Panel. (2012). Why not now? A Bold Five-Year Strategy for Innovating Ontario’s System of Care for Older Adults. Retrieved from: http://www.oltca.com/axiom/DailyNews/2012/June/LTCIEPFullREport_web_jun6.pdf Ministry of Municipal Affairs and Housing. (2007). Best Practices and Consumer Protection for Life Lease Housing in Ontario. Retrieved from: http://www.mah.gov.on.ca/AssetFactory.aspx?did=4067 McDonald, S. (2011). Ontario’s Aging Population: Challenges and Opportunities. Ontario Trillium Foundation. Retrieved from: http:// www.otf.ca/en/knowledgeSharingCentre/resources/aging_population.pdf Ministry of Health and Long-Term Care (2009). Long Term Care Home Renewal Strategy. Retrieved from: http://www.health.gov.on.ca/english/providers/program/ltc_redev/redev_mn.html Ministry of Health and Long-Term Care (2009). Long Term Care Home Design Manual. Retrieved from: http://www.health.gov.on.ca/english/providers/program/ltc_redev/redev_mn.html Ministry of Health and Long-Term Care (2009). Policy for Funding Construction Costs of Long Term Care Homes . Retrieved from: http://www.health.gov.on.ca/english/providers/program/ltc_redev/redev_mn.html Ministry of Health and Long Term Care (MOHLTC) (2013). Rai-MDS 2.0 LTC Homes – Practice Requirements. Retrieved from: http://www.health.gov.on.ca/en/public/programs/ltc/docs/rai_mds_practice_requirements.pdf Ministry of Health and Long-Term Care (2009). Transition Support Guidelines. Retrieved from: http://www.health.gov.on.ca/english/providers/program/ltc_redev/redev_mn.html Ontario LHINs (2007). Projected Prevalence of Dementia. Retrieved from: http://www.alzheimer.ca/on/~/media/Files/on/PPPI%20Documents/Projected-Prevalence-ofDementia-LHINs-April-2007.ashx Ontario Long Term Care Association (OLTCA)., (2011) – Why Not Now? - Long Term Care Innovation Expert Panel – Five Year Strategy. Retrieved from: http://www.oltca.com/axiom/DailyNews/2012/June/LTCIEPFullREport_web_jun6.pdf


Ontario Ministry of Finance Population Projections Rate. Retrieve From: http://www.fin.gov.on.ca/en/economy/demographics/projections/#s4b

Ontario Non-Profit Housing Association. (2011). Info on Aging in Place. Housing Administration. Retrieved from: http://www.onpha.on.ca/AM/AMTemplate.cfm?Section=Home&TEMPLATE=/CM/Content Display.cfm&CONTENTID=11884 Ontario Ministry of Finance. (2013). Population Projections. Retrieved From: http://www.fin.gov.on.ca/en/economy/demographics/projections/table10gta.html Ontario Ministry of Finance, (2013) Population Projections Rate. Retrieve From: http://www.fin.gov.on.ca/en/economy/demographics/projections/#s4b Places to Grow Act (2005). Retrieved from the Ministry of Infrastructure Website: https://www.placestogrow.ca/index.php?option=com_content&task=view&id=4&Itemid=9 Provincial Policy Statement (2005). Ontario Ministry of Municipal Affairs and Housing . Retrieved from: http://www.mah.gov.on.ca/Page1485.aspx Region of Durham (2008). Durham Region Official Plan. Retrieved from http://www.durham.ca/departments/planed/planning/op_documents/dr_official_plan_2008/20 08dropoc.pdf Region of Durham (2013). Development charges. Retrieved from: http://www.durham.ca/print.asp?nr=/departments/works/fees/development.htm Regional Municipality of Durham. (2013) Development Charges By-law 44-2008. Retrieved from: http://www.durham.ca/departments/clerk/bylaws/bylaw44_2008.pdf

(Sinha, 2012) Developing Ontario’s Seniors Care Strategy: A Central East LHIN Perspective. Retrieved from: http://www.centraleastlhin.on.ca/uploadedFiles/Home_Page/Be_Informed/Sinha_CELHINFin al.pdf


Soil Research Institute (1960) Agriculture and Agri-Food Canada: Soil Associations of Southern Ontario. Retrieved from: http://sis.agr.gc.ca/cansis/publications/surveys/on/on30/index.html Stantec Consulting Ltd. (May 2011). Town of Ajax (South of Hwy 401) Stormwater Mangement Retrofit: Revised Existing Terrestrial and Aquatic Baseline Report. Retrieved from: http://http://www.ajax.ca/en/doingbusinessinajax/resources/PDENG_D_AppA.pdf Statistics Canada. (2010). Population Projections for Canada, Provinces and Territories: 2009 – 2036. Retrieved from: http://www.statcan.gc.ca/pub/91-520-x/91-520-x2010001-eng.pdf Statistics Canada. (2011). Census in Brief: Living arrangements of seniors. Retrieved from: http://www12.statcan.gc.ca/census-recensement/2011/as-sa/98312-x/98-312-x2011003_4-eng.cfm Statistics Canada, (2013). Census Profile. Retrieved From: http://www12.statcan.gc.ca/census-recensement/2011/dppd/prof/details/page.cfm?Lang=E&Geo1=CSD&Code1=3518005&Geo2=CD&Code2=3518 &Data=Count&SearchText=ajax&SearchType=Begins&SearchPR=01&B1=All&Custom=& TABID=1 Statistics Canada., (2013). Portrait of generations – Canada http://www12.statcan.gc.ca/census-recensement/2011/as-sa/98-311-x/2011003/fig/fig3_2-2eng.cfm The New Downtown Ajax. (2013). Town of Ajax by the Lake. Retrieved from: http://www.ajax.ca/en/doingbusinessinajax/downtownajaxabout.asp?hdnContent= The Planning Act (1990). Retrieved from the Ministry of Municipal Affairs and Housing Website http://www.mah.gov.on.ca/Page1760.aspx The Weather Network. Statistics: Ajax, Ontario. Retrieved from: http://www.theweathernetwork.com/statistics/summary/cl6155878/caon0006/metric The Weather Network. Statistics: Durham, Ontario. Retrieved from: http://www.theweathernetwork.com/statistics/precipitation/cl6119511/caon0201 Town of Ajax. (2006).Demographics and Statistics. Retrieved from: http://www.ajaxfirstforbusiness.ca/en/invest/demographicsstatistics.asp


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Town of Ajax. (2013) Development charges. Retrieved from: http://www.ajax.ca/en/doingbusinessinajax/developmentcharges.asp Town of Ajax (2013). The Corporation of the Town of Ajax Zoning By-Law. Retrieved from http://www.ajax.ca/en/doingbusinessinajax/resources/PD_PLN_D_ZONINGBylawNEW2k13 .pdf World Bank (2013). Education Data. Retreived From: http://data.worldbank.org/topic/education World Health Organization (2012). Dementia: A public Health Priority. Retrieved From http://www.who.int/mental_health/publications/dementia_report_2012/en/index.html


Ballycliffe Lodge Retirement and Long-Term Care Home Interim Report