August 7, 2025 | BOMA International, Ella Krygiel
Our population is aging—and the healthcare industry is struggling to keep up with the demands required to care for older Americans. According to the United States Census Bureau, they reported as recently as this past June that older adults outnumber children in 11 states and nearly half of U.S. counties. Their research discovers that though children still outnumber older adults—the gap is narrowing as baby boomers continue to age into their retirement years. So, this brings the question, what does this all mean?
Well, in short, eldercare is expensive. According to KPMG, the cost for nursing homes and adult daycare in the Consumer Price Index have risen at almost twice the pace of overall inflation. This, along with the fact that many older Americans might not have the savings, retirement accounts or wealth to cover rising care-related costs, puts them in a vulnerable position.
Given these challenges, four experts in the commercial real estate industry discuss how the healthcare field can adapt to meet these needs. Read below to learn more.
Building for Longevity and Community
When discussing the healthcare real estate strategies needed to address our aging population, air quality standards were top of mind for Guy Colglazier, VP & GM of the Commercial Division at Aeroseal. “In senior care settings, where respiratory vulnerability and immune sensitivity are more prevalent, the ability to control airflow and maintain clean, well-ventilated indoor spaces can be critical to both daily comfort and long-term health outcomes,” he says. In addition to supporting the wellness of a building’s interior, Breana Wheeler, U.S. Director of Operations at BREEAM points out that we must consider the longevity and adaptability of the building itself. “Healthcare facilities need to accommodate a broader range of physical and cognitive abilities while remaining operational during extreme climate events — including heat stress, which disproportionately impacts older adults.” Wheeler emphasizes that resilience to environmental stressors is not just a design consideration, but a functional necessity for serving a more vulnerable population.
Healthcare Facilities Today aligns with Colglazier and Wheeler’s recommendations, noting that the way a building is constructed can make all the difference in regulating temperatures. For example, they discovered that masonry buildings, compared to buildings made from wood, helps keep the building significantly cooler, which is a great benefit in the summer months. Beyond the operational side of things, Amin Mojtahedi, PhD, Assoc AIA | Design Innovation Manager at HGA mentioned that he’s seeing a growing interest in embedding senior living into the broader civic and cultural life of cities. “For example,” Mojtahedi says.
“Rethinking a library branch as both a literacy hub and a dementia-friendly community center. Urban centers are the best candidates to host the diversity of aging experiences: LGBTQ+ elders, immigrant elders, low-to moderate-income seniors.”
In a similar viewpoint, Rob Zirkle Principal | Practice Group Leader, Vice President at HGA agrees that proximity matters for aging Americans, as he believes that retiring Boomers can “reanimate” downtown spaces.
“They’re healthier, wealthier, and more urban-minded than past generations and value walkability, access to care, and social connection,” Zirkle says. “Proximity matters because seniors are far more likely to utilize care that’s easy to access on foot or by transit.”
Flexible Care Environments
In order to better support growing senior care demands, Colglazier reiterates the focus on air quality and temperature regulation within their facilities. “Advanced air sealing methods can dramatically reduce leakage in ductwork and building envelopes, improving air quality and comfort while cutting operational costs,” he says. “These performance improvements are especially meaningful in senior housing, where even minor fluctuations in air quality or temperature can have serious health implications.” Air-sealing technologies are relatively simple but highly effective solutions that seal the gaps in a building’s structure where air may leak, such as in walls, windows or aging caulking, The Washington Post states. However, as Colglazier describes, even the smallest fixes in sealing in your home or building can result in energy savings of 5 to 10 percent according to the Energy Department.
In addition to air-sealing approaches, Zirkle believes that “the primacy of ‘aging in place’ demands an integrated, phased approach — where active adult communities aren’t isolated endpoints, but gateways into a continuum of care that evolves over time.” He adds: “As residents’ needs change, services and spaces must flex accordingly — from fitness and wellness programming to more clinical care delivery models.” Mojtahedi has a similar view to Zirkle in highlighting care as a “continuum” rather than a stiff trajectory. He suggests that CRE professionals move beyond the “independent vs. assisted” duality and consider more fluid, “dignity-centered” transitions. “This means that design for dementia shouldn’t be a niche, but the baseline,” he says. “Flexibility and adaptability of the space, supported by technology that enables autonomy rather than surveillance, should be added to the baseline.” Mojtahedi raises an important point about designing with dementia in mind. According to the National Library of Medicine, by mid-century, the number of Americans age 65 and older with Alzheimer’s dementia may grow to 13.8 million. This exacerbates the need to consider individual’s differing care requirements.
Creative Solutions
Below, Colglazier, Mojtahedi and Zirkle share their final thoughts for managing the challenges tied to senior care and aging-related real estate demands:
- Update aging infrastructure to suit modern protocols: “Many of the buildings serving our aging population were not designed to support modern energy performance targets or infection control protocols,” Colglazier says. “As a result, issues like duct leakage and inadequate ventilation can go unnoticed for years, even as they directly affect residents’ health and comfort.”
- Prototype new models before scaling them: “We’ve seen success in projects where an idea with potential for great change has been thoughtfully and surgically piloted,” Mojtahedi says. “Imagine temporary leases for recovering seniors, artist-in-residence units for intergenerational engagement, or ‘third spaces’ for informal caregiving networks. Testing an idea at this scale, if successful, inspires confidence and encourages more professionals to stay hopeful and continue imagining better futures for our seniors.”
- Plan with location in mind: “One of the clearest lessons in senior care real estate is that supply remains vastly outpaced by demand — and the gap is only widening,” Zirkle says. “In states like California, progressive land use tools such as State Density Bonus Law are helping unlock density for market-rate senior housing projects. Viable projects must be planned near transit-rich, workforce-accessible locations.”
Real estate solutions for the senior care crisis will be among the many important topics discussed at next year’s BOMA Medical Real Estate Conference, taking place April 29 – May 1, 2026 in San Diego. Plan to join us for medical real estate’s premier education, networking and business development event.
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