Like many Johnson County residents, Betty McKray came to Iowa City to go to college, moved away and came back to retire and enjoy the many amenities of a college town.

"I retired here because it's a great community with so much culture and activities available to people," McKray said. "It's a wonderful opportunity for education, culture and health care."

Jean James works with gallon milk jugs during water aerobics Friday at Melrose Meadows. Press-Citizen/Jason A. Cook

McKray, 83, embodies the population of older Americans that have made Iowa City and Johnson County a retirement destination and helped boost a reputation that continues to foster a growing market for elder care. In the last three or four years, the elder care industry has grown substantially in Johnson County, said David Purdy, executive director of Elder Affairs Inc. The agency provides services to help older adults live in their own home for as long as possible.

The industry growth is mirrored across the state and projections show a senior population boom is soon to come. But Charity Rowley, 74, a Senior Center commissioner, questions whether Johnson County services are ready. Iowa City still is a college town with businesses and retailers that cater mainly to 20-somethings, she said.

"That's partly because many people have not retired yet," Rowley said. "They're waiting for the baby boomers to retire. I'm a Depression baby, and there were fewer of us."

Reasons for growth

Dorothy Brown, 78, reaches for a beach ball while playing catch with Bob Thompson, Carol Thompson, Lida Sigg and Jean James during water aerobics Friday morning at Melrose Meadows. Press-Citizen/Jason A. Cook

"A lot of growth at this point has been by professionals that are bringing their parents here," Purdy said. "New people come here because they have children here. It's becoming a destination to grow older (here). People like the health care, the smaller town setting and social services offered, that's what is making it a destination."

So is recognition in national media. The Wall Street Journal described Iowa City as a favorite place to retire in a 2001 "guide to life after 55" article by Steve Weinberg. In addition, he AARP ranked Iowa City as the sixth-best college town in which to retire.

The assisted living industry responded with a 48 percent growth in the last four years, making it one of the fastest growing industries in the region. Meanwhile, homebuilders have increased attention on universal design concepts specifically for the elderly market, even condominiums now cater to the retired community by making seasonal chores obsolete with lawn and snow maintenance crews.

Assisted living centers are designed for people who can no longer live independently but do not yet need the specialized care of a nursing home. Seniors ages 60 and older represent 10.3 percent of the Johnson County population, according to U.S. Census Bureau estimates as of July 1, 2002.

There are 191 assisted living programs in the state and eight are in Johnson County, according to the Iowa Department of Inspections and Appeals. Five years ago, there were 50 assisted living facilities statewide with two in Johnson County.

The facilities employ more than 150 people locally. Average annual incomes and net wages were not available upon request.

"It wasn't until a few years back that there weren't any assisted a living facilities in Johnson County," Purdy said. "I've seen businesses come in the market specifically geared toward the elderly."

Community draw

According to a 2004 U.S. Census Bureau report, a large wave of workers born during the Baby Boom of 1946 to 1964 will leave the work force over the next few decades. The health care work force will see the largest loss of older workers in the next five to 10 years.Closeness to family, health care services that keep them active and cultural opportunities are reasons seniors gave Judy Hesson for moving to the area.

About 40 percent to 50 percent of residents at Melrose Meadows' 22-unit assisted living center come from outside Johnson County and from out of state, Hesson said. Residents, whose average age is 83, range from UI alumni to people who want to retire close to family, she said.

"We have people that never lived in Iowa but because their children are associated with the larger businesses in Iowa or maybe with the university they moved here," Hesson said.

According to UI Alumni Association records, there were 16,770 living alumni in Johnson County as of March. That is 4,482 more than the combined number living in Linn, Iowa, Washington, Cedar and Muscatine counties. But the draw isn't limited to the immediate Iowa City area.

Distance to health care services and maintaining the small town atmosphere is no longer a problem for elderly once small towns like Tiffin and North Liberty have developed closer to Iowa City.

Options breed competition

Lawyer Joe Johnston plans to build a $4 million, 50-unit elderly living center on five acres of his expansive 20-acre Tiffin property.

In North Liberty, Greenwood Manor partners plan to sell the nursing home license to a non-profit organization, after building a new nursing home in a proposed Liberty Medical Center development. The Greenwood Manor home was built in 1965. The facility, licensed for 87 beds, has not been full in the last five years, said Jerry Nicholls, a Greenwood Manor co-owner.Additional expansions are taking place at existing elder care facilities. The Silvercrest Legacy Pointe campus in Iowa City added a 24-apartment building for independent living in July. Additional construction will continue on the second of three independent living apartment buildings and the campus may see a nursing care facility in the future, said Dereck Johnson, executive director.

All these additional home care options, coupled with more federal and state funding have made the elder care industry more competitive in Johnson County, Nicholls said. He has been in the elder care business for 27 years and also owns an assisted living facility near Wellman that was built in 2002.

"To be competitive and be able to offer the kind of services that the public wants, we have to go to a new building," Nicholls said. The new building has a "household concept" design for 20 nursing home residents to eliminate an institutional feel, he said.

As the Baby Boomer generation enters the Iowa City landscape, the elder care industry also will have to respond to new service demands for recreation and nutrition, Purdy said. The Johnson County Task Force on Aging already is preparing for the growing elderly population by conducting a survey of senior services, he said.

"Baby Boomers will probably have a different idea for what a meal should be," he said.