Raya's Paradise operates several boarding homes that care for people… (Michael Robinson Chavez,…)
Just off the trendy Melrose strip, on the western edge of Hollywood, is a refuge of tree-lined streets where neighbors greet each other by name and young couples start families and stick around into their golden years.
Lately, it has also become a battlefront in a broader clash of conflicting imperatives: how to balance a government push to keep the aging and disabled out of institutions against community desires to protect the character and value of residential neighborhoods, particularly in a shaky housing market.
When news spread on a tranquil block of Sierra Bonita Avenue that a developer wanted to tear down a modest 1920s duplex and build an 11-bed board and care facility for people with dementia, the outcry began.
Neighbors were already concerned about the growing number of group homes for the elderly and recovering addicts in the area, many of them for profit.
A Times analysis found 24 licensed facilities offering residential care for the elderly within a mile of the proposed project and three more waiting for state approval. It is one of several such clusters that have emerged in Los Angeles County — including parts of the San Fernando Valley and South Bay — where families can afford fees that run into thousands of dollars per month. Large swaths of the county's less affluent areas have no such facilities.
Some neighbors on Sierra Bonita worry that another care home will mean more parking headaches, more ambulance sirens and increased downward pressure on property values that have tumbled about 25% in six years.
Douglas Madore, who has owned a duplex on the street for nearly 50 years, recalled two disturbing encounters with elderly residents who wandered from another nearby care facility. One woman showed up on his doorstep insisting he vacate "her" house. Another time, a man walked by screaming for help.
"I feel for these people," Madore said. "I'm not a kid myself." But he said he spent $200,000 upgrading his property — an "investment wasted" if he can't find a buyer.
Other residents argue that such facilities help people age with dignity in their own communities.
"Where are they going to end up? On Melrose with pot shops?" asked Alla Tenina, who owns a house on nearby Vista Street. "I personally don't want to be pushed into a commercial area."
The issue's sensitivity is reflected in the reluctance of some fierce opponents of the project to have their names published. Several said they did not want to offend elderly neighbors or be accused of NIMBYism.
"I have nothing against people in rehab. I have nothing against older people," said a 20-year resident. "It's still a business.... If I wanted to live downtown, I'd live downtown."
Debra Cherry, executive vice president of the California Southland Chapter of the Alzheimer's Assn., said such conflicts aren't unusual. In March, in response to residents' complaints, the South Valley Area Planning Commission rejected plans for a 156-bed elder-care facility in Tarzana after a zoning administrator had approved it.
Advocates for the elderly say more needs to be done quickly to ensure that a growing Alzheimer's population has appropriate housing and care. An estimated 155,575 Los Angeles County residents had Alzheimer's in 2008, a figure that is expected to nearly double by 2030 and triple by 2050, according to Cherry's group.
"The first of the baby boomers turned 65 this past year, so what we are going to see is a ballooning in the numbers of people who have Alzheimer's disease and age-related cognitive impairment," she said.
The bulk of Alzheimer's care is provided by family members. But as the disease progresses, those afflicted need help with basic tasks like getting dressed or preparing a meal, Cherry said. Family members can't always provide that level of care, and hiring help typically costs $10 to $20 an hour. Funding for in-home aides and other support has been slashed because of state budget shortfalls.
Families may be left with a single choice: a more expensive government-funded nursing home.
That's not necessarily the best or most cost-effective option for people with dementia when they don't need the medical services, said Dr. Linda Ercoli, director of geriatric psychology at UCLA.
Studies show that smaller, more home-like facilities can offer a more familiar environment, often with better staff ratios and more personalized care, said Ercoli, who has urged city officials to support the concept proposed on Sierra Bonita.
State law exempts facilities with fewer than seven residents from special permitting requirements in single-family neighborhoods. Costs at small facilities can be prohibitive, however.
"If you're lucky, you'll find something around $3,500," said Majid Ali, a 57-year-old acupuncturist whose mother has Alzheimer's. "More often than not it's $6,000 to $7,000 per month and up."