One night Miriam Grobani fell in her Pikesville apartment. "I don't know how long I was lying on the floor" before she was able to get up, she said. The incident got her thinking about living elsewhere, with assistance more readily available.
"My doctor told me I shouldn't be living alone," said Grobani, who declined to give her age.
So in June, she moved into an apartment in North Oaks, a rambling "life care" complex for older people off Reisterstown Road, northwest of downtown Pikesville. Now, help is only a pull-cord away. Each room has one for summoning a nurse. And the halls are lined with support rails.
North Oaks is one of 52 facilities that Life Care Services Corp., based in Des Moines, Iowa, manages throughout the United States, making it the nation's biggest provider of elderly housing that includes flexible health-care services.
North Oaks celebrated a grand opening last month, although residents have been moving in since last December.
"The purpose is to provide an active lifestyle" while providing an array of services that can be increased along with the health needs of the resident, said Linda Vinson, the sales director for North Oaks.
The "life care" concept for elderly people includes three essential features:
* Private living quarters for residents who are able to care for themselves. North Oaks has 189 apartments, mostly with one or two bedrooms.
* A package of services that relieves residents of the burden of home maintenance and many other chores that may become difficult in old age.
* On-site health care. The North Oaks health center can accommodate just about any medical contingency except intensive care and surgery. The center maintains a ratio of one nurse for every three residents, Vinson said.
Residents living independently can get health care or physical therapy at the health center or recuperate there after hospital surgery.
Others whose health has declined to the point where they need help dressing and bathing may live in the center's "domiciliary care" unit, where they may furnish their rooms with their own belongings and come to meals in a dining room.
For those who have become largely incapacitated, the health center offers care in what are essentially hospital rooms.
"We'll take care of them the rest of their lives," Vinson said.
Residents regularly take trips to nearby shopping malls, doctors' offices, theater and other entertainment in Baltimore, either in their own cars or aboard shuttle buses. Within the North Oaks complex itself, a convenience store, billiards room, library, health spa, cocktail lounge and other amenities offer plenty to do.
To qualify to live in North Oaks, a person must be at least 65 years old, capable of independent living at the time of purchase and able to afford the costs of living there.
The units start at $88,000 for a one-bedroom apartment on a lower floor to $232,000 for a two-bedroom on the eighth, which is the top floor, Vinson said. The prices go up about every six months.
If a resident decides to leave or dies at North Oaks, 90 percent of the purchase price is refunded to the resident or to his estate.
Monthly maintenance fees range from $1,188 to $2,137, she said, with the fee increasing $552 for a second person living in the apartment.
Vinson said that 156 of the 189 North Oaks apartments have been sold so far. With many of those units occupied by married couples, the resident population is about 300.
North Oaks sits atop a hill where Thomas Wilson, a local philanthropist, started a late-19th-century summer camp for impoverished city youths. Later, it was the site of the Mount Wilson State Rehabilitation Hospital.
Life Care Services, the management company, owns half of North Oaks. The other partners are Dr. Elmer Hoffman, a Towson surgeon, and Mullan Enterprises, a local builder and developer. Mullan was in charge of gutting and renovating the old hospital building, dressing it up with decorative stucco, and adding three new wings. Vinson said the project cost $45 million.
The partnership bought the 200-acre property in 1984. After project planning and sales of some living units ahead of time, construction began in 1988 on a design by an Iowa-based architecture firm.
The North Oaks decor is rendered in rich mahogany, deep blues and hunter green. Parts of the complex are easy to mistake for a country resort, which is the intention.
The maintenance fee covers one meal a day in a dining room that has high pillars, sconces on the walls and the elegance of an old hotel. Residents can pay to take the other two meals there or choose to cook for themselves in the kitchens of their apartments.
The average age of North Oaks residents is in the mid-70s, Vinson said, with most of them living independently in their own apartments.
"There are a lot of people here who are fine, but they want someone to eat dinner with," she said. "They want somebody to be with."