Elderly Care Home Market Spain - (Research March 2021)
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Elderly Care Home Market Spain
(Research March 2021)
1. Introduction ............................................................................................................. 3
2. Executive Summary Spain......................................................................................... 3
3. Executive Summary Europe ...................................................................................... 4
4. Spanish Market - Details of Demand ......................................................................... 7
5. Spanish Market - Details of Supply ........................................................................... 8
6. Spanish Market - Monthly Price...............................................................................10
7. Spanish Market - Senior Living Communities............................................................11
8. Spanish Market - Investment Considerations ...........................................................12
9. Where To Invest ......................................................................................................14
10. Further Reading.......................................................................................................16
The Art Of Living In Spain – Elderly Care Home Research – March 2021 2
1. Introduction
The objective of this report is to describe the main factors that affect the demand and supply
for residential places for the elderly in Europe and Spain specifically, the current
characteristics of the offer, short term and medium term outlook of the Spanish care home
market and the resulting opportunities for (real estate) investors and care home operators.
This report is based on information found in a variety of publicly available online sources,
mainly derived from 2019 and 2020 market studies from Cushman & Wakefield, Jones Lang
LaSalle, PWC, Knight Frank and CBRE. This also means that the figures and calculations
mentioned in this report should be put in that perspective (i.e. some figures date from 2018
and 2019 and therefore have changed, albeit not in a significant way).
The links to the market studies of these consultancy organizations that have been used for
this report can be found in Chapter 11, at the end of this document (some are in Spanish
only). A variety of links to other (mainly Spanish) articles and reports can also be found there.
2. Executive Summary Spain
Spain is set to face the challenge of an ageing population over the next 2-3 decades. The
increase in life expectancy and the resulting chronic conditions of the elderly will lead to a
rise in the demand for (social) care services.
The public sector is struggling to meet the increasing demand of public places in care homes.
This explains why the private sector is playing an increasingly important role to cover this
shortfall. More private and government-subsidized beds are being offered to meet the needs
of the elderly. Out of the total of 381,340 beds offered in 2018, 25% (95,898) are under public
ownership, while the remaining 75% (285,442) are private.
Life expectancy in Spain has increased notably while the birth rate has decreased, producing
an aging population. Currently, 19% of the population is over 64 years old. From that age, the
average life expectancy is 22 years, but only 53% of that time is in healthy conditions. That is,
we live longer, but age is associated with a deterioration that requires specific care.
According to estimates of INE (Spanish bureau for statistics) if this trend continues, in 2050
Spain will go from 9 to 16 million people over 64 years of age (around 230,000 people a year),
approximately one third of the population. This would place Spain as the oldest country in
the European Union. Moreover, people in Spain are predicted to have the longest life
expectancy in the world by 2040, beating Japan into second place. This demographic
challenge constitutes a fundamental element to guarantee long-term social and economic
sustainability.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 3
In addition, the social and labor changes of the last decades have transformed the structure
of families and homes. The incorporation of women into the labor market, the decrease in
the number of children and the increase in longevity, among other factors, have changed the
structure of households and the traditional family system of care within families. The Spanish
tradition of caring for the elderly within the family is gradually disappearing, stimulating the
demand for professional elderly care (homes).
The ageing population, the increase in single-person households, the entry of women into
the labor force, the reducing traditional family system of care and the increase of dependent
people requiring care: these 5 factors all contribute to the rise in demand for care homes and
related facilities and services in Spain.
According to the latest available public data (Q1 2020), in Spain there are around +/- 5,400
residences with 381,000 places in nursing homes for the elderly, 4.4 places for every 100
people over 64 years of age. This figure is below the 5 places as recommended by the WHO.
This represents a current deficit of around 107,000 places (report JLL, 2018). With this
recommended ratio and the INE population projections, a need for 785,000 beds in 2050 is
estimated, double the current number and requiring +/- 180 new residences each year.
25% of the places are publicly owned, although the management can be private. The rest are
privately-owned places, of which 34% are subsidized places, with a regulated price set
according to the income and level of dependency of the user. Any user can access the private
places by paying the monthly fees in full themselves, or by financing part of the fee with a
subsidy. This subsidy is available to those individuals that have (at least a low level of)
dependency AND don’t have access to a public place (due to a long waiting list for example).
3. Executive Summary Europe
Before going into the details of the Spanish market, in this section an overview of the
European market is provided.
There has been a clear increase in
capital targeted at the elderly care
home and senior living property market
in recent years. As a share of all
commercial property transactions, care
home and senior living investment has
also jumped up to 2.5% in recent years.
This remains a small measure of the
circa €285 billion invested annually
across all commercial sectors, but there
is clearly growing appetite for elderly
care property assets.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 4
There are six structural and sector-specific drivers which help to explain the current shift in
investor interest and these also explain the sector's future growth potential. While countries
are maturing at different rates, these six drivers apply to the continent of Europe as a whole,
with all health and social care systems looking to prepare for the future.
1. Ageing Populations
Until 2050, the elderly population in the European Union is projected to more than double,
up by 130% (Eurostat: Ageing Europe — looking at the lives of older people in the EU). An ageing
population is the root of this growth with care bed demand projected to bulge to unchartered
levels across many developed economies. Many countries are already feeling the strain of
this with care home occupancy levels nearing capacity and informal methods of care
beginning to look unsustainable as the medical needs of the elderly become more acute.
Rapidly ageing populations across Europe will be the biggest long-term driver of growth in the
care home market. The share of people over the age of 80 is expected to surge across Europe
and especially so in Spain, Germany and Italy. The demographic shift will also be driven by
increasing life expectancy – a product of developments in medicine and medical procedures.
Estimates suggest the cost of long-term care across Europe will rise from 1.8% of GDP at
present, to between 3% and 5% in 2060 (EPRS - Older people in Europe: EU policies and programs).
Countries like Italy and Spain, where cultural norms – until recently - have limited the need
for long-term care, need to adjust their healthcare budgets as their societies evolve.
2. Appetite For Alternative Sectors
Investor interest in the healthcare sector is partly a reflection of structural change in global
property markets with investors increasingly seeking out alternative sectors. Broader real
estate surveys indicate that 66% of investors wish to increase their holdings in alternative
sectors (Emerging Trends in Real Estate: Creating Impact – Europe 2019, PWC & Urban Land Institute). Care
homes and senior living residences are among the alternative sectors most sought after
because of the long-term income they offer and a growing awareness of the demographic
fundamentals driving these markets.
3. Strong Property Performance
Occupancy rates are among the highest of any property class, typically close to 90%, with a
constant flow of residents needing care beds. Lease lengths for care operators are usually
between 20 and 30 years. The most attractive European markets (like Spain) offer prime
yields around 5% - 5.5%. The operational performance of many private care home providers
is also garnering attention from real estate investors as well as private equity firms targeting
going concern acquisitions. Pre-tax profit margins for private operators range from 25-35%.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 54. Formalization Of Care
Many western European countries rely heavily on homecare or informal methods to care for
the elderly. Informal care is typically delivered within families and households and while
difficult to quantify is very common in Italy, Spain and France. However, the number of multi-
generational households is declining across Europe, limiting the ability of many families to
assist elderly relatives. Secondly, the scale of population ageing in many countries is such that
by 2050, 1 in 6 adults will be over the age 80. This compares to around 1 in 15 at present
levels. Over 80’s are more likely to suffer from chronic and degenerative health conditions,
such as dementia, that require specialist nursing care and propel the need for (full-time)
residential care.
5. Growing Private Sector Involvement
Much of the healthcare provision within Europe falls under state control, especially acute
(hospital) care which accounts for between 60-70% of healthcare spending in most countries.
The same cannot be said for the care home sector which is characterized by private sector
ownership in many countries, making it more accessible to investors. The market is now
experiencing a (further) shift toward the private sector as publically operated homes continue
to struggle against rising demand and cost pressures. It is expected to see more and more
private operators leading the development of new homes and growing their share in the years
to come, creating a larger pool of real estate investment opportunities.
6. Consolidation And International Expansion
The European care home market has long been fragmented and restricted to small localized
operations. However, the last decade has seen the market begin to consolidate both
domestically and internationally. This consolidation has given birth to operators with care
home portfolios spanning across regions and countries. Merger and acquisition activity has
been common with several operators expanding into neighboring countries.
Korian, Orpea and Domus VI are the
largest pan-European operators by bed
numbers and have created scalable
businesses across Europe. The table to
the right shows the extent of this
expansion. With private operators
gaining a greater share in many
countries and continued consolidation
among the main players, it is
expected to see more interest from
investors as healthcare becomes an
increasingly global alternative asset
class.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 64. Spanish Market - Details of Demand
Currently, there are around 9 million people over 64 years of age in Spain, almost 3 times
more than in 1960, and the figure is expected to exceed 16 million in 2050, according to INE
projections. In 2050, a third of the population, 16 million people, will be over 64 years old, for
an estimated total population of around 49.6 million inhabitants.
Having a better grasp of how the 64+
population in Spain is distributed as
well as its evolution, it is essential to
understand how the demand for care
homes will take shape.
In the overview depicted on the right, it
shows how the age of the population
will develop over the next few decades.
In 2050, Spain will become the oldest
country in the EU. The life expectancy of
Spaniards after turning 65 is almost 22
years, but in many cases with a high
degree of dependence to carry out basic
activities.
In Spain, 65-year-olds will develop, on average, 53% of their remaining years in a healthy way
(free of disabilities or in conditions of personal independence), compared to 50% on average
in the EU. This implies that in 47% of the remaining years they will be able to operate
independently in the development of all their daily activities.
Regarding this dependence, and according to a study of the Spanish Society of Geriatrics, the
main activities that elderly people need permanent help with are of a social and non-sanitary
nature: avoiding loneliness and receiving help for activities such as dressing, taking
medication - in many cases, these are poly-medicated patients -, grooming or simply being
supervised. These are activities that they cannot do on their own, and therefore require the
assistance, formal or informal, of a third party.
Spain has a less developed care home market, largely due to the reliance on informal care.
The care of the elderly is a less developed business in Spain than in many other European
countries, as Spanish families have traditionally looked after their elderly members at home.
However, this structure has gradually broken down in recent years due to demographic
changes, leaving elderly relatives to rely on third party care services.
The incorporation of women into the labor market, the decrease in the number of children
and the increase in longevity, among other factors, have fundamentally changed the structure
of households and the traditional family system of care within Spanish families.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 7There are large regions of Spain that have many elderly people who live alone and few adults
who can care for them, mostly women. The dependency ratio (the number of people aged
over 65/the population aged 15-64) in the European Union was at 30.5% in 2018. The
dependency ratio for the elderly in Spain is 29%, with great disparity between provinces.
As depicted in the chart above, the outlook for the next few decades provides a bigger gap
between Spain and the average in Europe. It is expected that in 2050 southern Europe (Italy,
Spain and Portugal) will have a significantly higher dependency ratio (estimated at 63%) than
the European average. A higher dependency ratio means a higher need and thus a higher
demand for care homes, related facilities and services for the elderly.
5. Spanish Market - Details of Supply
In Q1-2020, there were +/- 5,400 residential centers for the elderly in Spain with a total of
381,000 places available. Regarding the evolution of these variables, between 2005 and 2010
it experienced a notable increase of almost 25% in just 5 years. Starting in 2010, the economic
crisis and cuts in public spending on social affairs slowed down this growth, which, despite
everything, has continued being positive.
Throughout the 2005-2018 period, the number of places has grown at a compound annual
rate of 2.2%, a figure in line with the evolution of demand, if we consider that around 76% of
the people living in residences are over 75 years old, and this population segment experienced
a compound annual growth rate during the same period of 2%.
The market consists mostly of small national
entities that operate a single center. The 10 largest
companies barely account for 17% of the total
number of places offered. The average size of the
Spanish residences is 67 beds, although it varies
greatly between autonomous communities.
The chart on the right shows the percentage of
residences according to the number of beds they
provide (Envejecimiento en Red, 2020).
The Art Of Living In Spain – Elderly Care Home Research – March 2021 8The residences can be privately owned (75%) or publicly owned (25%). Among those privately
owned, some may receive public funding/subsidies for certain residents (“Plaza Concertada”).
Therefore, there exist three main types of residences:
A. Public Places: Publicly-owned places, whether publicly or privately managed, in which
the resident pays a public maximum price based on their income.
B. Plaza Concertada: Privately owned places that are partially publicly financed (only for
certain residents) and have private management. The resident pays a public price
based on their income, in a similar way to public places. The remaining part is paid by
the government to the private care home owner.
C. Private Places: Privately owned and privately managed places with a market cost,
where the resident pays the entire amount.
Obviously, care home operators tend to offer beds in regions where there is greater demand,
i.e., where there are more people aged over 64. To that end, they look at the coverage ratio,
which is the ratio between the number of beds and the population aged over 64. The WHO
recommends that this ratio should stand at 5 places for every 100 people aged over 64. This
ratio is already met by countries such as the Netherlands, Sweden, Belgium, Finland, Germany
and France but Spain does not comply. The coverage ratio in Spain stood at 4.2 in 2018,
meaning there is a shortfall in Spain of 107,000 beds.
The population aged over 64 in Spain in 2018 was 9,081,860, while the number of beds
offered amounted to 381,340. If the population growth projections are accurate, by 2033
there will be a total of 12,851,860 people in Spain aged over 64. In order for the sector to
reach the ratio of 5 beds for every 100 people aged over 64, it will be necessary to increase
the number of beds by 272,000 (2018-2033). This would require +/- 18,000 new beds being
added every year in Spain.
Within Spain, the lack of places is not
homogeneous, but varies greatly by
autonomous community. In mainland
Spain, the greatest deficit of care homes
occurs in Murcia (2.2), Valencia (3.0),
Andalusia (3.2) and Galicia (3.3). See image
on the left.
These regions will require greater levels of
investment for the number of beds to
meet the demand (that is projected to
grow at 2.3% on average per annum).
However, also Spain as a whole will require
significant investments in residences to
cover the needs until 2050.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 9The importance of the coverage ratio is shown by the real estate investment decisions of
leading European parties. An example of this is the Pan-European property investor
Cofinimmo from Belgium. They are currently investing EUR 56 million in the development and
construction of 5 new care homes. These care homes are all located in the areas with the
lowest coverage ratios: Murcia, Valencia, Andalusia and Galicia.
If there is already a deficit of 107.000 places (2018) needed in residences for the elderly, the
gradual aging of the population and the increase in the dependency index will aggravate this
situation in such a way that, based on the demographic estimates of the INE and the
recommendations of the WHO, in Spain around 785,000 residential places will be needed in
2050, double the existing ones (dated 2018). Currently, there are around 272 residential
centers with more than 25,000 spaces in the project portfolio pipeline - of which 61% are
from the private sector. However, this is an insufficient figure to cover the gap.
6. Spanish Market - Monthly Price
Care homes in Spain are typically large, often offering more than 100 beds and the intensity
of nursing can be limited. This is reflected in fee rates which are in the region of € 1,800 -
2,200 per month, lower than elsewhere in Western Europe. The prices of residences in Spain
are low compared to other European countries. This relationship continues to be maintained
when the retirement pension is considered. The average pension in Spain (€ 1,134 / month)
allows covering almost 60% of the price of a private place (€ 1,955, including Value Added
Tax), above the European average.
The prices of private places in residences for the elderly reflect, once again, a high degree of
heterogeneity between autonomous communities, varying from € 1,421/month in Castilla La
Mancha to € 2,496/month in the Basque Country, a difference of 76%.
According to a report by the OECD and the European Commission, (Joint Report on health care and
Long Term Care Systems & Fiscal Sustainability) these differences are mainly determined by the cost
of personnel. Due to the characteristics of the service and the fact that it is very employment
intensive, it is difficult to reduce the ratio of caregivers to users below a certain minimum
level. This means that the provision of the service involves a very similar number of hours of
work in all countries, making the cost of this work decisive. Around 60% of a care home
income is destined to the remuneration of the workers, 2.2 times more than the average of
the service sector in Spain.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 10In private residences, the financing will depend entirely on the users. Only in case an elderly
person cannot receive a place in a public residence (due to the unavailability of a public place)
and having been recognized as a person with a certain level of dependency, they will be able
to obtain a subsidized place (based on the PEVS, the Spanish Law of Dependency). The
amount of the subsidy depends on the degree of dependency and the user's income level.
7. Spanish Market - Senior Living Communities
Care homes have, until now, been the market’s solution for residents that require (intensive)
24/7 care in the closing stages of their life. However, the longer life expectancy and the better
health of citizens when they retire have given rise to new ways of living after retirement.
The public sector in Spain has thus far been unable to provide a comprehensive response to
this trend in terms of investment, also creating opportunities for private investors that are
able to take advantage of the potential of Senior Living. The Senior Living concept entails
residing in a community where the elderly can continue to enjoy life thanks to the leisure
options, activities and minimum care services on offer.
Senior Living is already an established sector elsewhere around the world, such as in the
United States, Australia and New Zealand. In Europe, the United Kingdom and France are the
countries with the highest number of resorts of this type, with renowned groups in both
countries, such as McCarthy & Stone and DOMYTIS, respectively. With its ageing population,
Spain has the potential to become another major market in the future. Certain investors have
already seen the opportunity and have launched projects in Madrid and Barcelona.
In addition to the domestic demand among the Spanish population, there is also potential
demand from foreign nationals, mainly from other European countries (UK, France, Benelux,
Germany, Nordic countries), who are attracted to Spain by its excellent climate, culture and
cost of living, factors that are complemented by the convenience and simplicity offered by
this product. This applies especially for the areas along the Spanish coastlines.
There are currently 340,000 foreign nationals living in Spain, aged over 64, of which
approximately 69% are nationals from a European Union Member State. Demographic trends
in Europe also point to a progressive ageing of the population. Europe-wide, the population
aged over 64 is expected to rise by over 37 million to reach 20% of the total population by
2030 compared to 16% now (2018, Oxford Economics estimates).
Spain therefore represents also a major opportunity for the development of a residential-
tourism model with products that combine, in varying proportions, tourism, leisure,
community and residential concepts. The range of products and possibilities is very broad.
For those people who have the financial means, privately-run residences which offer more
tailor-made services are the answer. Private care homes located in Spain’s coastal areas are
also attracting more residents, including from other European countries, because many of
these homes employ English-speaking professionals and offer a mix of socio-health care and
leisure facilities, taking advantage of the micro-climate in the region.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 118. Spanish Market - Investment Considerations
• While Spain does provide publicly-funded care homes for the elderly, obtaining a place
in one of these retirement homes is a long and complicated process. Furthermore,
health service cuts implemented over the last few years to reduce Spain’s hefty public
deficit has led to a deterioration in the quality of service offered in state-managed
residences, as well as a reduction in assistance offered to the elderly still living in their
own homes.
• Spain still relies on an estimated 2 million informal cares and commits less than 1% of
GDP to long-term care. As a result, care provision is less developed than elsewhere in
Europe. The number of elderly people is expected to boom from around 3 million to
over 7 million, by 2050. These forecasts have not gone unnoticed with care operators
and investors now beginning to circle.
• The market is fragmented with fewer large operators than elsewhere in Europe.
Recognizing the gap in care provision, international operators have been moving into
the market.
• Overseas capital is already being targeted at the Spanish care home market with
international buyers looking to capitalize on the huge demand for residential care and
a largely free market structure, compared to elsewhere in Europe.
• Real estate investments in the care/nursing home sector for the elderly in Europe
reached a record volume of € 7.3 billion in 2019. Despite the need to meet the growing
demand for residential places for the elderly, the level of investment in Spain is still
below that of neighboring countries.
• The Spanish market has a modest level of investment. However, the entry in recent
years of companies specializing in residential real estate assets and the arrival of new
operators has significantly changed the investment landscape: in 2019, investment in
residences for the elderly reached 300 million euros, doubling the investment made
in 2018.
• In Spain, the real estate component is often still owned by the operators. However, in
recent years there has been an externalization of the real estate component; several
portfolios have recently been acquired by investment funds. In only a few years, the
landscape of investors has considerably broadened and changed.
The sector is increasingly more efficient and specialized and there is a clear line being
drawn between OpCo and PropCo. This allows the operator to focus on its core
business, the day to day running of the facility and securing liquidity through sale &
leaseback deals to further its expansion strategies. The guaranteed and long-term
contracts allow real estate investment funds to secure higher (and more stable) yields
than would otherwise be obtained from more traditional asset classes.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 12• Sale & Leaseback begins to gain relevance (again) in the real estate market, as a
financial mechanism to alleviate the solvency difficulties that the Covid-19 pandemic
situation is generating. A phenomenon like the one that produced the economic crisis
of 2008, especially in sectors with owned properties, such as residential homes for the
elderly, that need the assets disposed of to develop their business. It is a real estate
formula very common in businesses in the tertiary sector such as hotels or offices, and
for some years is now also being applied to the elderly care residential sector.
Specifically, geriatric groups decide to sell their properties to Real Estate funds and /
or Listed Stock Companies for Investment in the Real Estate Market (“Socimi”), with
which they sign long-term rental agreements, many structured as "triple net”, in which
tenants assume all expenses, insurances, taxes associated with the use of the property
and assume the cost of maintenance. While this may provide a slightly lower rental
income, it’s very long term and income stability is guaranteed for 25-30 years typically.
• Spanish prime yields for care homes currently stand at 5.0%. Yields are compressing
given the significant investor demand, dipping by 50 basis points versus last year,
although Spain continues to offer higher yields than other European markets. This
trend is set to continue over the short to medium-term as the current development
pipeline comes on steam, bringing new portfolios to the market. The market is
expected to attract increasing capital volumes from institutional investors, mirroring
the trends observed in other consolidated markets.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 139. Where To Invest
As mentioned, Murcia is currently the area with the lowest coverage ratio in Spain (2.2). The
table below (Source Statista) shows the growth of the number of residents aged 65 and above,
between 2020-2035 in the Murcia region.
If we apply the coverage ratio as
recommended by the WHO (5 residence
places for every 100 people above 65),
we can conclude for example that there
is a need of 13.600 beds in the Murcia
region in 2025 (based on 272.000
elderly). Assuming an average
residence size of 70 beds (Spanish
national average), this means that the
Murcia region needs 194 elderly
residences in just 4 years (2025).
According to the IMAS (Instituto para la Mejora de la Asistencia Sanitaria), in Q1-2020 there
were just 53 elderly residencies in the Murcia region, resulting in a deficit of 141 elderly
residences by 2025. Other sources and calculations arrive at a similar conclusion: According
to the Spanish organization Asociación Estatal de Directoras y Gerentes de Servicios Sociales,
in Q1-2020 there was a deficit of 8.364 beds in the Murcia region. Assuming again an average
residency size of 70 beds, this would result in a shortage of 120 elderly residences by 2025.
The Spanish government so far has not been able - and will not be able - to provide the
required beds (mainly due to insufficient funds to finance these projects). This, in combination
with the fact that most residences in Spain are privately owned and the current move of
investors, PE funds and (more) private operators into the market, shows the attractive
opportunities currently available to operators and real estate investors alike.
In addition, it should be noted that the above-mentioned calculations and opportunities only
reflect the need for the internal (Spanish) market. However, as stipulated before, there is also
a growing market for Senior Residences targeted at foreigners that want to spend their golden
years in an attractive area with a good climate. Without doubt, Murcia is one of the best areas
in Spain in this respect. With over 300 days of sunshine per year, it's no wonder that more
and more foreigners from the Norther part of Europe are considering retirement in Spain, but
why is Murcia one of the most attractive areas?
With its enviable climate and proximity to many countries in Northern Europe, Murcia lies in
the south east and is one of Spain's least touristy regions. It boasts 250 km of spectacular
coastline, known as the Costa Calida and is made up of a principal city, medieval towns,
mountains and fishing villages. The area is rich in history, culture and tradition. It benefits
from an unspoiled landscape compared to the crowded Costa Del Sol and Costa Brava. It's
warm and sunny, all year round. The summer heat is less intense and winters generally dry.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 14Murcia has all elements to become the “Miami of Europe” for snowbirds. The region offers
the best value for money, not just property-wise, but also regarding the daily cost of living. In
addition, the climate is ideal for outdoor living and enjoying activities like walking, hiking,
fishing, tennis and watersports, supporting a healthier way of life. Also for golfers the area of
Murcia is a paradise since it has 20 Golf courses within just one hour drive.
Murcia has clean air; therefore, it is also a popular destination for asthma, arthritis and
rheumatism sufferers. In combination with the Mediterranean diet, living in this area helps
reduce the risk of major disease and increases longevity of life. The WHO classified the area
just north of Murcia (Torrevieja) as one of the healthiest areas in the world to live.
Furthermore, it enjoys a low crime rate and is generally clean. Besides, a lot of low-cost
airlines provide flights to Murcia.
The landscape is varied with long and sandy beaches, high cliffs and little inlets. La Manga –
the sleeve – is a 22-kilometer strip of land lying between the Mediterranean and the Mar
Menor. Mar Menor is a very nice spot to swim, as the water is hotter than in the sea. There
is also a small part of it where people go to cover themselves with some sort of black mud
which is frequently visited by people suffering from rheumatism.
Elderly with limited mobility will find this a relatively easy beach to use as ramps and wooden
walkways help to access the beaches. The water is not tidal and has only very insignificant
currents and waves, so it's perfect for elderly bathing. It has shallow fringes which slope
gently, and is only 7 meters deep in the center, so the water temperature is warmer than that
of the Mediterranean, particularly around the edges where it is possible to wade out 50
meters from the shore and still only be waist deep. The Mar Menor beaches offer shallow and
calm bathing conditions, whereas the Mediterranean beaches are wider, longer, windier, and
are susceptible to wave conditions and currents. Therefore, bathers can enjoy the waters of
the Mar Menor for most of the year.
The Art Of Living In Spain – Elderly Care Home Research – March 2021 1510. Further Reading
Links to the main market studies used in this report
• CBRE: https://www.cbre.es/es-es/research-and-reports/residencias-tercera-edad
• PWC: https://dependencia.info/imagenes/radiografia-sector-residencias-pwc.pdf
• Cushman & Wakefield: https://www.silvereco.fr/wp-content/uploads/2019/05/ETUDE-European-
retirement-homes-16-05-19.pdf
• Jones Lang LaSalle: https://www.jll.es/content/dam/jll-com/documents/pdf/research/jll-es-en-care-
homes-report.pdf
• Knight Frank: https://content.knightfrank.com/research/656/documents/en/european-healthcare-
care-homes-elderly-care-market-2020-6902.pdf
Links to various other documents and (Spanish) articles
• Orpea In The Long Term Care Sector:
https://gala.gre.ac.uk/id/eprint/22272/7/22272%20LETHBRIDGE_ORPEA_in_the_Long-
Term_Care_Sector_2018.pdf
• European Commission – Long Term Care:
https://ec.europa.eu/info/publications/joint-report-health-care-and-long-term-care-systems-and-
fiscal-sustainability-country-documents-2019-update_en
• PWC - Emerging Trends in Real Estate:
https://www.pwc.com/gx/en/industries/financial-services/asset-management/emerging-trends-real-
estate/europe-2019.html
• Eurostat – Ageing Europe:
https://ec.europa.eu/eurostat/statistics-explained/index.php/Ageing_Europe_-
_looking_at_the_lives_of_older_people_in_the_EU
• EPRS - Older People in Europe:
https://www.europarl.europa.eu/RegData/bibliotheque/briefing/2014/140811/LDM_BRI(2014)14081
1_REV1_EN.pdf
• Viability Study for a Spanish Elderly Residence (Spanish):
https://ruc.udc.es/dspace/bitstream/handle/2183/18155/SantosRivas_JoseIgnacio_TFG_2016.pdf?se
quence=2&isAllowed=y
• Cost Estimation for a Spanish Elderly Residence (Spanish):
http://envejecimiento.csic.es/documentos/documentos/enred-info19-costeslares2017.pdf
• Various Statistics Regarding Spanish Elderly Residences (Spanish):
http://envejecimiento.csic.es/documentos/documentos/enred-estadisticasresidencias2020.pdf
• Search engine for Spanish Elderly Residence Homes and General Information (Spanish):
https://www.inforesidencias.com/particulares
• Meal Costs Spanish Elderly Residences (Spanish): https://www.elmundo.es/comunidad-
valenciana/2015/11/08/563f005122601da12c8b45b8.html
• Growth of Murcia Elderly Resident population (Spanish):
https://es.statista.com/estadisticas/632925/proyeccion-de-la-poblacion-mayor-de-65-anos-r-de-
murcia/
• Need for beds in Murcia (Spanish):
o https://www.laopiniondemurcia.es/comunidad/2020/01/24/faltan-8-000-plazas-
residenciales-34867632.html
o https://www.laopiniondemurcia.es/opinion/2020/04/21/negocio-residencias-mayores-
33994984.html
The Art Of Living In Spain – Elderly Care Home Research – March 2021 16• Big or small Elderly Residency – Advantages, disadvantages and trends (Spanish):
https://www.inforesidencias.com/contenidos/mayores-y-familia/nacional/es-mejor-una-residencia-
geriatrica-grande-o-una-peque-
a#:~:text=Si%20hacemos%20una%20divisi%C3%B3n%20vemos,religiosas)%20tienen%20m%C3%A1s
%20de%20100.
• Increasing popularity of Sale & Leaseback for Spanish Elderly Residences (Spanish):
o https://www.balancesociosanitario.com/economia/residencias-de-mayores-inversores-y-
gestores-apuestan-por-el-largo-plazo-en-sus-contratos-inmobiliarios/
o https://cincodias.elpais.com/cincodias/2020/03/06/companias/1583523769_624703.html
o https://www.infolibre.es/noticias/politica/2020/05/11/el_otro_gran_negocio_con_las_resid
encias_fondos_inversion_inmobiliarias_destinan_cientos_millones_comprar_geriatricos_106
655_1012.html
o https://www.inmoley.com/NOTICIAS/1912345/2019-1-inmobiliario-urbanismo-vivienda/02-
19-inmobiliario-012-23.html
o https://www.eldiario.es/economia/inversiones-residencias-mayoreslos-envejecimientoante-
ofertapublica_1_1295805.html
o https://attac.es/el-otro-gran-negocio-con-las-residencias-fondos-de-inversion-e-
inmobiliarias-destinan-cientos-de-millones-a-comprar-geriatricos/
• Increasing Shortage of Spanish Elderly Residences (Spanish):
o https://cincodias.elpais.com/cincodias/2020/03/06/companias/1583523769_624703.html
o https://www.elespanol.com/invertia/economia/20201002/espana-necesita-incorporar-
plazas-residencias-ancianos-proximos/524948925_0.html
o https://www.65ymas.com/sociedad/en-espana-faltan-66000-plazas-residencia-cumplir-con-
recomendado-por-oms_19818_102.html
o https://www.eldiario.es/sociedad/espana-plazas-residenciales-personas-
mayores_1_1077128.html
o https://www.eldiario.es/economia/inversiones-residencias-mayoreslos-envejecimientoante-
ofertapublica_1_1295805.html
• New Elderly Residence Murcia. Collaboration Operator Clece Vitam & RE Fund Cofinimmo (Spanish):
o https://www.plantadoce.com/empresa/clece-a-la-conquista-de-cartagena-invierte-13-
millones-en-una-residencia-para-mayores.html
o https://brainsre.news/clece-invierte-13-millones-en-una-residencia-para-mayores-en-
cartagena/
The Art Of Living In Spain – Elderly Care Home Research – March 2021 17You can also read
