ST. PETERSBURG — Prem Shah, 26, juggles two BlackBerrys at his new desk in an unfinished office. He's been here every morning for more than six months, and now it's just weeks away: his own piece of the family business.
His dad's the CEO, his mom corporate treasurer, his brother president.
But what do you do when the family business is hotels — and you always wanted to go into medicine?
You figure out how to welcome a different kind of guest.
• • •
The Shah family business started in the late '70s with a 60-room Best Western in eastern Ohio. Raxit Shah and his wife, Ketki, moved from Toronto to build the American dream. They saved up every nickel, as one son put it, and bought their first hotel. Raxit Shah says his only early goal was to survive and be successful — perhaps run a hotel or two. But one hotel turned into three, then more than 20. Holiday Inns, La Quintas, a Courtyard by Marriott.
Their sons, Punit and Prem, grew up in the business. They were a precocious pair: Prem started flying lessons when he was 9, and had a pilot's license by high school. Punit, four years older, developed a hotel by himself at age 18. Prem, less fascinated by construction sites, loved charity work in his parents' hometown in India, where his father opened an eye hospital.
So while Punit studied hospitality in Boston, Prem went abroad to study medicine.
Even as kids, they didn't sleep much. Their parents had built a company from nothing. How would the boys make them proud?
"It's a lot of pressure," Punit Shah says, "because you're trying to live up to that expectation."
• • •
But after medical school, as Prem Shah worked for a psychiatrist near Atlanta, he realized he didn't want to practice medicine.
Practicing medicine meant being stuck in an exam room. It meant seeing just a narrow part of a patient's care.
In Poland and at DeKalb Medical Center, Shah worked with dementia patients. He was developing expertise in Alzheimer's disease. He had interned for psychiatrist Todd Antin, who hired him.
Antin didn't think he should practice medicine, either. Shah was inquisitive, hard-working, enthusiastic, overachieving. He spoke well. He wrote well. And his family's business had recently partnered with friends to open its first assisted living facility.
Antin saw shortages in his industry, of psychiatrists — and of beds.
"There's great need and demand," Antin says.
In 2006, an industry survey showed dementia patients made up 15 percent of all assisted living residents. In 2009, it was a third. In coming years, there wouldn't be nearly enough spots at places with trained staff.
Shah had a passion for dementia care — and a family in hotels.
Perhaps he could care for Alzheimer's patients another way.
• • •
Shah never had his brother's certainty about joining the family business. And he wasn't expected to.
"We wanted Prem to feel free," Punit Shah says. "My family and I felt he should pursue anything he wanted to do, so long as he was going to be successful at it."
But his Atlanta experience had him thinking again of Florida, where the family had relocated in 2002. Americans flocked to the state to retire. In Pinellas County, nearly 30 percent of the population was older than 60. And more than 30,000 of them likely had Alzheimer's.
Assisted living is one link in the chain of elder care — when you don't yet need the constant medical attention of a nursing home. You might need help bathing, eating, dressing or using the bathroom.
But even assisted living facilities struggle to meet the needs of residents with dementia. Nearly a third of the facilities nationally have special units for such residents — mostly to keep them from wandering away. Sometimes the only big difference is that the units are "secure" — the doors are locked.
And they can be expensive, above the national average of $3,200 a month for assisted living. Many don't take insurance, especially from the state. Shah wanted to design a place, like recent projects such as Brentwood Senior Living Community in St. Petersburg, that did more than store relatives away. He wanted to make it affordable. It could be bigger than Tampa Bay's other dementia facilities, some of which have just five or 10 beds. The biggest in Pinellas County has fewer than 100 beds.
He had a proposal for the family.
Five years ago, the family's Liberty Group company had opened Central Tampa, an assisted living facility with an even wider mandate to take residents who were tough to place. Director Karim Alibhai works with social service agencies to take in seniors with dementia, who are at risk of ending up abused or neglected, in jail or homeless. The project encapsulates the promise and the challenge of focusing on dementia — the facility has corrected nearly 50 problems cited by the state since it opened, many of them minor, three of them related to patient safety.
The need for it was stark. Its more than 90 beds are always full.
Shah was eager to create his own space for Alzheimer's care.
In February, he and his brother found a boarded-up St. Petersburg nursing home. Outside, it was drab concrete block. Inside, it had shiny institutional floors. But there was a gazebo out back, and big rooms that had housed four patients each. They could be suites for couples.
The brothers strategized. Add wood flooring, carpet, crown molding, art, lighting — and a hospital-like setting could start to feel like home. His brother, the hotel guy, got juiced about the construction project. What others said would take a year and a half, he could make happen in six months.
It was what would happen inside that excited Shah.
• • •
The project included a shower attached to Shah's office — he knew he would work those long Shah-family hours. At work before 6 a.m., still talking business at 11 p.m., sending e-mail at 2 in the morning.
On his desk are checklists, the final countdown to doors opening at Bristol Court Assisted Living Facility. His father and brother say the project and investment are his.
"This isn't a job for me," he says. "It's a passion."
On a Thursday morning, Shah walks out to meet the owner of a rehab company, Greg Coya, a former jai alai player, who likes the problem-solving of working with dementia patients. One woman wouldn't use her walker and would fall. She always gripped her Bible. So his staff created a pouch labeled "Bible" on her walker. She carefully stowed the book, and stopped falling.
"You have to go and be almost like a detective," Coya says.
Shah is adding his own details, gleaned from studies and experts. The whole building is secure — even the yard in back, with room for gardening and yoga, has 8-foot fences and bolted-down chairs. Stairs will be gated off. Staffers need key cards to get in and out.
Instead of using dishes from other family companies, Shah bought green — a color shown to boost eating by Alzheimer's patients. The meals are designed with finger foods. Walls are color-coded to help residents find their rooms. Room numbers include a spot for a photo. Each door has a blank space next to it for residents to decorate.
Everything from fun to function has an Alzheimer's twist.
Recreation includes memory games, some of them computer-based, that double as therapy. The ceilings hide wireless Internet, to support a piece of software called Eldermark that helps staffers track residents' activities and medicine. A quick barcode scan into a laptop on the medicine cart keeps each dose synched with pharmacies, reducing the error rate.
Shah has applied for not just an assisted living license for Bristol, but also a limited nursing license, so there can be a doctor's office in the building. He has contracted for hospice care. This may be the last home his residents ever have.
Shah plans a few strict rules: no cell phones, which might disturb residents. (That also limits the chance for irreverent cell phone photos.) No staff smoking, even during breaks, since the smell can also be upsetting. He urges respect. Residents are always to be called "Mr." or "Mrs." unless they prefer something else.
"We want our residents to feel like this is their home, they live here, they belong here, and they can pass away here happily, with dignity," he says.
Bristol Court, to open next month, will be the largest dementia-only assisted living facility in the county, and perhaps the entire Gulf Coast. Shah's asking to be licensed for more than 130 beds.
He sees Bristol Court as a start.
His dad and brother built an empire in hotels. Bristol Court is his Best Western.
News researcher Caryn Baird contributed to this report. Becky Bowers can be reached at firstname.lastname@example.org or (727) 893-8859. Follow her on Twitter at @bbowerstimes.