Building the NEW Aging Continuum

The following presentation was presented during the “Aging and Technology Industry Webinar”  hosted by GrandCare Systems and sponsored by Dakim Brain Fitness on September 9, 2010.  The PowerPoint presentation may be viewed by clicking here: Building the New Aging Continuum[i].

Participants in the WEBINAR stated that it was “fantastic, always learning”, “so true”, “Great presentation”,  “I love this image”, “This is resident centered care writ [sic] large”, and “Terrific presentation!!!”.  One commented, “I have been waiting for existing senior living communities to actively reach out to the greater community”, while another said, “This all helps take away the dark scary thoughts of ‘retirement living’.”

In addition, the host stated that the presentation “put into words the value of aging technologies to care providers and the NEW continuum of care. Many  in the aging & technology industry have been struggling to express this, especially to our aging service colleagues.”


The purpose of our discussion today is to:

  • CHALLENGE some of the current concepts of senior care,
  • Explore new options, and
  • Talk about the role that technology companies can play in this evolution.

But, first, let’s lay some groundwork.

What do you think of when I say “Senior or Retirement Living”?

It’s amazing how many people today think of only 2 alternatives:  the aging adult staying in their own home or moving into an ASSISTED LIVING FACILITY.  I show these on the slide as white & black because that’s how they’re often viewed: as good or bad.

I find this interesting for a couple of reasons.  First, in a survey of baby boomers done in preparation for the 2010 ALFA National Conference & Expo[ii], only 62% knew what the term “assisted living” means.  Of that group, 39% thought it was the same as nursing homes!

This all seems strange to me because it wasn’t that long ago when assisted living was touted as a positive alternative to “having to go into a nursing home”!

In reality, “Senior or Retirement Living” mean different things for different people and cover a broad spectrum that is based more on the housing designation than on the type of services provided.

For instance, some might think of a golf course community as Retirement Living, while others would think of a CCRC, independent living facility or the newest thing à Naturally Occurring Retirement Communities (NORC).  Senior living covers everything from 55+ restricted housing to Assisted Living and Memory Care/Alzheimer units and by adding the word “CARE” even extends to nursing homes.

It’s no wonder our potential customers and their families get confused.

And, amazingly, MANY of the people that operate and market these different types of senior living properties have such tunnel vision re. their own product that they’ve never visited or checked out the other models, can’t really explain the difference to a prospective resident or their family, and oftentimes don’t even recognize the others as “true” competitors!

Except for the life care CCRC model and a few other scattered operations around the country, we don’t have a true continuum of care today.  Even in this model, the so-called continuum doesn’t begin until the aging adult moves into a communal housing arrangement, as depicted by the white arrows on this slide.  That higher functioning individual will then receive increasing levels of care (yellow arrows) as their health deteriorates.

Whether in a CCRC or other rental style senior living community,  the traditional approach has been an implied contract:


The senior living community provides shelter, security (mental & physical) and ACCESS to care and other services such as meals and housekeeping.

Interestingly, the very insulation promised by the senior living facility is now beginning to work against them with newer generations of “seniors”.

The AGING-in-PLACE concept is gaining in popularity as an alternative that many technology companies support with their products.

Although it sounds GREAT; what the individual may WANT and what they truly NEED are not always in balance.

I’ve been in this business for a long time and I can unequivocally state that there is no UNIVERSAL solution that’s RIGHT for ALL of the PEOPLE all of the TIME!

This next slide illustrates that:


Most of us will need the majority of these services at some point in our life.  The difference is that aging adults tend to:

  • Need MORE of them at the same time (e.g. access to medical care), and
  • May NEED HELP in obtaining those service in order to maintain a high quality lifestyle.

My REVOLUTIONARY CONCEPT is remarkably simple, although its implementation will be earth-shaking to many current operators.

My vision is to focus

NOT on the product we sell, but


INSTEAD of a Spectrum of Companies

Providing services in different LOCATIONS,

We create SENIOR LIVING COMPANIES; which are

SPECIALISTS in dealing with the needs of Seniors

and provide a Continuum of Services

Regardless of where the Customer (Senior) Resides.

INSTEAD of fighting over where the senior lives

We help them find the RIGHT SOLUTION


At this stage of their life

(recognizing that it may change over time);

AND THEN SUPPORT Them with the Services

that will make it a viable decision.


Although it might be marketed as such, it is actually an investment decision.

Today’s senior living communities are really in the best position to extend services into [and generate revenues from] the broader community by supporting those seniors who are “not ready” to move into the facility, but still need differing levels of help and support.

By building bridges to the community these facilities will build relationships with future residents and generate traffic into their buildings by involving outside individuals in activity, meals and socialization programs.  As those individuals continue the normal aging process, many will choose to move into a senior living community and obviously the one that has been providing on-going services will have a competitive advantage.

Now, let’s take a critical look at our collective success in meeting ALL of the needs of our aging adult clients.

We begin with the ASSUMPTIONS that Maslow’s Hierarchy of Needs[iii] applies to all individuals, regardless of age; and that an aging adult doesn’t “retire” their EGO at age 65!

The castle model has done a pretty good job of meeting the first two (basic) level needs, and because of communal living, offers some socialization.

On the other hand, Aging-in-Place services meet those same basic needs – ALTHOUGH the risk of isolation, especially from peers, has a tendency to increase.

Progressive Retirement Lifestyles is endeavoring to build a New Aging Continuum by offering a package of “bridge” services to existing senior living operators.

Based on Healthy Aging / Wellness Concepts, the H.A.S.P. (Healthy Aging for Seniors) program is designed to provide AGING ADULTS – in their own home or as part of a senior living community – with the support services they need to maintain their independence and the quality retirement lifestyle they desire for as long as practical.

Initially, we’ll extend the basic services currently provided by the operators, but we hope to build a RISING TIDE that will result in improved and more sophisticated services to help our senior clients achieve their higher level needs while demonstrating the dignity and respect they deserve.

I would like to walk you through an example of how I envision some of these services being provided, but first want to go back to our castle and bridge and bring technology into the equation.

As we go through the example, you will see how Technology forms the pillars that bridge the Aging-in-Place initiatives with the senior living communities.  I encourage technology vendors to adopt the philosophy of providing service to their aging adult customers regardless of where they are residing.

I actually look forward to the day when prospective residents demand that senior living communities offer the same types of technological advancements that they may have become familiar with “at home”.

Virtually all services that can be provided in a private residence can or SHOULD also be provided in the facility setting. The CHOICE should become more about desire and economics, instead of location.

We’ll begin with some of the Instrumental Activities of Daily Living (IADLs), which are often more geared towards independent living.  The items with a red checkmark are areas where technology is already playing a role for some clientele.  Weekly housekeeping and linen service is a natural extension of the standard services provided within senior living communities.  It’s a service that is often needed by the aging-in-place senior, but generally would not create enough of a need unto its self to generate a move-in decision.

Food preparation can be provided in the client’s home, but cooking for 1 or 2 is certainly going to be a much more expensive operation than in a facility.

Assistance with the so-called ADLs or Activities of Daily Living such as bathing and dressing is a personal service and can be delivered wherever the senior is located.

Recently, there has been a lot of hype about the use of technology such as passive monitoring and medication reminder / administration systems to help seniors with declining health remain in their own homes.   In addition, I’ve seen discussion about retro-fitting houses to include design features geared specifically towards the needs of the elderly, such as the picture of the dishwasher styled, below the counter storage unit for dishes.  I’m not suggesting that every apartment in a senior living community be outfitted with these technology enhancements, but I do believe that operators should dedicate a percentage of their units to “smart home” technology in order to better meet the on-going needs of their residents.

This next slide identifies some of the services that the senior living community would provide at its building under a PAID SUBSCRIBER program.  This would entitle the outside individual to participate in a select number of activities each week, as well as making 1 or more nutritious meals available when the subscriber visits the facility.

These programs are generally group oriented and offered to both in-house residents and outside clients.  This interaction provides needed socialization for the participants in addition to the other benefits of the programs.

Frankly, it will require an upgrading of the activities in many of today’s properties to deliver meaningful programs that are more than just filler, or as one nationally known writer termed them as “Summer Camp for Seniors”.

For instance, under learning new skills, I’m talking about something more than arts & crafts.  We want to help the participants achieve their self-actualization needs by doing things such as learning to play a musical instrument, how to use a computer, paint, or as shown here to re-cane a chair.

They would be encouraged to participate in a variety of programs designed to promote their wellness & independence in mind, body and spirit.

The facility would offer a number of clubs and encourage the participant to join and interact with in-house residents.  This would include social clubs such as the Red Hat Society, bridge clubs, bible study, sewing groups, drama club and men’s groups (e.g. a sports club with activities centered around the big screen TV).  There would also be lifestyle coaching groups for things such as diabetes or weight management.

Of course, the subscribers would be invited to attend the facility’s social functions, marketing events, etc. such as this “Elvis Visit”.

Some programs such as seated beach-ball volleyball, bell choir, and horse racing are primarily designed for socialization and to just encourage the participants to have FUN and enjoy their day.

In other situations, the facility will set up group and individual competitions using techniques such as the Wii system.  This is a picture of the winning team for a Big Board Scrabble tournament that I created for one building.

Finally, the subscribers would be encouraged to utilize (for an additional fee) the other amenities of the host facility.  This might include having their hair done at the in-house beauty salon, or receiving customized 1 on 1 exercise / training at the rehab clinic.

One area I haven’t addressed is Cognitive Training.

That’s because I wanted to give a specific recognition to Dakim for their recent initiative to offer a home product as a supplement to their standard facility based BRAIN FITNESS service.  This is a great example of a marketing strategy to meet the needs of the customer WHEREVER they may live.

The New Aging Continuum program has the potential of a win-win-win situation!

First, it’s a win for the Aging Adults who receive the services that they NEED and WANT.  They get to CHOOSE and thus maintain their independence and dignity.

Second, there is a WIN for the technology companies that have the potential to turn the existing and/or future senior living communities into showrooms for their products.  They may even consider joint venture / co-marketing or distributorship relationships with certain operators.

For instance, the average 110 – 120 unit community will have an active data base of 800-900 to as many as 1500 prospects. AND, I’m sure they would be interested in communicating with the individuals in the technology company’s customer data base.

Finally, there is a potential WIN for progressive thinking senior living communities and companies for whom the Continuum offers both a new revenue stream and a marketing investment.

Their key is to let the subscriber SAMPLE the product with “just enuf” participation to whet their appetite for more.

To illustrate this concept, I use the analogy of creating a Slippery Slope.

The first step is to get the individual through the door.  Once on the slippery slope, momentum will increase as they continue to have satisfying experiences at the building.   They will make new friends and their apprehensions will dissolve with the potential for a move-in substantially increased.   The greater the degree of interaction within the facility, including things like using the beauty shop, the stronger the likelihood that the subscriber will decide to become a full-time resident of the senior living community.

I am continually interested in learning of new technology and their applications to the Senior Living Industry.  I’ve provided my contact information and invite your feedback and / or a detail discussion about the application of these concepts in your specific situation or with any of your existing or potential customers.

[i] The audio portion of this webinar may be accessed at The audio for this presentation begins at approximately the 12 minute mark.  We apologize that the video portion did not record the slides for simultaneous viewing.

[ii] Phil Lempert, CEO, Consumer Insight, Inc., Keynote Address on May 26, 2010, Phoenix, AZ

[iii] Go to for additional discussion of Maslow Hierarchy of Needs as it applies to residents of senior living communities and other aging adults.


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5 CommentsLeave a comment

  1. This is the most comprehensive description of aging in place issues I’ve ever seen.

    Thank you very much for sharing it!



  2. […] Building the NEW Aging Continuum Art Carr | September 13, 2010 at 12:21 pm | […]


  3. Art, you did a fantastic job! Thanks so much for sharing your wisdom with the weekly aging & technology industry participants. This call is hosted every Thursday at 2pm Eastern Time. All are welcome to join us!

    Thanks again Art! We continue to receive positive comments about your presentation!!


  4. […] Building the NEW Aging Continuum September 2010 3 comments Published in: […]


  5. […] Building the NEW Aging Continuum Art Carr | September 13, 2010 at 12:21 pm | […]


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