And now … The Rest of the Story

2014 Women's Final Four

NCAA Women’s Basketball Tournament

TRIVIA Question:  Who is the winningest Division 1 basketball coach of all time?  Clue → it is NOT in a men’s basketball program and it is NOT a man.

Answer:  Pat Summit, Head Coach Emeritus with the University of Tennessee “Lady Vols” basketball team.  “She kept her elite program in the winner’s circle for almost four decades, producing a mind-boggling record of 1,098-208 (.840) that included the most victories in NCAA basketball history. During her tenure, the Lady Vols won eight NCAA titles as well as a combined 32 Southeastern Conference tournament and regular season championships. Tennessee made an unprecedented 31 consecutive appearances in the NCAA Tournament and produced 12 Olympians, 34 WNBA players, 21 WBCA/Kodak/State Farm All-Americans earning 36 honors, and 39 All-SEC players earning 82 recognitions. Along with the success on the court, Summitt’s student-athletes had tremendous productivity in the classroom. Coach Summitt held a 100 percent graduation rate for all Lady Vols who completed their eligibility at Tennessee.”[i]

The Lady Vols along with UConn (Connecticut), South Carolina and Notre Dame are again a number one seed in the 2014 NCAA Division 1 Women’s Basketball Tournament with 1st round games beginning this weekend.  Although Pat won’t be on the sideline for Tennessee (Holly Warlick now coaches the Lady Vols), other familiar coaching icons will be at tLadies Basketball Coach Iconshe tournament including Geno Auriemma from UConn, Tara VanDerveer with the Stanford Cardinal, and Kim Mulkey, coach of the Baylor Lady Bears.  These 4 coaches have produced over 3260 victories,  winning 20 national championships in a combined 115 years of coaching, and each has become an institution at their university.

In total, teams from 30 states will be participating in the women’s tournament with New York having the most teams (6), followed by California and Tennessee with 5 each.  Seven other states (Georgia, Indiana, Iowa, Louisiana, Oklahoma, South Carolina and Virginia) have 2 schools in the tournament.  This should give you plenty of opportunity to generate competition for your residents – especially in those situations where you have both large (i.e. major conference) and smaller schools competing (e.g. Stanford vs Cal State – Northridge;  LSU vs Northwestern LA, or Texas vs Prairie View).

Women's Tournament by State

  • A special mention should be made for the “Black Knights” women’s basketball team of the U.S. Military Academy.  Although located (and counted as a NY school) at West Point, NY, this team is really a “national” team and should receive support from across the country.
  • Kudos to Connecticut and Notre Dame who are each undefeated in regular season and conference tournament play going into the NCAA tournament.
  • There are 5 additional states (Idaho, Illinois, Indiana, South Dakota and West Virginia) that were not included in the Men’s NCAA tournament.  {See “Forget the Activity Calendar. . . ACT NOW!” for suggestions about utilizing the NCAA tournament as the basis for an enriching resident activity program and marketing event}
  • Five schools — Akron, North Dakota, South Dakota, Winthrop and Wright State – are all making their first NCAA tournament appearance
  • 25 of the teams join their male counterparts at the Big Dance.  The Women’s Tournament adds post-season play for 39 additional teams and gives you 5 more states to build resident support around.

    How about a competition between the Men’s and Women’s teams for the 25 colleges with both teams in the SHOW?  Who will go farther in their tournament? 

The NCAA Women’s Basketball Tournament offers some challenges, but many more opportunities for meaningful dialogue and interactive programs with the predominantly female population in today’s senior living communities.   One of the challenges is that the NCAA tournament has only been organized for women since 1982 so it’s unlikely any of your residents ever played in the tournament.

TRIVIA:  Kim Mulkey played on the first championship team from Louisiana Tech in 1982 and is the first person, man or woman, to win a basketball national championship as a player, assistant coach and head coach.[ii]

TRIVIA:  Tennessee and Connecticut have won almost 50% of the National Women’s Championships with 8 titles a piece.

On the other hand, most of the 1st and 2nd round games are played “on campus” with attendance a lot less than at the men’s games.  Therefore, if your community is near one of the 16 tournament sites you might have the chance to actually take a group of residents to see one or more of the games.

Los Angeles, CA Toledo, OH
Seattle, WA West Lafayette, IN
Ames, IA Knoxville, TN
Iowa City, IA Chapel Hill, NC
Waco, TX Durham, NC
College Station, TX College Park, MD
Baton Rouge, LA University Park, PA
Lexington, KY Storrs, CT

The Sweet 16 games will be played in Lincoln, NE; Stanford, CA;  Notre Dame (South Bend), IN and Louisville, KY with the Final Four in Nashville, TN.

One of the biggest opportunities is to create an inter-generational sharing experience for your residents, their adult daughters (bobby-soxers and baby boomers), grand-daughters and great grand-daughters.  The residents and their adult daughters lived through a cultural revolution started by the United States Congress’ passage of Title IX of the Education Amendments of 1972.  This legislation changed the face of women’s athletics across all levels and 10 years later led to the first NCAA Women’s Basketball Championship Tournament.

  • In 1971, the year before Title IX became law, fewer than 300,000 girls participated in high school sports, about one in 27. In 2002, the number approached 3 million, or approximately one in 2½.[iii]
  • In 1972, fewer than 32,000 women competed in intercollegiate athletics.  Women received only 2 % of schools’ athletics budgets, and athletic scholarships for women were nonexistent.  In 2008-09, a record number of 182,503 women participated in competitive college athletics, accounting for 43% of college athletes nationwide.[iv]

Along with the increased participation, the game of “girls” basketball itself has also seen significant change.  Before Title IX (i.e. when all of the residents as well as the Bobby-soxers and many of the Baby Boomers were growing up), girls basketball was more a part of the Physical Education curriculum than a competitive sport.  Today’s young girls would hardly Ollie-Hoosiersrecognize the half-court game, uniforms of Bermuda shorts and white blouses, and all foul shots thrown under-hand like Ollie in the movie Hoosiers!  Fast breaks, rebounding “above the rim”, even dunks were foreign to the pre-1972 women’s game.   SO, set up an inter-generational discussion group and encourage your residents (and prospects) and their older adult children to share their remembrances of girls basketball in the “days of yore”.  Invite a local college or high school team to participate in the discussion and help them understand the legacy that they have inherited. Humphrey Bogart said, “Louie, I think this is the beginning of a beautiful friendship in the movie Casablanca and you can build that same type of on-going relationship with a local school team throughout the coming year.

Finally, the Girl Scouts of America developed Girl Scout badgea new patch that members can earn with activities focused on the history, importance and media portrayal of women in sports.  It was developed in conjunction with the 2014 NCAA Final Four in Nashville, TN and offers a tremendous opportunity for your residents to interact with the young scouts.

You have all the ingredients for a dynamite activity program and customized marketing event that demonstrates appropriate respect for the life accomplishments of the residents.  The potential of getting multiple generations from the same family together in your building focused on a common interest – including participation in March Madness games as discussed in a prior article – is priceless.

 


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The “GRADUATE” turns 75!

It’s the late 1960’s.  The war in Vietnam is escalating and college campuses are erupting in violence across the country.  Then comes the quintessential coming-of-age film with a young, drifting college graduate fulfilling an adolescent fantasy by being seduced by an older woman.  This film was the springboard for stardom for Dustin Hoffman and “Mrs. Robinson” became a chart-topper and Grammy Award winner for Simon & Garfunkel.

On August 8, Dustin Hoffman will reach 75 years of age and enter into the target demographic for senior living facilities.  He is part of the “Bobby-sox Generation”[1] that will drive occupancy for the next decade.  Other notable bobby-soxers turning 75 this year include:

Bill Cosby                                               

                                                                            Warren Beatty

General Colin Powell (ret)

Former Sec. of State

George Takei                        Billy Dee Williams

Mister Sulu”                           “Lando Calrissian

Jack Nicholson 

Roberta Flack

Betty

Elinor Donahue

Burt Reynolds      

Morgan Freeman

Richard Petty  “The King

At the time “The Graduate” was filmed, a U.S. male could expect to live to an average age of 67 years (74 years for a woman)[2].  That meant that the average man – who, in 1967, would have generally been expected to become the principal family breadwinner – would retire at age 65 and have a few years of retirement before dying.  His widow would then live another 7 to 10 years and likely need some form of health care support in her waning years.

These are the demographics and statistics that have driven the development of the senior living industry for the past 40 years and led to the adoption of the “rest home” mentality throughout much of the industry.  A quiet, secluded location was considered appropriate for the aged to live out their remaining years.  As providers, our focus was on giving high quality medical care and supportive services to make the resident comfortable in their final years.

DO THESE INDIVIDUALS LOOK LIKE THEY ARE READY FOR A REST HOME?

The reality is that the world has changed radically as a result of medical advances since 1967.  Our sampling of bobby-soxers have already beaten the odds by exceeding their projected life expectancy.  They are still vibrant and active with life expectancy now increased for white men to over 76 years and 81 years for women.[3]  Beyond the extended life projections, the Christian Science Monitor and other articles[4] note several significant changes in the make-up of the aging population.  The gap between male and female mortality has narrowed to just 4 years[5]        as women are now smoking more with higher incidences of obesity and uncontrolled high blood pressure.  In addition, the life expectancy for blacks (African-Americans) has made great strides towards the white statistics.

These analyses suggest that the successful senior living facility of the future must appeal to a much broader demographic than just the traditional 80+, widowed, white female.   Fundamental changes in everything from location and building design to lifestyles management will be necessary to offer a product and services that will appeal to the Bobby-sox generation.


[1] Born 1935 – 1945.  See http://wp.me/pCemc-bn for a further discussion of the Bobby-sox Generation

[2] See:  http://demog.berkeley.edu/~andrew/1918/figure2.html

[3] Christian Science Monitor, June 19, 2012:   http://www.csmonitor.com/USA/Society/2012/0619/Racial-gap-in-life-expectancy-reaches-new-low-in-US

[4] e.g. ABC World News, June 16, 2011:  http://abcnews.go.com/Health/life-expectancy-men-outpacing-women-study/story?id=13850055#.UCGh26DN6So

[5] USA Today, 4/20/12:  http://www.usatoday.com/news/health/story/health/story/2012-04-19/Life-expectancy-improves-slower-for-women/54419298/1

Continuing Challenges or OPPORTUNITY …

for the Senior Living Industry?

Will operators continue to “cut costs” – even when it entails reducing services for the residents?

Will the focus continue to be on “need-driven” admissions and move-ins?

Will the average age of residents continue to increase while the average length of stay decreases?

Will new development and innovations continue to stagnate?

Will the “Aging in Place” movement continue to gain strength with seniors choosing to buy more services that help them stay in their personal residences?

OR

Is this the year that:

a)       The industry begins to prepare for the changing demands and needs of new generations of potential residents? [READ MORE]

b) Progressive visionaries challenge the “status quo” in design and operational philosophies?  [Update to Follow]

c) More emphasis is placed on providing a quality lifestyle for the resident, regardless of his/her medical (physical & mental) limitations/capabilities?  [Update to Follow]

d) Operators embrace new technologies to provide a stronger value proposition as a viable alternative to the prospect remaining in their own home? [Update to Follow]

e) New entrants from outside the industry and foreign investors assume leadership roles with new energy and vision?  [Update to Follow]

The Bobby-sox Generation

a Target Rich Environment for Senior Living

The first members of the “bobby-sox” generation (born 1935 – 1945) will turn 76 in 2011.  As discussed in “Do Senior Living Communities Need a Wake-up Call?” and “Do not go gentle into that good night[i], this generation will be more demanding and EXPECT many amenities (considered options today) to be included in the standard package in the future.  The bobby-soxers will be less willing to compromise their independence for the “one-size-fits-all” approach utilized in many of today’s senior living facilities.

Recognizing and understanding the desires of the customer is essential in any business.  In senior living, we need to revise our mental images of the stereotypical resident if we are to successfully market to this generation.  Because of the preponderance of celluloid images that keep our heroes forever young, it’s hard to imagine that ELVIS would be 76 this month if he were still alive.  Do we really believe that this generation whose icon flew his entourage in a private jet from Memphis to Las Vegas just to get a “PBJ”[ii] will be satisfied with a set menu at set times in a set place as is common in many communities today?

Is it reasonable to assume that the generation that fostered the 20th Century success of higher end hotel companies (e.g. Marriott, Hyatt and Four Seasons) – with concierge floors, lounges, suites, king-size beds, etc. – will accept 200 – 300 square feet of personal living space?  Will they be prepared to “give up” their home to move into a space that’s probably smaller than their current bedroom?

Will the members of this generation who have been used to success, affluence and independence be prepared to turn over control of all their daily activities to facility staff with programs such as arts & crafts – see “Summer Camp for Seniors” – as their only daily stimulation?

This Bobby-sox generation is often overlooked as it is sandwiched between the “Greatest Generation” – which includes the World War II veterans – and the huge numbers of “Baby Boomers”.  Yet, there are over 20 million bobby-soxers in the U.S. today, accounting for approximately 7% of the total population.  This group accounts for over 50% of the 65+ population (Medicare eligible) in the country and there are now 15% more living members of the Bobby-sox generation (10 year group) than all prior generations.[iii]

The following pictures depict a sampling of well-known Bobby-soxers from business, government/political, sports and entertainment industries.  Although these celebrities are more recognizable, each represents many other everyday members of the generation from all aspects of society.

See which, if any, of these individuals come to mind when you think of 65 – 75 year olds.   And then, THINK AGAIN because they are rapidly becoming your TARGET DEMOGRAPHIC.

NOW IS THE TIME TO BEGIN PREPARING!

 

Frankie Avalon (1940) and Annette Funicello (1942) – Singers, actors & former teen idols; she was the favorite Mousketeer

Alan Alda – Captain Hawkeye Pierce on M.A.S.H.  (1936)

Tom Brokaw – TV News Anchor & Author of “The Greatest Generation” (1940)

Bill Cosby – Comedian & Actor(1937)

Neil Diamond – Singer/Songwriter (1941)

Elizabeth Dole – U.S. Senator & Cabinet Member; head of American Red Cross & wife of Presidential nominee Bob Dole (1936)

Mike Ditka – Pro Football Player, Coach & TV Commentator (1939)

Michael Eisner – Disney CEO (1942)

Jane Fonda – Actress & Political Activist (1937)        

Harrison Ford – “Indiana Jones” Actor (1942)

Morgan Freeman – Actor (1937)

Louis Gerstner  CEO of IBM (1942)

Joe Gibbs Hall of Fame Pro Football Coach  with the Washington Redskins (1940)

John Kerry – US Senator & Presidential Candidate (1943)

Sandy Koufax – Major League Baseball Pitcher & Hall of Famer (1935)

Ralph Lauren – Fashion Designer (1939)

George Lucas – Creator of “Star Wars” (1943)

John Madden – NFL Coach & TV Announcer (1936)

John McCain – Retired Navy Captain, Senator & Presidential Candidate (1936)

Mary Tyler Moore – Actress (1936)

Joe Namath – New York Jets Quarterback & Super Bowl Champ (1943)

Jack Nicholson – Actor (1937)

Al Pacino – Actor  (1940)

Colin Powell  Retired General (US Army), Chairman of Joint Chiefs of Staff, & Secretary of State (1937)

Paul Prudhomme – Chef (1940)

Robert Redford – Actor & Producer (1936)

Pete Rose – Professional Baseball Player (1941)

Diana Ross of the Supremes (1944)

Jay Rockefeller – U.S. Senator and former West Virginia Governor (1937)

Barbra Streisand – Singer & Actress (1942)

Ted Turner Entrepreneur & Media Mogul (1938)

Tina Turner – Entertainer (1939)

Jack Welch – G.E. Chairman/CEO (1935)

Raquel Welch – Actress (1940)

Jerry West – NBA Icon (1938)

ADD A COMMENT

to describe a BOBBY-SOXER who represents this generation [They don’t have to be well known like the people above].

PLEASE discuss ways in which their personality, needs and demands will be different than the “Greatest Generation” and/or individuals currently residing in senior living communities.


[i] Both published by Art Carr on the Progressive Retirement Lifestyles BLOG.  Go to http://wp.me/pCemc-3f and http://wp.me/pCemc-5x respectively.

[ii] Peanut butter and jelly sandwich.

[iii] 2010 projections are from: Table 12. Projections of the Population by Age and Sex for the United States: 2010 to 2050 (NP2008-T12), Population Division, U.S. Census Bureau; Release Date: August 14, 2008

What Does the Future Hold for the Senior Living Industry?

Dust off the crystal ball, get out the Ouija board and tarot cards, and check with your swami! There are signs that we are coming out of the recession, so will the senior living industry quickly rebound and get back on track?

After all, the “graying of America” is no secret. The Administration on Aging[i] reports that the number of “older Americans” (i.e. over 65) grew by 4.5 million to 38.9M in the 10 years ending in 2008 and are expected to increase to 55 million by 2020.  The 85+ population will increase by 43% to 6.6M from 2000 to 2020 and will just begin to include the “bobby-sox generation (born from 1935 – 1945) with NO baby-boomers in that statistic.  So, won’t that create a “rising tide that floats all boats”?

OR, are there other forces at work that will have a profound and long-lasting impact on the industry? Have these forces been gathering strength behind the scenes while the industry accepted blanket excuses for census declines because of the real estate problems and loss of portfolio values?

Perhaps, now is the time to learn some lessons from the Long Term Care Industry. The 1980’s were “heady” days for that segment of the senior care spectrum. Each year, more facilities and beds were added and the financial markets were happy to fund the growth and consolidation of the industry. They read the statistics at the time and KNEW that the demand would continue unabated “for our lifetime”.  Beverly Enterprises was the clear growth leader after securing the first public equity funding in 10 years in 1980. This and other financings fueled their growth from 100 facilities in 1980 to almost 1200 by the end of the decade.  Hillhaven and others soon followed suit.

So, what happened?  Why did Beverly shrink to less than 300 buildings?  Why has the total number of SNF beds and facilities been decreasing each year (to only 16,000 facilities today)? Why didn’t the demographics continue to drive the growth of the nursing homes?

Obviously, there is no one universal answer to these questions.  Changes in the hospital payment system clearly had an impact on the type of patients being discharged into the SNFs. Meanwhile, the intermediate care (“walking wounded”) residents, and especially the private pay, disappeared from the nursing homes.  WHY?  Because of the rapid development of alternative services for these individuals:  ASSISTED LIVING, INDEPENDENT LIVING and HOME HEALTH.

Americans continue to live longer and the number of older Americans has continued to increase.  The difference is that they no longer have to look only at nursing homes as their source for elder care and support. The introduction of these other alternatives caused a major and permanent shift in the elder care paradigm.

TODAY’S SENIOR LIVING COMMUNITIES FACE THE SAME TYPE OF CHALLENGE AS THE NURSING HOME OPERATORS IN THE 1990’s.

Various studies[ii] have shown that between 85 – 90% of older Americans wish to age-in-place and there are a multitude of new technologies being developed to assist them in achieving that goal. Meanwhile, both independent and assisted living communities are increasingly hearing: “I’m not ready yet!” when communicating with their leads. The question may soon change from WHEN they’re ready to “Will they ever be ready to move-in?”

With the poor economy, it has been very easy to bury our head in the sand and assume that “I’m not ready yet!” is a subtle excuse for the prospect’s inability to afford the services at this time. Although this may be true, it’s also likely that newer generations of prospective residents are less willing to compromise with lifestyle choices than their older siblings and/or parents.

Currently, many assisted living facilities have minimized their census drop by focusing on potential residents with heavy care (and/or memory care) needs. This has been a decent short-term solution to the economic downturn, but parallels the nursing home industry’s gravitation towards heavier, skilled and even sub-acute care.  While they focused on moving those types of patients in the front door, the lighter care residents were going out the back door and into the new assisted living communities 10 years ago.

WE MUST OPEN OUR EYES AND RECOGNIZE THE THREAT OF THE AGING-IN-PLACE PHENOMENA! Otherwise, assisted living will simply become “junior” nursing homes and independent living will struggle to find suitable residents.

As ALFs become more like nursing homes, with heavier and heavier care residents, the probability of increased government oversight and regulatory requirements increases. When that happens, the flexibility to run the buildings with a consumer driven approach will decrease as the cost of care goes up.  Not a pleasant forecast!

Will the government step in and dictate changes to the industry as they’ve repeatedly done for nursing home residents? For instance, while many senior living communities still require all residents to dress for breakfast and be in the dining room at 8am sharp, the new MDS 3.0 being implemented October 1, 2010 for nursing homes requires that residents be allowed preferences for time to awaken, etc.

In a private-pay, “resident-first” environment, these would appear to be “non-issues”.  Yet, one female resident complained: “I worked all my life and had to get up in the morning.  Now, I’m retired and don’t think I should be made to get up and get dressed by 8 o’clock in order to have breakfast!”

We need to learn from the nursing homes’ history where the population that was financially able to pay privately for their services “voted with their feet” as new alternatives evolved. This group told nursing home operators that their physical plants, care options and lifestyles did not meet their demands. Are prospective residents telling senior living communities the same thing today?

To counteract the aging-in-place THREAT, operators need to re-evaluate every aspect of their services to determine ways to add greater value to their prospective residents.  Future residents are likely to want more options and choices, with fewer rules and restrictions. Socialization and lifestyle enhancements (probably more than upgrading the appearance of the building) need to be strong marketing points.  Incorporating some of the “stay-at-home” technology into the senior community may be advisable.

Let Progressive Retirement Lifestyles help you with this evaluation process and turn the aging-in-place challenge into an opportunity. Call Art at 615-414-5217 to discuss the creation of unique outreach programs that provide services to and generate revenues from your prospects who aren’t “ready yet”.

READ COMMENTS


[i] “A Profile of Older Americans: 2009” published by the Department of Health & Human Services’ Administration on Aging.  CLICK HERE for link.

[ii] For example, see Tessa ten Tuscher’s Investor Presentation for Living Well Assisted Living at Home on SlideShare on LinkedIN.

“Do not go gentle into that good night”

– Dylan Thomas

 

In the 1920’s, T.S. Eliot ended “The Hollow Men” with:

This is the way the world ends
  Not with a bang but a whimper.”

This became a philosophy of aging for 20th Century generations.  The senior living / care industry offered protective living environments to meet the expectations of these generations as they aged with increasing physical and/or mental frailties.

BUT the 21st Century is a different world and the bobby-soxers (born 1935 – 1945) and baby-boomers won’t be satisfied to simply fade into the sunsetas their parents and grandparents did.  They won’t “go gentle into that good night” and the senior living industry must evolve to meet the increased demands of these future generations.

Today’s senior living communities were designed to provide care and services for “The Greatest Generation[1]and/or their parents.  These individuals lived through the Great Depression and were molded by the experiences of World War II.  They worked hard and made a better life for their children who often became the first in their family to attend college.  Frequently, they worked for the same companies their entire career and were rewarded with generous retirement packages, including lifetime health benefits.  Others built their own businesses, anticipating that their children would join and then succeed them in operating the company.  In either scenario, the parents were expected to retire with their productivity and significant contributions to society at an end.

The general message from the adult children and even the government has been:

You’ve done enough.  Just sit back and let us take care of you.

Medicare and related programs in the mid-1960’s created the funding for the development of modern health services to “insure” adequate care for these elderly.  Nursing homes and home health evolved from cottage businesses into professionally managed multi-million dollar industries.   Assisted living, independent living and investor owned CCRC’s developed to supplement non-profit (primarily church-related) life care communities and traditional “old folks” homes.

Operators built self-contained communities and assured residents that all their needs could be handled within these enclaves.  Food and shelter, security and transportation for essentials such as doctor appointments[2] were provided.  Activity programs were scheduled to entertain and fill the residents’ days.

Today, prospective residents are told that their worries will be over if they agree to move-in and pay an all-inclusive fee.  Concerns about meals, cleaning and maintaining the house and yard, or paying insurance and utilities, etc. are eliminated.  Depending on the type of facility, care needs may be provided directly by facility staff or arranged with private caregivers / home health companies.

This comprehensive approach led one resident in a recent Tennessean article[3]tostate: “They really take good care of me here. . .  They do everything for you.  They would even make my bed if I wanted them to, but I said ‘No, I want to do something.’”

Progressive Dependency

This chart demonstrates the loss of independence and increasing dependence on caregivers as the senior progresses through varying levels of care.

For individuals who experienced the shortages and deprivations of the Depression and World War II, the value equation was fairly simple.     They understood that the move to a senior living community was a compromise as their health and support needs increased.  They were used to adapting so giving up some independence to receive service was an acceptable alternative and they were willing to live with restrictions such as standard meals at set times.

However, these generations are dwindling – e.g. World War II veterans are dying at the rate of 1000 per day. [4] The replacement generations do not appear as willing to accept this one-size-fits-all-mentality.

The industry has seen quarterly declines in average occupancy for more than 2 years with blame placed largely on the economy and specifically the real estate market.  It’s time for a wake-up call if the industry wants to rebound from this census slump.  Another hidden (or ignored) factor is the “changing of the guard” with new demand models and demographics for today’s aging population.

There currently seems to be an over-riding preference for “Aging in Place”.  The Tennessean[5] states: “Despite more alternatives than ever, the overwhelming majority of elder Americans choose to age in place — in their own home, within the communities where they have lived for decades or have family ties.”

At some stage in the aging process, however, staying at home may NOT be the best option. Health and care needs, financial considerations, safety concerns, marital situation, housing condition, proximity of family members and the availability of caregivers and other components of a strong support system are factors that will impact this evaluation.

Yet, many senior specialists[6] note that the elderly will often stay in their own home until a “crisis” arises.  As a result, the senior is often “placed” in a higher level-of-care than required, with an unneeded loss of independence.

This is obviously not the best for the resident.  Could a senior living community do something differently to encourage the individual to move in earlier?

First, recognize that today’s aging population demands more than three meals a day and the “3-B’s activity program” – i.e. bingo, bible and birthdays.  They are not willing to retire their egos when they stop working.  They desire many more active and productive years with the ability to control their own destiny.

Focus on lifestyle vs real estate.  A HOUSE is an “object that can be bought and sold” while a HOME has “meaning and attachment to … personal living space” that can’t be “bought or sold”.[7] It takes more than living in a Taj Mahal to generate enough value to prompt a move-in.

Apply a scientific approach to the structure and organization of daily activities for the residents.  Utilize Maslow’s theory and healthy aging concepts to challenge the residents to continue to age gracefully, achieve new successes and “CREATE PRECIOUS MEMORIES”.  Treat the residents with dignity and respect by developing imaginative programs that stimulate and challenge their mind, body and spirit, going beyond the kindergarten style Summer Camp for Seniors[8] or cruise ship mentality.

Become familiar with the research about the negative impact isolation has on aging and couple this with Maslow’s need for socialization to develop a powerful marketing tool – offering a SOLUTION for potential residents and, especially, their adult children.

Revise marketing strategies to include education about your scientific approach and other 21st Century initiatives.  Use these to differentiate your community from the competition, AND eliminate prior perceptions.

Train staff to PROMOTE INDEPENDENCE by “helping” residents with their activities of daily living, but not “doing it for them!”  A former resident related an incident where she was made to feel “helpless and incapable” because, at an outing, “everyone tried to get food for me as if I couldn’t do things for myself.”[9]

Finally, accept that the new generation is guided by the words of Dylan Thomas:

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.


[1]Tom Brokaw, 1998.

[2] Maslow refers to these as “basic” needs in his Hierarchy of Needs.  Select “Maslow” in the CATEGORIES drop-down box to access additional articles dealing with differing levels of needs.

[3] “Facilities offer convenience and care” by Jessica Bliss, 12/27/2009.

[4] Associated Press, May 24, 2008

[5] “Elderly forgo assisted living – opt to stay at home” by Jessica Bliss, 12/27/2009

[6] Click on this link to review comments posted in the Senior Care Services Companies group on LinkedIN.

[7] Courtesy of Jason Popko.

[8] By Ellen Brandt, Ph.D., August 1, 2009 on the Ellen Interactive blog.

[9] Essay by Betty Warren, Hickory, NC, 2006

Do Senior Living Communities Need a Wake-up Call?

Although the housing slump may have “bottomed-out”,  occupancy declines, especially for independent living, are more widespread [1]. for-rent-sign-02.jpgWill the industry re-bound with a business-as-usual mentality?  Will new generations of customers be satisfied with today’s level of service?

There is no question that the real estate crisis and decline in portfolio values have impacted occupancy in senior living communities.  AND, it’s easy to buy into the concept of “We just need to hold on, the demographics are still there, and we’ll be OK as soon as the housing market recovers”.  The reality may be very different.

While the country has been in the economic doldrums over the past couple of years, several dynamics have been changing, largely un-noticed by the industry.  First, the demographics are changing – the target market is gradually moving away from the “greatest generation”[2] [World War II vets are dying at the rate of 1000 per day] – and the industry must prepare for the “bobby-sox” generation (as a prelude to the “baby boomers”).

This generation, born between 1935 and 1945, is affluent and benefitted from the medical advances and healthy lifestyle initiatives of the 20th century.  As a result, they will have longer life expectancies with more males in the target population.  They demand value and will be less willing to compromise than their parents and older siblings who were tempered by the depression and WW II.

In the 1990s, assisted living (“AL”) developed as an alternative to nursing homes, and independent living (“IL”) has in large part developed as an alternative to assisted living facilities.  The newest option is “aging-in-place” with various surveys documenting the desires for aging adults to stay in their own home.  In the past, this wasn’t practical for many people, but we are seeing the development of a number of new companies that use various enabling technologies to provide cost-effective alternatives to senior housing. For example:

image002A study several years ago indicated that up to 80% of AL admissions were driven by the need for assistance with medication management.  Yet, there are now numerous automated medication reminder systems for use in the home.

Numerous organizations have developed cognitive fitness systems to provide brain exercises and delay the effects of Alzheimer’s and other senile dementia.

Rosemary Bakker, a gerontologist with Weill Cornell Medical College has established the website This Caring Home to help caregivers and family members design a “smart home”, allowing individuals with early stage dementia to remain in their own home.

In addition to the psychological appeal of these options, the current economic malaise is forcing prospective residents – and their families – to become more value-conscious consumers.  These products and services will take market share from IL and AL communities by offering greater independence at lower costs.

As a result, the standard AL resident in the future may become a medically complex individual with multiple health/psychological conditions.

The impact on the traditional IL model may be even more dramatic.

Is Everything Doom & Gloom?

The answer is that it doesn’t have to be – IF operators heed the wake-up call and are willing to consider new options:

1.   Embrace new technology, instead of resisting it.  Future generations won’t appreciate things such as internet access, a social networking site for the community, etc. as an added value – they will expect it as a minimum level of service.

Technology should be utilized to promote independence (no matter what level the resident demonstrates at move-in).  View this as an investment in extending the higher functioning of the resident for extended periods of time, which should decrease the turnover rate, extend the average length of stay, and increase the occupancy percentage.

Offer the same technology services that are marketed for “at-home” care in a bundled package, so that the senior living community becomes the value-added solution.  Sell the advantage of having someone on-site who can and will MANAGE the technology for the senior, at the same time they are receiving other traditional services such as meals and transportation.

2.  Meet more than the basic needs for the residents. Abraham Maslow developed a Hierarchy of 5 levels of needs, as depicted in this diagram.image001

The senior living industry has traditionally done a good job of meeting the basic physical and security needs of the residents.   However, there is tremendous opportunity to offer and market services that address their higher-level social, ego and self-actualization needs.

In fact, programs meeting those needs could be the differentiators that trigger the move-in decision.  Interestingly, these needs are the most difficult for the senior to achieve while living alone in their home.

Too often society has assumed that seniors forgo these higher-level needs when they “retire”.  Yet Lasell Village, a CCRC located on the campus of Lasell College in Massachusetts was created around the principle that retirees would move into an independent living setting where they would be committed to an annual continuing education curriculum.  This program is clearly helping the “villagers” achieve their “Peak needs”[3]!

Senior living communities must adjust with the times and add these value-added initiatives if they wish to overcome the inertia caused by the economy and plan for the future generations.

What initiatives are you taking to use technology and/or meet your current or prospective residents’ higher level needs?  Please add your comment by clicking on “Leave a comment” below:

Additional Links for New Technology Options:

Good Design Age Well

Center for Technology and Aging

CareData Trak

CogniFit

Dakim, Inc

GrandCare Systems

MyFitBrain

TheCaringStore.com

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[1] NIC MAP®, 9/1/2009

[2] “The Greatest Generation” by Tom Brokaw (1998)

[3] “Peak – How Great Companies Get Their Mojo from Maslow” by Chip Conley (2007)