Laurie Orlov is a friend and publishes the website Age In Place Technology Watch. She sits in an interesting place in the world of seniors and aging. She has a strong "age in place" but also recognizes there is a place for senior living. My personal view is that she is too harsh on the CCRC industry and I wish she had offered some solutions. (So don't get mad and unsubscribe . . . please) Nonetheless, it is a provacative read and repressents a point of view. Her article is republished here with permission. - Steve Moran
Maybe You Have Ann Clinton Stuck in Your Mind Too
This woman and her husband spent $351,424 plus $4600 per month for the "security" of having access to the continuing care of a CCRC. The "continuing" part of the CCRC was in one direction – she discovered that returning in a motorized wheelchair from the nursing home section to the independent living bingo game engendered big protest – from the other residents as well as management.
You may have seen this yourself – people putting wheelchairs and walkers at a dining room door and limping in so that they could eat with friends in the "independent living" dining room. These are well-documented -- if not well-understood -- policies. The message, perhaps constructed by CCRC marketing (?) independent living residents don’t wish to see people who are not as "independent" -- or at least who don’t appear as independent -- as themselves.
When the Going Gets Tough – the Tough Change the Name
CCRCs have offered well-defined services -- even though the entrance financial mechanics vary widely – no doubt as a result of the economic status and available cash within the prospective market. Residents have been moving in who are older and frailer.
IL residents start out independent (perhaps), but may add private duty home care services and bumping up monthly expenditures to staggering amounts, in some places not discounted for couples. Perhaps you have also read about the effort to change the CCRC moniker to something more modern. No doubt there is great industry frustration with these average move-in ages in the mid-80s, with a shorter duration stay due to the resident's demise or not discussed much, running out of money.
The Industry Seems to Wait and See
Virtual assisted living – once discussed at a LeadingAge event by Evangelical Homes of Michigan exec Steve Hopkins -- didn’t seem to catch on – perhaps due to the large investment in brick-and-mortar, and even 10% or higher vacancy rates for Independent Living units.
What is taking the place of Independent Living?
For some younger folks, 55+ communities are seeing growth. At the other end of the age/health spectrum, senior housing firms are investing in memory care construction -- and that segment is growing. While senior housing overall growth seems relatively stagnant, the home care industry is booming, some of its workers supplementing inadequate staffing levels for frailer residents wishing to remain in independent living units.
Who Talks About the Marketing Elephants in the Room?
Many issues deserve more public discussion (thank you, Paula Span and The New York Times).
- The unsustainable private pay cost of assisted living -- more than $50,000 per year in some Northeast states.
- The average assets and income of older adults are declining and cannot last through multiple years in a CCRC.
- Life expectancy averages for women who reach 65 seem to be rising sharply -- up to and beyond 88 years. Does it surprise anyone that move-in is deferred until the mid-80s -- or even when dementia sets in? Perhaps average ages will rise again in coming years. Independent living residents may walk unaided into the dining room or into their apartment/home door, but how long will it be before they need assistance?
Marketers may disclose policies, but do they warn about practices that could sharply change the resident’s future years – where they will encounter segregated dining rooms, restrictions on roaming around a campus, and other, perhaps costly and painful lifestyle changes, beyond being able to play bingo?