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The Future of Independent Living

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By Jack Cumming

In a session at the LeadingAge meeting in Philadelphia, Cecily Laidman of Cadbury at Home, a Springpoint endeavor, asked . . . perhaps rhetorically . . . “Is Life Plan at Home the new independent living?” Rhetorical, perhaps, because the evidence in the room was so compelling that Continuing Care at Home (CCaH), the more common appellation, is most likely just that.  

Of course, it’s not unique in claiming to be the new alternative to independent living. The Village Movement, despite its limitations and its variations, also makes a similar claim. For what is generally a less affluent constituency, Naturally Occurring Retirement Communities (often with services) and PACE (Program of All-Inclusive Care for the Elderly) are not dissimilar. They all respond to the common preference of people to resist moving to a campus community in the early stages of aging.

What was surprising was the format of the panel. In the front row on the dais were five consumers – members of CCaH programs. The providers, who enable the CCaH service delivery model, were seated behind them. One of my personal heroes, Amazon’s Jeff Bezos, has said: “the 'secret sauce' to Amazon's success is an 'obsessive-compulsive focus' on customer over competitor.” In panel 087-A in Room 103 C on a Sunday afternoon at the Philadelphia Convention Center, that focus on the customer was on full display.  

The consumer-members who found peace of mind in their CCaH purchase, all after visiting numerous residential CCRCs, were uniformly enthusiastic. They particularly love having a Lifecare Coordinator check in on them regularly to make sure they are okay. In short, they have found for themselves that dedicated, self-sacrificing adult daughter (yes, it’s usually a daughter) to check on them and to look after them. Moreover, their real-life adult children are freed to continue in their lives, many of which are highly productive for society.

One consumer-member’s comment was that she had anticipated that someday she might have to live in a CCRC but after a visit to one, she knew she wasn’t ready for that yet. Joining the affiliated CCaH program assured her of assistance with minor challenges that might come her way with the understanding that she would go to the top of the waiting list for the popular local CCRC if it ever came to that. She found that commitment immensely reassuring. Others were reassured that the Lifecare Coordinator is a trained professional who isn’t shocked by their lifestyle, a lifestyle – two women living together – which some might still find disconcerting even in our more tolerant world of 2018.

Actuary Brad Paulus was on the panel to reassure attendees about the financial soundness of the programs. The CCaHs represented on the panel, as well as my experience suggests that most CCaH programs are actuarially determined to ensure that they are financially sound and to project how demand for services is likely to eventuate among an aging population of members.  

He also made the point that not only do CCaH managers have the resources to evaluate providers of in-home services for reliability, capability, and trustworthiness but that they also have the size as purchasers of services to demand that their clients receive the best of the best. Individuals, or more likely that real life adult child alluded to above, seeking services only after the need arises, do not have the same bargaining power.

Returning to alternatives like the Village Movement or Naturally Occurring Retirement Communities, it’s evident that CCaH programs can pick up where those programs tend to leave off. That’s when aging moves beyond the need for socialization into a need for active delivery of professional care services whether in the home or on a campus. As one consumer panelist, who is active in a local Village, remarked, “Many volunteers who are driving people to doctors’ appointments and the like, see through that experience the need ahead, so they are some of the most welcoming customers for CCaH programs.”

The prospect of age-related needs is common to all personality types, to all socioeconomic groups, to planners and non-planners alike. CCaH and its likely future derivatives provide an all-embracing model to give people the peace of mind they seek; to provide services when and as they are needed; and to help the industry reinvent itself to adapt to the newly emerging consumer mindset. Seeing those enthusiastic consumer-members on the panel at LeadingAge was refreshing.

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