For most seniors . . . for most of us, senior living is a scary place. Thoughts on how to change that.
This blog was first published at stuhicks.com – Editor Before you argue with me on this, first sit down with ten prospective residents or their families and make that statement. โSenior Housing communities are scary places.โ Watch their affirmative smiles, see them nod, listen to their stories about fathers who vowed to never โgo there and grow old.โ
Are you ready to talk about how the Senior Housing industry is structurally broken?
Are you ready to examine the inherent flaws in the industryโs accepted model?
Are you willing to admit that the script American society forces upon our seniors actually hijacks the final act of their livesโ performance?
Relevance
I remember attending my first NIC conference and thinking that the industryโs name โ Senior Housing โ needed to be changed. I was excited to hear Margaret Wylde speak about the concept โ albeit her ideas seemed to fall on deaf ears at the time. (Weโve been fortunate to move away from โHousingโ to โLivingโ, but Margaret wasnโt even talking about that half of the monikerโฆ) Think about it. Regardless of age, who wakes up in the morning and says to themselves, โGood morning Senior?โ Again, just ask those prospective residents. Itโs rare to find an 80 year old, let alone a 65 year old, who thinks of themselves as a โseniorโ. So why does the industry pitch a product line that isnโt even relevant to its target market?1 Go just a little deeper into Senior Livingโs continuum of care communities to see how the industryโs own terminology is self-defeating. C.C.R.C.โs โ Continuing Care Retirement Communities โ pitch โCareโ and โRetirementโ to prospects who do not see themselves as old, in need of care, or want to join a community of โold peopleโ. Again, ask the prospects. Ask them this: โwhy havenโt you considered moving to a community before now?โ Itโs a valid question after all โ most C.C.R.C. and Independent Living communities make the claim that their offerings are perfect for 55+ adults. Yet count how many 57 year olds, or 62 year olds, or even 75 year olds that most communities expect to welcome this year.2 The answer to this question โ โWhy havenโt you considered moving to a community before now?โ โ moves us closer to the heart of the problem with Senior Living in America. But before we get there, letโs look at a Senior Living model thatโs far different from ours โ and is proving difficult for American operators to understand: China.
Should Senior Living in China be Our Model?
About the same time I entered the Senior Living industry I was blessed to meet an industry innovator whom youโve likely never heard of. Nancy Fox was an American born in China to missionary parents. We met through a friend who had told me very little about her grandmotherโs remarkable influence on the United States nursing home industry, but had mentioned Nancyโs love for chess. During visits to meet Nancy with my eight year-old son (who tried desperately to check his old foe as she regained her mastery of the game,) I discovered how the American concept of aging deeply corrupts what life in our Senior Living communities could be like. Nancy described the typical Chinese senior living community vividly. โFirst,โ she pointed a crooked finger at the plastic flowers and rarely played piano in her Assisted Living communityโs staged-for-the-public great room, โthe Chinese senior homes look a lot different than this. When I go into their community gathering rooms โ the women are all busy. The able-bodied are buzzing about, helping those who donโt move so well anymore โ like me. Thereโs humming and singing and lots of laughing and chattering. Some are knitting blankets, some mittens, some little hats. All for the village newborns. You see in China, the hospitals donโt give a take home bag with a swaddling blanket to every new mother like they do here in America. In China, the village relies on their seniors for these things.โ โWhen I walk down to the menโs work room thereโs a pot-bellied stove keeping everyone warm. The more able-bodied are sawing and hammering while others are sanding and painting. Same humming and whistling and chatting. Theyโre fixing toys. Because in China when a child breaks a toy they donโt go to Wal-Mart and buy two more. No, they bring the broken toy to the back stoop of the senior home and then come back a week later to pick it up โ better than new!โ โLook at this place,โ she said bitterly. โLifeless.โ โIn China they live with purpose. Here, weโre all just passing time.โ
And thatโs the difference . . .
In America we say to our seniors: โyouโve raised a great family, done well in your job, but now that youโre not moving as fast as the rest of us, now that you donโt talk (and think) as fast as the rest of us, itโs time to be cared for and entertained.โ And the Senior Living industry says: โif you can afford our community, then weโll offer you better care and entertainment than youโd ever get at home, or in your familyโs home โ where youโre really just a burdenโฆ.โ3 Care and Entertainment. Iโve worked with clients across the nation, representing over two thousand communities โ covering every quality level from โThree Diamondโ to โFive Diamondโ (where trips to mall are replaced by trips to the symphony) โ and the industry product line is best summarized as a Care and Entertainment model. And it leaves residents purposeless โ just passing the time. Without stating it outright, the American Senior Living industry says, โjob well done, time to retire in care and comfort, come to us and pass the time peacefully in your last chapterโฆ.โ And we wonder why data suggests the industry achieves less than 5% market absorption. When we have honest conversations with our prospects and are willing to ask why they havenโt looked at our communities sooner, we wonder why they say things like, โwe werenโt ready yet,โ or โweโre still independent.โ If weโre honest, weโll admit that the real answer behind those words is โwe arenโt ready to go where old people go to pass the timeโฆ where old people go to die.โ
Solving the Problem
So how should the industry go about solving this fundamental product flaw? Most companies wonโt be able to even consider the kinds of full scale changes required to re-position their communities to attract younger, independent, mature Americans. But some will, and those that are willing to accept the challenge โ to intentionally craft not only spaces and places, but programs and lifestyles that breathe purpose back into their residentsโ lives โ should find a growing market for their vibrant communities. (Click here to learn about a Vitality Model for Senior Living.) โ Notes 1) Solving this issue has become even more of a challenge now that even the worst storylines must be followed in order to achieve any reasonable level of lead generation โ the basic flaw we face as internet search engines (Google) make change and creativity liabilities to marketing success. 2) Existing I.L. community residents are around 82 on average, while new offerings arenโt doing much better at 79. 3) Industry marketers agree that the #1 concern American seniors have is: โwe donโt want to become a burden on our families.โ (Followed closely by, โwe donโt want to run out of money.โ)
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I’ve long been impressed by Steve Moran’s understanding for what needs to be said and for his courage in saying it. In today’s contribution Stuart Hicks maintains that call for forward thinking.
Hicks makes some valid points, and all thinking people among the industry leaders should pause to consider what he says. His first point, “Senior Housing communities are scary places,” should give people pause. No one likes to grow old; no one likes to be relegated to institutionalization; no one wants to become irrelevant to the larger society.
If the industry requires that those who buy its products concede that they no longer matter, then it clearly has a problem. That IS scary. If the alternative is that their children decide that their parents are no longer relevant, then that’s a bigger problem. That’s even MORE scary. My children don’t love me anymore; they’ve just put me away in a gilded cage.
When one is a resident, as I am, these challenges become still more manifest. But they need not be. There is an opportunity to rethink the industry’s preconception and to reimagine the needs that it serves and the products that are offered. This is something which imaginative residents well understand and to which they can make informed and clearheaded business contributions.
But too often executives only listen to residents to humor them and rarely to heed them. Residents become second class citizens merely by the act of moving into residence. That is not something that is well-understood before the move is made, but it is increasingly understood and the result is a growing resistance to the industry.
This need not be. This should not be. No industry can long endure if it treats as second class the customers who pay its fees and whom the industry exists to serve. This is a clear discrimination in which a person is judged by a decision to buy the industry’s products rather than by the content of their character.
In many, perhaps most, senior industry organizations a resident — no matter how well qualified — cannot serve on the board merely because that person is a resident. That is discrimination. That IS VERY scary. Why would any thinking person accept such second class status if they fully understood how out of tune the industry is with those it serves?
I couldn’t agree more.
50% of those in AL communities have some degree of dementia (a need-based reason they have moved in). Dementia care is the biggest growth engine for the business. In reality, assisted living is the new nursing home. What is IL? A long-deferred (for financial reasons) feeder system for AL.
It has become stranger and stranger to me that people with dementia needs are relegated, by and large, to real estate businesses. The AL model is a dysfunctional one on so many levels. And I found the article supportive of a healthier model and insightful. Yes, people know they have come to these places to “spend out their last days”. Of course, that’s scary. And passive “entertainment” does nothing to enrich their lives. People want to live lives filled with purpose. And a business model that puts mission before real estate sounds like a good place to start.
In my opinion, we make our places even scarier with our “industry” language of:
dietary, nursing, environmental department, human resources, etc. Hmmm!