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. “Senior Housing communities are scary places.” Watch their affirmative smiles, see them nod, listen to their stories about fathers who vowed to never ‘go there and grow old.’
Are you ready to talk about how the Senior Housing industry is structurally broken?
Are you ready to examine the inherent flaws in the industry’s accepted model?
Are you willing to admit that the script American society forces upon our seniors actually hijacks the final act of their lives’ performance?
Relevance
I remember attending my first NIC conference and thinking that the industry’s name – Senior Housing – needed to be changed. I was excited to hear Margaret Wylde speak about the concept – albeit her ideas seemed to fall on deaf ears at the time. (We’ve been fortunate to move away from “Housing” to “Living”, but Margaret wasn’t even talking about that half of the moniker…) Think about it. Regardless of age, who wakes up in the morning and says to themselves, “Good morning Senior?” Again, just ask those prospective residents. It’s rare to find an 80 year old, let alone a 65 year old, who thinks of themselves as a “senior”. So why does the industry pitch a product line that isn’t even relevant to its target market?1 Go just a little deeper into Senior Living’s continuum of care communities to see how the industry’s own terminology is self-defeating. C.C.R.C.’s – Continuing Care Retirement Communities – pitch “Care” and “Retirement” to prospects who do not see themselves as old, in need of care, or want to join a community of ‘old people’. Again, ask the prospects. Ask them this: “why haven’t you considered moving to a community before now?” It’s a valid question after all – 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 – “Why haven’t you considered moving to a community before now?” – moves us closer to the heart of the problem with Senior Living in America. But before we get there, let’s look at a Senior Living model that’s far different from ours – 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 you’ve 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 grandmother’s remarkable influence on the United States nursing home industry, but had mentioned Nancy’s 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. “First,” she pointed a crooked finger at the plastic flowers and rarely played piano in her Assisted Living community’s staged-for-the-public great room, “the Chinese senior homes look a lot different than this. When I go into their community gathering rooms – the women are all busy. The able-bodied are buzzing about, helping those who don’t move so well anymore – like me. There’s 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 don’t 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.” “When I walk down to the men’s work room there’s 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. They’re fixing toys. Because in China when a child breaks a toy they don’t 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 – better than new!” “Look at this place,” she said bitterly. “Lifeless.” “In China they live with purpose. Here, we’re all just passing time.”
And that’s the difference . . .
In America we say to our seniors: “you’ve raised a great family, done well in your job, but now that you’re not moving as fast as the rest of us, now that you don’t talk (and think) as fast as the rest of us, it’s time to be cared for and entertained.” And the Senior Living industry says: “if you can afford our community, then we’ll offer you better care and entertainment than you’d ever get at home, or in your family’s home – where you’re really just a burden….”3 Care and Entertainment. I’ve worked with clients across the nation, representing over two thousand communities – covering every quality level from ‘Three Diamond’ to ‘Five Diamond’ (where trips to mall are replaced by trips to the symphony) – and the industry product line is best summarized as a Care and Entertainment model. And it leaves residents purposeless – just passing the time. Without stating it outright, the American Senior Living industry says, “job well done, time to retire in care and comfort, come to us and pass the time peacefully in your last chapter….” 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 haven’t looked at our communities sooner, we wonder why they say things like, “we weren’t ready yet,” or “we’re still independent.” If we’re honest, we’ll admit that the real answer behind those words is “we aren’t ready to go where old people go to pass the time… where old people go to die.”
Solving the Problem
So how should the industry go about solving this fundamental product flaw? Most companies won’t 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 – to intentionally craft not only spaces and places, but programs and lifestyles that breathe purpose back into their residents’ lives – should find a growing market for their vibrant communities. (Click here to learn about a Vitality Model for Senior Living.) — 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 – 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 aren’t doing much better at 79. 3) Industry marketers agree that the #1 concern American seniors have is: “we don’t want to become a burden on our families.” (Followed closely by, “we don’t want to run out of money.”)
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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!