Following is my response to Senior Housing Forum 6/7/17 post, “The Senior Living Industry Is A Disaster And Will Never Get Better." Steve Moran, publisher, brought up several commonly held views of senior living that are addressed in this article. CLIKC HERE to view my response.
- Owners and operators are greedy.
- Companies don't really care about residents, or family members.
- Nobody is willing to change.
- The industry is too expensive.
Owners and operators are greedy. Companies don't really care about residents, or family members.
Owners and operators are like everyone else. They care about residents and family members. Some just don’t know how to demonstrate their care, and at the same time, remain solvent and build their public and/or private business.
“Care” is based on the same roots as “career” – “carros,” or “karros,” a word in many languages that mean “wagon” or “wagonload.” Owners and operators are carrying a heavy weight in a cart that bounces along a rocky road, not knowing exactly where they are going.
The senior living industry a tough industry, in which people who live in the communities are physically declining and dying. Many owners and operators work in the industry for personal reasons, such as having cared for a parent or close friend or having experienced working in various positions with residents in an assisted living or nursing community. As a result, they want to improve the quality of care for community members.
According to Nader Shabahangi, founder and CEO ofAgeSong’s elder communities for over 20 years:
At one point, the senior living industry only saw its role as one that assisted elders with basic living needs, not to help them live in meaningful communities that provide continued integration of elders in and with society. The former approach often led to the valid criticism of senior care providers ‘warehousing’ elders. This warehousing criticism was based on an overall simplistic approach to eldercare which led to large profit margins in the industry. Now developers and operators have a difficult time to let go of such margins. But in order to provide more sophisticated and intelligent care, more professionals in social work, psychology and other human services need to be employed, all people who cost more.*
Nobody is willing to change.
Like most of us, many senior living owners and operators don’t know how to change. The senior living industry, like other industries in the 21st Century, is in constant flux, because so much new information is coming in every day. In order for decisions to be made, information needs to be absorbed, digested, and shared. Owners and operators need to be ready to try different solutions and be open to changing a decision if a better solution comes along.
We all, including owners and operators, need to change the way we view terminology, such as “care” and “caregiving.” If we change the meaning of “caregiving” to “care partnering,” where owners, operators, family members, staff, and residents learn from each other, instead of of “caring for” residents, then we have a whole new approach to the senior living industry.
If we change the term “residents” to “community members,” then we equalize the playing field. Community members are like everyone else, including owners and operators. They happen to have one or more disability that requires assistance. Who doesn’t have one or more disability that requires assistance? How many owners and operators know how to operate the technology used in their communities? How many owners and operators make all their own meals? We all need care and we all have varying abilities!
When we see something we like or dislike about another person, we have that quality in ourselves. We see community members who are depressed, afraid of declining and eventually dying. Are we afraid of getting older? losing some of our memory and/or physical ability? Dying? The more we communicate meaningfully with community members, the more we learn about ourselves. All levels of employees need to be engaging with community and family members throughout each day.
Committed assisted living community staff and management often experience burnout, working long hours for low pay compared to other industries. According to Nader, “The carepartners, who belong to the lowest paid people in the United States – yet are asked with helping our elders (one time that will be you) in most intimate and relational ways – are tired of working two and sometimes three jobs to make ends meet.”
What if management, staff members and volunteers identify what they love to do and then explore how they can use their passions to fill a need in society, as advocated by Richard Bolles, whose career book, What Color is Your Parachute?, has sold 10 million copies all over the world?
What if they first experience a self-assessment of their motivated skills through a Knowdell card sort, (physically arranged the cards, rather than taking a paper and pencil assessment), and then apply their motivated skills to meet the perceived needs and preferences of community members in a way they could provide quality services for community and family members? For example, if a staff member or volunteer likes to write, she could interview community members and transcribe interviews for Pen Pal letters to elders in other assisted living communities. If an executive director has language teaching skills, he could conduct a staff English speaking session once a week.
What if we changed the way we view elders?
The profit margins of yesterday belong to an outdated concept of who are our elders: not useless members of society but rather highly mature, experienced as well as knowledgable people whose wisdom must be used to steer this planet and people in more sensible directions, whose experience can maintain certain ethical and rational standards of sustainability for both civil conduct and care of our planet.*
For many years, at AgeSong’s elder communities, members of the community, at any age, stage or ability, have been invited to join “Elders Academy,” and to participate in groups together. The groups are often led by community members. Individuals, who happen to have Parkinson’s, memory loss, aphasia, and other physical, emotional, or mental challenges, speak up, dance, sing, play music, have political, psychological, and philosophical discussions, and support each other. They are “meaningfully engaged,” rather that just “entertained” by professional entertainers.
Instead of dressing up the community for visits by current or prospective family members and state licensing representatives, management and staff members invite visitors to participate in the community. At AgeSong’s WoodPark community in Oakland, the daughter of a community member brought in a sewing box to engage her mother, who is deep into memory loss, with recollections about sewing, a hobby that her mother enjoyed in the past. The mother-daughter pair is joined by others who have interest in sewing. A family member led a men’s group. Family members play the piano and sing with community members. They hold birthday parties for their loved ones and invite members of the community to participate. Members of the community entertain their fellow elders playing the piano and singing familiar tunes. All management staff lead groups and walk the floors several times a day to engage with room-bound folk, as well as others who are roaming around the community or sitting in isolation in a public room. A “Family Connect” email is sent out weekly. Quarterly “Champagne Brunches” are held for families and friends with their loved ones. Volunteers and entertainers return frequently because they are having such a good time with community members.
In addition to the basic required assisted living skills, line staff and management staff, along with community members, family and friends, volunteers, and visitors, are trained to apply concepts collectively developed by AgeSong management staff, such as the following:
• Providing Meaningful Engagement with Individuals of a wide range of Ages, Stages, Forgetfulness, & Abilities
• Finding Meaning in “Challenging Behaviors"
• Seeking to Understand, rather than Control
• Recognizing Mental and Physical Interconnectedness
• Celebrating a Variety of Spiritual Beliefs
• “Getting to Know” New Community Members
• "Learning From," as well as "Providing Care For," Elders
• Celebrating the Cultural Heritage of Community Members, Staff, and Visitors
The industry is too expensive.
Why not design services and products that cut down industry costs and yet enhance quality of life? The time spent by care partners in providing basic living skills could be changed to “quality time.” Brushing hair could be a “beauty parlor” activity. Showering could be a “spa” event. Dressing could be the “Queen’s Dressing Table.”
Changing adult briefs every two hours takes much too much staff time, energy, and financial resources. How about changing how we view this unpleasant task to “Groom of the Stool?” Ben Franklin invented the flexible catheter for his brother in 1752. How about using urinary or other type of catheters?
Most of today’s senior living community owners and operators are not greedy. They passionately care about the folks who live in their elder communities (https://www.argentum.org/magazine-articles/making-senior-living-career-lifetime/) and are willing to change. Like most of us, many owners and operators just don’t know how to change, and at the same time stay within budget and make a profit. We all need to expand our vision of who elders are and how to both fill the needs of others and work with passion.
Elders are a resource, not a liability. Aging allows us to mature, not to decline. This shift in attitude towards our elders and anyone being older than what is considered young (and has that not moved to a younger and younger age with teenagers now being used in marketing and on billboards everywhere?!) – this shift, indeed, is the challenge ahead of us? Senior care providers can either help or obstruct the much needed attitudinal change towards valuing our more mature members of society.*
Companies really care about members of their community, staff, and family members. The industry is too expensive for most folk. There is a need to create products and services that keep costs down and keep improving quality.
NOW is the time for the Senior Living Industry to get better!
Dr. Sally Gelardin is an Elder Community Consultant. As former Regional Director of Engagement and Education for AgeSong’s elder communities throughout the San Francisco Bay area, Career Planning and Adult Development Career Coach, and Career and Life Transitions Educator, she writes articles for industry and public media and designs training programs for paid and family “care partners” (alternative way of viewing “caregivers”), volunteers, and community members on how to serve elders and how to be an elder. For more information, contact firstname.lastname@example.org and view sallygelardin.com.
Adler, J. Making Senior Living the Career of a Lifetime. Retrieved June 9, 2017: https://www.argentum.org/magazine-articles/making-senior-living-career-lifetime/
Bolles, R. Why Pursuing Your Dream is Still Important. Retrieved June 9, 2017: http://www.jobhuntersbible.com/articles/view/why-pursuing-your-dream-is-still-important?
Career Planner. How To Use the Knowdell Motivated Skills Card Sort. Retrieved June 9, 2017: https://www.careerplanner.com/Video/Knowdell-Motivated-Skills-Video.cfm
Fuller, J. Top 10 Ben Franklin Inventions: Urinary Catheter. Retrieved June 9, 2017: http://science.howstuffworks.com/innovation/famous-inventors/10-ben-franklin-inventions1.htm
Moran, S. The Senior Living Industry Is A Disaster And Will Never Get Better. June 7, 2017. Retrieved June 9, 2017: https://www.seniorhousingforum.net/blog/2017/6/7/senior-living-industry-disaster-and-will-never-get-better?pmc=MC&MyID=sal%40gelardin.net.
*Shabahangi, N. Reflections on Eldercare Today and In the Future. Retrieved June, 7, 2017. http://agesong.com/today/18204/reflections-eldercare-today-future.
Zarralli, N. It Was Once Someone's Job to Chat with the King While He Used the Toilet. April 6, 2017. Retrieved June 9, 2017: http://www.atlasobscura.com/articles/king-toilet-attendant-england