This seems to be the underlying proposition of virtually every senior housing community: Let us entertain you to death.
The Classic Eagles song “Hotel California” ends with these words . . .
‘“Relax”, said the night man, “We are programed to receive. You can check-out any time you like, but you can never leave!”’
This seems to be the underlying proposition of virtually every senior housing community: Let us entertain you to death.
The Classic Eagles song “Hotel California” ends with these words . . . ‘“Relax”, said the night man, “We are programed to receive. You can check-out any time you like, but you can never leave!”’
One of the biggest challenges senior housing confronts, particularly with respect to the Boomer Generation, is that the underlying proposition of virtually every senior housing community is this:
“Move into our community where we will entertain you until you die.”
It might even be fair to say we are entertaining our seniors to death.
The Upscale Hotel Experience
A year or so ago, I attended the annual AHCA convention in Las Vegas. I am not quite sure how happened, but I ended up with a room in the Four Seasons Hotel. This was quite a treat/experience for me because I am more of a Hampton Inn kind of guy. At first it was kind of fun, particularly because I could say “I am staying at the Four Seasons” but honestly, I found it a little creepy. One morning I was running late, jumped into a shower and left my dirty clothing lying on the floor. I came back after breakfast to tidy up and found someone from the hotel had come in and cleaned it all up, including my dirty socks and underwear. When all was said it done it was a fun experience, but if someone offered to let me live out the rest of my life in a Four Seasons Hotel I would pass on the opportunity in a flash. I know that living in that kind of luxury would be terribly damaging to me. I would lose my physical health and even more importantly it would destroy my mental health. My brain and my body would more rapidly decay from laziness.
Beyond Entertainment
While I believe entertainment needs to a part of every community’s activity program, I don’t believe it should be the most important part, I would argue that it should be the least significant part. Activities programs need to start with the premise that seniors want to learn, to grow, to create and are capable of doing so.
- I envision a senior community that have a wood shop, an art studio, a potter’s wheel, a computer classroom, a video studio and video editing equipment.
- I dream of a community where school children come to be tutored and read to.
- I would love to be involved in a community where the residents are giving talks to their fellow residents about the things they are experts in or just interested in.
- I imagine a community where there is a vegetable garden that produces food for the community itself and for others in their town that are in need.
- The community I would want to live in, would have an underlying philosophy that my life still has value. That I as a resident I still have things I can contribute to the housing community I live in and perhaps more importantly, that I can still contribute to society as a whole.
On Thursday this series will conclude with my vision for the right kind of activity program. Some Questions:
- What would your ideal activity program look like?
- Maybe you already believe you have the greatest activity program and would like to share what you are doing and what makes it so special.
- Do I have this picture all wrong?
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I agree with you 100%. I have seen too many folks move into AL and then feel totally worthless and feel they have no value! I have seen their health decline because of this as depression sets in. People need to feel relevant and worthwhile…..and our elders really have a lot to give to others but they just don’t have the opportunity in the current day facilities.
There is a German group (the Augustinum Group) that would fulfill every one of those points that you wish in your ideal community. It is based on the CCRC model. And also a place where developmentally disabled adults receive training. Cross pollinating the communities with different populations is a benefit to all. I cross pollinate generations to some small degree with my folks and community members in the retirement community where I am fortunate enough to spend my time> (work is not a term I would use, I thoroughly enjoy my interaction for “my folks”!) Here at our CCRC, the residents give talks about experiences or classes that they taught in years past. (We are situated in a vibrant university town so there are plenty of profs who live here)
I think that your ideas are spot on…Could this work within an entirely new model of retirement living? Which brings me back to the Co-housing CCRC idea that I talked about earlier in a previous post. Is it worth it to find and brainstorm those ideas that you have had and I as well to see what new communities we as a collective group can come up with?
Hi Laurie: Thanks for confirming what I wrote. One of the great ironies of this issue is that perhaps if we made some of these radical changes, we would see an increase in the percentage of seniors who are living in senior housing communities. This is something I wrote about a few months ago in my article The 1% Difference . . . Imagine the Impossible!
Steve
Hi Peter:
The German model sounds very interesting, I will have to do some research. I am working on an article about a community that will start construction next year that will incorporate a lot of these ideas. It probably won’t get published until after the first of the year.
Steve
Absolutely correct. Independence and social interaction within, and external, to the community is absolutely essential to active, healthy aging.
I totally agree! The newest research shows a healthy brain learns at every age AND that new learning strengthens the brain!
I teach science classes at ccrcs and assisted living. I know we never stop being curious humans eager to learn something new!!
What a delightful concept. I want to move into this community! I want to live till I die. So thanks for this wonderful commentary and list of I wants. Happy Holidays to all!
Your article is spot-on. Front-line staff at assisted living communities and professional care givers need training on how to cultivate a natural conversation with their residents about activities. Lifestyle and community should not end when a senior moves into a residential facility. During my tenure as an assisted living administrator , I would know the “core” activities. But I would always modify, add or delete based on the wants of the residents. The key to success is to ask the residents what they want.
I ran one building where the residents insisted that we had BINGO twice a day. Satisfaction was high in this building but not in another. The same can go with frequent outings versus having guest lectures. Chair Yoga might not work for everyone but at least it is introduced.
In regards to entertainers, the best entertainers have been those that engage the audience. Visiting a senior where the piano is played in the corner and half the audience is asleep is not a good source of entertainment.
It has been my first hand experience that the elderly want similar opportunities just as they did when they were younger adults. Now that I consult with families and professional caregivers, my top recommendation is to look at the facility activity program. It tells you a lot.
I like those ideas, but I might be prejudiced (note the last name). Especially want computer/internet access, so I can learn what those “HTML tags & attributes” are about. I’m almost ready to move in when we find it.
From LinkedIn Groups
Group: Senior Care Services Companies
Discussion: Let Us Entertain You to Death
I never thought of it that way. CONTRIBUTING to the activity instead of just doing it….I like it and get it.
Posted by Kimberly Moulds
From LinkedIn Groups
Group: Senior Safety and Security for Long Term Care
Discussion: Let Us Entertain You to Death
“While I believe entertainment needs to a part of every community’s activity program, I don’t believe it should be the most important part, I would argue that it should be the least significant part. Activities programs need to start with the premise that seniors want to learn, to grow, to create and are capable of doing so.”
Steve, if you can edit your discussion to include this, it’s more reflective of your content of the article than the lede. This is an extremely valuable article on how communities should be structured to give the residents purpose in the outside world. I am thinking about including it in today’s updates for Telecare Aware (www.telecareaware.com) though it is not health tech oriented (our focus).
Posted by Donna Cusano
I am entirely in agreement, although I worked in communities that the residents felt the need to be entertained all the time. On weekends if there were no activities, they felt somewhat let down.
Eventually, as the census evolves their expectations will evolve as well.
Clara Arbiser
Wow – those are exactly the same sentiments I have. Merging multi-generations with a big-brothers-big-sisters type of program might also be a worthwhile effort. Match those who are working and need a sense of deeper meaning with seniors with similar interests. Works for both parties. I think structured volunteer program that allows the seniors and volunteers to come up with relevant activities would ultimately help fill future rooms with the families of those volunteers. Again…works for both parties. So many opportunities! I enjoy reading your posts and hope to one day be formally involved in senior living for a living so I can help make some of these dreams come true.
I was the activities director at a SNL. My supervisors often wanted me to schedule activities like “balloon volleyball” , crowning the King and Queen at the Valentine’s party, or placing items like “Wheel of Fortune on Channel 10” on the activities calendar. They looked at activities as a marketing tool so they wanted the schedule to be full. My 85 year old mother has never called her friends and invited them over for a game of balloon volleyball. It is fine to do creative ideas for physical therapy. I agree that providing the supplies for self intiated activites is a much better option.
From LinkedIn Groups
Group: On a Mission for Culture Change
Discussion: Let Us Entertain You to Death
Thank you for that article! I come from an organization that is Eden homes and culture change is very important to us. Part of the culture change is to provide meaningful activities to our residents. We have gardens and clubs. Our resident/elders join committees to make decisions that effect their environment. Mission Health Services also takes a group of residents to Moab (in southern Utah) to go river rafting. We are also instituting an arts program. Meaningful activities is the antidote to boredom, one of the plagues that effects our resident/elders in nursing homes.
Posted by Heather Hutchings
I vote for music & kids.
I’d love to see a music room – you could have a piano and other instruments available (can’t most people shake a tambourine?). One AL facility I know is physically co-located with a children’s preschool, and the kids NEVER visit the AL side of the building! I’m sure there are good reasons for the separation, but I’ve seen great grandchildren cheer up entire rooms of AL residents, why not have a weekly visit from nearby school children or music students? Lectures and movies are great but participatory activities are so much better!
I love what you envision for the future of the communities. I have a question though to feed off of it. I am in SW PA area. We have a few “CCRC” models here but I question if they are true “CCRC”.
Let me give you some food for thought. I have worked in the industry for about 7 years. I have been a referring agent helping families find care for 18 months and the rest as a director of sales and marketing for a national LTC provider as well as a locally owned provider (where I am at currently). My father who is in his 50’s was worried about not having LTC insurance. Quite frankly, due to his health and that of my step-mothers, I had told him that the cost of LTC would be outragious and to consider selling their house upon retirement and move to a CCRC, that there they would benefit from their investment.
But I have seen where these CCRC communities find ways that a resident may no longer “eligble” to stay within the services that they provide, after paying a hefty enterance fee, staying in IL, moving to AL and then perhaps a alzheimer’s unit. What I have seen, that if certain behaviors (not including any aggression that would require a 302, but something like undressing, swearing, etc) they were deemed not eligible and family had to find another place to leave. If CCRC are designed to care for you thoughout the aging process this also needs to be addressed to protect the investment. To me, I think that if you designate that you can provide care through all of the aging stages, then that should mean the progression of Alzheimer’s disease and the behaviors that come with it as well. I believe that the industry is going to change dramatically within the next 10 years and we need to think outside the box to attract the new consumers. One of the ways is by all of your points that you discussed and then some. But the health care reform I think is also going to play a role in how it changes to, and probably not for the best.
Great points Steve! I would add, “Just leave me alone when I want to be left alone!” Too often people are asked repeatedly to attend an activity that they don’t want to. It might even be something that they like. They just don’t feel like going at the moment. Aren’t there days you just want to stay in your pajamas and hang out? Don’t ask me what I wore all day while I watched the snow come down 🙂
At every facility I visit, every resident has a choice of what they want to do. No one is forced to go to any activity they do not want to go to. I do feel that there is too much emphasis on entertainment. The most beneficial activities are those which engage the residents. Growing vegetables is very nice, in a raised bed that the residents have access to. I am a horticultural therapist.
The average age of seniors moving into independent living facilities when I started 18 years ago was 86. They were required to be able to walk on their own without a wheelchair or walker. Rules have changed and the age has advanced a great deal and the people are moving with wheelchairs and full time aids into independent living. Many have too many impairments to fully enjoy the activities provided.
The average age of nursing home visitors are getting younger. More nursing homes are stressing short term rehabilitation, that is where the money is. Nursing homes have the most needy population and are the least funded for activities. Activities departments are understaffed as well.
Many people are suffering from diagnosed depression and that is another reason why they are unmotivated.
Agree completely with you Steve! I wrote an article in 2009 for the International Journal on Active Aging that talks about creating Purpose-Driven Senior Living Communities – in short – what if we built senior living not next to hospitals, but next to elementary schools, animal shelters, etc. What if senior living became an agent of change in the broader community by supporting residents to continue contributing, changing, growing. A PDF of the article is on my website kayvannorman.com Would love to hear your feedback. Kind Regards, Kay
Robert I agree that in most communities residents are given a choice. There are two problems with this: 1. The choice is often a meaningless activity or nothing 2. Many seniors will choice to just sit and watch TV, because they cannot see anything beyond that for the reasons you pointed out.
The other element of a great activity or life enrichment program, that I have not really written about but is hugely important is the the program director needs to be able to motivate people to get involved.
Thanks For contributing to the discussion.
Steve
Thanks so much for bringing up this very important point!
I’ve enjoyed working with one of the largest Osher Lifelong Learning Institutes in the country and the concept in this organization is a nice mix of concerts/lectures/plays with interactive opportunities like a beginners’ band, volunteering at such places as Southeast Guide Dogs and Lighthouse (blind services), a trip to a working dairy farm where participants churn butter, a Crime-Scene Investigation session that included vinyl gloves for all and a mock crime scene to investigate, and so many hands-on growing and contributing opportunities. Often IL communities (within a reasonable distance to an OLLI) make agreements that allow the IL residents membership in the OLLI from which they can choose a la carte activities from the OLLI catalog.
Also unique and interactive are some of the focuses of the Academy of Senior Professionals at Eckerd College (Florida) where seniors are involved in mentoring the undergraduate college students interested in careers those seniors enjoyed before retirement. You can imagine how rewarding such an arrangement can be for both parties.
Finally, in the early 2000’s, I remember a proposal being made to the University of Alabama by the then Director of the Child Development Center. She wanted them to consider building an IL and/or an AL next door to the Child Development Center to greatly increase intergenerational opportunities. I have not checked lately but believe this was in the works and would not be surprised to hear reports that thrust was a huge success for all involved.
So the concept is out there (hallelujah!) and slowly taking root. Hopefully it will soon be so ingrained in our thinking that we’ll operate this way instinctively.
By the way, loved the idea of a garden (elevated, per Robert) and will add that to my ever-growing list …