By Jack Cumming
If senior living is to thrive and improve the lives of aging Americans, we have to change the perception, and the occasional reality, of the industry. This was driven home for me by a recent article I read on Medium. The title is “Assisted Living Isn’t Care — It’s a Crime with a Billing Department.” Wow! That’s devastating.
Our Demanding Mission
Accepting responsibility to care for frail and vulnerable people is a high calling. It should never be undertaken lightly, merely because it is a promising asset class. Of course, even with the best of intentions, things can go awry from time to time. Working with families, residents, and aging advocates — collaborating — can avoid we/they confrontations and improve performance.
The family that loses a loved one will naturally be mighty upset. But postings describing costly neglect, like this Medium article, are devastating for the industry, regardless of whether the descriptions are accurate or not.
If this is true for assisted living and skilled nursing, which provide for people who need care at move-in, think of how much more devastating it can be for the trust expectations of people who move into an independent living residential unit in a life plan community (CCRC). Many of them are locked in by entrance-fee commitments, so they have no good alternative if the management changes and care responsiveness is diminished.
Protesting Instead of Responding
To read much of the trade press, and the “educational” material published by industry advocates, including the leading trade associations, many providers see themselves as misunderstood, victimized by superficial, sensationalist journalism. That’s convenient and self-serving.
What’s comforting reassurance for those in the industry, though, doesn’t seem to be changing popular perceptions. It’s important that what people experience matches what they expect and what they think they’ve been promised. There’s been a flood recently of negative media reporting on individual situations.
We’ve long known that the industry, through its trade associations, has resisted constructive regulation that might have ensured financial soundness, fair contracts, and equitable resident experiences. Many providers still have a jaundiced view of their residents, even of talented independent living residents. That may reflect the intoxicating, addictive rush of top-down control and self-importance, but the outcome is a perception that senior living is not an industry to be fully trusted.
A Better Mindset
Safeguards to earn trust can result from effective collaboration with aging people and a resulting change in mindset. Residents want a safe, dignified aging experience. Subordination to corporate direction is contrary to meeting that expectation.
To achieve effective collaboration, the industry moguls would have to be willing to give residents the dignity of full partnership. It’s the residents who fund the industry. Not surprisingly, there are similar industries that are better servants of their customers.
Many private social organizations, qualified by IRC 501(c)(7), are member-led and member-governed. They may employ a club manager, but the manager is there to serve the members and not to meet the expectations of a corporate overlord.
Similarly, cooperative housing corporations qualified under IRC 216 are resident-led and governed. They also may employ a managing agent or property management corporation, but control and empowerment reside with the residents. As noted elsewhere, cooperatives are better than condominiums for entities in which resident deaths are common.
What Would Change Look Like?
If the industry trade associations were to collaborate with residents, prospective residents, and their families, aging in America could be much better than what it is. For now, too often, providers are selling institutionalization and pretending they’re not. That calls for change in substance and not mere semantics.
There are some who don’t think that senior housing buildings should be called “facilities,” even though that’s exactly what they are. Moving into a building or property will be moving into a facility, so long as residents give up the self-determination they enjoy in a home they own for residential living in a building owned by someone else.
The opportunity for collaboration may be the industry’s best hope for its future. Who might take the lead in trying to shift the trend toward empowerment and security? Will the leadership come from the advocacy associations, or will it come from entrepreneurial disruption?
This is one in a series of articles exploring how providers, residents, and resident families might work together for better aging.
