By Jack Cumming

A recent New York Times news analysis by Tyler Pager quoted Derek T. Muller, a law professor, “It’s really hard to be a lame duck president or to be treated that way, and people are talking to you like your term’s already over.” The idea was that the President knows a third term is unlikely, but he’s using it as a distraction from his lame-duck status.

Residents for Life

That made me think of those of us who are residents in CCRCs. I suppose that residents in a rental model or resident ownership community can leave or stay voluntarily, so they aren’t lame ducks in the same way as is an aging resident with a nonrefundable entrance fee. It’s almost inevitable that many staff members will view such lifers as though resident views are like those of a lame duck, president or not.

Some residents are content with this status. Where I live, we have a woman who recently moved in at age 99. She’s delightful to be around, but I doubt very much that she has an entrance fee contract like most of the residents. One can only speculate, but I have to imagine that some allowance was made for her advanced age. A few months ago, she had her 100th birthday. That’s an extraordinary achievement, but we all know that it comes with a short life expectancy.

Onset of Frailty

Other residents have some health condition that leads them to believe that they should move in. It may be real, or it may be imagined. Or, they may simply no longer trust themselves to live where they’ve been, reacting to mounting stress from their advancing years. Others believe that with age comes fewer options if something happens. They believe that it’s best to move in sooner rather than to risk coming too late.

Typically, residents like these also think of themselves as lame ducks. They are content to just drift with the flow. Often, they don’t even keep up with the news. Some find the news stressful while they are seeking an end to stress. They only want happy talk and trivial chatter. They are resigned to the exigencies of old age and are content to wait placidly for life’s end to come take them away.

Trusting Optimists

Most residents just trust that all will work out for the best. Perhaps, as a general rule, most people are optimists and believe that life will work out just fine. They don’t want anything to disturb that sense of complacency. In corporate life, we call such people company careerists. They never question the status quo and are loyal to anyone above them on the corporate ladder.

The number of such unquestioning optimists increases with age as people’s sense of worth fades into their pasts. That is a challenge for senior living. It can be tempting for senior living leaders to lapse into complacency. That can lead to their missing changes in the marketplace in which people want purpose. Senior living can seem like institutionalization, meaning that self-realization abates, and people resign themselves to the myriad rules that govern their lives.

Shrinking Market

The consequence of that executive complacency can lead to a shrinking of the market opportunity as younger oldsters stay put and the average age at move-in creeps upwards. What might residents, or the industry, do to avoid this sense of being over the hill and now meandering down the other side in the valley of the shadow beyond?

The best choice for residents is clear. If you don’t want to be a lame duck, don’t be a resident. A better choice is to affiliate with a senior village, to come together with others in a co-housing venture, or to work with the social services staff at a local senior center. These choices are easier for those who delay residence than is the case for existing residents. Whether to stay in residence or to leave is a more difficult choice for them.

Industry Response

The industry’s choices are more evident, though it’s more difficult for an established industry like senior housing to evolve than for an individual to make choices. Any change would have to begin with ending the notion of final housing for old people. Those age restrictions, especially when combined with the notion of lifetime annuitized entrance fees to reduce future recurrent fees, label institutions as housing for human lame ducks. It’s only natural for residents to be labeled as lame-duck, over-the-hill oldsters in the last stage of life.

Of course, that’s not the case for those who move, say, in their seventies, from a single-family house to a multi-family dwelling, perhaps one near to assisted living or a hospital but not directly affiliated. That loses the connotation of senior housing, which may be exactly why such independent aging citizens are not viewed as lame ducks.

Unbundling Care

Many of today’s CCRCs have already moved from including care services from “independence” through skilled nursing as part of an actuarially determined flat-rate bundle called a Type A contract. They may still require acceptance of a bundle including meals and entertainment, but care services, which were and remain the core distinguishing element of senior housing, are often fee-for-service or paid for by escalating tiered pricing.

With that shift, senior housing loses much of its meaning. Perhaps it’s time for the industry to be seriously considering whether age restriction is serving a socially responsible purpose. It may also be time for many in the industry to drop the other shoe and to spin off care services into affiliated separate enterprises.

If an entity wishes to offer contracts, comparable to those of long-term care insurance, offering smooth access to services as needed with financial advantages, that is something that it might do. But, that would be a different business from the centrality of the care premise in today’s senior living.

Consequences

That leaves us with the central question. How would the market respond if the industry were upfront with the implicit outcome that residents are lame ducks for life? Would there be a better market response and a better social purpose if the senior housing industry were to step back from its pretenses and to reestablish itself as better living for all ages with an emphasis on services for older people?

Think of it this way. There are clear comparisons between cruising and CCRCs. Cruise ships, though, offer experiences. They are in the experience business. CCRCs, even when they pretend to be life plan communities, offer care services. They are in the healthcare business. Which would you prefer, a residential experiential life or a residential care-receiving life? The answer is self-evident, and so is the commensurate opportunity.