By Pam McDonald

Now that most senior living leaders are over the shock of the COVID-19 lockdown, Colin Milner, founder and CEO of the International Council on Active Aging (ICAA), believes they are ready to start looking to the future. He, along with Bob Kramer, formerly of NIC; Ken Dychtwald of AgeWave; and former U. S. Surgeon General Dr. Richard Carmona, organized a task force of industry thought leaders to begin envisioning the new next for senior living. He discusses their White Paper — Creating A Path Towards the ‘Next Normal’ in Senior Living — with Podcast Producer Pam McDonald. The following are some of the interview’s significant takeaways. Listen to the full podcast HERE.

As COVID-19 hit, I think everybody was in a state of confusion, trying to figure out what to do. The what to do was, rightfully so, do everything I can to keep my residents healthy and safe. But as time went on and it’s only been six months, all the focus was going on infectious disease control; managing people’s movements. But we’re not looking at what impact this is going to have on our future.

So, we brought together 154 thought leaders to try and figure out what this actually means for the next normal, because I don’t think there’s going to be a new normal, at least not anytime soon. It’s just going to be the next normal and the next normal. So here we are with this document (you can download it here).

By the way, there were 900 ideas, strategies, and tactics that were recommended that we whittled down to 35. And I’m not speaking from the scientific side; we leave that to the CDC, HHS, the World Health Organization. I’m talking about the business side. The business of bringing your residents’ lives back to life as opposed to remaining in lockdown. We created these 35 strategies and tactics to create a path towards the next normal.

Proactive versus Reactive

In the conversations that I was having everybody seemed frozen, and they weren’t thinking about what this actually meant moving forward. It was more reactionary. And what we wanted to do was to change that so we could look at it differently. As in, if I’m in the middle of building a project right now, what does that actually mean to the building that I create? Is this something that’s going to be around for a while or are there going to be other issues like this?

One of the strategies that came out of this is not just simply to have a plan, but to be prepared. In other words, to actually have a stock of PPE and other elements like that in your property so if an issue occurs, you can respond immediately.

We looked at how all of this is going to impact everything from the built environment to staffing, to technology. Because I can guarantee you, the one thing that we have seen, between H1N1, the swine flu, Ebola, is things aren’t going to stop. It’s just when they come, how prepared are we? How have we built, designed, and programmed our communities to respond to these pandemics?

Panel Selection

We had a lot of people who were trying to invite themselves to the task force and we were excited to see that. But we did invite individuals based on a variety of factors. One was that we viewed them as thought leaders in the industry. We invited people from a diverse group of communities and a diverse group of positions. We didn’t want just all CEOs from multibillion-dollar corporations, which we had. 

We had active adult communities, independent living, independent living apartments, CCRCs, assisted living, long-term care, therapy providers, and suppliers to the industry, as well as a variety of about eight or nine different industry associations. So, it was a moment of great collaboration where the industry really came together to imagine what the future might look like.

We asked and people were thrilled to participate. A couple of people were just simply swamped and couldn’t participate. It was a big ask because a half-day in the middle of a pandemic is a huge commitment. We held the meetings over two days so we would be flexible to people’s schedules; and some people participated in both of those meetings.

We sent them the ideas we’d generated and asked them to run those through their own taskforce on their site. We had 900 ideas that we then whittled down to the 35 that we thought would be: 1) implementable, 2) impactful, and 3) important to moving the industry forward. 

The Skilled Nursing Assumption Problem

The industry has been getting a black eye for a long time. All that’s happened is we’ve been hit now in the other eye. For many years, senior living has been positioned as somewhere that is your last stop. Now with COVID-19, the media makes you feel it is your last stop, even though that’s far from the reality. 

Everybody was painted with the exact same brush. So, if I have an active adult community that has zero cases of COVID-19 and my residents are still highly engaged in life, I’m being painted with the same brush as say, a nursing home down the road with 70 cases and 24 people who’ve passed away. That’s a travesty.

That was an issue the task force felt needed a lot more priority. The media needed clarity on the different segments of senior living. Senior living needed clarity on the different segments of senior living, as do families and residents of the communities, and prospects. There’s a lack of clarity out there.

We’ve been talking about it for 20 years now, but they say social change takes 30 years, so we’ve got another 10 to go, unless we do something about it and do it rapidly. I think this is a moment where we have the opportunity to reset, to look at how we want to move forward. 

We’ve been moving slowly. For example, we’ve been talking and talking about technology and all of a sudden in the midst of a pandemic, we’re rapidly embracing it. So, I’m hoping that good can come out of this awful situation, where we rapidly move forward.

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Active Aging

I’d like to see more emphasis put on the “active aging” instead of senior living, but that has been happening too over the last 30 years. I’ve seen a huge shift compared to when I first started ICAA nearly 20 years ago. Wellness has gone from a small room in the back of the community, typically an apartment with donated fitness equipment, and no staff. Now many communities have a stand-alone, furnished wellness center, that’s highly staffed. We’ve seen a big difference.

The definition that we use for active aging is really about being engaged in life, actively engaged in your lifestyle and the aging process. So, it’s not about becoming a marathon runner, even though that’s the aspiration for some. It’s about being engaged in all the areas of life so that we can get the most enjoyment out of the life that we have been privileged to call ours.

The 35 recommendations seemed to fit under two overriding themes: 

  1. How do we optimize the health and wellness of residents and staff, which, of course, is front and center right now? And, not just from the protection side of things. Now we’re seeing huge issues with social isolation and frailty because people are locked down, unable to get out. We’re seeing cognitive decline and emotional health issues. So, number one is looking at optimizing the health and wellness of residents and staff.
  2. How do we actually develop a new value proposition for senior living? Because the current value proposition is just taking a beating and is changing. The value proposition overall perceived by the public and the media has been — you come to a community, you get care, that’s it. Instead of looking at creating a lifestyle that someone wants.

Your Lifestyle Is How You Want to Live

As we emerge from all of this, people are going to be looking at, if a pandemic happens, how do I keep my lifestyle going? What is your community going to do to help me do that and do that safely? Your lifestyle is how you want to live. And the question is, how do you want to live the rest of your life? I think, as did the task force, that the communities focused on helping you get the most out of that, moving forward, are going to be even more front and center. 

Six Key Themes

Underneath those two areas are six key themes. 

  1. First, designing and redesigning or renovating the built environment, interiors and exteriors. The first thing you have to look at keeping well is the building. It has a huge impact on things like air filtration, sunlight, and the surfaces that you can manage for infection control. So, one of the key strategic questions was: what will a “well” building look like moving forward? How do you create spaces that are helping people to stay well? As an example, quiet spaces where people can meditate, by themselves if they wish, in an environment that is under lockdown.
  2. Another thing, establishing trust by being prepared. Not by having a plan, but actually being prepared for emergencies and unexpected events. Today, we’ve got floods, tornadoes, hurricanes, fires, blizzards, war; all of these different things. So, we just need to be prepared.
  3. A third focus is continuing to develop the purpose-driven, caring, passionate staff we have seen come to the forefront during this time. And that’s not just current staff, that’s as new staff come in. Bring them into your culture. Give staff more control over how they respond, as opposed to being micromanaged. What we’ve seen is the people who’ve stepped up and are doing things not in their job description. There’s a great opportunity to further the culture. So, when new people come in and you’re onboarding people, it’s “this is our culture.” This is how we are, not only positioning the community, but the community is this. Really continue that commitment beyond today’s employees, who have been rock stars, by the way.

(Get the last 3 themes in Part 2, coming soon.)

These takeaways have been lightly edited for space and style.