By Jack Cumming

Gail Kohn is the coordinator for the District of Columbia’s age-friendly city initiative. She spoke recently at the February 15, 2022, 20th anniversary celebration of the village movement. For those who may not know, the village movement is a growing nationwide development to support aging Americans where they choose to live, which may not be on a senior living campus. It is a grassroots program that began in 2002 among a small group from the Beacon Hill section of Boston.

The Words of a Prophet

Gail Kohn’s remarks during the celebration sounded like those of a prophet. “What a pleasure to be here for this program,” she began. “It has been a walk through what has been an absolutely wonderful transition from where I was before I came into the village world … which was in an age-segregated continuing care retirement community … into the world of where people want to be, as opposed to the 5% who choose to be in institutional placements, as wonderful as they are. People really, really prefer to stay home.”

Not everyone will agree with Ms. Kohn. Some may even want to argue with her. But, if we listen to her, what can we take away that can help today’s senior living owners and operators prepare for the future that she, and others, clearly want for themselves?

  • First, we infer that she once worked for a CCRC, but she is happier working in “the village world.”
  • Second, she views the age segregation of CCRCs as opposed to the “world where people want to be.”
  • Third, she believes that no more than 5% of the eligible population choose “institutional placements,” which is a characterization that she associates with CCRCs.
  • Fourth, she observes that “people … prefer to stay home.”

Is Senior Living Home?

We can start with that last “observation” since that is the most telling of all. Can a CCRC be considered a “home” in the same way that one might move to an apartment building to find freedom from the home maintenance challenges of a single-family dwelling? The obvious answer is, “Of course.”

Ask yourself if that quick “of course,” is still credible if the CCRC owners view independent living as an antecedent to assisted living, memory care, or skilled nursing. People do prefer to live at home if we can make senior housing truly a home.

To pursue the goal of keeping the “home” in senior living, we might take a fresh look at some of the most cherished rules.

  • Residents are “retired.” As more and more people embrace productive aging, there is a need for coworking spaces on campus. It’s time to drop the “R” from CCRC. That shift is a small step that may help remove the “institutional” cloud to demonstrate that congregate living is liberation and not confinement. There is growing evidence that continuing productive activity delays the onset of cognitive decline and dependency.
  • No resident can also be an employee. Example: An organist comes to support the on-campus chapel service each week. When she moves in, she is terminated and replaced by a new organist. Is that bright-line distinction between residents and employees desirable or necessary? Wouldn’t having a marketing person who lives onsite be a stellar testimony to the community?
  • Residents must be over a minimum age. Today’s residents may balk initially at allowing younger people to move in, though it’s unlikely that many younger people will. Still, having some younger residents will enliven the community and further remove the stigma of “institutionalization.”
  • Tipping is not permitted. Staffing is a problem. The evidence that stingy tippers may be disadvantaged is indeterminate. Moreover, tips can be pooled and shared with back-of-house employees as in many restaurants and hotels. It’s common for private social clubs to add a preset gratuity to all “house” charges. Appreciation payments might go a long way to lift morale and to help retain staff. Residents are less likely to grumble if they know that service charges directly benefit frontline staff.
  • Transitions. For those who live outside senior living, there may come a time when self-perception, family pressure, or adult protective services decide that independent living is no longer appropriate. Within senior living, that decision is made by staff. Although money considerations ought not to be a factor, there can be an inherent conflict of interest that requires the highest level of integrity by those with decision authority.

Popular Sentiment

The growing popularity of the village movement reflects an uprising of sentiment that runs contrary to the past evolution of the senior living industry. Gail Kohn’s frank assessment gives voice to challenges that now confront the industry. How operators will adapt is unclear.

The decisions that are now being made around conference tables and within boardrooms will be determinative of whether today’s senior living is tomorrow’s “home for life” or whether other options evolve to meet the needs of older people.