By Jack Cumming

Not long ago, Senior Living Foresight published an article titled, “What Do Residents Want?” and today we answer that. The answer is straightforward. “Residents Want To Be Heard.”

Here’s our story. It’s a story of a successful breakthrough by at least one community, John Knox Village in Pompano Beach, Florida. It’s a story you can emulate.

On March 23, Pioneer Network, an organization committed to culture change in long-term care, hosted a conversational webinar featuring resident engagement in the Pompano Beach community. You may have previously seen materials about the Green House Project implementation there.

The conversation was positive and heated at times, but as people listened to each other, it converged on a belief that residents need to be heard and heeded. The alternative was suggested, that ignoring residents will inhibit move-ins and result in unsatisfactory occupancy.

An Overdue Conversation

The current management of John Knox Village has placed a high premium on resident engagement, with the result that there is a very positive relationship between the residents and the executives. That is, however, not always the case, as shared by Ramsey Geyer, a member of the Florida Governor’s Continuing Care Advisory Council and a resident at Westminster Woods — one in a conglomerate owning 22 communities.

The kernel of Mr. Geyer’s view was simply stated by him: “The part that’s missed in a lot of providers’ relationships with their communities is that they don’t listen. They want the residents to sit there, be thankful for what they have, and be grateful for everything that they’re given. They [the providers] forget the fact that there are a lot of residents who are not senile old people, sitting in their rocking chairs.”

Patricia Burdsall and others echoed Mr. Geyer’s perceptions. “The [providers] don’t really care what we [the residents] think,” she said.

Happy Residents

Many readers will have encountered this kind of disquietude among residents, though the contrary story is that many, probably most, residents openly express their happiness with communal living. We most often hear, “We only wish we had come here sooner.”

The nation needs senior living. Residents are lifted up by the commonalities of living together in a mutually supportive home.

Despite the many positives, though, it hurts the industry when people believe that they aren’t heard and that they don’t matter in the decision-making of the governing executives and their boards. That perception has long been seeping out into the larger community beyond the walls. It’s damaging for an industry that, at its best, offers a positive lifestyle, support, and peace of mind. Those are living qualities that people of all ages want and that are particularly important as people begin to fear that age-related decline may leave them dependent.


The justification for executive condescension may have made some sense in the beginnings of senior housing. There’s an understandable paternalism in faith organizations providing philanthropically financed care for retired church workers and others of modest means. People who are lifted up through the generosity of others have reason to be grateful for what they are given.

That justification does not apply to those affluent people who move into market-based housing. They are paying their own way, and they’ve entered into a contract sealed with a substantial consideration to provide the agreed benefits. They expect the service approach that comes with that mutuality. Not only do they pay their own way, but almost without exception, they have to demonstrate wealth as a precondition for move-in.

These are often highly skilled and professional people. They expect to be informed and shown respect. That a lack of transparency is so often the case in the industry (e.g., how many providers openly share their bylaws?) is indicative more of an ingrown culture than of an industry striving for excellence.

Mindset Matters

Many in the industry view their mission as long-term care rather than as enhanced living. Many residents also accept that characterization. More and more entering residents consider it to be primarily long-term care. They wait till they are “ready for that.”

Those other residents, however, who buy the lifestyle, understandably become uneasy when they feel unheard and uninformed. The long-term care mindset among both providers and prospects prevents senior living from reaching its potential in a culture that values autonomy and homeownership.

To change that culture would require a reversal of mindset in the councils of the powerful, whether they gather in corporations or trade associations. No one wants to be a second-class citizen, beholden to others who take their money but expect them to be grateful. John Knox Village in Pompano Beach is a good paradigm for simple changes that the industry can adopt without giving up executive control.


How many residents do you have on your board? LeadingAge has none. Still, LeadingAge claims to be “the trusted voice for aging” working to free America from ageism. It is the primary representative of today’s senior living industry. Its membership is limited to not-for-profit providers, implying that it is more consumer-focused than investor-funded or cooperative resident-owned entities.

Changing mindset will take time and commitment. It may even take an occupancy crisis. Or, change may come from outside today’s provider culture. It seems likely, though, that change in one form or another will come.

How many residents are members or shareholders in your corporation? Those numbers tell a story.

Residents just want a voice. They want to be heard. They don’t want to be dismissed as irrelevant elders past their time. Senior living can be stronger by including the resident perspective as part of its governing purpose.