By Jack Cumming

Not long ago, Colin Milner, Founder of the International Council on Active Aging, was a speaker among a group of industry leaders. What caught my interest was his call for standardization in the industry. He was pushing back against the industry’s predilection for changing vocabulary, e.g. renaming “facility” to be “community,” etc. while leaving the substance unchanged.

Pursuit of Well-Being

Milner is a Canadian native, who comes from a fitness background. But he has evangelized an active aging concept integrating fitness with other aspects of well-being, ranging from the spiritual to the social and emotional. Since his remark about standardization was off the topic of the meeting, there was no further discussion of it then, though it raised the question, “Would the senior living industry benefit from greater standardization?” It’s a good question and deserves some thought.

There is a widespread saying in the industry, “If you’ve seen one CCRC, you’ve seen one CCRC.” The takeaway is that there is no standardization. Each CCRC is its own individual phenomenon. Moreover, CCRCs have recently been rebranded by Mather and LeadingAge as Life Plan Communities, further complicating the matter of what a shopper might expect to find. The same lack of standardization applies in other sectors of senior living.


Mr. Milner’s suggestion led to a consideration of other industries where standardization is already common to see what the pros and cons of his idea might be. To think of parallel industries, we have to first consider what senior living is. Many think of the senior housing aspect and consider it a real estate industry, and there is an element of that. But once housing needs are met – and those needs are, for the most part, age-neutral – the operating industry is a service business much like the restaurant or hotel industries.

Both the restaurant and hotel industries have evolved with chain concepts. Before World War II, there was little branding of restaurant chains – White Castle comes to mind. But the range of chains that we know today is a product of the “branding” revolution led by Procter & Gamble in the second half of the 20th century and extended to hospitality services as Americans started to travel more.

Can anyone doubt that the quality predictability brought about by branding has advanced consumer confidence in services and products and has been an engine for economic prosperity? Colin Milner is on to something. Yes, senior living operators regularly speak of branding but can you think of any senior living brand that has the predictability of, say, Olive Garden or Marriott? Some may point to Brookdale, though it’s clear that Brookdale is struggling both with its imaging – happy caregivers attending to hapless residents – and with its finances as its stock trades at about 8% of what it sold for just seven years ago.

Legal Standardization

From a legal perspective, there is no uniform nationwide standard for what defines the various tiers of senior living ranging from home care to independent living to assisted living and all the way to skilled nursing, though skilled nursing’s dominant hospital-like setting derives from the Great Society legislation of 1965. Even such a central concept as the “Continuing Care Retirement Community (CCRC),” or its “Life Plan Community” renaming, has no uniform legal definition or even, in most states, no clear legal recognition.

While providers sometimes complain about the number of regulations with which they must comply, the industry has done little to foster a proactive approach that might result in nationwide uniform regulatory standards like the model laws and uniform codes that govern some other industries. Given the record of the past, it seems unlikely that regulatory standardization will materialize any time soon.

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The Potential for Branding

Procter & Gamble (P&G) famously developed the concept of branding, together with the position of Brand Manager. Central to their thinking was a reputation for quality. So that a brand name would have substance, meaning, and a deserved positive reputation. Their concept was grounded in consumer (buyer) research to discover why consumers resisted certain products, trusted other products, and valued certain features and standards. For instance, before P&G introduced Pampers diapers in 1961, with assistance from the Benton & Bowles advertising agency, mothers used cloth diapers and diaper services since they believed that was healthiest for their babies.

The Pampers product development team concentrated on making disposal diapers safer, healthier, and more convenient, and the advertising team made sure that consumers knew of the Pampers advantage. The result transformed baby care and gave P&G a profitable new product line. We should quickly add that P&G with its highly advertised brands benefitted from the disruption of grocery retailing by the proliferation of the all-inclusive, self-service supermarket concept.

For the most part, branding and rebranding in senior living has been superficial and not sold to the national market. Common for senior living branding is a clever name, often a name that has to be explained, and an associated set of graphics and language. Missing, though, is branding that, like the Pampers example, addresses the substance of the core resistance points that keep consumers from being enthusiastic buyers for themselves or for their loved ones.


Just as P&G benefitted from the move of retailing away from small shops – bakers, butchers, and dry good purveyors – to supermarkets and, more recently, to mega stores and now to online retailing – so senior living might benefit from a disruption in multi-family housing in the 21st century. Here are observations that lead me to think that might be likely if a developer-owner-operator decides to lead the change.

  1. The returning vets from World War II wanted single-family suburban housing and William Levitt responded with Levittowns, starting a housing revolution.
  2. Today, many people yearn for a simpler, more energy-efficient, less hassled lifestyle. Multi-family communities, similar to many senior living developments, with onsite conveniences, amenities, and medical support can meet that need.
  3. Multi-family buildings are much more environmentally friendly than are single-family homes. And congregate living lends itself to socialization and even to coworking.
  4. Ownership is more common in standard multi-family living with support services on-site than it is in supportive senior living and that can give consumers the autonomy that gives life meaning and purpose.

This list could go on but that’s the essence of what I foresee as possible. Moreover, senior living operators are already versed in creating such a hassle-free lifestyle. All that prevents it from becoming more generalized are the artificialities of age barriers, the absence of conveniences needed by families with children, and the notion that one single operator has to provide all the onsite conveniences.

One can imagine a national operator creating such a housing offering and advertising it effectively to create a popular national housing brand built on substance and eagerly adopted by the public. Such an intergenerational, natural living model might well appeal to a public benefitting not only from the longevity revolution that has dramatically increased life expectancies in our time but also from the vitality revolution that is creating a new era with vital active elders aging gracefully.

Looking Forward

As much fun as it can be to speculate about such possibilities, we can’t know what the future will be. We can’t know who the winners and losers in senior living will be. We can know that change will be a certainty. If disruption comes, and it may, today’s senior living owners and operators will have to decide whether to adapt to the change or to dismiss it as a flash in the pan.

That judgment – adapt or dismiss – is critical to change and culture management. Consumers attracted by a new brand offering simpler living may well disrupt senior living and housing in general. It could lead to new concepts for active aging.

Colin Milner’s call for standardization may well prove to be prophetic.