By Steve Moran

It is time for us to face this harsh truth and do something about it. What’s the proof you ask?

  1. Ten million stories over the last few months about nursing homes and senior living residents dying in senior living. And this is the least damaging of the constellation of evidence.
  2. The Wall Street Journal recently published an article titled “Covid Spurs Families to Shun Nursing Homes, a Shift That Appears Long Lasting” that should be required reading for every senior living leader.

    Here are a few quotes:

    “The pandemic is reshaping the way Americans care for their elderly. Prompting family decisions to avoid nursing homes and keep loved ones in their own homes for rehabilitation and other care.”

    “Occupancy in U.S. nursing homes is down by 15%, or more than 195,000 residents, since the end of 2019, driven both by deaths and by the fall in admissions.”

    “I don’t think we’re ever going to go back,” he said. “The drive to get every patient home who can be home is going to continue.”

    “‘We should be able to provide more services in the home setting that can enable somebody to be independent,’ said Seema Verma, administrator of the Centers for Medicare and Medicaid Services.”
  3. The Facebook Group Caregivers for Compromise – because isolation kills too! This group has 14,000 members all talking about the isolation crisis. And that is not all, there are several dozen state groups with the same purpose.Take a look at a few posts. “. . . So mom with covid has been talking to me. Lethargic today, I can’t have a conversation on the phone. Last vitals her o2 sat was 90. has been 95 to 97. going round and round with phone calls. I did just call back and talk to some arrogant nurse that informed me the doctor had been called. Wow. I’m impressed. I can not believe we are locked out and our loved ones are neglected. My mom is healthy except for mobility. She wants to live. I am so sorry to vent but when does this stop?? Last night, while on the phone with my Aunt who is in [a] Covid unit at her facility (not sick Thank God!). She laid in her bed with feces all up her back!? Call bell on 2 hours no one comes. She started saying it’s burning my skin and I can’t stand it much longer. I hang up and call the facility. Finally someone answers and 24 minutes later they come in while I’m on the phone with her to change her roommate, then her.”

    And finally this:


    “Again, my dad got ill because he wasn’t getting enough fluids. I always made sure he got enough before covid. Now supposedly he has end-stage dementia again. Yes again. It’s funny how he gets enough fluids and his end-stage dementia improves.

    “Fast forward to now. Dad is in the hospital recovering from sepsis, but now again they say severe dementia, and all I have been doing is prolonging his death by treating dehydration and infection. I’m sorry if they put out enough in the first place we wouldn’t be here.

    “My dad’s memory and conversation skills were pretty darn good in October. Now I got tricked into palliative care. I was told they would be like an extra set of eyes getting the care he needs. Now they are concerned about me wanting to prolong his natural death, pushing to change to DNR. He was better before he went into the hospital.

    “I’m sorry the nursing home failed.

    “But it will be he couldn’t drink due to his dementia. Well, how come he expressed to me he was thirsty. This is all such bullshit. Now I have to let my dad die. It’s just not right. A failure to see how we got here. I kept him alive before. He was still enjoying life.”

    These are not extreme, had to search hard to find the quotes, examples. This is typical in this group.

  4. Foresight TV Episode 13 – A Fresh Look at How Boomers Want to Age. This live broadcast includes Chip Conley and David Stewart, who are two of the biggest, most influential, loudest voices in the “what is possible as we grow older” category. To them, the idea of moving into senior living is a form of “SENIOR DYING”.
  5. One More Thing – Senior Living Is a Hard Thing to Buy. This was one of the most shocking revelations of my career of writing about senior living. When I became a consumer, I discovered that even as someone who knows the biz, it is complicated and confusing to get someone you love into senior living.

    Some of it is regulatory licensing stuff. But much of it is that we don’t actually spend much time thinking about the customer journey.

It is easy to hate the message and the messenger, but this is the public perception reality. It should not be. I believe that congregate, social living is the single best way for older people to live their best possible, highest potential last chapters.

Will independent living, assisted living, memory care, and skilled nursing ever go away? The answer, of course, is no. Some people will prefer those options, and for others, it will be the very best option for them. But it is mostly not what people want.

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The Fix

 I don’t have all the answers but this is a good place to start:

  1. We need to tell stories about how we are transforming the lives of residents and team members. The stories are there but we are remarkably terrible about telling them. Go ask your CEO to tell you a transformation story. Most will hem and haw, then blurt out “there are so many”. But at the end of the day, they don’t have one.

    Every leader should have at least two transformation stories. One about a resident and another about a team member. Really more than that, but those two are a good start.
  2. We need to completely rethink programming so it is primarily purpose-driven rather than entertainment-driven. We need to make programming more resident-driven than staff-driven.
  3. We must become a bigger part of our local communities, rather than an island that people either come to live on or to visit. Senior living communities should be the marketplace community center.
  4. We need to rethink how we use staff. Happy staff means happy residents. Happy staff and happy residents mean full, vibrant communities. 

We will be spending a lot of time during 2021 talking about how we can make this all happen. I would love to hear your thoughts and ideas.

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