The Shifting Landscape of Aging and Assisted Living

For the 20th Issue of CALA News & Views, we celebrated CALA’s past successes, but we also took a look into the future of the association and the members it serves. During our interview with Robert Kramer, founder and president of the National Investment Center for the Seniors Housing & Care Industry (NIC), we were struck by his insightful view of what the future may bring and the ways in which Assisted Living can adapt to serve new consumers. Take a look at some highlights from the article, and then let us know: what do you think the future of Assisted Living will look like?

NV-fall shifting landscape

Q: In what ways have cultural views of aging impacted Assisted Living in the past, and how are these shifting?

Robert Kramer: I think we’re beginning to serve a customer that thinks very differently about retirement and aging. The previous generation accepted the idea of a “declinist” view of aging, where you have a relatively short time after you “retire.” To retire, from the Latin derivative, means “to go away,” so the traditional view is that you disconnect. You disengage from the activities you’ve been involved in. You then begin an inevitable period of decline which ends up with the final form of disappearance: death. This view of retirement and aging values comfort, security, and safety most highly, which were huge values of the Greatest Generation. But their life expectancies were shorter than the boomers’ will be. A majority of the boomers are going to have a quarter of their life ahead of them after the normal retirement age of 65. Many boomers are going to live into their 90s and 100s.

Q: So, how is the aging experience evolving and how will that affect the growth and development of Assisted Living?

Robert Kramer: The “D” word concept of retirement—disconnect, disengage, decline—really contrasts with an emerging “E” word concept of retirement and aging. Aging is a time to engage, enrich, experience, enjoy. Consumers will want housing that will make them feel integrated with rather than separated from. I don’t mean they’ll want to hear somebody practicing their drums at 2am in the morning. But they also won’t want to live in a community where people visit only if they’re staff or family and otherwise have no reason to go there. I think that type of community will be strongly rejected by our customer of tomorrow. They want to be able to interact with people of all ages. They’re going to be attracted to places where there’s life, vitality, continuous learning opportunities.

That’s the boomer generation….their values are engagement, connection, enrichment, the idea of continuous life enhancement. You can almost hear a boomer say, “I’m not finished…what do you mean? I’m ready for an encore career.” The old notion of retirement is that you’re done. You retire and hope to have a few “good years,” but for all intents and purposes, your productive years as a contributing member of society are over. And that’s a pretty unattractive view, especially when that may be the next 25 years of your life.

Q: What will the consumers of tomorrow be asking for, and what should providers do to prepare for those demands?

Robert Kramer: Right now, we’re entering an era of consumer-driven health care—trying to get rid of the silos—which will preoccupy us for the next five to 10 years. But I think that as the first boomers turn 80 in 2026, the decade after that will bring enormous pressure to get rid of the silos in aging services. And in 15 years, we’re going to see consumer-driven aging and life services.

Right now, you can have a lot of money and be very smart and well-educated, yet still be confused and overwhelmed when you’re trying to arrange care for a loved one. The number of different silos and buckets of aging services is just dizzying; I say this from personal experience. Now, I’ve been in the field for years—I’m reasonably smart and knowledgeable about the terminology. But when I took over managing the care for a 95-year-old loved one, I felt like I was taking a PhD in eldercare. Everything—data, payment models, communication—was so disconnected.

Boomers are going to demand an integrator. They’re going to want someone to oversee their primary care, handle their Medicare bills and insurance information…even coordinate travel or personal care attendants. They will expect it, and they’ll be willing to pay for it. Right now, companies that feel like they have a trust relationship with seniors—financial advisors or pharmacies, for instance—are trying to figure out how they leverage that trust to become a platform provider in the future. Somebody’s going to fill their need for a life management services coordinator, and I believe that good operators in our space will have the opportunity to do that for their residents.

Q: What will the Assisted Living community of the future look like, and who will it serve?

Robert Kramer: We don’t serve the boomers yet, but we are starting to serve the silent generation and I think they are more like the boomers. The average age now of entrance into Assisted Living is usually in the 82-to-86 range and the average length of stay is about 24 months. Of course, communities see great range in the age of their residents, but mid-80s and above is really the population we’re serving. We’re not serving people in their 70s or even early 80s, and the first boomer doesn’t turn 80 for another decade.

We’re going to see an enormous variety of products. The products are only beginning to be designed and conceived of today that will serve people 65 to 85. And we’ll see another whole range of products—more similar to the care products we see today—that will serve people 85 to 110. Still, those are broad age ranges of 25 years. Imagine the same product serving someone who’s 15 and someone who’s 40. I would argue there are some of the same differences when you talk about serving somebody who’s 65 and somebody who’s 90.

Many people in our communities will continue working. Other communities, I think, will be noted for their philanthropy, their volunteerism; for instance, a community may become noted for how many residents serve as volunteer teachers or caregivers. So, rather than groups of people united by what they did in their previous life before they retired, it’s going to be groups united by what they do now and what their identity is now.

You have a changing customer, so you’d better understand what they value. A “we’ve always done it this way” approach will be a good way to go out of business. Because you’re going to have a different customer, you must figure out how to adjust to them. This new customer will also be more demanding; the other “E” word that goes with the boomer’s view of retirement and aging is “entitled.” They’re used to forcing the market to give them what they want, and they’re not just going to go along with whatever their community’s management decides. They want to be engaged, and you’d better expect that and be ready for it.

This post was excerpted from CALA News & Views Fall 2015: The 20th Issue.


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