Archive for the ‘Lifestyle Choices’ Category

Finding Happiness In Senior Housing

Three things came together to spark this blog:

  • A January 17, 2015 New York Times article entitled “Mean Girls in the Retirement Home” (http://nyti.ms/1KStZ4j),
  • A 2014 study by the American Seniors Housing Association (seniorshousing.org) entitled Unlocking the Mystery Behind Very Satisfied Independent Living Customers – Make Them “Feel at Home” and
  • A dinner conversation with a couple who are friends and former neighbors about choosing among several retirement communities in Boston, where they plan to relocate to be closer to their children.

The New York Times “Mean Girls in the Retirement Home” article documents the presence of cliques in senior housing communities that sometimes make it very difficult for a new resident to fit in.  Some new residents face outright hostility from existing residents who are already part of well established social groups.   It also documents the steps taken by a 97-year-old new resident and her daughter to help the new resident fit in and make friends.

ASHA’s “Feel at Home” study of very satisfied independent living residents also identifies cliques as a problem in established senior housing residents but it goes on to study factors that are most important for making a senior housing resident feel at home and be very satisfied in an independent living community.   The ASHA study is intended to help operators of independent living communities make their residents feel at home and boost satisfaction levels, resident retention and resident referrals, all of which can have a meaningful impact on the bottom line.

Last month, as I spoke with my friends in their late 80s about their move to a senior housing community in a new city, it occurred to me that the New York Times article and, particularly, the ASHA study can provide potential senior housing residents with an excellent list of what will be most important in making them happy in senior housing and a data-driven check list of what to look for as they consider various communities.   This blog attempts to reformulate the ASHA study into a compact guide to happiness in senior housing for potential residents.   My thanks to David Schless, Executive Director of ASHA, for giving me permission to use the study results in this manner.

What’s Most Important For Happiness?

How frequently and how strongly a senior housing resident feels at home accounted for nearly half of the overall satisfaction of senior housing residents in a 2012 ASHA study.   The 2014 study explored what caused independent living residents to “Feel at Home”.   ASHA’s “Feel at Home” study was based on a survey of 6,858 predominantly rental independent living residents in 11 metropolitan areas who completed a 55 question survey.   ProMatura Group, a well-respected survey research firm based in Oxford, MS that specializes in senior housing and care research, conducted the survey, evaluated the survey results and authored the ASHA study.  I want to thank Margaret Wylde Ph.D., CEO of ProMatura Group and her staff since for this blog I have borrowed liberally from the ASHA study, which was the product of their work.​

 

ASHA Feel At Home Graph

Key factors contributing to “Feel at Home” identified in the 2014 ASHA study include satisfaction with private residence (32%), camaraderie with others (31%), sense of control (14%) and staff know them well (5%).  Other items contributing less that 5% of “Feel at Home” included:

  • Number of friends in the community
  • Decorated residence the way they like
  • Know the things they need to know about the community
  • Quality of daily activities and programs
  • Dining program
  • Dining schedules
  • Frequency of seeing friends outside the community
  • Transportation provided by the community

What To Look For When You Visit?

ASHA’s “Feel at Home” study and this blog focus on satisfaction of independent living residents.   Someone moving to independent living is about 85 years old, is moving from their a private residence they have occupied for an average of 19 years, usually a single family home, and is healthy enough to live with minimum outside help with the activities of daily living (See Senior Housing Options above for a more detailed description).   The prospective resident is typically active in making the decision about whether and where to move.

Private Residence – Most senior housing communities are designed to wow you with their façade, grounds and the common areas you see just inside the front door, what marketers call “curb appeal”. While the ASHA study indicates the quality of common areas contributes to resident satisfaction, the study indicates attributes of the private residence are more important to residents feeling at home and being very satisfied.   Key factors in making a private residence satisfying include:

  • Unit size – Just like with Goldilocks, the most satisfying independent living residence was not too big or too small, with 841 sq. ft. on average being “just the right size”.
  • Decor and Storage Space – Being surrounded by familiar things, having a décor that you liked and the ability to store possessions where you can access them were important for overall satisfaction with one’s private residence.
  • Natural Light – In the ASHA surveys more than half of the “I’m Home” customers strongly agreed with the amount of natural light in their residence, so looking for multiple windows that allow for plenty of natural light is a feature prospective residents and their families should consider.
  • View from the Windows in Private Residence – Along with natural light, “I’m Home” customers were likely to have a nice view from the windows in their private residence.   More than half (54%) of “I’m Home” customers strongly agreed they enjoy the view from the windows of their residence.   A view doesn’t have to include beaches, mountains, parks or rivers; a nice view can be as simple as a tree, a small garden area, a fountain, or a bird feeder.

Camaraderie With Others – Camaraderie with others was nearly tied with “satisfaction with private residence” as the most important factor making senior housing residents feel at home and very satisfied.  Other factors, such as having close friends and the number of friends also contributed to residents’ satisfaction.   Gauging how well you or a loved one will fit in at a senior living residence can be difficult to do during a visit. Things you can ask about or do during a visit for how welcoming a community will be include:

  • Warmth of Greetings – Make it a point to notice if you are greeted warmly by staff and other residents.
  • Cliques – Ask staff specifically about the presence of cliques in the building and the specific measures staff takes to address cliques and the off-putting behavior that may be associated with them.
  • Steps To Help New Residents Fit In – A senior housing community cannot impose friendships on new or existing customers, but staff can and should facilitate that eventuality. According to the ASHA study, staff from the very beginning of association with a new customer need to learn who they are, what they like, identify and help them form links with other customers. Items noted in the ASHA study that might help include staff sponsoring house warming coffees for a small group of residents in a new resident’s unit after they settle in and having a mentor from among the existing residents help acclimate newcomers.  You should ask what specific steps each community takes to help new residents fit in.
  • Cultural Fit – Try to assess how you or your love one’s economic and social background compares with that of other residents and how the future resident’s age and physical and mental capacity match up. New residents that are on the slightly younger side, more mentally alert and better dressed may find it easier to fit in according to the New York Times article.
  • Interests – What are your interests and are there any others at the facility that have similar interests or some other connection that might make it easier for you to make one or two friends.
  • Try It Out – You should definitely try the dining and do it in the residents’ dining room not in a private dining room while meeting with the marketing staff.   This will give you an ideal of the quality of the food and how it is served as well as how receptive existing residents are to newcomers. Many senior housing communities also allow for short-term respite stays or give prospects a chance to try out the community.   This may offer a better way to assess your compatibility with a community than a visit or two of a hour or so.   You may also want to visit in the evening to see what staffing and the activity level is like after prime viewing hours.

Sense of Control – Sense of control was about half as important to resident satisfaction and feeling at home than a resident’s unit and camaraderie with other residents but did matter. Factors affecting a sense of control included:

  • Information – Knowing where things are, how things work and what is going on can be important for residents to feel in control.   The orientation and communication process between the building and its staff with residents is worth asking about. Sales counselors should explore the social preferences of prospects and ensure they understand the communal nature of the community. They should discuss group activities, dining, and the many interactions with others that occur during a typical day.
  • Scheduling Flexibility – New residents moving from a private home where they may have few visitors to a senior housing community with scheduled meals and activities and its own daily routine can experience a loss of control   Flexibility on meal times, when to get up and go to bed and options for transportation and activities can contribute to a resident maintaining a sense of control.
  • Options – Not Requirements – Residents should be encouraged to be out of their residences and participating in activities but should feel that have the option to pass on activities that aren’t of interest.

Staff Knowing Residents – How well the staff knows a resident accounted for about 5% of residents feeling at home and being very satisfied.   You should get a sense of staff interaction with residents during a visit and should explicitly ask existing residents if they believe the staff know them well.

Strategies For A Successful Transition and Finding Happiness

To ease the transition and find happiness in a move to a senior housing community, the studies suggest the following:

  • Recognize The Move Will Be Stressful – It is important for a senior moving into a community and their family to recognize that such a move is a major transition and will be challenging and somewhat stressful under the best of circumstances.
  • It Will Take Time To Adjust – Very satisfied residents who “Feel at Home” have an average tenure of four years, versus three years for those that sometimes feel at home and two years for those who don’t feel at home. So the longer a resident lives in a senior housing community, the more likely they are to “Feel at Home”.   Give yourself some time to adjust and stop missing your former home.
  • Identify Some Positives – Despite the magnitude of the change, there are usually real advantages for a senior previously living on their own.   These include: greater social interaction, better nutrition, more physical activity and potential greater freedom of action if you take advantage of community provided transportation and support services.
  • Incorporate Familiar Items – A resident’s own furniture and other familiar and personal items can help make the new residence “Feel At Home”.
  • Visit Often – The quality of visits by family members is important to overall satisfaction and can help ease the transition and the feelings some new residents may have of being isolated in their new surroundings.
  • Get Out and About – Opportunities to visit places and friends outside the community is also an important factor differentiating very satisfied residents.   Excursions with family members or friends, using transportation offered by the community, or Uber or taxi may all be beneficial in easing a transition to a new senior housing community.

 

 

 

 

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Relationships Key to Happiness In Retirement & Seniors Housing

I spent a recent weekend on the Rhode Island shore with a eight friends I have known for over 40 years and several of their spouses/significant others.     We try to get together every two or three years and it is amazing how quickly we are able to reconnect and how reminiscences we have all been over many times before are still a pleasure to hear.

This weekend experience reminded me of the importance of relationships – with a spouse or significant other, with your children and family and with friends and neighbors – for happiness.     I believe the importance of relationships in making us happy is too often overlooked when seniors contemplate a move from work to retirement, in relocating to a new location for all or part of the year, and in thinking about and executing a move to a seniors housing community.

Relationships In Retirement – One important aspect of moving from full time work to full time retirement is that many of our friends and social relationship revolve around our work.   We all have business colleagues inside or outside our organizations that we interact with socially as well as professionally for lunches, dinners, conferences and meetings, charity events, golf and other activities.   These relationships are hard to maintain when you no longer see these colleagues on a regular basis.   If you want to maintain these relationships you, as the retiree, will have to work hard to maintain active contact with former colleagues.

Even if you make the effort to keep connected with former colleagues, many of these work-connected relationships will slip away when you retire because you simply won’t be moving in the same circles as former colleagues.   To supplement these relationships, you need a plan of action to build alternative social relationships, particularly some that are intellectually stimulating.

Once you do retire, some of the most significant challenges you encounter in your social relationships may involve your spouse, significant other, children and other family members.   The relationship with your spouse, if you are married, may be the most important post-retirement relationship you have.   But the nature of your relationship with you spouse may change dramatically as one or both of you has more time at home and you negotiate new responsibilities on household chores, financial management, planning vacations and social activities.     It is important to anticipate and discuss these changes in advance and to maintain an active dialogue as you settle in to your post-retirement lifestyle.

Relationships with children are another important aspect of happiness for retirees but can also create challenges.   Children may live far away, may want more of your time for childcare than you want to give or may not want your advice or help now that you have more time to offer it. For many of us baby boomers our retirement may coincide with our children marrying, getting traction in their careers, establishing families and generally feeling more independent from parents and less in need of parental advice. It is important for the parent/retiree to be sensitive to these changes in roles and to adapt to changing conditions.   It is also important to let your children know if you believe they are claiming more of your time for childcare or other responsibilities than you want to give.

Relationships As We Age – Another aspect of relationships that I believe is very important for happiness and underappreciated as we age is the loss of connectivity to others as your mobility and that of friends is reduced, you or friends relocate to new locations or a spouse or other close friends die.     Many seniors face a gradual narrowing of social relationships and human interaction for the reasons just noted.     Most of the literature that discusses a senior moving to senior housing, including a July 10, 2015 New York Times article entitled “Team Effort In Making Decisions on Elder Housing” focus on a senior’s cognitive and physical abilities, as well as financial considerations, in determining when a move from a home to seniors housing is appropriate.   I believe an equal or more important reason to consider seniors housing, and one that I believe is a good predictor of future health, is a senior’s social network and level of social interaction.   If a senior has lost a spouse, has a shrinking network of social relationships and has very little interaction with peers, family or friends when living at their home or apartment, I believe a move to seniors housing should be actively considered as a way of putting a senior in a position to re-establish meaningful social relationships and interactions.  It may be appropriate to adopt for seniors the same rule I recently saw advocated for children – if they are spending more than two hours a day in front of a screen, be it TV, PC, videogame or tablet it may be time to examine their level of social interaction consider intervention.

I believe there are also practical advantages to discussing a senior’s potential need for seniors housing in terms of social interaction, rather than cognitive or physical limitations.   In the discussion of social interaction, there is a presumption and a focus on a senior being alert, active and in need of human interaction rather than a focus on declining mental and physical abilities.   A move to a senior housing community to make new friends and increase social interaction is a much more positive discussion than a move to prevent falls or keep a senior from harming themselves through mental lapses.   It is also a discussion that can and should happen sooner in a senior’s life when they will gain much more out of a move to a seniors housing facility and before a life incident forces consideration of a move under crisis conditions.

In a future blog, I will discuss the challenges to fitting in and establishing positive social interaction after a move to seniors housing based on some recent industry research.

 

 

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Downsizing

My experience indicates there are two times in the lives of many seniors when downsizing is most likely to be considered.   The first occurs in one’s late 50s or 60s after the kids have left home and the second in one’s late 70s or 80s when care needs may dictate a move to a more manageable setting with greater options for care and support.   The first move may start with or incorporate a second home or may only involve a move of a primary residence.

Thanks to the creativity of America’s homebuilding and seniors housing and care industries and the substantial buying power of affluent seniors there are a wide array of housing and location choices for seniors to consider.     In this blog post I focus on the first downsizing move, that undertaken by many in their late 50s or 60s.   See the section of this blog on seniors housing and care for a discussion of moves to supportive environments at a later age.

Let me start with my own downsizing decision.   When I was 55, and my wife a year younger, we moved to a 2,700 sq. ft. three bedroom condominium from our 3,300+ sq. ft., cedar shake, four bedroom home in a well established neighborhood where we had lived for over 12 years and raised our son. Our decision to downsize was driven by my belief that there would be strong demand from baby boomers as they aged for well-located condominiums and we it would be better to buy ours before competition from other boomers increased prices.

The condominium we selected is in a mid-century modern highrise building designed by Mies van der Rohe.   We found our downsized home after a about a year of looking for a condominium and a couple attempts at bidding. It took this long for us to understand our options and think through the location and environment we wanted. We looked at both townhouse type and multi-story condominium units in a variety of neighborhoods.

When we began looking for a smaller home in the Baltimore market we found that while 1,500 to 2,000 sq. ft. two bedroom condos are very prevalent there are relatively few large units better suited to baby boomers downsizing from a single family home.   Our key criteria for a downsized home included:

  • Having everything on one floor
  • Three bedrooms, one for us, one for a guest room and one for an office
  • An accessible location, near restaurants, medical care and public transportation
  • Enough space to entertain
  • Covered parking
  • Security

In the end there were relatively few units that met all of our criteria. We could choose between a number of high-rise buildings near the established neighborhoods where we had lived for many years and new and converted buildings on or near the waterfront in downtown Baltimore.   We also found some very nice detached and luxury townhouse units but some of these were bigger than we needed and were not in accessible locations. We opted for a multi-story condominium building closer to the established neighborhood where we previously lived rather than a building near the water because it was closer to friends and, while the water was nice, it came with about a 50% price premium for a unit of similar size.

The building we choose offers one story living, has a doorman who can deliver your groceries, dry cleaning and packages, is on a bus line and is walking distance to restaurants, some shops and The Johns Hopkins University’s Homewood campus with its library, book store, cultural and sporting events and green space. It is a home where we should be able to live for many years, even if we become less mobile or have to give up driving.

Mistakes, from my perspective, I see others making in downsizing include choosing:

  • Multi-story townhouses when the ability to negotiate stairs could become an issue in future years, if even for temporary periods
  • Locations where no public transit or even decent cab or ride service options, like Uber or Lyft, exist
  • Locations remote from family, friends, social and cultural activities and medical care
  • Designs poorly adapted to aging even when offering first floor master bedrooms, such as laundry rooms on another floor or just enough stairs to make the home inaccessible for wheelchairs without expensive and unsightly renovations

Even though baby boomers in their 50s and 60s may be in very good health, able to drive and have few cares about temporary or ongoing physical limitations, I would not purchase a downsized-home in which it may be difficult to age with but I welcome your views.

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