I’ve written previously about the importance of diversity on the board of directors for continuing care retirement communities (CCRCs, sometimes referred to as life plan communities). A board comprised of people from an array of backgrounds provides the community with unique perspectives and valuable input that helps ensure its long-term financial stability and success—a criterion that is in the vested interest of all current (and prospective) residents.
While it’s vital that a CCRC’s management team listen to the viewpoints of their board, there’s another group whose voices must be heard and heeded as well: the CCRC’s residents.
I was recently talking with a friend and colleague, Rev. Bob Nicholson, who is a retired minister and lives in a CCRC in Seattle. He’s also a member and former president of the National Continuing Care Residents Association (NaCCRA). I was honored to have been invited by Bob and his colleagues to present at their annual gathering at LeadingAge last year. I remember noting to them the irony that there would be hundreds of vendors and thousands of participants showing up that week, all focused on how to attract more seniors to their respective businesses. Yet, there I was in a room full of these companies’ target demographic, and no one was talking to them! As Bob and I discussed this, our conversation turned to the ways in which the CCRC industry as a whole could better-seek input from seniors. His mantra: If it’s about us, include us…a concept that I echo. Bob offered two examples—one at the macro level of the industry and another at the micro level.
The macro: Changing the senior living industry from the top, down
Bob and I both have attended numerous meetings and conferences on the senior living industry and other retirement-related topics. With very few exceptions, the speakers are doctors, social workers, geriatric sociologist, marketing execs, or other “industry experts.” And there’s a lot to be gained from listening to and learning from the expertise of these speakers.
But as Bob noted in our conversation, “very rarely in these settings did I ever hear, see, or experience a person such as myself—now in my 84th year, an active leader in NaCCRA, and a resident of a CCRC for a decade—included as a presenter.” It seems like a tremendous oversight by those planning conference agendas not to call on the very people who may well have the most expertise about the senior living industry, since they “live it” every single day!
Bob recalled an interesting test case to this “voice of the resident” concept from the LeadingAge conference a few years ago. That year, for the first time, NaCCRA led a panel discussion entitled “What Providers Can Learn from Residents.” Bob was the VP of membership for NaCCRA at the time, and given that the session was to be held at 8 a.m., he thought he was being optimistic to bring literature for 35 attendees. 259 people showed up. As it turns out, the NaCCRA panel was the best attended and most highly evaluated session of the conference that year—yet a similar session hasn’t been offered since.
It seems clear from this example that there is agreement among the professionals working within the senior living industry that the insights of CCRC residents has value and should be influencing the direction the industry is moving in. It’s encouraging to see this, but I believe more needs to be done by CCRC industry influencers to encourage and pay attention to the voice of the resident. As Bob says, “If it’s about us, include us.”
At the micro level: The price of listening to (or ignoring) residents’ feedback
As Bob pointed out in our discussion, the residents of CCRCs also bring a wealth of knowledge with them when they move into a community. There are retired doctors, executives, engineers, CPAs, and more who possess unique knowledge that is directly transferable to the benefit of the CCRC…if management is willing to listen (as they should be). Given the background and expertise of these retirees, the feedback loop between CCRC residents and the community in which they live can be invaluable. And conversely, ignoring the insights offered by residents can be very, very costly. Bob recalled two cases that exemplify how resident input has the potential to impact their community.
- On the positive side, a resident in a for-profit Florida CCRC reviewed the community’s balance sheet and saw an $8,000 per month water bill. The community was adjacent to a lake, so the resident consulted with a hydrologist and presented a plan to the management team: A pump could be purchased, eliminating the water bill and saving the CCRC nearly $100,000 per year.
- On the flip-side, a CCRC had its 25-bed skilled nursing unit shut down by regulators for deficiencies that had been pointed out by several residents with medical backgrounds, academic and clinical. Management staff had ignored these warnings, and the residents ended up paying the price when the nursing unit was closed for 11 days while regulators did a top-to-bottom examination and review.
Hearing residents’ voices
In a follow-up to our conversation, Bob shared with me via email a statement from Jack Cumming, president-elect of NaCCRA, who is a resident of Carlsbad by the Sea in California. Jack wrote:
“I’m a resident. I’m also an actuary… In fact, I was an actuary before I became a resident, and I didn’t suddenly become an object for compassion and care merely because I became a resident. This is the dilemma that confronts many providers. Some residents need care and deserve compassion, but not all. The tendency is to view residents as customers, that is, as something separate and apart from the salaried staff. Residents, though, tend to view themselves as participants.”
Jack’s statement is a great summation of the complex relationship between CCRCs and their residents. Sure, residents want nice amenities and should they need it, great care from their CCRC, but perhaps above all else, they want respect. They want acknowledgement of who they are as people—their accomplishments, their intellect, their interests. And CCRCs and other providers must find ways to bridge this divide if they want to truly meet the comprehensive care needs—mental and physical—of their residents. There is so much talk within the senior living industry about the prevalence of societal “ageism,” yet when communities disregard the talents, experience, and expertise of their residents and prospective residents, they themselves are engaging in ageism.
I don’t mean to suggest that residents should be running the community. There is certainly value to having some separation between management and residents to ensure some fiduciary objectivity, but CCRCs should continuously look for opportunities to include residents in decisions that impact the community as a whole; they should find ways to encourage (and act upon) resident feedback. “If it’s about us, include us.”
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