Lois A. Bowers

It’s funny how sometimes a single remark can lead to a new realization.

Last month, I wrote about the first impressions I had of a senior living community where I spent multiple days at the request of Where You Live Matters, the American Seniors Housing Association’s consumer education campaign. The goal of the visit was for me to “live the experience” and see whether, indeed, where seniors live matters.

In that column, I wrote about some of the little things that, as I looked back, I saw added up to my first impressions of the community. In this column, I’m going to touch on levels of care.

As I mentioned previously, for this project, Brookdale Senior Living graciously offered to host me at Brookdale Westlake Village in Westlake, OH. My purpose wasn’t to assess Brookdale or this specific community, per se; rather, it was to try to look at senior living more broadly, from the perspective of a resident or someone who might benefit from the Where You Live Matters campaign.

Westlake Village is a continuing care retirement / life plan community. I already was familiar with the CCRC concept, of course, from my years of writing about seniors housing and care. Even before then, however, I knew that some senior living communities offered multiple levels of care and services, although I don’t recall anyone calling them CCRCs. One of my grandmothers lived in such a community and progressed through several of those levels. And it was big news when, after I graduated from college, a CCRC was built in my hometown, altering the suburban landscape.

Only about 6% of Brookdale’s communities are CCRCs (which at Brookdale means they offer at least three levels of care), according to my calculations based on information available on the company’s website. It was fortuitous, therefore, that Westlake Village was the community chosen for my assignment. For it’s there that I realized a benefit of CCRC living that would not have occurred to me earlier in life.

Sure, I already understood the ability of residents to move from independent living to assisted living to skilled nursing (or memory care if needed and available at a particular community) without relocating outside of the community. That ability, after all, is a major selling point of CCRCs. I’d venture a guess, however, that most people tend to regard independent living, assisted living and skilled nursing as discrete segments within the same campus. I know I did, even with my previous familiarity with CCRCs.

It wasn’t until my visit to Westlake Village, after I spoke with Director of Resident Programs Julie Mooney that I was struck with another benefit of the continuum of care. Sometimes, she said, residents move into independent living and enjoy their new friends and activities, but as their health needs change, they move on to assisted living. No surprise there — that’s what CCRCs are all about. But, Mooney said, although each segment of Westlake Village has its own activities calendar, that doesn’t mean that a former independent living resident now in assisted living can’t continue to participate in independent living activities with the friends that he or she already has made.

This idea seemed like an epiphany to me because it’s not a benefit that communities seem to promote readily on their websites. Online information about CCRCs at the Brookdale and Where You Live Matter sites, for instance, introduces the concept of CCRCs in general, including the aforementioned benefits, and provides some answers to finance-related questions that prospective residents may have. I didn’t see any mention of potential integration between residents in different levels of care and service, however.

The current focus of marketing materials makes sense, of course. When older adults are considering a move into a CCRC, costs are a crucial consideration, and ideally, new CCRC residents move into independent living when they are relatively healthy and uncertain how their health might progress and needs may change. It may be difficult for older adults even to formulate questions related to their possible future lives.

In fact, the only reason this benefit of having several levels of care in one location occurred to me is that someone I care about lives in a skilled nursing facility due to health needs and some physical limitations. His cognitive abilities, however, resemble those of an independent living resident, so he finds his community’s group activities — which are designed to appeal to the most residents as possible — less than ideal. The “book club,” for example, consists of a staff member reading to residents rather than residents reading on their own and coming prepared to discuss a book. I can’t help but wonder what this man’s life would be like if he lived someplace that also catered to residents whose minds and wishes were more like his.

If your senior living community offers integrated activities — formal or informal — between levels of care and you’re not already mentioning that fact to prospective residents, consider doing so under the appropriate circumstances, as Mooney did to me. Think about broaching the topic directly rather than implicitly on your website, too, since that’s where many older adults and their families begin the search for a new place to live. Those making the big decision to move — and undertaking all of the little actions that come with it — might find it reassuring to know that they might have one less major readjustment to make in the future and that your community has programs in place to meet not only needs related to their physical health but also needs related to their social and mental health.

It may seem like a small point, but it’s just another way that it matters where seniors live.

I’ll share additional insights gleaned from my visits to Brookdale Westlake Village in the future. In the meantime, please check out the slideshow of activities at Brookdale Westlake Village and the brief videos below.

Lois A. Bowers is senior editor of McKnight’s Senior Living. Contact her at [email protected]. Follow her on Twitter at @Lois_Bowers.

Assisted living residents enjoy a birthday party with cake and a sing-a-long:

Brookdale Westlake Village has a snazzy machine for bingo: