For many, the arduous journey to senior living is stressful, if not downright scary. As if leaving the familiarity of neighborhoods and friends and relatives isn’t bad enough, adapting to this new place full of finality can be fearful, strange and unsettling.
Owner-operators and their expert “engagement” partners both agree that ensuring their residents feel home again is a tall order compared to tending their health needs.
Some seniors may welcome the change, free of mortgages and yardwork and house chores while bursting with the luxuries of rest and recreation. Others are easily overwhelmed in a swirl of emotions and fear.
What makes seniors wilt when they become residents instead of homeowners?
The reasons vary surprisingly from one generation to the next. A common thread: They’re all insecure about something.
Stephea Scheurer-Melnyk, vice president of operations for Senior Living Culinary Group at Unidine, says fears in this population are very broad among the “traditionalists, boomers and Generation Xers” who comprise those they now serve.
“Traditionalists are concerned about personal and financial security, illness, injury and fear of being alone,” she observes. “Boomers share some of these concerns, but also desire to maintain independence and stimulation. Gen Xers face challenges with acknowledging they are indeed seniors now, and value customization and access to resources.”
For many, loss of mobility and strength, both physical and emotional, makes them feel vulnerable and unsure. “Outside of ‘tech-timidity,’ physical impairments play a factor,” notes Sarah Hoit, CEO and cofounder of Connected Living Inc. It’s no small irony that even as they are swimming in high technology, poor vision or hearing can make it difficult to use it, she adds.
“Seniors worry about the same things as everyone else, like how they look and will be perceived by others,” says Christopher Krauss, director of rehab for IN2L. Regardless of the core reason behind it, age often brings extra insecurities due to diminishing physical and cognitive abilities. “Some are just naturally apprehensive in groups, or maybe socially awkward by nature, and others could be upset, sad or generally unhappy about wherever they are now compared to where they were, or want to be.”
Far too often, new residents retreat toward a place of safe solitude. The visage of an aging woman sitting alone in a dining hall can be crushing, particularly to those who provide culinary services, like Tim Bouchard, senior vice president of operations for the Senior Living Culinary Group at Unidine.
“Many senior residents prefer to eat alone, as this was their practice before joining a community,” he says. “They fear changing their habits, especially when it comes to the ritual of meals. Some may view the dining room as a restaurant where you do not sit down and join whoever is at the table.”
The loss of independence can be as devastating as the loss of anything else — nearby friends and family, once good health, strength and agility. Last Thanksgiving, Laura Mock became the primary caregiver for her mother after she was placed on around-the-clock oxygen.
“She currently lives independently but her physical health is declining,” says Mock, a certified therapeutic recreation specialist and customer success manager for IN2L.
K4Connect CEO and co-founder Scott Moody says change can be difficult. “Even as children get older, they become more adverse to change themselves, an aversion that grows with time,” Moody says. “Just try to move a teenager from one school to another, or find yourself switching from an iPhone to an Android. We go along, but we’re not happy about it.”
APPROACHES THAT WORK
Every dedicated company serving senior living has its own secret sauce, its own unique and proven methods for coaxing seniors out of their shell and engaging with the community, and world at large. This is hard work, and not for amateurs. Yet they all share common sense approaches. Externally, those including Mock say facilitating family ties is critical, and “can be very helpful and reassuring.”
Internally, one successful exercise requires a thoughtful and meaningful getting acquainted period. Krauss says listening, empathizing, adapting and nurturing are key. A million questions burst forth in him that begin with “Who are you?” and end with “What fills your heart?”
THE POWER OF FOOD
One of the things that hospitality providers like Unidine and Sodexo have learned is the tremendous value of making new residents feel welcome. Think about the time you bought your first home and the neighbor next door brought brownies. Rob Bourgon, district manager for Sodexo, suggests bringing new residents a fruit and wine basket or flowers with a bottle of wine.
Sodexo Business Development Director Daniel Lucey points out that such gestures aren’t judged by grandeur, but sincerity.
“It can be as simple as bringing fresh flowers to residents, preparing a special meal for someone, providing comfort cards for families with sick loved ones, or even assisting residents with technology,” Lucey says. “There are more grand gestures such as holding a senior prom for residents to share the joy of the communities’ high school employees attending prom, providing a ‘chef stage center’ display cooking, providing vendor fairs showcasing local foods utilized in the community, or organizing a stop hunger drive for the less fortunate members in the community.”
Bourgon says withdrawn seniors’ eyes light up when the chef who prepared their meals pays a personal visit in the dining room. He also suggests courtesies such as inviting residents to participate in dining events like lifestyle food seminars and dietitian presentations that include chef prepared samples.
Bouchard suggests creating community tables in many dining rooms as a way to spark conversation, connection and inclusion.
At one Unidine client community, the dining service team established a monthly Food Club to help residents express their tastes and involve them in the creative culinary process, notes Scott Dahlin, senior district manager. “In the past, chef demos simply prepared food in front of the seniors but lacked engagement and hands-on involvement.” The effort paid off. How else can one explain “Build Your Own Pita Pizzas?”
Its role in helping seniors feel engaged within and without is unmistakable, and the promises of technology in senior living have only now become partially fulfilled.
In a pilot with Hewlett-Packard and Brookdale, Connected Living gave tablets to 30 of the most “disconnected” seniors in one building. After using the devices for 14 days, those residents, who were not dressing, showering or socializing, lit up — actively using the CL program, on average, nine times a day. “The improved socialization increased compliance with hygiene, participation in community activities and decreased hospitalization,” Hoit says.
The possibilities are nearly endless, as evidenced by the following examples.
- Krauss recalls working with one severely withdrawn senior who rarely left her room and declined every invitation to engage in group activities. He knew she had an affinity for storytelling, particularly an experience she had with her siblings and her father when she was very young. “When she told her story she always told it with an energetic smile and she told it to anyone who would listen,” Krauss recalls. “In her story she spoke of how her father walked her and her brothers and sisters from their home near the beach a few blocks down to the water. At one point in her story I asked her, ‘Wouldn’t it be great to visit that spot again?’ Her eyes lit up as she asked, ‘Yeah. But how, that’s in New Jersey?’” When Krauss used the Google Earth app to show the woman her home town, all bets were off. “With that revelation, she was eagerly engaged, open and interested in interacting with me,” he adds.
- Mock remembers a retired Navy pilot who had become withdrawn in his assisted living quarters. Using the IN2L system, the elderly man was shown how to use a computer flight simulator, and he suddenly opened up to others in the community. “For the first time since he moved in, he was grinning from ear to ear and telling the staff about some of his memories from his flying days,” she says. The man eventually gave other residents virtual plane rides to their favorite destinations.
- After Mock showed Google Earth to one withdrawn resident, who had come to the U.S. from Germany decades ago with her husband, she started speaking in German as she pointed to the iN2L tablet screen. “I had to slow her down and ask her to take a deep breath so she could explain to me the places the iN2L slideshow was taking us,” Mock says. “We were able to see the park where they had their very first kiss! I don’t know about you, but when an 89-year-old can show you where she had her first kiss with her husband in a whole different country, that’s pretty powerful!”
- There are many stories about the emergency power of tech as well. Danielle Myers, general manager at Status Solutions, recalls one gentleman who couldn’t find cables from staff to jump a dead car battery. Using the company’s self-service tablet with its “communication and access to information everywhere” (CATIE) platform, the gentleman marshaled a slew of nearby residents, all gathering in the parking lot with their own cables in hand. Providers like Sara Hoit are quick to sing the praises the Internet of Things has produced. “Once a senior joins the online world, technology quickly becomes an integral part of their life,” she says.
But Hoit and others also emphasize the importance of using tech responsibly. That means not only being sensitive to privacy issues (Connected Living’s platform employs private social networking and informational groups), but mindfully showing both seniors and caregivers how to properly use it. The aim is to avoid dangers and mitigate the usual tech intimidation.
To that end, Connected Living employs guided learning tactics such as in-person or hand-over hand instruction, as well as remote support through virtual tech ambassadors. Its Connected Living University also provides online educational materials and video tutorials targeted to older users.
And to ensure the engagement possibilities are not missed by vision and mobility-challenged seniors, Connected Living recently added an Alexa option to its offering, so a senior can access, using their voice, community information and direct connections with friends and families along with the other features of the Alexa platform.
KEEPING TECH TETHERED?
No doubt tech’s place in senior living is permanent, yet evolving. “One of the greatest fears residents have is losing contact with the outside world. Technology and apps help them stay connected to friends and family members outside of their new home,” says Avery De Sostoa, business development executive for Sodexo Seniors.
And it continues spawning interesting relationships among the vendors themselves. For example, Connected Living’s app allows residents and their families in Sodexo client facilities to view all their meals ahead of time. The company uses another app called Bite, which is an extension of the community’s menu and includes everything from ingredients to nutritional value, De Sostoa says.
In the same breath, however, she is quick to emphasize the vital role human touch and human face-toface interaction play. Everyone agrees about the importance of keeping technology in the right perspective.
Says Connected Living’s Sarah Hoit: “The fear and apprehension we see among seniors when it comes to technology centers around confidence and education — that is, the perception of too much or too complex technology, feelings of inadequacy, lack of social interaction and communication and negative opinions of devices. Technologies aimed at seniors remind them they are old, and many are care- or health-related, which is why we feel our name and approach is so important.”
Krauss agrees. “For someone who is familiar with apps and technology, that can be a successful approach,” he says. “However, if an individual isn’t already comfortable with tech, throwing a tablet or computer at them, even if preloaded with apps and experiences they might like, could prove frustrating.”
Simply offering technology is another factor that can add to unfamiliarity and overwhelmed feelings if it’s not geared toward seniors to meet them on their level, observes Status Solutions’ Danielle Myers. “Conversely, when designed with seniors and their day-to-day lives in mind, introducing the right technology can be key to helping seniors feel engaged. Even integrations that may seem small, such as a built-in radio station that’s curated especially for them to play ‘oldies,’ or being able to send and receive pictures from friends and family, can make a big difference to a lonely senior.”
The end goal is overcoming solitude.
“One true fear people have at any age is that of being lonely,” says K4Connect’s Scott Moody. Over-reliance on apps is a very real risk today with any age group — particularly seniors, adds Moody, whose philosophy is focused on “digital inclusion to foster physical connection. To that end, we need only work hard to foster connection to family and friends outside the community, while being keenly focused on fostering connection across those living in the community.”
In spite of all this talk of social “engagement,” those who manage senior living communities would do well to remember there’s a little part in every senior that cherishes engagement in a private way that also allows for reflection and yes, “re-booting.”
“I see so many communities obsessed with getting people out of their rooms and participating in activities which sometimes are meaningful and engaging, yet too many times are almost demeaning,” says Jack York, president and co-founder of IN2L, whose tagline is “dignity through technology.”
“To me, meaningful engagement does not require attending activity programs, but only if the community invests in the experience to make it happen. I think technology can turn the narrative in a good way, but [the resident] should have the option to stay engaged in their own room, in their own space, if that is their preference,” York adds. “Maybe my perspective will change later in life, but for now, if I were in a community, I would much rather be ‘engaged’ in my own space — Skyping with my kids, listening to Springsteen, maybe a Stephen King book on tape, or watching my daughter sing over and over.”