Nancy Swanger, PhD, is the founding director of the Granger Cobb Institute for Senior Living and an associate professor in the School of Hospitality Business Management in the Carson College of Business at Washington State University. She recently spent a few minutes with McKnight’s Senior Living discussing what the hospitality and senior living industries can learn from each other and why breathing is “a really great thing.”
Q: You have a lot of experience in the restaurant industry as an owner and operator, among other roles. How did you become interested in senior living?
A: Like almost everyone that I’ve ever known, I fell into senior living quite by accident. In my case, in my personal life, my husband and I have been restaurant operators for almost 40 years, but in my academic world, when I made that switch over, I had been teaching in a hospitality school. I still have my fingers in the hospitality business, but I’m not the manager/operator of the restaurants that we still have today.
In terms of making that leap from restaurants to senior living, that’s not been an operational leap for me. I was the director of the hospitality school for about 10-and-a-half years at Washington State, and ours is the third-oldest hospitality program in the country. We’ve been around since 1932.
Some [senior living] operators from the Puget Sound area in Northwest Washington approached me and said, “Hey, you’ve got this great hospitality program, and we’ve got some senior living operations, and we think we should be collaborating.” And I had zero idea what that even meant. My parents were in their 80s, still living in their own home, and in my very narrow paradigm of the world, all I could think about was skilled nursing, nursing homes. And I thought, “I’m not seeing this big giant leap here of how we’re going to go from hospitality to senior living, but sure, I’ll listen. Here we go.” So then I drank the Kool-Aid, and it’s been a wonderful ride ever since. It’s really been an academic shift and focus for me, not an operational shift.
Q: You knew Granger Cobb. What is it like to be the founding director of an institute named for him?
A: It is really an honor and a privilege and a blessing. And I think those who were fortunate enough to know Granger — he had a heart the size of Manhattan. The guy was just so warm and genuine and so passionate about this industry, and it reminds us every day of the standards we need to uphold.
I think it puts a little bit of burden on us. We don’t want to ever do anything in the work that we’re doing to discredit his name or not honor him in some way. Arms-wrapped-around-us-as-we-do-this is how I would describe it, to make sure that we try and do it the way we’re supposed to be doing it. We have a lot to live up to by having his name — and in a lot of our printed materials, we actually have his signature. We’ve incorporated his actual signature into a lot of our work. And so you see that every day and it’s like, “This is Granger Cobb. We’d better pay attention to the details and get this right.”
Q: The Institute is part of the School of Hospitality Business Management. What do you think the senior living industry can learn from the hospitality industry?
A: A lot of things, and one of them is that in hospitality, we are very much about creating experiences for people that they aren’t able to or don’t want to create on their own.
Even just something as simple as going out for a sandwich. Everyone can make a sandwich at home. Why are they going to go somewhere and pay money for a sandwich? It’s the ambiance, the experience, it’s the person you might be dining with. It’s the servers. It’s a variety of things in those relationships that matter.
I think the exact same holds true in senior living. Care partners and other staff and the executive directors or GMs and all of those people — med techs, everybody who interacts with the resident on a daily basis, and even the other residents — there are opportunities to make their day just a little bit better by going above and beyond. And I think that’s where the intersection between the hospitality and the healthcare piece comes together. And a whole lot of those things don’t cost a dime. Great operators have figured this out, and they’ve hired the right people and put them in places with their residents to create these very meaningful experiences along the way, throughout a day, that they might not even realize are happening but could make a huge difference to the resident and/or their family.
Q: On the flip side, what do you think the hospitality industry could learn from the senior living industry?
A: On the hospitality side, we do everything for everybody in some ways. We know that’s not the best approach in senior living. In senior living, you want to create experiences, but you want those residents to come alongside you, because you want them to maintain their independence, their dignity, their quality of life, along the way.
I think sometimes in hospitality we over-serve. That sounds weird, but there could be some limits or parameters around what we’re doing for meaningful experiences for people. Not that we wouldn’t continue to do those things, but that we should roll those guests into that experience to come right along with us and help us create that as opposed to just doing it all for them.
Q: Medical care, healthcare, is becoming a greater part of senior living than it was in the past. How else has the industry changed since senior living began being taught at your institution?
A: I’m 64 years old, so I’m near the end of the baby boomers. And the baby boomers’ perception of what that industry is was probably very much based on their experience with their grandmas or grandpas. If they couldn’t be at home with family, they were in a nursing home, and that was not a good or pleasant experience.
As an example, I have millennial children. My dad passed away a few years ago. I’m not retired. My mom never even learned how to drive, and so I could not leave her in her home alone. We moved her down here, and she lived in a community near where I work. And so I transitioned a bit and became the adult daughter of a resident. But because of that, my adult children in the area went there to see her all the time. So they have a very different perception about what this industry is or what it might mean, and I think we’re seeing that more and more.
The students I have in class now, the sort of traditional 18- to 22-year-old, may have already been in a senior living community, because they’ve got a loved one there. Also, I have several students who may have had their first job in a senior living community. Maybe they were doing some stuff in food and beverage, or maybe they got a CNA through high school and now are care partners. Whatever it might be.
A shift has occurred over time from that very strict, 24/7, medical model nursing home to a more holistic experience, but the industry itself is transformed in that people aren’t waiting just until they need 24/7 skilled nursing care.
Many years ago, they started into this notion of, “Well, I could be an independent living resident, but if I’m an assisted living resident, there are options for me to get some additional care.”
I do think the level of acuity has increased, and I think you’re seeing some of those health services pushed further down into communities that maybe hadn’t been there before, and I don’t see that going away. I see the industry finding a way to deliver those services to residents in AL communities, or whichever level they’re in, much longer and delaying what might end up being 24/7 skilled nursing or hospice care.
Q: You mentioned students. Do you think the senior living curriculum attracts students to the university or the college or the school? Or is the industry more likely to be something they find out about once they’re there?
A: I think at this point it’s the latter. I want it to be the other way around, but this has been a work in progress.
These industry folks that I talked about, who started this — it was Jerry Meyer, who was at the time COO of Aegis Living; it was Bill Pettit, then-president of Merrill. Gardens; it was Tana Gall, who was the president at the time of Leisure Care; and then it was Granger Cobb, who was the CEO of Emeritus. When they came in about 2009 and those conversations started, we created a course. We did some things, but it’s taken us a long time to get where we are. We’ve actually only had a major in senior living since the fall of 2020, and that wasn’t the best time to be starting a major in senior living.
Before the major started, we created an elective course as an offering in the hospitality school, and it was kind of an introduction to this whole industry. And they flew over the mountains from the west side of Washington to the east side of Washington to teach the class.
I had no clue. I could write up a syllabus and herd the cats and get students to class on time, but I couldn’t teach the content. They did. They sent company executives over all the time.
And so for that elective course, which is the first course in the major sequence, we’ve probably put over 700 students through that class. And they all had to be people who were not majors in senior living, because we didn’t have a major. So, interestingly enough, what it has done is, there are several of those students who were in that class who then discovered there might be a career opportunity for their major that they hadn’t even thought about. And so we do have several former students who are placed in the industry but who don’t actually have the degree.
The students who came in starting fall 2020, their first option to graduate [with the major] would be spring 2024. We are starting to pick up a little bit. We now have about 15 to 20 students who are somewhere in the system who have said, “I think I want to pursue this as a major.” Whether they’re doing that on the front end or after they’ve been here for a little bit, I’m not sure we know that.
We also have a minor in senior living management. That one started fall 2021 and takes less time to get. We have graduated three students with the minor.
And then we have an online, on-demand, non-credit-bearing certificate program.
Q: What kind of students do you think are attracted to go into the program or into senior living as a career?
A: I think it’s people with varying interests. We had a young young man in our spring session of this class who was in construction management. Interestingly enough, his family is developing senior living communities. That was a nice fit. So it was about a tie of his major to that area.
But in terms of people who want to go out and be in community operations, you have to have the right heart. You can come from lots of areas, across various majors, minors, whatever it might be, but at the end of the day, you’d better have an affinity for an aging population, and that all comes from the heart.
And I think that ties very closely to what we already do in hospitality. I can teach you how to make a bed, and I can teach you how to make a sandwich, and I can teach you how to make change. What I can’t teach you how to do is care, and that holds very true for senior living. If you don’t care, it doesn’t matter what I teach you, this isn’t the place for you. I think a caring heart and an affinity for that population and just the general desire to be of service and help others [are characteristics of those attracted to the industry].
Q: You recently were named to the Board of Trustees of the Vision Centre, which is working to create university and college programs and facilitate internships to prepare future generations of aging services leaders. Congratulations on that.
A: Thank you.
Q: And as you know, recruiting and retaining workers is a top challenge for the industry. What are your hopes for the Vision Centre?
A: I’m really honored to be included. [President and CEO] Doug Olson has done a great job of bringing some key industry people, some key industry partners and some key academic partners together into the same space to try to build this out.
I really see my role as helping us build out other academic programs across the country. No one university is going to handle this work. I don’t care how many graduates you turn out; you are not solving this one on your own. This is one of those things — and I’m as competitive as the day is long; I just should throw that in there — but we aren’t going to win by operating in a silo in this space.
The program we have is different. It was the first of its kind in this country that was housed in a hospitality school in a college of business. So I guess what I hope to do is lend some help for other similar programs, starting sort of with the “low-hanging fruit” of other hospitality programs and saying, “This is a natural extension of your product line. Let’s figure out how we repackage some of the things you have. What do you need to create? How can I maybe help navigate you through this process, because the need is there and what you’re already doing in your hospitality program fits very nicely.”
So that’s what I see as my role, really helping to build out — and maybe create some templates and some how-to, because I didn’t have any of that. It was fly-by-the-seat-of-my-pants and listen to the industry. Thank God, they just steered us in the right direction. But [I want] to provide some tools and support for people in programs who want to grow and develop and get into this space, because it’s where all the demand’s going to be.
I tell young people, “For the next 40 years, you can write your own ticket. You do anything in the aging space, you can write your own ticket, because the demand is there.”
Q: Congratulations also on being named to the United Nations Healthy Aging 50 list in 2022. I understand you were one of only four people in the United States to be recognized for “transforming the world to be a better place to grow older.” What do you think needs to happen for the world, and especially the United States, to be a better place to grow older?
A: Thank you for acknowledging that. I was shocked, is probably the best word, and humbled and so honored to be recognized. I think the entire world is in crisis with their aging population. This is not a US-centric issue. There are several countries around the world that are probably in deeper trouble than we are. I think about China. I think about India and what do we need to do?
I think there are several things we need to do. First of all, we need to get rid of the “ism” word and embrace an aging population and realize that some of the solutions to these problems may be with that population in and of itself. That is a group that’s going to need some places to live, some things to do and have a lot of years left in their life that they may be able to contribute back to their society.
I think in the US, we’ve got to get out of that mode that, “Oh well, you’re 65 and you’re done, you’re retired, collect your Social Security,” which may or may not be there, and just go away quietly.
For me, that’s another third of my life I still have to live. I’m not going anywhere if I have anything to say about it, and so I think we need to embrace some of that.
We have older people with so many skills and talents who could be mentoring younger people or mid-career changers or young people in intergenerational-type experiences. All of those things matter.
We also need to look at some things related to immigration reform, related to these workforce challenges. It’s real. And I don’t even want to say that and make it sound like it’s some big political spin, because really it’s not. My understanding is, there’s a clause in a certain visa statement that if we just changed the phrasing just slightly, we could open up some opportunities for people with their visa status to come in and come to work in our communities.
We have to do something. Doing nothing isn’t going to be helpful.
You know the old saying, “Hope is not a strategy.” We have to become more proactive in some of the things we do, both as operators, trade associations, vendor partners and then just sort of as citizens.
We’ve got to realize, if you’re breathing, you’re aging, and that’s a really great thing, because the alternative to that means you’re not going to be blessed with aging. How do we become more active participants in our own lives, in our own communities, to embrace this for what it is and the opportunity it can create?
Q: Is there anything else you’d like to mention that we haven’t discussed so far?
A: The only other thing I would like to say is, I just want to stress how grateful I am for the industry partners who have helped us along the way with the work that we’re trying to do. We have an active steering committee. We have a strategic plan. We have had industry partner involvement — which also includes some association members and some vendor partners — from day one to help us guide this.
We’ll come full circle. My background is restaurants, and my degrees are in education. How did that link me here? I have no idea, but I was, gratefully, able to recognize an opportunity and listen to those fab four folks who came and talked to us early on and listen to them, and we still listen to them. And I think that a key to all of this is just remaining so closely tied to the industry and working with them to help everybody get this right.