Jody Holtzman and the Longevity Economy

What Exactly IS the Longevity Economy?

What is the Longevity Economy? It’s 8.3 trillion dollars. It’s 42% of total U.S. GDP. It’s equivalent to the third largest stand-alone economy in the world. It’s the rapidly growing market of products and services designed to benefit older adults, plus the multiplier effects of job generation, new businesses formation, and tax revenue across the U.S. economy. It’s a term that was coined by a new Thought Leadership team at AARP in 2009 to capture the full macroeconomic impact driven by the economic activity by and for older Americans.

At a time when common wisdom was leading to proposals to cut Social Security and to cut Medicare, the first boomers began to retire, and there was a sudden, rapid growth of startups in the health, digital health, and aging services industries, plus increasing interest by larger established companies.  

“AARP began pushing back against the notion that we can’t, as a society, afford all these old people,” said Jody Holtzman, Founder and Senior Managing Partner of Longevity Venture Advisors, former Sr. Vice President of Thought Leadership and Market Innovation at AARP, and a Nexus Insights Fellow

Holtzman, who was recognized as a Top 50 Influencer in Aging by NPR/Next Avenue, was a guest of Phyllis Ayman on her podcast Seniors Straight Talk. The two discussed “The U.S. $8.3 Trillion Longevity Economy: Its Meaning & Impact.”

“To support the claim that we can’t afford all these old people – although no one would put it that bluntly – everyone would point to Medicare and Social Security as evidence, saying the programs were unsustainable. They were making an economic claim that we as a society can’t afford something, but their evidence and arguments weren’t economic. Their evidence was a design function of these two programs.”

Those arguments were based on an “ageist attitude toward older people and their usefulness,” Holtzman argued, “combined with an ignorance of one of society’s most important economic assets – older Americans.”

“Just 35% of Americans drive about 42% of US GDP, and over 50% of US consumer spending.” – Jody Holtzman

He and his team at AARP hired Oxford Economics, who found that consumer spending by older adults generates a GDP of $8.3 trillion. At a time when the economy was lagging, “This was the one enormous growth market.”

It didn’t take long for the market to catch up with reality. “The market moves faster than the culture,” Holtzman said. “In fact, the market recognized the value and potential value of this demographic shift across every asset class; venture capital, private equity, public companies, real estate. And brokers responded by making it easier to invest with new ETF’s, REITs, and portfolios designed to benefit from this demographic wave. It cuts across industries.”

In fact, older adults are a powerful economic driver. “The economic impact analysis showed that a population of just 35% of Americans drive about 42% of US GDP, and over 50% of US consumer spending,” Holtzman said. “What other segment of the population generates such a positive disproportionate impact?”

Instead of arguing that we can’t afford to support older adults, Holtzman said, “It’s that we can’t afford not to because they are driving economic growth. And it’s having multiplier effects that benefit society and people of all generations.”

Listen to the podcast.

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Jacquelyn Kung and Bob Kramer discuss surprises about Senior Living during the pandemic

Foresight TV Recap: The Counterintuitive Way to Attract More Move-Ins

The media has gotten it wrong when it comes to its coverage of senior living, particularly during the pandemic. 

“There’s a stereotype that older adults, especially those living in any type of senior living community, have lost all independent agency. So that feeds the perception, the sense that in the midst of COVID, they’re desperately lonely, desperately afraid,” said Bob Kramer, Founder and Fellow of Nexus Insights. “There’s no common perception that they, too, could rise to a crisis, just like we see other people in society do.” 

Senior Living Foresight publisher Steve Moran hosted Kramer and Jacquelyn Kung, Nexus Fellow and CEO of Activated Insights, in a recent episode of Foresight TV entitled “The Counterintuitive Way to Attract More Move-Ins.” 

“Media tends to write stories that reinforce what journalists feel, or what they believe their audience feels, and add facts to magnify those feelings,” said Kung. 

But it’s more than just the media, according to Kramer, “All of us quickly fall into believing in stereotypes, and parroting them. That narrative doesn’t get it right at all. And that’s what we’re trying to address, with the rich data that Jacquelyn and her team have collected at Activated Insights.”

Activated Insights has been surveying senior living residents and their families since 2018. These surveys provide insights into the actual experiences that residents and their families have with congregate living. Their experiences during the COVID pandemic and shutdown are surprisingly different from the national perception. 

One of the surprising findings: When looking at the incidence of loneliness in congregate settings, specifically senior living, the Activated Insights research found that just under 20% of seniors counted themselves as very lonely. 

“I think the image over the last year-and-a-half is that everyone in a senior living community is feeling trapped and lonely,” reported Kung. “But 4 out of 5 seniors are not feeling like that.”

Even more surprising? Prior to COVID, the incidence of loneliness among senior living residents was 26-27%, higher than what was found during the pandemic shutdown.

“It’s not that we’re saying there aren’t some very lonely and scared seniors in our senior living communities,” Kramer added. “But the perception that all seniors are feeling terrified, trapped and lonely isn’t borne out by what the data show. We’re all quick to jump onto stereotypes, and sometimes those stereotypes miss what’s truly going on. We want to get that contrarian message out.”

“Providers believe they know how their residents feel, because they hear from them every day,” she added. “But do they hear from everybody? No.” – Jacquelyn Kung

According to Kung, prior to the pandemic, resident survey responses frequently focused on “the usual: the food, the seasoning, the staff.” But during the pandemic, “The comments were an outpouring of community and belonging,” as well as gratitude for being in the community, and gratitude for feeling safe. “This isn’t what the media is covering about the pandemic,” she said.

The two pointed out that now, when the industry is particularly stressed, the data provide insights into how to attract people to live in a congregate setting. The important stories to tell are those about the sense of being safe, of belonging, and being part of the community. “It’s contrary to the perception,” said Kung.

“Providers believe they know how their residents feel, because they hear from them every day,” she added. “But do they hear from everybody? No. And providers are often surprised at the results when they finally survey everyone. When you don’t actually ask people, then you may be working on the wrong things. You may not be working on things that actually matter to your customers. How do we delight and provide quality experiences for our customers and their families? It’s by hearing from everyone, and not just a few who come to you.”

Listen to the full episode.

Jacquelyn Kung is the CEO of Activated Insights and a Nexus Insights Fellow. Bob Kramer is the Founder and Fellow of Nexus Insights. He is the co-founder, Strategic Advisor, and former CEO of NIC. Steve Moran is Publisher of Senior Living Foresight.

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Experience design in senior living

Experience Design for the Often Undervalued Longevity Market 

For Sarah Thomas, CEO of consulting company Delight by Design, and a Nexus Insights Fellow, “experience design” is about creating “an engaging experience that brings value to the consumer and delights them throughout the customer journey.” This is especially true in the longevity market, a market Thomas says has been undervalued in the past, and which is where her company is focused.

Delight by Design works with firms that are looking to design more accessible products or more inclusive services, and investors who are looking to expand their portfolios. These organizations may need assistance in understanding the wants, needs and market opportunities for the older adult consumers. That’s where the Delight by Design team truly shines.

Thomas was featured recently in an article entitled, “How Tech and Common Sense is Bringing Experience Design to Senior Living” on the Senior Living Innovation Forum (SLIF) blog. “Applying my background as an occupational therapist,” Thomas told SLIF, “I focus on human-centered design to create environments and experiences where residents are living their best lives, not defined by age.”

According to Thomas, experience design can “help companies foster a sense of purpose, encourage community engagement, improve mental health, elevate physical activity, increase healthspan and lifespan.”  

“We want it at the touch of a button with on-demand functionality, and we should be expecting the evolving consumer to want the same in senior living.”

Technology plays an important role in experience design, not for its own sake, but for how it can improve efficiencies and help consumers. “In Silicon Valley, we design products to replace the greatest caregiver of all—Mom!” Thomas said. “Bring me food, clean my house, make my bed, and drive me! We want it at the touch of a button with on-demand functionality, and we should be expecting the evolving consumer to want the same in senior living.”

Thomas predicts that tech-based experience design innovations will bring improvements across the entire senior living experience. She predicts that seniors, who are used to living in a high-tech world, will come to expect it. “We need more availability of basic tech-enabled experiences; we need to offer technology that reaches families beyond the walls of a resident’s community, includes more telehealth, counseling, dietary support, and increased access to other resources that improve quality of life across all dimensions of wellness,” she said.

Read the full article.

Sarah Thomas will discuss the importance of experience design at this year’s Senior Living Innovation Forum in October. Nexus Fellows Bob Kramer and Ryan Frederick will also be sharing their expertise as speakers.

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Nursing home strike in Pennsylvania

Understaffed, underpaid and unsafe: Nursing home strike in Pennsylvania

David Grabowski, Professor of Health Care Policy at Harvard Medical School, and Nexus Insights Fellow, was recently interviewed by The Times in a story about 12 nursing homes in Pennsylvania that have voted to authorize strikes

Nurses, nurse aides and other caregivers have authorized issuing a 10-day strike notice at 12 nursing homesIssues include “a growing crisis involving the COVID-19 pandemic, chronic understaffing and low pay, and industry regulations in desperate need of reform,” according to the workers’ union, SEIU Healthcare PA.

Zach Shamberg, president and CEO of the Pennsylvania Health Care Association, cites two major issues affecting the industry, a shortage of workers and declining Medicaid reimbursements.

A statement from the union states that the workforce has been, “Stretched to the breaking point after decades of understaffing, lack of investment in a workforce that makes poverty wages, and a pandemic that took an unimaginable physical, mental, emotional and financial toll on caregivers who have dedicated their lives to our most vulnerable.” There were more than 13,000 COVID-19 nursing home deaths in the state.

Owners and workers both express a concern for the health and safety of residents.

Read the full article.

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Transforming senior living

How Managed Care Companies are Transforming Senior Living

The senior living sector, which is experiencing a period of unprecedented disruption, has begun to show signs of a major transformation. Several weeks ago, Tim Mullaney, editor of Senior Housing News, wrote a fascinating article (behind a paywall) on the significance of the recently announced Lifesprk acquisition of Tealwood Senior Living. Central to Mullaney’s analysis is the recognition that the acquisition is an early sign of major changes taking place in the senior living sector. As Mullaney writes, the transaction suggests that the industry is “not just rebounding but transforming.”

I believe that Mullaney’s analysis should be required reading for every senior living operating company executive and every investor who has more than a two-to-three-year investment horizon. Here’s why. For several years, a number of us in the senior living field have been predicting that managed care companies would either acquire or build their own senior living platforms. Now, as Mullaney points out, this concept is no longer just a theoretical possibility but is happening – and is “about to become more commonplace.”

Mullaney sees the integration of the two platforms as a template for a new operational model of senior living that’s more integrated across the continuum of providers and payers. The model will also challenge the way real estate-based investors view value creation in the sector. Lifesprk is a home care provider whose model is rooted in home and community-based services (HCBS) and who contracts with health systems and payers, assuming financial risk and reward. Mullaney sees five pain points or shortcomings in today’s senior living product that he believes at least on paper, the innovative Lifesprk senior living model will address.

Enhanced consumer appeal

Mullaney notes that Lifesprk’s “life care manager” will help address the many frustrations of adult children who currently must connect all the dots of the health care and long-term care systems for their loved one. Typically, the eldest adult daughter must coordinate care for their parents even when they reside in a high quality private-pay senior living community. By communicating with the family and caregivers, as well as the different providers and payers, the “life care manager” will help address this common frustration of adult children, especially the adult daughter, when they’re paying $4,000 to $10,000 a month, but find themselves still heavily involved in coordinating care.

Too often, families are the point people for figuring out the right setting and the right care for their parent, and for ensuring that healthcare and senior care providers are communicating with each other. This is in addition to figuring out who will pay for the care, and how. Senior living options that leave the burden on the adult child or spouse to connect will be replaced by models that truly provide what the adult children think they’re paying for.

Affordability

Joel Thiessen, CEO of Lifesprk, believes that by bringing all the payment sources together under one experience, and by taking on global risk, savings will be generated – and could be invested in housing and services. The model opens the door for providers to improve the affordability of care without impacting quality. As quoted in Mullaney’s article, Thiessen says, “We think we can use both sides of a person’s wallet, their insurance or their Medicare/Medicaid benefit as well as their private pay and put those together under one experience versus one butchering the other.”

Health and Wellness

As Mullaney points out, wellness was already a hot topic before the pandemic. Consumers and value-based care providers and payers alike are demanding engaging and healthy lifestyles. With their “electronic life record” which records not only medical-based and care-based key data, but also lifestyle-related information, Lifesprk is in a better position to address this trend. Integrating lifestyle data into the record enables ongoing preventative health, management of chronic conditions and an increased emphasis on vitality and staying well rather than sick care only once one is sick. This approach reflects the likely model of healthcare delivery of the future that is predictive, preventative, and participatory, rather than reactive, curative, and after the fact.

Changing Capital Structures

While real estate investment returns have been high across the sector, capital structures are in need of change. Pointing to problems such as oversupply, and to heavy regulatory criticism of private equity ownership, as well as the fact that Lifesprk promises a more competitive offering, Mullaney argues that REITs will quickly recognize the need to adapt. He highlights examples of this recognition, such as Welltower’s joint venture acquisition of HCRManorCare with health system ProMedica, and the new Formation Capital strategy, which bears some resemblance to the Lifesprk move.

The Home Care Threat

Finally, Mullaney suggests that the recent boom in home care need no longer be viewed as competition with the senior housing and care industry. Instead, Mullaney argues, “senior living providers should emphasize that they are HCBS settings, while also finding ways to extend their services beyond the walls of their buildings.” Rather than be distracted from the mission of providing better care for the growing population of older adults, leaders such as Thiessen see an opportunity in the home care business. The moves they make now should be watched closely. They may, indeed, define the industry for years to come.

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Nexus Insights Fellows News 2021

Nexus Fellows Flash Bulletin: June 2021

The Nexus Fellows are leaders in the aging industry, helping to shape public policy and redefine aging and aging services. From books to podcasts, here’s a sample of some of the work they’ve been doing in the past month:

  • Jay Newton-Small, CEO of MemoryWell, is wrapping up a second year of their joint contest for Hilarity for Charity, Seth and Lauren Miller Rogen’s Alzheimer’s charity and Humans of Dementia Storytelling Competition. It’s a competition for high school and college students to write the best profile of someone living with Alzheimer’s. Winners will have the chance to meet Seth and Lauren Rogen during the virtual celebration. Additionally, MemoryWell has added three new members to their team.
  • Jacquelyn Kung, CEO of Senior Care Group at Activated Insights, was interviewed by Skip Lineberg, host of The Main Thing Podcast, about elder care, and her passion to improve the aging experience. “The main thing I’ve learned in my lifetime so far is that getting older is what you make of it. And I see it as full of good news. Socially, we get happier as we get older, and the research shows that.”
  • Jill Vitale-Aussem, president and CEO of Christian Living Communities, sat down with Senior Housing Investors Podcast to talk about her book, “Disrupting the Status Quo of Senior Living: A Mindshift.”
  • Sarah Thomas, CEO of Delight by Design, delivered the keynote on designing products and services for the aging population with Chief Medical Office of AARP, DR Charlotte Yeh. Additionally, she moderated two panels featuring the important work of seven agetech startups at the Rehab Tech Summit mini-Summit. Thomas was an expert judge at the AOTA 2021 Inventors Showcase, where 11 startups pitched their innovative products designed to serve people across the lifespan. The winner designed a novel gait belt that improves the safety of caregivers and residents in senior living and beyond.
  • Dr. Bill Thomas, founder of The Eden Alternative, The Green House Project, and Minka, recently traveled the country, talking with elders and their care partners in more than 125 cities. He learned about their hopes and fears, and listened to their stories. What did he discover? That people want better alternatives for senior living. “It turns out that older people pretty much want what everyone else wants: to belong to a community that includes people of all ages and remain connected to the living world,” Thomas said.
  • Nexus Founder & Fellow, and NIC Strategic Advisor, Bob Kramer, has joined the Edenbridge Health Board of Advisors to help expand access to comprehensive, integrated, community-based and person-centered care for the frail elderly through innovative applications of the PACE Program.
  • In the blog post, “Just Move It,” CEO of SmartLiving 360, Ryan Frederick talks about the importance of physical exercise for older adults. “Inactivity is the fourth leading cause of death and about 1.5 billion people in the world are inactive to the point that it risks their long-term health. At a health care conference several years ago, four recent surgeon generals were asked for one tip for successful aging. They coalesced on one word: move.”
  • Nexus Fellow Kelsey Mellard, CEO of Sitka, sat down with Sanjula Jain Jo on Her Story for a candid conversation about being a healthcare leader and her transition from the Midwest to DC to Silicon Valley, building a resilient team, and overcoming challenges.
  • Longevity economy expert, Jody Holtzman, formerly of AARP is proud to be on the advisory board of Intuition Robotics, which is mitigating loneliness among older adults with the companion robot ElliQ. “The growing mismatch between the number of people in need of caregivers and the availability of caregivers is a multifaceted challenge for individual families and society more broadly. Technology must be part of the solution. Companion robots like ElliQ and others in this space, like my friends at Joy for All/Ageless Innovation, have an important role to play.”
  • Caroline Pearson, Senior VP of Health Care Strategy at NORC at the University of Chicago, announced the release of new research from NIC and NORC that looks at the impact of the pandemic on seniors by care setting. “Mortality rates increase by complexity of care, but, in lower acuity settings such as independent living communities, they are comparable to surrounding populations.”

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Better Together panel discusses the future of senior living

Better Together Live – the Future of Senior Living

The past 18 months have been tragic for residents of senior living communities, their families, and their staff. As we begin to gain control of the pandemic, we must begin to think about the future of senior living, and decide how to move forward to avoid the mistakes of the past. 

To answer that important question, Patrick Bultema, CEO of The Eden Alternative and Penny Cook, CEO of Pioneer Network gathered some of the leading thinkers in the industry for a podcast, entitled  “Better Together: Given the impact of COVID, what comes next?” This lively roundtable featured Lori Smetanka, Executive Director of Consumer Voice, and two Nexus Fellows, Bob Kramer, Founder & Fellow of Nexus Insights and Strategic Advisor & Co-founder of NIC and Dr. Bill Thomas, Founder of The Eden Alternative, The Greenhouse Project and Minka. Together, these five industry experts tackled the issues that ail our current aging service industry, and presented recommendations for the changes needed in order for it to succeed, going forward.

Highlights and Key Take-Aways: 

We must stop taking our frontline health care workers for granted. 

COVID has been a wake-up call. Although we cheer for hospital workers, we don’t give them enough support. They have been working the most dangerous jobs in America. We cannot go back to the days of taking frontline workers for granted. To maintain a high quality of care, the people providing services need support in the form of training, living wages and benefits, and career ladders. And there must be accountability from providers on how they are using public monies and funds.

We must create home and community-based models of care.

More than 90% of those infected contended with the illness at home, surrounded by family. Although people can care for themselves or their families at home, or receive all needed services in age-segregated congregate living settings, we have created an empty lane in the middle – between pure age segregation and pure aging in place. Access to services are needed that are focused on wellness and supported by people’s home and community-based shared benefits.”

Communities must engage residents and families in asking what they want. 

People were frantic, particularly residents and family in SNF and ALFs, for safety, isolation and inability to connect. People were being told to stay home. One of the residents in a community remarked, “But what if your home is a death trap?” 

When we look at long-term care, there isn’t a whole lot of preparation or proactive thought about what people need and want in the future. People need options, they want to be engaged in the community similar to how they lived before and they certainly don’t want to rely on the facility van to take them out. Lack of quality of life during the pandemic meant being kept in their rooms with the curtains and the door shut. These communities are not engaging residents or family in asking what they want. Residents and family should be included in the strategic planning. Which services do they want or need? It’s important to get feedback.

 

“But what if your home is a death trap?”

 

Transparency must be a requirement.

Transparency is critical. Providers may not have wanted to share information about COVID cases or deaths, and in fact, some chose to suppress that information. But family and residents needed that info to make decisions for themselves and their loved ones. 

We must rethink the way we think and talk about aging.

What do we really offer in senior living? We have to rethink our basic terminology. The way that we think about aging, health, retirement, healthcare, diversity. Many terms are ageist and self-defeating, and not what we actually want for our residents. If we don’t change something, we are going to get disrupted right out of business. Senior Living represents to boomers what they did with their parents and they want nothing to do with it. 

COVID showed us that we need to give people a sense of being connected and belonging. What are your goals in moving here? Where do you want to grow? Where do you want to contribute here. It’s wrong to think that the older you are, the more helpless you are, the less you have to give. With technology we can transform the sense of home, and help individuals remain safe, healthier and connected for longer.

 

Senior living represents to Boomers what they did with their parents, and they want nothing to do with it.

 

Funding is critical to success.

Although skilled nursing has gotten a lot of public support dollars, that’s not true of others. How many can survive with expenses way exceeding revenues? The weak have gotten weaker. Many companies do not have the funds to invest in the necessary people and technologies. When it comes specifically to long-term care, we have got to have a real conversation about how we are addressing ageism as a nation. Do we care as a nation if our elders die in poverty? If we do care, we have to figure out a way to fund long-term care. 

We must solve the caregiver crisis.

The number of family caregivers is the biggest demographic shift in this decade. It’s not the increase in the aging population, it’s the ratio of unpaid caregivers, aged 45-64, to those over 80, which is going from decreasing from a ratio of 7 to 1 to a ratio of 4 to 1 by 2030. Where will the paid caregivers come from? They are going to be more expensive. Saying everyone is going to age in place without funding will lead to an epidemic of shut-ins and loneliness in their own apartments rather than truly creating a community and honoring our elders.

 

Do we care as a nation if our elders die in poverty? If we do care, we have to figure out a way to fund long-term care.

 

People want choices, but they must be affordable.

Aging in place is something everyone wants. They want to choose where they live, whether it’s a community or in their own homes with services brought to them. There needs to be a variety of choices. Most people can’t pay 80, 90, or 100 thousand dollars for assisted living or skilled nursing. There’s a lot of waste in the system, where the dollars are being spent. People need to be a part of the decision making, planning, providing solutions for themselves. They don’t want to be put in a bed and forgotten and left, which could happen anywhere. How can the community come together to help individuals needing care? 

We must invest in social capital.

If we try to spend our way through the aging of the boomer generation, new sources of capital need to be deployed. The largest reservoir of capital is social capital. This is the good that comes into your life through your friends, family, neighbors, people that are willing to make social investments because of a relationship. The biggest issue with aging in place is aging in the right place. If you pursue a rigorous commitment to aging in place, you end up isolating people and their stock of social capital falls. If you end up with congregate care settings, they are not rich in social capital. They create some fellowship and facilitate interaction, but do not foster interdependence amongst their residents and staff – they are not set up that way. This middle lane will succeed based on new models to create, sustain, nourish and enrich social capital. Housing is important, but community is more important.

 

Watch the entire podcast:

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long-term care infrastructure op-ed in The Hill

America’s long-term care infrastructure: A road to nowhere – Op-ed in the Hill co-authored by Nexus Insights

In a recent op-ed in The Hill, Nexus Insights Fellows Anne Tumlinson, David Grabowski and Robert Kramer, raise an important point that has been missing from recent discussions around transforming long-term care following the pandemic. The Biden Administration has proposed a $400B investment in home- and community-based services (HCBS). We assert this investment is necessary but not sufficient. Without additional spending on services to help families navigate and manage long-term care services, this HCBS investment is basically a “road to nowhere.” We argue for the need to create a network of long-term care service hubs across the country to help families navigate services.

As you know, there have been A LOT of thought pieces around improving long-term care going forward, but we have not seen this point made elsewhere. Thus, we believe it would be an ideal time to make this point as policymakers consider the Biden proposal.

Excerpt:

Long-term care is complex. Few Americans plan ahead and most wait until a crisis pushes them into a frantic search for solutions. It doesn’t have to be this way.

Every day older adults lose their ability to care for themselves. Often, they are discharged from the hospital too weak or confused to be left alone or care for themselves. Now what? Who will take care of them? Is home- or facility-based care the best option? How much will it cost and who will pay? Does Medicare cover it? Does Medicaid? If home care is the answer, how do you find a qualified and affordable caregiver? Where do you even start? Life-changing decisions must be made, and fast.

Read the full op-ed in The Hill.


Anne Tumlinson is CEO of ATI Advisory and the Founder of Daughterhood. David Grabowski is Professor in the Department of Health Care Policy, Harvard Medical School. Robert Kramer is the founder of Nexus Insights, and the co-founder and Strategic Advisor & former CEO of the National Investment Center for Seniors Housing & Care (NIC).

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Jay Newton-Small and Bob Kramer discuss MemoryWell and person-centered care

Putting the Person Back in Person-Centered Care: Jay Newton-Small and Bob Kramer on the Power of Data to Transform Senior Care

Are your residents truly known, valued, and seen as people by your staff? Are they known as more than the sum of their ADL needs or underlying health conditions? 

Bob Kramer, Founder & Fellow at Nexus Insights and Co-founder and Strategic Advisor for NIC, talked with Jay Newton-Small, founder and CEO of MemoryWell and Nexus Fellow, about the value of data to deliver improved care and quality of life for residents of senior living.

A TIME contributor, Newton-Small developed the concept for MemoryWell from her own experience with her father. She wrote a narrative story of his life to help his care staff understand him better, and to provide better, more personalized care. 

Now her company has taken it further, working with senior living communities to foster connections between residents and other residents, and between residents and staff, based on connections, interests, lifestyle, and historical experiences revealed by their life stories. The company is able to help communities understand what services are needed, and who would most likely use or benefit from those services. 

“We shine the light to help you see who are the people you’re serving.” – Jay Newton-Small

“Where we are now is a shot in the dark,” said Newton-Small. “We shine the light to help you see who are the people you’re serving. So you can market, plan, sell and care for these people in a more focused way, that takes the guesswork out of it.”

The data has other powerful uses as well, which Newton-Small describes in the interview, which aired on Foresight TV. It can be used to get to the root causes of health issues. And, when aggregated, can be used in a predictive way, to help with prevention. “Right now our health care system is a reactive system. It’s an incredibly expensive system because we react to a problem,” said Newton-Small. “But if we know that a problem is coming down the pike and we can match people with resources that are available, then we can delay, defer and even sometimes prevent those problems from happening.”

See the whole interview.

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alternatives for senior living

Dr. Bill Thomas Leads the Way with Better Alternatives for Senior Living

Geriatrician Bill Thomas is renowned for his innovative thinking, which has helped transform the industry’s understanding of aging, aging services, and senior living. Dr. Thomas is a Nexus Insights Fellow and founder of The Eden Alternative, The Green House Project, and Minka. Not one to rest on his laurels, Thomas recently traveled the country, talking with elders and their care partners in more than 125 cities. He learned about their hopes and fears, and listened to their stories. What did he discover? That people want better alternatives for senior living. “It turns out that older people pretty much want what everyone else wants: to belong to a community that includes people of all ages and remain connected to the living world,” Thomas said. 

He took the insights gained during his travels to apply towards three important initiatives: Lifesprk, Kallimos Communities, and Canopy. Each one designed to upend traditional approaches to senior living. Each one is designed to put the resident at the center of the solution.

Thomas has recently been named the Chief Independence Officer of Lifesprk, a company taking a state-of-the-art approach to senior housing and services. This title reflects Lifesprk’s approach to seniors, and their efforts to improve quality of life for seniors, by providing a more holistic and wellness-centered experience. Lifesprk integrates housing with home and community-based services, and recognizes the uniqueness of each resident and their individual life goals.

Lifesprk acquired Tealwood Senior Living, a Minnesota-based company with 35 senior living communities across Minnesota and Wisconsin. Included are three communities offering skilled nursing services, where Lifesprk plans to test its innovative approach. The goal is to provide continuity of care, to make it possible for residents to receive care in their own homes, and to reduce the need for care at hospitals or clinics. The result will help seniors retain their independence longer, be healthier and lead richer lives.

“One-hundred percent of the people living in [senior living communities] need access to primary care, and over time an increasingly high percentage of them need access to supports and services,” said Thomas in an interview with Senior Housing News. “What if a provider of housing is able to wrap the housing access around to primary care and supported services? That’s what’s coming down the pike.”

Thomas’s second initiative is Kallimos Communities, an affordable multi-generational community. The vision for Kallimos is to improve wellness and reduce loneliness for its residents at an affordable cost, by encouraging neighborliness and multigenerational shared housing. “Some of the loneliest elders in America live at home on streets filled with houses but without friends, family, or neighbors as part of their daily life,” Thomas said. “Large senior living buildings offer a solution for some but can be expensive and often carry the stigma of being “old folks’ homes.”

“Let’s create a model that’s actually based on one of the oldest ideas we have, which is people living in their own homes.” –  Dr. Bill Thomas

Each Kallimos community consists of “pocket neighborhoods,” which will have up to 50 small homes clustered around a shared green space. The communities will include public amenities, such as small shops for basic goods and services, gathering areas and swimming pools. Along with traditional administrative staff, the communities will include “weavers”, designated staff who have the job of  encouraging connections among residents, and supporting residents in achieving their health and life goals. Additional staff known as “keepers” will maintain the indoor and outdoor areas, and may be responsible for cooking and gardening.

Two initial Kallimos communities in Colorado and Texas are in early stages of development. The design is based on a set of principles introduced by Thomas, and further developed by the University of Southern Indiana, called MAGIC (multi-ability, multi-generational, inclusive communities.) The homes will be compact, and designed with features and technology that will support aging in place. 

The COVID-19 pandemic also cast a glaring spotlight on disadvantages of traditional senior living, with elders clustered together in one large building. This clustering put elderly residents, who were in the highest risk category for severe illness and death from the disease, at a much greater risk for exposure to the disease. 

Deinstitutionalization of the nation’s nursing homes was a clear answer which led to Dr. Thomas’ involvement in Canopy, a joint project with Signature Healthcare. Canopy has many similarities to Kallimos. Canopy communities are a cluster of small, close together ADA-accessible houses, focusing on the importance of neighborhoods. Services, such as assistance with many activities of daily living, is typically a component of nursing home living. For people living in Canopy, services will be provided efficiently within the residents’ homes. And in many cases, neighbors can help neighbors.

“I’m saying, let’s go beyond, let’s move past the era of mass institutionalization,” said Thomas, in an interview with Politico. “Let’s create a model that’s actually based on one of the oldest ideas we have, which is people living in their own homes.”

In fact, funding for non-medical services, such as rides to the grocery store, help prepping meals, and meal delivery, have recently started being covered by private Medicare plans. The trend toward increasing coverage of home and community-based services (HCBS) is expected to continue. “The pendulum’s swinging to home and community-based services,” said Thomas. “And in order to make those services really work, we need better homes and better communities — and that’s what Canopy is designed to provide.”

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