No matter how one defines a senior living community – as a full continuum CCRC or MLRC, as an IL/AL/MC community or IL/AL – seniors’ desire to age in place has impacted both the business and care model. A trend best described as “acuity creep” has seniors eschewing earlier life-style moves into retirement communities until a physical need arises, foregoing transitions from IL to AL or Skilled Nursing until absolutely required by regulations, and changing the mix, look and feel of retirement communities across the nation.

The reasons for this shift seem to be primarily economic and emotional. The economic crisis has depleted seniors’ wealth through loss of investments and loss of value in primary real estate. It has also brought with it a sense of fear and uncertainty as it relates to the future. Seniors are less inclined to leave their own homes until it is absolutely necessary.

Consequently, the average age of a resident has risen in most senior living communities over the last ten years. As they age, they are requiring more services. A recent anecdotal survey of operators indicates that many are providing “assisted-living-lite” services to many residents in independent living. The idea that a resident transitions from IL to AL then to either MC or SNF services is less and less the norm. Many are bypassing the AL transition entirely and remaining in their IL residences. When not bypassing levels of care, residents are utilizing greater levels of services and resources. Communities are responding by establishing home care service affiliates to provide bathing, medication reminders and companion services and the like to an increasing number of residents. On the one hand providers are to be commended for meeting the needs of their residents.

However, that flexibility is not without risk. As seniors age in place concerns for their safety also rise, as well as the risk of increased liability. In addition, aging in place causes an IL community to begin to look and feel a little more like an AL community. This could decrease the appeal of the community to that next generation of potential residents, now put off by the more frequent reminders of their own mortality. A third factor revolves around pricing; many IL communities were built in the last ten years with an increasing array of amenities which may not be perceived as necessary by the new customer. The pricing models based on these higher fixed costs may need to be revisited as well.

By most accounts, aging in place is here to stay. It will be interesting to see how providers deal with the necessary changes to their business and care models in the coming years in order to remain viable and caring communities.

By Keith Kreidel, Haskell Senior Living Solutions

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