Corporate Fitness and Active Aging

Our use of the word “wellness” in senior living is confusing and potentially problematic for the consumer. When the possible definition by organization for “wellness” swings all the way from a few group fitness classes at one community to a full-blown medical clinic in another organization, it’s challenging to succinctly define what is being offered under the wellness banner. 

Sometimes I visit a community and they have a wellness director who is an RN with primary responsibilities for running the community’s outpatient clinic and helping residents navigate their health care needs. In other cases, I interact with an individual at the community level whose title is wellness director, but whose primary roles are focused on running the fitness program. Those two individuals have two very different focus areas, diverse areas of expertise, and they offer two entirely different value propositions for prospective residents. And neither of them paints a full picture of what community wellness can be.

How you define your community in the area of wellness can be a point of distinction and a clear competitive edge for your business. But I wonder if that definition is best suited to be made at the community level or if there is a need, or even better a benefit, to defining it at an industry level. LeadingAge has initiated a “NameStorm” to find a new term for “continuing care retirement community” (CCRC). Is there a need for this kind of industry-wide focus on how we universally define wellness in senior living?

If we use the well-recognized dimensions of wellness (and I’ll go with the seven defined by the ICAA) as the means to define individual wellbeing, then the essential duties of the RN clinic director and the fitness program manager fold into various dimensions. But so do the essential duties of several other common jobs at a CCRC, including the activities director, the social worker, the dietician, the chaplain, etc. I could argue that each employee at the community has some portion of his essential duties impacting resident wellness.

I think, in a lot of cases, we get wellness all wrong. We want to box it into neat compartments, but it really spills out to all areas of the organization. Wellness is about building meaningful lifestyle opportunities for residents. It’s about honoring who they are as individuals and finding ways to help them tap into what motivates them, what provides them with purpose, and what keeps them engaged in life.

As I’ve started shifting my view on resident wellness in senior living to this broader perspective, I’ve started wondering whether resident wellbeing doesn’t need to sit a little higher in the organizational chart. Wellness isn’t just fitness and it’s not just activities. It doesn’t belong under either of those “departments.” It’s not limited to nutrition or spiritual designations, and it’s not focused on health care and clinical services.

Perhaps it’s the culture we’re trying to build.

But if that’s true, if wellness provides a cultural focus for our organizations, then each employee needs to have a stake in what it means to provide person-centered opportunities for well-being. And that message needs to come from the top. It can be supported by a well-developed employee wellness offering, as well (which is being discussed more and more in senior living). It can get folded into employee goals, job descriptions, and team meetings. And while one person should probably have ultimate responsibility for wellness in the community, it cannot operate in a silo apart from other elements that are unique to what your community offers. (This post talks more about how the various departments can collaborate better.)

How are you cultivating wellness beyond your fitness programming, your activities calendar, and your clinic?

Download our whitepaper on how you can create a culture of wellness in your senior living community.

During my morning commute a few months ago, I switched on the radio and caught the tail end of a brief NPR story about doctors not communicating to their patients when they are diagnosed with Alzheimer’s. Because I am surrounded by this disease in the workplace and have experienced it first-hand in my family, I was quick to become empathetic and my heart sank into my stomach. It just seemed so unfair and, well, wrong.

The next day, I decided to dig a little more deeply and find the article in writing. Maybe I missed some important details at the beginning of the story. Maybe the twist was that these patients were being diagnosed but simply forgot after they walked out of the doctor’s office doors, because, after all, they do have memory loss and dementia. Unfortunately, that was not the case.

According to this specific study, an alarmingly low number of patients with Alzheimer’s (only 45%) claimed that they were given this diagnosis by their doctor. When the study looked past the patient’s input, still only 53% of family members or caretakers reported being aware of the diagnosis. The reasoning behind this sits among a variety of excuses, ranging from the doctor having limited time in each appointment to the doctor simply feeling uncomfortable.

Is It Acceptable to Withhold the Diagnosis?

Are these legitimate excuses? Is it ethically acceptable to withhold information that is unknowingly being written down in your medical records just to save one or both parties from feeling uncomfortable? 

Sure, it feels terrible to look someone in the eye and tell them devastating news, but when a person is relying on someone, their doctor in this case, to keep them informed, the doctor needs to take responsibility here. Withholding this information puts the patient at risk of harming himself, as well as those around him. What if those around a person with Alzheimer’s believe these forgetful moments are merely part of a normal aging process? Maybe one day the person with Alzheimer’s cannot recall a street name, which may seem normal, but what if the following week(s) lead to such scenarios:

The person with Alzheimer’s…

• Goes for a walk or bicycle ride without telling anyone and gets lost.
• Accidentally leaves the gas burner on all day while home alone.
• Needs help but forgets how to dial the phone.
• Leaves the water running in the bathtub, does not realize it, and goes to bed.
• Gets in a pool alone and forgets how to use their legs, loses footing, and goes under.

Some of these examples may seem extreme, but they are actually scenarios that either myself or someone I know has personally witnessed. So many dangerous situations can be avoided if family or close friends are aware of the diagnosis. And though there is no cure, doctors are finding medications that can help slow down the disease process, and researchers are finding more and more ways for people with Alzheimer’s to gain a better quality of life through means such as music, aquatics, memory care, and more.

I often see family members or caretakers get frustrated, and even angry, with people who are forgetful. When we are able to have a medical diagnosis, can realize that it is truly a disease and out of the person’s control, and can view the whole picture, we are opening a door to having more compassion and understanding for the situation a person with Alzheimer’s is facing. 

How many suffer from joint pain and inflammation?  Feel stiff and sore? Deal with lack of circulation, feel tired, depressed or have lack of energy, even have trouble sleeping? If you answered yes to any of these questions, then the big question is why are you not getting a massage?!?

Getting a massage is a proven way to reduce some of these issues.  Because we are living longer and keeping much more active, our muscles, joints and bones will develop forms of stiffness, aches and pains.  In addition we start to have limited range of motion or flexibility.  Aging brings about many other conditions that affect our bodies, such as osteoporosis arthritis, back pain and reduction in circulation. Massage therapy cannot cure these issues, but it has been proven to alleviate them.  A good licensed massage therapist can use techniques that focus on areas of the body to gently get to those muscle contractions or knots, making the muscles feel less stiff with more capability to move. 

Feeling down and depressed? Guess what? Getting a massage can actually help improve your mental health.  A regular massage can play an important role in boosting moods by providing that much needed contact.  Sometimes certain oils or creams used in massage therapy are another form of enhancing mood. 

Can’t sleep? Guess what? That’s right a massage can help you sleep better! Massage Therapy has been proven to relax the body, reduce stress and even assist with concentration.  When you get a massage, you can throw away your worries or even think about things as you relax, therefore, not having to think about them when you’re ready for sleep.

So now that you realize how good massage can be follow these helpful tips prior to setting up an appointment:

• Always consult your physician and research your massage therapy options. 
• Look for a therapist who specializes in working with active agers.
• The words gently or soothing in the types of massage descriptions.
• Always get referrals
• Verify that they are licensed.  

The question is not why should I get a massage?  The question should be why not get a massage?

Your community fitness center is more than just group fitness classes, check out our white paper and how you can create a culture of wellness in your community.

Raise your hand if your senior living community does not have a formal, functioning, and strategically built new resident onboarding/orientation/integration process. It’s common—really common—to see communities either have no process or expectations on how to integrate new residents, or to have expectations that are so loose and disorganized that the “process” is ineffective.

There is so much to take care of when someone moves in, not to mention all the other responsibilities of community jobs that don’t stop just because a three new residents arrived last week. Still, I think we’re missing a huge opportunity to do right by those new residents in the community’s wellness program when we only look at orienting them to the community as simply another item on the “to-do” list. You might be wondering how I’m making the leap on the orientation affecting wellness. Bear with me and read below about three ways you can do better with new residents to ultimately build a better wellness program.

Of course, in order for this to make sense, you’ll need to appreciate that I’m coming from the position that your wellness program is more robust than simply filling the calendar with “one and done” activities. For your wellness program to be multidimensional and person-centered, it has to be based on fulfilling the purpose and passions of the residents you serve. For tips on how you can better evaluate the quality of your programs, read this blog. 

#1: Shift Away from Telling Them What They Need to Know.

In most communities where I’ve provided wellness consulting, if there is any formal new resident integration process in place, it involves staff scheduling time with the resident to tell him about a particular area of the community. There’s usually collateral involved, and the time the staff member spends with the resident is usually a download of programs, services, and how-to’s related to that department.

I’m all for making sure new folks have the information they need in your community. They should absolutely know how to place a work order for service, how to reserve their seat on the bus trip to the symphony, and how to access their financial accounts with the community. But spending your “I’d like to get to know you better time” with that individual overloading them with do’s and don’ts, calendars, contact information, and anything else on your 20-point checklist will be daunting and downright exhausting for even those who are wildly enthusiastic about their move into your community. Imagine how it feels for those who are ambivalent about their transition.

This is not the end of your onboarding process.

#2: Start Focusing on Individual Purpose and Passion.

Once you’ve followed through on providing the basic how-to-get-what-you-need information for new residents, you can turn your attention to understanding individual resident passions. It’s understanding what makes an individual tick that sheds light on his potential. And that is the place you can help him connect in your community.

Several months ago, I wrote about the position of activities director and how it’s turned into something of an order-taker role. Tasking your activities director with onboarding new residents in a different way can be a great first step toward breaking down that order-taker paradigm. It could also be appropriate to consider a Community Navigator, as described in this blog from Glynn Devins, for this kind of role. Regardless of whose job it becomes, someone on your team initiates the “get to know you” visit with a new resident. But instead of using that time to download from a checklist, the time is spent asking open-ended questions that drive conversation and allow the staff member to honestly learn about what motivates and inspires the new resident.

I would advocate for some set/standard questions, but also allow space for the conversation to meander along the individual’s personal history to afford glimpses of who that resident is and what they’re truly passionate about. (In truth, your team members may need some training to learn how to do this style of conversation and investigation.)

Remember, too, that by the time a resident is ready to move into your community, they’ve already gone through the prospecting and sales process with your counselors. There’s a good chance that the resident answered several questions about personal interests as part of that wooing process, and using that information in advance of the 1:1 session will help maximize everyone’s time during that face-to-face meeting.

#3: Use What You Learn.

The information you gather from your sit-down with the resident should be used to start building a resident profile to help you connect that individual to opportunities in the community to learn and grow. You should also use the information you’re gathering from all new residents to build a database that informs your wellness programming strategy, because now (finally!) you have a basis from which to build programs and services that speak to the actual articulated needs of your residents. You’re no longer slapping spaghetti against the wall to see what sticks; instead, you’re building what they’ve asked for, and you’re feeding the resident’s purpose. You’re helping them live exceptionally well.

Throughout 2015, we’ll be blogging about our dreams for corporate wellness, fitness, and aging well.  Some of the content will represent a gentle “poking fun” at the industry, but it’s all written to stimulate thought about what really could be if we put our heads together and started mapping out what’s really possible in the realm of individual wellbeing.  We hope you’ll join the conversation by commenting on the blogs, giving us additional ideas about which to write, and/or by finding us out on Twitter at #wellnesswhatif.

We do a lot of wellness consulting in senior living, and by “wellness”, I mean non-clinical, lifestyle-focused consulting.  For many of our clients, that consulting relationship involves a thorough review of their “activities” department; in other cases, it’s focused more on what’s happening with their exercise program.  Regardless of the original area of focus, we always arrive at the same point – building a strategy that allows the community to shift from filling a calendar toward supporting resident purpose and passion.

Often, when I talk with a client who thinks he’s interested in having us come onsite to consult, there’s a heavy discussion about cost.  And while I certainly understand a business’s sensitivity toward expenses, I often wonder:  If budget (and occupancy – the two are inextricably linked) was no obstacle, what would you be expecting from your activities department?

Leadership in senior living communities have a lot to focus on, and it makes sense that activities might not rank near the top.  In fact, it’s common for that department to be well-liked by residents and to be well rated on satisfaction surveys.  So no pain point exists because there doesn’t appear to be an issue.  The challenge with continuing to look the other way is two-fold:

1. Your current residents may not realize what’s possible, so putting your faith in them to be your barometer for when something needs to change is ill-placed.  That is particularly true with activities because that area of your community traditionally bears out the 80/20 rule where 20% of your residents engage in 80% of the activities.  You are likely supporting the interests of a vocal minority in your community.  And the question becomes: What is your activities department developing to meet the needs and interests of the less-engaged majority? 
2. The adult child knows better.  They are not content with bingo, cards, and trips to the theatre, and they won’t be fooled by a full calendar that lacks opportunities for them to live out passions, dreams, and purpose. 

If you think your programming is top notch and you perhaps just have an engagement challenge, take a look at our slideshare on how to get your residents to engage.

Maybe you know wellness is an important differentiator for your community, but you really feel compelled to nail down a more favorable and consistent occupancy rate before you begin fine tuning programming and other lighter elements at your community.  I can see why you’d adopt that philosophy, but before you stake your claim there, consider reading this blog on how and why wellness is an important differentiator for any community.

Think also about the long term investment of putting in some money up front on wellness consulting that breathes new life into your campus and creates a new outlook on how activities are developed and delivered.  It’s a chicken and egg debate but if a $5,000 investment could be an important step toward solidifying occupancy and thus improving your budget outlook, would that $5,000 be worth it?

Here’s our picture of what it means to do wellness better in senior living:

• When you do wellness better, you have data your marketing and sales staff can work with to back up their stories with prospects about how fantastic it is to live well at your community. 
• When you do wellness better, you have more diverse, robust, and life-enriching programming on your calendar that appeals to a wide audience. 
• When you do wellness better in your community, you create natural bridges across departments for collaborative programming so that one over-worked activities director doesn’t have to do it all. 
• When you do wellness better you understand individual resident passions and interests and incorporate those at the personal and program level to ensure opportunities where you residents can live with vitality in the ways that are true for them. 
• When you do wellness better, you do so much more than fill a calendar.  You map out a program and service strategy, informed by data, resident interests, and past successes.

If you think your community may be falling short in one or more of those areas, check out what we have to offer in the way consulting to help you do wellness better.