Senior Living Communities - Where does Mom's rent go ?

Retirement communities seem like a great idea on the surface: like a cruise ship for seniors. Social opportunities, wellness opportunities, fine dining, special holiday functions, maintainence services, housekeeping; some have nurse stations, and some have full time LVN's represent a picture of complete care just waiting to put it's arms around your aging parent.
You and your parent tour a facility. The people are so nice. The place looks like a fine hotel. Everyone is so happy to see you. It must be heaven. Oops, trying to avoid that! But as the last stop on route, except of course for some of you, not a bad place to hang your silk scarf, and support hose.
"That beautiful apartment is how much?" $5,000 dollars a month..."and up!!!!????" You swallow. Subtle, but hard. Your parent imagines friends,fun, privilege, bridge players, and chocolate. So where does your rent go? I will give you a hint: it is not dining services, or housekeeping, or maintenance, or capital improvements of health care, or activities. In many upscale senior living communities, you may be surprised to discover that over 40-50% of the operational dollars go to marketing and not to services that directly benefit your parent. The reason is simple, senior residents move into these communities when they have an average of 5 years left to live. Sad, but factual. So inherent in all "retirement communities" is alot of resident turnover, even when residents are content within their community. Just imagine the numbers, when the residents are not content.
When a resident dies, an apartment becomes empty, and corporate revenues shrink. Some corporations have silent partners (investors), who do not appreciate declines in occupancy levels. Less occupants, less profits. So a tremendous amount of your rent dollars are spent attracting a continual stream of new residents. 40-50% of the yearly budget at the property level is spent on marketing, and the recruitment of future residents. There is even greater turnover, of course, when the services are so-so. I was given $2.40 per person per meal, based on two meals per day in one such upscale retirement community in La Jolla California, as recently as 2007. Marketing first, nutrition? Somewhere much farther down the list.
The caretaking mission represented by these corporations is really not their mission. Profit, not people, again is the mission. The mission of most of these communities is NOT to keep your parents content with cruise ship five star services, no matter what they say to you, during your "free" marketing tour and lunch. The corporate mission is to keep the building full, create large revenues, make tremendous profits,purchase more properties, turn them in to more goldmines. Oh, the hours spent in departmental leadership meetings, working on the shape of the spin.
Until late 2007, I functioned as the Dietary Director for one such "for-profit" corporation. This Carlsbad company, proudly announced, at the 2006 dietary conference for all dietary directors, that they made a NET profit of $11 million dollars with their 23 properties nationwide. More shocking is the fact that some of their properties went much of the year below full occupancy. You can just imagine the profit at full occupancy. Alot of profit for a company that on my campus, outside of dining services, had alot of resident turnover, unhappiness with other services, and four executive director turnovers in two years! It is only about occupancy folks. The rest is marketing.
I am not alone in my understanding of just how senior living communities operate. But, people on the inside of the industry, do not speak up because: they are care-givers, and need these jobs. Some, like me, become disillusioned care-givers, and leave the industry. Find the honest broker on your marketing tour, and call them later for a personal chat. They will tell you. Most workers, and local property leadership in these companies are disillusioned too. Or they have darker motives for staying in silence.
There are many things I discovered in my tenures, that have turned me off to retirement communities as a viable future option for aging adults. I have not even touched on the average direct care-giver to resident ratios of 1 to 20 :at the very best. This ratio is at the very root of the problem. Try caring for twenty parents with two hundred challenges daily per parent, and you will get the picture. The cloth just does not stretch to cover the need.
Higher corporate costs drive operational changes that should concern adult children seeking quality residential solutions to caring for their aging parents. I do not believe that all upscale retirement communities really fulfill their care giving promises: and today there are alot of other alternatives you should also consider.For this much rent ( and more), similar services, are offered for this inclusive price: you should, and do expect five star level housekeeping, fine dining complete with special holiday programming; wellness programs that focus on fall prevention, strength training, and balance education for your parent; maintainence (toilets do have their problems, so do air conditioners/heaters, elevators). If you are still considering an upscale independent living community of 100 to 500 occupants, consider this: every year, you can expect a cost of living increase of 5-9 % in these communities: whether you like it or not. And trust me, the corporation can always defend the reasons for the increase. You will have only the choice to pay or move.
Are indepenedent living communities really full of independent living seniors? Retirement communities ususally bill themselves as housing for independent living residents: those with minimal mobility and functionality issues. But in the last twelve years, I have seen less truly independent residents, and more highly dependent, borderline assisted living or early dementia type residents move in. The corporation is motivated simply by the drive to keep the place full. This creates a great demand on service personnel, often untrained. If your parent is very independent, it can be depressing. Your high functioning parent may be seated in the dining room, at dinner, with someone with incontinence issues. Or worse. So before you sign that rental agreement, remember what I have shared with you : current and future residents are hunted constantly by full time marketing people to keep the building full. We had 140 residents, and two full time marketers: they were each required to make 50 phone call contacts each day to "prospects". Be comfortable but observant, when taking a marketing tour of a community: observe the care giving ratio; study the interaction of the residents with each other, and with department heads, peak into administrative offices, talk with the maintainence director and the dietary director about the challenges of their positions. Call them later to ask about what they didn't say. Find out about the property's budget: anyway you can. Look at the food served; tour the kitchen, look in those walk-ins. Fresh, homemade preparations or commercial preparations? Sit down at lunch with a random group, and not of the marketer's choosing. Always try to take an 'unplanned' tour, to get the most honest insight.
In conclusion, you may get more services, of a better quality, in smaller board and cares, than you will in large retirement communities. Retirement communities do have a huge socialization advantage: alot more prospective playmates for your parents. But they are not for everybody. Make sure to take an industry savvy professional along with you while you are touring, and examining what you really ARE getting for your rent.

CHANGE THE WAY YOU COOK, SLOW YOUR RATE OF AGING

Twenty years of professional cooking, and mentoring of professional cooks has taught me skills that inspire wonder in my middle aged friends.  I could write a book on how to perfectly roast, saute, grill, fry, or caramelize anything from potatoes to  duck breast to rump roasts. 

There is more and more proof that these very techniques of browning our meats, caramelizing our onions, and garlic; french frying our potatoes, slow sauteing of veggies to brown them, roasting our turkey to golden brown, toasting our bread, and blackening our louisiana redfish, grilling our burgers over high heat are at the very causative heart of unhealthy aging. It is not good enough to pack your daily diet with all the antioxidants and nutritious whole grains that you can prepare and serve your health conscious family. The techniques that you use to cook these items, techniques made famous by almost all TV cooking show chefs, and two hundred years of Americans trying to gain mastery over classic french cooking skills, are equally critical.

Browning of high fat foods, such as red meat( worse if dusted in high glycemic flour, hot dogs, and bacon, or high glycemic vegetables such as onions or carrots, slow dry smoking of your baby back ribs can accelerate your visible aging, and more critically your cellular aging.  The browning process exposes the sugar in  a protein to a high temperature which caramelizes the natural sugars in the food, and gives it that beautiful caramel color. 

When a sugar binds with a protein, advanced glycation end products or AGE's are formed.  AGE's  compromise the effective functioning of particular proteins, and AGE's build up in the body over time: as more and more proteins are compromised (tissues, hormones enzmes, antibodies, nerve cells), your aging accelerates because the proteins can no longer function perfectly as they were designed: as they replicate imperfectly damage is done: aging is accelerated.  Our body and brain becomes a house of cards. Eliminating AGE's in the diet (there are other sources which I will discuss in other posts) should be at the top of anyone's list if they are concerned with avoiding cardiovascular disease,slowing the rate of their aging, or avoiding Alzheimers, diabetes, dementia.

   Many cooks pride themselves on black grill marks; many chefs like to "char": some chefs like to put blackened fish items on their menus: Avoid all of these.  Charring has been conclusively shown to be carcinogenic.  Avoid charbroiled ANYTHING !

Cooking starchy vegetables at high heat also produces AGE's or glycation as it is being simply addressed.  That is the problem with french fries. French frying of potatoes or yams or  produces AGE's and acrylamide. Acrylamide, also found in potato chips is strongly associated with developing cancer. Even FDA researchers found that it damages DNA and cell proteins, and creates a first step to cancer. Acrylamide is not present in uncooked foods.  It is not formed, however when you boil a potato.  The good news is coming, hang in there.  

I am crying over the french fries too !

Roasting our chickens and turkeys to a golden brown may be tasty, but the browned skins are a significant source of AGE's. The crusting of fish in seeds or nuts, very popular in the last ten years, is another category to avoid.  Foods that naturally have higher fat levels generate more AGE's: it is not the fact that foods may be sauteed or grilled, or broiled or roasted alone.  The damage comes from temperature , whether high, or low for long time , that produces browning. The worse damage occurs, especially  when high fat foods are  cooked at high temperature or for long periods of time.

There are many cooking techniques that do not produce or promote, or accelerate AGE's. Marinating protein foods, or cooking them in liquid, does not promote glycation.  Skewer smaller cuts of meat, fish, chicken, or vegetables will cook faster and avoid AGE formation; poaching in flavored stocks, gentle steaming. For stirfries, cut all ingredients smaller; enjoy soups and stews; choose fatty fish,organic chicken, or turkey ONLY  (no antibiotics or hormones) and grass fed beef, cook onions and garlic til transparent.  Saute over medium heat, not high heat, and avoid browning the vegetables.  Always try to cook using gentle heat.

Two years ago as the first of the baby boomers turned 60 years of age,  volumes of research data on aging, inflammation, and discovering just what accelerates or slows or rate of aging have been everywhere from the internet to the front table of the national bookstores.  We have learned that our daily food choices play a very significant role in just how well or how poorly we are aging.  A greater and greater number of big city restaurant menus are reflecting our new awareness: most  feature on a regular basis Salmon for it's anti-aging benefits, and it's sustainability: other nutritional powerhouses are becoming commonplace like  quinoa, wheat berries, grapeseed oil.  Plate presentations are  'going green": less center of the plate protein, and more veggies: recognizing the now well accepted virtues of a plant rich diet .

It is not good enough to pack your daily diet with all the antioxidants and nutritious whole grains that you can prepare and serve your health conscious family.  The techniques that you use to cook these items, techniques made famous by almost all TV cooking show chefs, and two hundred years of Americans trying to gain mastery over classic french cooking skills, are just as important in keeping you healthy.  Never forget, you are what you eat, and how it's cooked !

ACTIVE AGING COOL WEBSITES

WALK.SCORE.COM- ON-LINE TOOL THAT CALCULATES THE WALKABILITY OF A NEIGHBORHOOD. HELPING YOU LOCATE RESIDENCES IN NEIGHBORHOODS THAT SUPPORT WALKING. RESEARCH SUPPORTS THAT IN COMPACT NEIGHBORHOODS WHERE STREETS WERE DESIGNED FOR WALKING, THERE IS A SUBSTANTIAL DECREASE IN OBESITY,DIABETES,LUNG DISEASE,HYPERTENSION, CAR ACCIDENTS, AIR POLLUTION.

THE PEACE CORP HAS STARTED TARGETING VOLUNTEERS THAT ARE 50 + YEARS OF AGE. NOW, HERE IS A WAY TO START GIVING BACK TO YOUR WORLD.  WWW.PEACECORPS.GOV/MINISITE/50PLUS

CHECK OUT BODYVIVE @ WWW.LESMILLS.COM. ONLY 160 CLUBS IN THE U.S HAVE CERTIFIED INSTRUCTORS, AND PROGRAMMING.

 IF YOU HAVE BEEN VERY INACTIVE FOR DECADES OR HAVE HUGE BALANCE CHALLENGES: CHECK OUT SILVER SNEAKERS YOGA STRETCH AND SILVER SPLASH PROGRAMS WWW.SILVERSNEAKERS.COM

For a peek at the upcoming US Department of Health and Human Services guidelines for physical activity, to be released in October 2008, go to : www.health.gov/PA guidelines

Visit the Center for Successful Aging’s website: http://hhd.fullerton.edu/csa

 

TURNING OFF AGING, DRIVING DOWN HEALTH CARE COSTS

      Aging is not simply decay. You just don't wear out. But this how we have thought about aging until the research of the last five years has replaced our presumptive conclusions with knowledge.   One particular researcher from UC San Francisco demonstrated in 1993 that by manipulating a single gene in a one-millimeter worm; the worm's  healthy life span could be doubled.

      Cynthia Kenyon 's latest research has linked the growth of cancerous tumors to the aging process. The  conclusion from these two monumental breakthrough studies is that: is we can manipulate a single gene to slow aging, we can create a resistance in our bodies to the growth of cancerous tumors.

     You may recall from basic high school biology that cells divide: research has shown for quite some time that as cells divide little mistakes occur metabolically.  In our youth, our body's cells repair this damage to cells, tissues, organs: but as we age (not chronolgically, but metabolically), these mistakes accumulate, and our ability to repair all the damage created by these mistakes in cell division, just can't keep up.

      Mistakes in cell division, and metabolic aging imposed by poor lifestyle habits (the bad synergy that comes from poor nutrition, chronic idleness instead of movement, not forcing our systems to grow and adapt on the physical levels, and other forms of chronic stress) produce just about every disease and degenerative human condition that we as a society experience: Cancer, Alzheimer's, Parkinson's, Osteoporosis, cardiac arrest, stroke.

     The promise of this research is that controlling the genes that control aging, may be easier that controlling the decades of poor lifestyle choices that contribute to a person's disease, and degenerative aging. 

The financial value to our health care system would be huge: as lifestyle related disease, and degenerative aging have overburdened our country's health care system, and our individual health care premiums to a critical breaking point.

     Now that we have the knowledge that aging can be turned on, and turned off, should our society continue to financially support individuals'  that repeatedly make illness choices, overuse and burden the health care systems, and  drive the cost of medical care for those practicing wellness thru the roof ?  It is the individual's right to make illness choices, including those that lead to morbid obesity.  But these individuals  are making themselves ill, overusing the health care system, and pay the same monthly fees that I do.  Health care should be VERY expensive for those making illness choices, maybe that would be the necessary deterrent.