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.

ARE YOU SIGNALING YOUR BODY AND BRAIN TO AGE ?

     If at middle age, you are aging ungraciously, it is likely that for decades you have been signaling your body, and brain to survive by becoming depressed: if you are chronically stressed, physically, or mentally, you have created a low grade state of depression in your body as a healthy, adaptive response to what is understands as your ultimate survival challenge.
     If you suffer from depression, you can turn your take a look at your lifestyle survival strategies, and make different choices.  In nature, depression is normal: it is a survival mechanism. Depression is the body and brain’s response to famine, excess food intake, and inactivity.
As we evolved over millions of years of howling, blizzarding winters on the African savannah, it was this “survival depression” that kept us alive until the warmth of spring.  We hunted and gathered every single day; we were only sedentary if there was a famine. As winter, drought or famine approached, we became sedentary, built up our fat reserves, made our shelters to hibernate: we burrowed for warmth, and safety, in small spaces that made it impossible to move, further slowing down our metabolism. These natural behaviors signaled the critical systems in our bodies and brains to shutdown, decay, atrophy, loose their muscles, in order to survive the winter. Survival depression was our healthy response to our environment.
Now here we are in 2008, with lengthy commutes to work, whole days sitting at our computers, with little movement of our bodies; hours of TV, or checking email, surfing the web, nights of reading alone in our big houses with central heating, and air……….we are sending the signals to our body that it is winter everyday. When we don’t send out the signals EVERYDAY to our bodies to ‘hunt, and forage’; eventually this constant depressed state of decay, this modern equivalent to survival on the Tundra, takes over. And as we chronically age, the rate of this decline, and decay just accelerates. Too many decades of simulate winters.  Our bodies and brains are just responding. No wonder that we have a picture of aging in America that is one of decay, decline. Our modern lifestyle is killing us.   During our evolution, the effect of adaptation on the part of the body to the physical work of hunting and gathering, lead to chemical changes in the brain: optimism ( I will survive); increased energy, curiousity, zeal for exploration, alertness, and a willingness to work with others.
In 2008, we see an overabundance of food supply, particularly the cartoon fun foods of zero nutritional value but tons of age-accelerating sugar; we control the temperature of houses and cars, and the tigers that would be chasing us, are in our zoo’s.  Our need to exercise, move constantly is who we are. This body is really a bunch of chemical and electrical impulses that drive all our cells to function when we are forcing some adaptations on the part of our bodies and brains to occur.
     Without these acts to trigger growth in our bodies, on the cellular level; we decay. We survived over hundreds of millions of years, because each one of our ancestors got it right, and passed on their strength, speed, and smarts genetically. It took us millions of years to evolve to this point: evolve from bacteria going back billions of years. But we are basically unchanged.
     In the absence of these pressures that cause our bodies and brains to adapt, and on the cellular level to “grow”, our bodies and brains start shutting down. Daily we are sending out signals to our bodies to decay, and do so quickly. No matter what we choose to think, this is what our choices tell our body: no need to adapt, no need to get strong, no need to grow: we have to go to work, sit in our cubicle, move information on our computers. Our body is not designed for sitting in front of a computer, or a TV; or driving a car to Northern California to take in 600 miles of incredible sights, or staying in bed all day because it is Sunday.
So, as we repeat this mal-adaptation over thirty years, we reach fifty, and are ‘suddenly’ surprised that we are falling apart. If you find yourself 'suddenly suprised', read on: you change the course of your life. If you are a woman, it is critical that you raise your own awareness about the process of aging: consider that 3 million of the 70 million baby boomers are expected to live past 100 years of age. Of this 3 million boomer centurians, 85 % will be female.
You can change the signals you are unwittingly sending your body and brain: return to this site, and find out how..............