✨✨General Discussions

It seems that encouragement of transparency should be a priority for NaCCRA, for CCRC resident associations and for CCRC boards. I'm at a CCRC that was founded back in the 70's (Medford Leas). I'm guessing that a culture of paternalism evolved naturally back then because much of the resident population consisted of women who had never worked, who were financially dependent on their husbands and who didn't have experience understanding/managing finances. It was a compassionate thing for a husband to care for his wife by ensuring that when he died (and women typically outlive men, so that was normal) she would be cared for and wouldn't have to worry about the money. Turn the page to 2024, though, and baby boomers are entering the resident population, full of women who held responsible and often executive jobs, who earned and managed their own financial assets and who don't really have time for paternalistic attitudes. They want to know what's actually going on: what is occupancy, if it's not up to snuff, what's being done to address it? What are the short and long-range plans for ensuring the health and stability of the community? What role does the board play in holding the CEO to account? How aware are board members of the issues and concerns of residents? The answers to these kinds of questions are critical to intelligent and interested residents in order to feel comfortable in a community. So transparency should be encouraged by all parties actively engaged in ensuring the health of a CCRC community.

Even though the demographic change of Baby Boomers moving into retirement communities had been predicted for years, the CCRC I chose had made no preparation whatsoever for that change. Prior to my moving in, the facility had been providing services for previous generations with very different attitudes on retirement, and one of them was called the Silent Generation. Most were women and most, but not all, had been homemakers and they did not speak up.

Change is coming slowly as the newer generation increases in number, but the old attitudes of paternalism continue firmly entrenched. This will be a long struggle for residents seeking autonomy, and who want to be active participants in their own lives.

Your comments are spot on, and exactly mirror my experiences. I moved into a CCRC that was marketed to be as being forward looking, cutting edge and moving with developing changes in the industry. This was not the case at all. Years later I figured out that they had marketed to me what I had told marketing I was seeking, and not what they had to offer.

Many recommend the book “Disrupting the Status Quo of Senior Living” by Jill Vitale-Austen. It describes forward-thinking as congregate living, Green Homes, caregivers in-home, daycare for residents in need of supervision, and innovations not yet imagined. The next generation speaks up and will not enter a CCRC without these.

This sounds like an important book. If you have read it, would you like to post a Blog review of it?

Richmond Shreve

NaCCRA Board Member

Forum Moderator

I can give you a sampler of content. I use Readwise when reading on a Kindle, Here is some of the highlighted passages. I made so many highlights, I exceeded the Kindle limit. I am adding a screenshot of the Chapters.

You will see she covers many topics

• We shifted from the traditional framework of segregation, paternalistic rules, and institutional mindsets to an inclusive culture of possibilities and purpose, where people continued to grow and flourish, instead of just existing. (Location 247)
• 
  
• I learned about the role that ageism plays in our communities and how our current focus on hospitality undermines many of the things that are important to well-being. (Location 253)
• learned about the importance of purpose, growth, and inclusion, new approaches to driving organizational change, and the way that building design can promote a healthier community. (Location 255)
• Peter Block says: “The shift in the world begins with a shift in our thinking. (Location 272)
• As environmental gerontologist Emi Kiyota so aptly concluded, “Elders living in grass huts in Africa with children at their feet are often happier than people in assisted living homes with a chandelier over their heads.” (Location 567)
• senior living organizations can use hospitality to set the stage and do what hospitality is best at doing—welcoming strangers. (Location 735)
• Excellent customer service, making people feel welcome through concierge and reception services, and move-in protocols are critical in these situations. (Location 736)
• We must remove paternalism from the equation and support all residents in making their own well-informed decisions—whether we agree with them or not. (Location 753)
• modifications shouldn’t be forced on a community or a resident. This type of change requires education and two-way dialogue. (Location 755)

• Fear of future disease or decline, indeed, seems to be a driving force behind the exclusion of elders living with frailty. (Location 1186)
• Todd D. Nelson, author of Ageism: Stereotyping and Prejudice against Older Persons, defines ageism as “prejudice against our feared future self.” (Location 1186)
• ableism, defined as prejudice against those living with different physical or cognitive abilities, and fear of age-related illness and debilitation, were at play. (Location 1195)
• Power believes that part of the stigma of the disease comes from the segregated and less-than-optimal living environments that (Location 1201) our society provides for these individuals. (Location 1202)
• Dr. Martin Luther King, Jr., described segregation in this way: “Any law that uplifts human personality is just. Any law that degrades human personality is unjust. (Location 1207)
• All segregation statutes are unjust because segregation distorts the soul and damages the personality.” (Location 1208)
• “Ageism and ableism, like all prejudices, influence the behavior of their victims,” says Bill Thomas, M.D., cofounder of The Eden Alternative. (Location 1210)
• “It is our obligation to address ageism and ableism just as we would address sexism or racism.” (Location 1211)
• Instead, it is best accomplished by having open and honest discussions about segregation, ageism, and ableism. (Location 1306)
• Residents embraced the definition of ageism as being “prejudice against our feared future selves” (Location 1319)
• Questions for Discussion and Introspection Where does segregation or ostracism of those living with different cognitive and physical abilities occur in your community? When have you experienced feeling ostracized or marginalized in your own life? How did it impact you? Discuss the definition “ageism against our feared future selves.” How much does the fear of the future play into the way people of different cognitive and physical abilities are viewed and treated in your community? Who in your organization can work to drive inclusivity? What education is needed in your organization to drive inclusivity? (Location 1341)
• 
  
• From the day they moved in, they were welcomed by other residents. Each night they were invited to dinner by different people. Folks would call them or leave notes on their door asking them to join. The people inviting them weren’t members of an official welcoming committee. Rather, this practice was embedded deep in the culture. Inclusion and acceptance are simply a part of the social fabric. It has become “just the way we do things around here.” (Location 1462)
• Highly competent, highly experienced human beings move into a senior living setting and become helpless consumers. (Location 1484)
• I realized that my current approach was undermining the power and capabilities of the people who lived in my community. I was creating helplessness. (Location 1487)
• True community, says Charles Vogl, author of The Art of Community: Seven Principles for Belonging, comes only when people are connected to and care for each other.5 (Location 1538)
• recognize the power that elders have in holding meaningful and significant roles in our communities, and in the world. (Location 1876)
• reframes elders as valuable assets—people with life experience and knowledge that can help strengthen the resilience of the community—rather than as a population that just needs the rest of society to care for it. (Location 1952)
• We discussed the role of resident leadership in calming the system and guiding the rest of the population to feel excitement rather than dread. I asked the (Location 2010)
• The Ask Me! team’s motto was, “If you don’t hear it from us, it probably isn’t true. (Location 2015)
• As Adam Grant shares in his book Originals: How Non-Conformists Move the World, experience and expertise lead people to view things in a particular way. Those who have been the most successful in the past often perform the worst in a new environment. (Location 2488)
• Pathways to Culture Change (Location 2510)
• Theory of Diffusion of Innovation, (Location 2512)
• This theory teaches us that any time we introduce something new to an organization or a system, we can expect a standard distribution of responses. People will fall into one of the five categories, as shown in the bell curve for Figure 9.1. Figure 9.1 (Location 2513)
• No longer should you think of your role as being the one to get everyone on board. Your job is to focus on the innovators and early adopters. (Location 2533)
• 
  
• Don’t let the laggards get you down! (Location 2536)

• top-down standardization approach, (Location 2606)
• when every suggestion brought up by residents was met with a response from the executive director that he’d run the idea by the corporate office. (Location 2613)
• This type of culture is often driven by a desire for corporate branding and standardization. Proponents of this approach point to hotel, restaurant, and retail chains. (Location 2616)
• for a sense of community to develop, people need to have influence on their community and see themselves as citizens instead of consumers of services. (Location 2622)
• when we operate from a place of control, we stomp the life and personality out of communities and squash the spirit of those who live and work in them. (Location 2629)
• decisions should be made by residents, or those working closest with them. How can we drive this community-based purpose, influence, and creativity (Location 2632)
• while ensuring that the culture of the larger organization is also alive and recognized at the community level? (Location 2633)
• “We see everything through our own lens and our own experiences and, when faced with a situation, we jump to conclusions and make stuff up rather than trying to figure out what’s really going on.” (Location 2805)

Ann MacKay

Charlestown, Catonsville, MD

NaCCRA Board Secretary and Past President 2018

This book is a must for residents who seek to be involved in their communities, serve on committees, resident boards, or otherwise want to take a more active role in their community. The price is trivial to the value it provides. My guess is that supply and demand has driven up the price and it only had a single printing.

Consider getting one for the library, or one the share. It's worth it. Mine is heavily notated and I refer to it a lot.

We are in rapidly changing times and these changes are predicted to continue for some time.

Hopefully, as more of us read it, we can share insights with each other?

Here is what ChatGPT says about it. I'll post this on the Ageism forum as well. It cuts across several concerns we all have: costs, ageism, and continuum of care issues.

-------- ChatGPT--------

"Disrupting the Status Quo of Senior Living: A Mindshift" by Jill Vitale-Aussem challenges traditional approaches to senior living by addressing societal biases such as ageism, paternalism, and ableism. Drawing from her extensive experience in managing senior living communities, Vitale-Aussem critiques the prevalent hospitality model, arguing that it can inadvertently diminish residents' sense of purpose and independence. She advocates for creating environments that promote autonomy, self-efficacy, and meaningful engagement for older adults.

HealthPro Press

The book has received positive reviews:

• Amazon: Readers commend the book for its insightful critique of current senior living practices and its call for transformative change.
• Amazon
• Goodreads: Users appreciate the author's perspective on fostering vibrant, purpose-driven communities for elders.
• Goodreads
• Midwest Book Review: The publication describes the book as "exceptionally well written, organized and presented," recommending it for personal reading and academic collections.
• HealthPro Press

These reviews highlight the book's impact in encouraging a reevaluation of senior living paradigms to better support the well-being and growth of older adults.

-------- end ChatGPT---------

Richmond Shreve

NaCCRA Board Member

Forum Moderator

Many CCRC residents have the book. I use it for reference and have read it. The book “Disrupting the Status Quo of Senior Living” is considered a great book. The members of the Medford Leas Resident Assn. were told about it. A good book that is worth reading.

The Amazon price is truly ridiculous. I remember buying it from the AARP sitre, but that seems not to be available there now. I did find it for $30 or so at https://www.healthpropress.com/product/disrupting-the-status-quo-of-senior-living

Nancy Eddy

nbeddy@gmail.com

I did email the publisher about discounts for Disrupt Senior Living. Here is the respond.

---------------------

hank you for your question! I'm so glad to hear the book is resonating with so many of you. I understand your concern with the list price. Unfortunately for e-books and print books sold through our resellers (Amazon, Barnes and Noble, etc.) we do not control that price. If you purchase directly through us, we do offer discounts, particularly when purchasing in bulk. Here are the details of our bulk discount offers: 

6-10 copies

5% off

11-20 copies

10% off

21-50 copies

15% off

51-100 copies

20% off

101+ copies

25% off

We are also happy to work with you to discuss other discount opportunities. I have copied Mary Magnus on this email—she is the Director of Publications for Health Professions Press and can discuss ways we can help meet the needs of NaCCRA. If bulk discounts are not something you are interested in, we can certainly offer a discount to your members for one-off purchases. 

Please let me know if you have any questions.

Thank you!

Kaitlin 

______________

Kaitlin Konecke

Campaign Manager | Brookes Publishing Co.

kkonecke@brookespublishing.com

Health Professions Press, an imprint of Paul H. Brookes Publishing Co.

www.healthpropress.com | blog.healthpropress.com | @healthpropress

Well Ann, you are as impressed with this pivotal book as I am. Thank you for being so proactive and sharing.

What makes the book special and useful is the author, through experience, has been able to pierce the social assumptions about ageing that impact our retirement years. These societal attitudes are difficult to observe because they permeate every facet of the culture. They are imprinted on our world view from earliest childhood. They look normal or "just the way it is." The first step to making a difference is understanding what one is dealing with.

Thank you Richmond!