While the industry scratches its collective heads trying to figure out what baby boomers want in a senior living community, millennials are pointing the way.  

The two groups have a lot in common. Baby boomers and millennials currently represent the largest cohorts in the American population, 74 million and 71 million respectively.  

Baby boomers are the parents of millennials and share many of the same values that shape their housing preferences. They’re both more interested in having experiences rather than accumulating things. They want to make a difference too.  

“Compare the values of someone 62 and someone 26, and they’re very much the same,” said Lilian Myers, an expert on aging and co-founder of EconomyFour, a social impact company based in Washington, D.C. “Both groups are interested in exploring what’s next.” 

Myers has built a career around looking at the trends that shape our views of technology and of aging. As a serial entrepreneur she helped launch several health technology start-ups. She eventually moved on to work for IBM, initially consulting with global clients on the digital transformation of healthcare.  

A project in Japan that linked isolated seniors by iPad to services from the postal service led her to become IBM’s global leader for aging and the longevity economy, conducting seminars on several continents to find industry solutions for age and longevity. “What it taught me was how universal and institutionalized age bias has become,” said Myers.   

The age of 65 began to be attached to decline and need of help only a century and a half ago as industrial era social safety nets were established, said Myers. Today older adults are better defined by their vitality than their age. “Boomers aren’t using traditional definitions of who is considered old,” she said. “It’s more about how we feel, and we don’t feel old. We’re working, starting new businesses, and giving back in ever-greater numbers.” 

Likewise, millennials are defying expectations. Many millennials, for example, are digital nomads, working remotely from anywhere without a formal office. They can travel and work, settling for months at a time in one place they like.  

The idea can be applied to baby boomers who might like a living arrangement where they can continue to work remotely and live where they want. Myers herself is a bit of a digital nomad, working remotely from her condo in Florida when she’s not on the road. 

The idea of digital nomads fits neatly with concept of portable living arrangements which are growing in popularity. At the NIC Spring Conference, attendees conducted a hackathon to brainstorm ideas for senior living communities that would appeal to baby boomers. A common feature of the communities was a portability component. One proposed project gave residents the ability to travel and live in different communities around the world.  

New alternatives 

Millennials like the idea of coliving, an idea that might also appeal to baby boomers, said Myers. For example, Roam is the global coliving and coworking community that combines work, travel and adventure. The website promises, “Strong, battle-tested wifi, a coworking space, chef’s kitchen and a diverse community.”  

Another emerging housing alternative is the modern micro apartment. These tiny, fully-equipped urban units are well suited to those who want to switch cities easily without being tied down by a lot of things they have to move.    

Millennials prefer urban spaces to the suburbs and so do a growing number of baby boomers. The city offers the advantage of walkable neighborhoods near services, parks and entertainment. No one needs a car.  

Senior living providers have been trying to cram everything into one building adding a hip bistro or coffee shop, said Myers. “It makes more sense to simplify operations and build partnerships that surround the resident in the way universities have for students.” Urban locations already have everything built in.   

Other trends are shaping housing choices. Like millennials, many boomers prefer living in a community with a multi-generational population. Both groups also want to stay connected without being walled off or being dependent. 

As a self–described optimist, Myers believes the coming generation of 45, 50, and 60 year-olds will alter stereotypes about aging with the help of their younger counterparts.  Myers stopped coloring her own gray hair when she noticed that young people in Asia and Europe were dyeing their hair white or grey. “It’s about stage, not age,” said Myers. “We’re looking for what’s exciting and what makes us feel connected, growing, and contributing in work, play, and relationships.” 

### 

May 10, 2019 

janekadler@gmail.com 

During the upcoming 2019 NIC Fall Conference, the “Innovations that Work” session will share ideas on innovative technologies and tools that are changing the way operators and investors care for residents. Rapid-fire, seven-minute presentations on five key topics will address real-world examples of innovative solutions to some of the most pressing challenges in the industry today.  

The session will include six speakers – each covering a solution to a key problem facing seniors housing and skilled nursing today.  Have you faced a challenging issue and used some type of innovation to solve it? If so, we would like to hear from you.  We are looking for solutions to problems that: 

• Are deployed (i.e. not hypothetical) 
• Have data showing the benefit associated with the soluti8on that can be shared 
• Have an operator willing to speak about their experience with the solution 
• Are innovative – approaches, systems, or solutions not familiar to >~ 80% of operators 

We are looking for your best solutions to help shape the thoughts and strategies that will influence industry peers. Ideally, those impacted by the problem will introduce a solution to fix the problem that shines a light on innovative thinking. This forum is not the place for canned sales pitches! NIC is specifically interested in your real-life experiences building on what’s worked in your partnerships to bring solutions to problems. 

Ready to start your proposal submission? CLICK HERE for more information 

Safeguarding the overall health of the seniors housing and care industry well into the future is a well-publicized initiative. Nowhere is that more on display than the upcoming Vision 2025 event to be held in Chicago June 19-20. This event will host over 30 colleges and universities, more than 35 seniors housing and care operating companies and key trade associations and strategic partners within the industry. The goal of the event is to ensure the health and continuity of the industry through the identification (and development) of at least 25 robust university and college programs. 

Vision 2025 is being sponsored by NIC, American College of Health Care Administrators (ACHCA), American Health Care Association/National Center for Assisted Living (AHCA/NCAL), American Senior Housing Association (ASHA), Argentum, LeadingAge, the National Association of Long Term Care Administrator Boards Foundation (NAB Foundation) and Ziegler.  

The content at the event will be robust and thought-provoking. Representatives from universities will provide an overview of the programs in existence today and their successes. They will also provide insights around opportunities that enhance partnerships between the industry and academia, as well as challenges faced over the course of developing their programs and partnerships. Attendees will also hear from key trade associations and operating companies about the business case for expanding university programs focused on seniors housing, care, and aging services. Several trade associations within the industry are deeply involved in efforts to expand the workforce and are already working closely with several of the universities in attendance. These efforts will be discussed throughout the day in panels and forums. Finally, the symposium will offer opportunities for attendees to interact in very purposeful, facilitated discussions focused on key priorities and next steps. 

Vision 2025 will be the first of its kind in the industry at a time when collaboration, passion, and action centered on expanding the workforce are of utmost importance. Getting this many key influencers and participants to rally around this single issue at one event is a monumental effort and all involved should be commended. The thoughts and ideas shared as a result of the event will surely move the seniors housing and care industry forward. 

The Labor Department reported that there were 263,000 jobs added in April, above the consensus expectation of 190,000.  This marked the 103^rd consecutive month of job growth.  The latest six-month average is 200,000, less than last year’s 223,000 monthly average but still very strong for this stage of the economic expansion.

Revisions added 16,000 to the prior two months.  Monthly revisions result from additional reports received from businesses and government agencies since the last published estimates and from the recalculation of seasonal factors.

In April, employment in health care rose by 27,000. In the past year, health care has added 404,000 jobs.

The unemployment rate slipped back to 3.6% in April from 3.8% in March.  This is the lowest rate in 50 years or since 1969.  A broader measure of unemployment, which includes those who are working part time but would prefer full-time jobs and those that they have given up searching—the U-6 unemployment rate—remained at 7.3%.  This was the lowest rate since 2000.

Average hourly earnings for all employees on private nonfarm payrolls rose in March by six cents to $27.77. Over the past 12 months, average hourly earnings have increased by 3.2%, down from 3.4% last month.   For 2018, the year over year pace was 3.0% and in 2017 it was 2.6%.

The labor force participation rate, which is a measure of the share of working age people who are employed or looking for work fell to 62.8% in April from at 63.0% in March, very low but up from its cyclical low of 62.3% in 2015.  The low rate at least partially reflecting the effects of an aging population.

This report, in combination with other recent data on economic activity, will support the Fed’s recent position of pausing interest rate increases.

As Alan Weil, Health Affairs Editor-in-chief stated, “This is a pretty scary reality that’s coming towards us.” It was an appropriate sentiment, as the nation’s leading peer-reviewed health policy journal released a groundbreaking new study, commissioned and funded by NIC, and shared with the world its unsettling findings. Addressing a room full of media and policy makers, as well as hundreds of viewers on a live webcast, Weil introduced the study, titled “The Forgotten Middle: Many Middle-Income Seniors Will Have Insufficient Resources For Housing And Health Care,” and added that, “this is a topic that’s easy to set aside for other priorities, but hopefully it will yield additional discussions.” 

NIC founder and Strategic Advisor, Bob Kramer, in his opening remarks, emphasized that the study is a starting point for a discussion that the nation’s policy makers and industry leaders need to engage in. “This research just scratches the surface, lifting the curtain. To continue to ignore this is at the nation’s peril, seniors’ peril, and particularly at the peril of poorer elders,” he said.  

Study authors David Grabowski, Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School, and Caroline Pearson, Senior Vice President, Health Care, of NORC at the University of Chicago, presented the study’s methodology and key findings. Echoing Kramer, Grabowski introduced the study by saying, “Today is about beginning a dialogue and hopefully an agenda about targeting care and housing to this population.”  

In her presentation, Pearson walked through the methodology and choices that were made in order to understand the resources and demographic nature of middle-class baby boomers. The study was designed to focus on boomers who, when they are over the age of 75, will neither qualify for Medicaid nor be able to afford today’s private-pay seniors housing and care options. The minimum amount that seniors will need in order to afford assisted living as it is priced today, as well as out-of-pocket medical expenses is $60,000. Here are a few key findings: 

• The number of middle-income seniors will nearly double to 14.4 Million by 2029 (43% of all seniors) 
• Seniors will be more diverse and more educated than today’s cohort
• 67% will have3 or more chronic conditions 
• 60% will have mobility limitations
• 20% will be defined as “high needs”
• 7.8 Million (54%) will have less than $60,000 annual financial resources, even when including housing equity. This group grows to 11.6 Million (81%) when excluding housing equity.

Grabowski acknowledged that assisted living and independent living communities today can help balance tradeoffs between medical care, long-term care and social needs of seniors who can afford them. Financial resources, however, dictate their housing and long-term care options.  

Aging baby boomers’ demographics mean they will face more challenges than prior generations, as they begin to need care. They are less likely to have a spouse, have fewer children to serve as caregivers, and will have less in pension wealth and other savings than preceding generations. Their sheer numbers will also pose a very serious problem. In fact, the study only projects to 2029, the year in which the oldest boomer will only be 83 years old. Peak demand for seniors housing and care services comes from seniors in their mid- to late- eighties. This means this challenge will be significant over a two-decade period, until approximately 2050.  

When Grabowski commented “Good luck with Medicaid. We can’t rely solely on Medicaid as a solution,” a grim laugh rippled through the room. While it came up in the question and answer period, there seemed to be little debate on the ability of the government to handle these problems alone. 

Instead, the study’s authors and several of the panelists urged stakeholders in industry and on the policy side to discuss a range of solutions and to work together. Grabowski, addressing approaches to solutions, recommended, “Not just a private-sector or public sector solution, but a joint public-private partnership.” On the private side, he suggested a number of strategies that might help lower the cost of housing and care for the consumer. Mixed income communities, high tech solutions to lower labor costs, better leveraging family and volunteer caregivers and a la carte pricing were all mentioned. Grabowski went on to suggest, on the public policy side, blending housing and Medicare products, similar to the new flexibility that has just been given to Medicare Advantage plans, and allowing Medicaid to pay a percentage of all services for long-term care, including room and board. He also suggested extending subsidized housing to middle income seniors. 

In addition to the article on the study’s key findings, Health Affairs published two articles with further insight and commentary relevant to the study, as well as a Kramer-authored blog post on the meaning and implications of the study’s findings. Authors John Rowe, Mailman School of Public Health at Columbia University, and Jennifer Molinsky, Harvard University, spoke on their articles, “Challenges For Middle-Income Elders In An Aging Society” and “What Can Be Done to Better Support Aging in Community?” respectively.  

Rowe, commenting on his years of study on aging and society, said “In this town policy makers, when they think of aging, they think of Social Security and Medicare and there the discussion ends.” His presentation focused on the Hartford Aging Index, which measures a senior citizens’ productivity engagement, well-being, equity, cohesion, and security in a given society. 

Molinsky’s presentation focused on the housing and community needs of aging seniors. She pointed out that by 2038 the number of 75-and-over households in America will increase from 14.1 to 28.2 million. Pearson et al.’s findings project that 20% of middle-income adults in this age group will have high needs that will make it difficult to remain at home, but Molinsky focused on the remaining 80%, many of whom will likely attempt to stay in their homes and communities for as long as possible. This group will need homes adapted to their care and well-being, as well as communities that are age-friendly. However, as she pointed out in her remarks, only 3.5% of today’s housing is accessible to scooters or wheelchairs.   

The final panel discussion, focused on policy, and moderated by Weil, featured Debra Whitman, Executive Vice President and Chief Public Policy Officer, AARP, Nancy Eldridge, CEO, National Well Home Network, Kai Hsiao, CEO, Eclipse Senior Living, and NIC’s Kramer. 

Hsiao pointed out that along with the challenges there are some real opportunities. “There’s a lot of opportunity out there. A question for the senior living sector is ‘why is our penetration rate static at 10%?’ Imagine our penetration rate if we built for this group.” 

Eldridge suggested a multi-faceted, broad-based approach to finding solutions: “We shouldn’t create a siloed intervention for this group. What we need for seniors today is nothing short of a robust system to support them. Bring down those silos, and work as a team. We need a lean program that’s very broad.” 

Whitman predicted that the shortage of care-givers would only worsen: “The only safety net for many is family. In 2010 there were seven unpaid caregivers (aged 45-64) for every person over 80. By 2030 there will be four, and by 2050 there will be only three. People today who are in their twenties and thirties have to step out of work to take care of a parent.” 

While the study’s findings shine a light on a substantial set of challenges, panelists expressed hope that, working together, public and private stakeholders would also be able to capitalize on real opportunities. As Kramer stated towards the end of the discussion, “At 10% penetration we’re not doing something right with the product. That’s a huge entrepreneurial opportunity.” 

Please visit https://www.nic.org/middlemarket for more information.