Obstacles and Optimism in the Aging Industry


The aging and long term care industry is at an epochal moment; with an unspoken mandate to accommodate a larger proportion of seniors than ever before. Baby boomers are the "new old," and their version of active aging sets a new precedent.

Unfortunately, the funds to pay for all of these aging boomers' needs are not assured by any means. With an overwhelming shortage of loved ones to care for family elders, long-term care insurance unaffordable for average Americans, and so few eligible for Medicaid (only lower income seniors qualify), the giant swath of older baby boomers might find ALTC options and services limited at best.

Inadequate and inconsistent regulatory processes, elder abuse, poor quality of care, and lack of coordination among ancillary services for the aged-all plague the industry.

Yet research on aging and disease, pain management, products to look and feel younger...all will pervade our media, literature, movies, and be the impetus for thousands of new inventions, industries, and research to mend the aging bodies that refuse to sit this one out.

The US Government's CLASS Act, insurance reforms, engagement of volunteers, and a new stripe of non-profit will be needed to care for this valuable asset-an energized and healthy (if they make healthy choices) older American.

That said, cases of illness and disease will multiply with the booming senior population-Alzheimer's disease, cancer, heart disease, addiction, depression, social alienation -and a new workforce must be there to assist the weak, the ill and terminally ill in our American family. At the same time, leaders in the industry, and healthy seniors, continue to show the huge difference healthy choices do make in preventing disease, extending longevity, enabling seniors to thrive into their 90s and beyond.

Despite weighty challenges, scientific breakthroughs and new models for ALTC can and should take this industry to new heights: A human lifespan of 120, people living to 100 as common as 85 once was, brain cells that replenish with use--contrary to old assertions--all bode well for ALTC.

With medical and conceptual advances will come a new phenomenon: seniors as the largest consumer group in America, with significant political and economic clout, something never before seen in US history. Their power will provide them opened doors to apply creative and precedent setting solutions to problems of older Americans and ALTC.

The collective senior population must grab the brass ring using their one-of-a-kind wisdom of experience-to be part of the solution, as the saying goes: To develop solutions not only for the elderly and related industries, but for future generations beset with crime, resource depletion, wars and economies on the brink.

"...the elderly, [are] one of the fastest-growing segments in the country's fastest-growing industry." (AARP 2011)

The number of citizens over age 85 will actually decrease from 2010 to 2030, however in 2030 a very significant increase will begin, and by 2050 the 85+ segment will be upwards of 25 percent of the US population.

Can we build enough nursing homes and retirement communities for them all? Or is that even the desired solution? In 2011, 90 percent of seniors indicate they want to stay in their homes as they age. Already 30 percent of seniors in the US live alone.

The boomers will have a hand in building systems to meet their own and their fellow seniors' needs--to fit their actively aging lives, since they are the power brokers in business, politics, government, education and non-profits. Instead of nursing homes, the trend will be "aging in place"-finding ways to age at home safely, with needed care, equipment, gadgets and designs built in to compensate for physical and even cognitive limitations of seniors

There is cause for concern, but also for optimism about the potential to refashion ALTC to deliver the quantity and quality of services needed by the next graduating class from the school of life.
A crisis is amiss-the dearth of available living spaces and services for seniors will only increase without drastic changes in the ALTC industry. This is because of the vast increase in the population of people entering their golden years.
Housing statistics for adults age 55+**

Baby boomers, roughly born between 1946 and 1964, are now in the age range of 47 to 65. In a study by National Association of Home Builders called Housing for fifty-five plus market - Trends and Insights on Boomers and Beyond they found:

Most people 55 years old or more do not live in age qualified communities or facilities. Rather, they live in neighborhoods inhabited by a blend of young, old, and middle aged people.

Analysis by HUD and the US Census Bureau indicates there will be a large demand for housing units focused on the needs and desires of the 55+ population, since the annual growth rate of number of households for this age group is expected to be over 40% of the households in the US by 2020.

The fact that most 55+ don't live in communities with age requirements may relate to their main criteria for choosing where to live: proximity to family and friends.

Additionally, increasing numbers of older Americans who are staying in the workforce have created new trends in types of housing seniors need or prefer.

The young end of the boomer group is just about to turn 55. These are tech savvy career minded people--the housing survey indicated that the increase in technology should lead to home based workers, ergo building of 55+ housing developments with designated office space.

Changes in long term care as we enter 2011 and beyond

Interested in learning more? Why not take an online Aging and Long Term Care course?

The old model of long term and end-of-life care centered on nursing homes. More appealing and optimal care systems are being developed with an entrepreneurial approach through business incubators like Signature HealthCARE, collaborating with the University of Louisville (Kentucky). These incubators focus on innovations in products and services beneficial to the elderly, and revamping the entire long-term-care industry.

The program underway at the University of Louisville is funded by state and business sources for extensive research and development of new products and facilities. The program is similar to the Apple Store concept, drawing together diverse sources to assure successful innovation across the non-profit, government, private business and incubator/entrepreneurial realms.

New prototypes - models for the future

In addition to the options for senior housing and in patient care, all the following are being explored as break out profit makers in the US economy, under the future-oriented vision of ALTC

Senior wellness services

Health Clinics

Pharmacy services

Unique needs housing alternatives

Products for seniors - bathroom adaptations, walkers, etc

Health care IT

Day care

Diverse factions, all aiming to meet the growing needs and changing demands for the expanding aging population, are proffering needed advances in ALTC. Motivated by profit and altruism-a combination ripe to launch award-wining solutions-these advances are or will come from:

Entrepreneurs building prototypes based upon home and community rather than institution or residential care

Universities and colleges, such as the University of Louisville, Kentucky

Existing business, non-profit and governmental leaders in the present ALTC industry

Slated to open in Georgia and Tennessee in 2012- skilled care facilities with groundbreaking concepts and systems in place.

Who provides care, and where: Understanding the types of services and facilities

a. Skilled Nursing Facility - Can be a permanent residence and full spectrum care site. A fully monitored setting with round the clock assistance with daily tasks-hygiene, meals, medication. Used if a person cannot stay at home or in a less monitored setting. A skilled nursing facility (SNFs), pronounced sniff, provides medical care by licensed professionals, including intravenous feedings, physical therapy, post surgery care, and other prescribed treatment. This setting can be an indefinite arrangement, or merely a recovery option after surgery or illness. Skilling nursing care can be available in less formal settings as well.

b. Adult Day Care - Seniors who are not able to remain alone during the day, or do not care to, may use adult day care. This option is helpful to working adult children or others who donate care, so that they don't have to leave mom or dad alone all day while they work.

c. Assisted Living- Separate apartments with minimal up to 24 hour care. Residents may live independently, needing only light housework, cooking, and optional group activities. Meals are served in a large dining, or residents may dine at home. Others need bathing, medications and so on. Activities are usually offered on a daily basis, such as cards, outings, sing alongs, etc

d. Residential Care Homes- Residential care for the elderly, called RCFE, provide 24 hour care and require a state license to operate, at least in some states.

Also called board and care homes, they are licensed for housing seniors. Some are also licensed to administer medical care. Located in suburban or other neighborhoods, in single family homes adapted to house four to ten residents, staffed by non-professionals-live-in or shift workers, providing for basic needs.

e. Home Health Care and non-skilled help: Seniors who are able to remain in their homes with assistance of agencies that provide professionals to help with minor health care or rehabilitation after surgery or illness. These care providers must be state licensed, and are paid for by the individual, except for certain types of services covered by Medicare. Also non-skilled workers, including care donated by friends or relatives. Most communities have local agencies that contract with you and dispatch helpers for cleaning, cooking, hygiene, and if specially arranged, medical care.

f. Alternative living arrangements -Sharing with a roommate who is able to assist with simple needs. Some agencies, such as "roommate finder" services, match seniors with people who can assist them with basic needs in part or full exchange for their share of rental expenses. Seniors who are fairly self sufficient but need occasional support, may room with one or two other seniors and split chores.

Some companies or agencies are working to match seniors with roommates or other shared living spaces. The Local Area Agencies on Aging or the National Association of Area Agencies on Aging have interfaced with these providers to help seniors contact potential roommates.

In-law living quarters are familiar to most, the outer units that sit on the property adjacent to a son or daughter's home. These offer privacy to the seniors and the family, plus the safety of proximity. Seniors without local (or any) family may look into renting such "in-law" dwellings with home owners who are willing lend them a hand with emergency routine needs, in exchange for a portion of rent payment or other services the active senior can offer; cooking, gardening, repairs, baby sitting etc.

g. Retirement Community Living - A retirement community may be one apartment building, condos, or an entire neighborhood of single family homes, such as the Del Webb's in Roseville, California. Residents are essentially independent. These communities are a wealth of social and recreational opportunities - classes, indoor games, golf and other sports, trips, and clubs based upon mutual interests. Some retirement communities provide graduated levels of care- called continuing care retirement communities.


A February 2011 ABC News broadcast on the graying of America made a case for seniors who resist giving up their own homes, exemplified by the determined senior citizen's take on nursing homes : "Everyone there is old". Further, "I am only 84".

While "Only 84" is absurd on the face of it , this is the emerging older Americans' mindset. To assist them within families, or to work with them as line staff or administrator, one must be clear about their self-estimation. In other words, they wish to be treated as the new old, not the old old. When interacting with seniors, especially 55 to 85, one must keep this in mind:

In a manner of speaking, 85, 75, 65 years of age is "not old," because of medical advances allowing for more active lifestyles than past generations. Moreover, life spans are increasing with medical technology and healthy choices. The neural pathways in the aging brain have been found to function well-seniors are able to think as well as younger people, except that they may need longer to process information. This, opposed to the old and incorrect belief that brain power declines with age, as brain cells die by the thousands daily.

What is the best way to convey to a healthy senior that it is time to take their medication...or tell an aging parent that their ski trip has you worried about their aging bones? They want you to know they still possess their memory, and they want to go skiing. They become offended that you consider them mentally or physically incapable merely because of their age. Indeed studies show that most any physical activity done in middle age can be enjoyed well into the golden years. In fact, activity is the very thing recommended for healthy aging and longevity.

Part of the solution - an exercise in futurism for the ALTC industry in the United States

The following article on "Intentional Communities" was reprinted from the website, "Future of Aging," a state of the art site on ALTC. Please read this material, brainstorm and jot down how you could become involved with this type of community. From the list that follows, take on the perspective that best fits with you, to focus your process of brainstorming:

1. Someone considering working in the ALTC field: Note how you could work within the "intentional community" concept, and make it the focus of your career. If needed, research the villages currently operational and the paid positions within them. But don't limit it to those existing positions-brainstorm how you could help the movement grow by creating a role and then selling yourself to the people who are operating the programs at present.

2. A senior - brainstorm how such a movement in your region could benefit you and other seniors, and what you could do to get a village started in your area. Research online to see how the existing villages got started. Also consider volunteering for some tasks a village would need done, and how volunteering would benefit you and fit into your life logistically: How much time you could give, what days, what type of tasks would be doable for you.

3. A close relative or friend of one or more seniors - how could you become involved or assist your older friends or relatives to become involved.