A decade from now, one-fifth of the American population will be 65 years of age or older. And while a number of senior housing facilities have sprung up to accommodate the growing elderly population, this generation of retirees is perhaps the first to express a deep desire to age in their place of choice.
But that desire necessitates the need for communities to embrace the elderly and their special requirements while transforming into places of inclusion.
One area senior housing organization ventured down that path five years ago with the start of its Neighborhood Program. The membership-based program offers health and wellness opportunities for community members and has been a resounding success.
“We had been talking about how we (could) kind of branch out and grow as an organization for many years. And we always got back to this: How do we serve the neighborhoods in which we operate?” said Courtney McGinness, vice president of community outreach for Episcopal SeniorLife Communities. “We just started thinking about how we are so intent on making positive interventions to the health of the consumers that live within our buildings that we can offer that to the extended community as well.”
ESLC is a faith-based nonprofit organization dedicated to understanding individual and community needs and responding to those needs. The organization offers a number of services, primarily in the senior housing spectrum.
ESLC’s Neighborhood Program was a shift in thinking, McGinness said.
“It’s really a transformational shift in the way that we operate. And it does take some time to get used to that, that we can extend beyond the property lines,” she explained. “And that doesn’t happen overnight.”
The program began with a pilot in Henrietta in 2012. ESLC staffers had begun a conversation with elderly neighbors to determine what they needed from their community and where they saw gaps in services.
“The neighborhood programs have really now evolved into what is a community health program, very much directed on wellness for seniors,” McGinness said.
The success of the Henrietta Neighborhood Program prompted ESLC to open five additional programs: Northeast Greece Neighborhood Program, River Edge Neighborhood Program, Honeoye Falls Neighborhood Program, East Avenue Neighborhood Program and Westside Neighborhood Program. The Neighborhood programs offer fitness in the form of Zumba and balance classes, as well as nutrition opportunities, health education and socialization.
“There are people out there with a limited health IQ, who don’t know how to manage some chronic diseases they may have, and if we’re there providing education then that’s a great thing,” McGinness said of the health education aspect of the community programs.
ESLC is hoping to reach community members that are “in-between,” seniors who are widows, fall into the middle-income bracket or those whose adult children have moved away and sometimes can be overlooked.
“People who have a lot of resources have always had the opportunity to choose what they want, when they want it, how they want it. People who are clearly safety-net poor people, who are disabled, who are on SSI, they have a menu of choices,” ESLC President and CEO Loren Ranaletta explained. “And then you have this broad range of consumers in the middle. Many are middle class people who have been teachers or postmen or foremen at a company, who have centered their lives on the household that they could afford. So their savings are invested in that.”
And those are the people whose neighborhoods are part of their extended family. They cannot conceive of leaving their homes to live in a home for the elderly.
“So what happens when that group of people starts to destabilize,” Ranaletta asked. “A lot of the people that we have picked up in the neighborhood programs are single members of the household.”
Last year, Ranaletta visited Beatrice Place, an ESLC senior living apartment community in Greece, and noted a group of about 15 individuals sitting together.
“They didn’t live in the building; they met each other by coming to the fitness class,” Ranaletta recalled. “And they said, ‘We’ve been neighbors for years and never knew each other.’”
Now the group goes to dinner together, visits casinos and gives rides to those who need to do shopping or run errands. The social connections that group of seniors made, Ranaletta added, were a result of the Neighborhood Program they attended.
The neighborhood programs have been successful in large part due to ESLC’s community partners, Daisy Marquis Jones Foundation and Greater Rochester Health Foundation. Many of the program’s events have suggested fees for community participation, but in some neighborhoods a fee would not work due to economic circumstances.
“It’s definitely not a profit center,” Ranaletta said. “It’s an investment of our professional time for a very important cause. We’re doing this because there’s been conversation on our board about what’s the best use of our resources. If we’re always just using our time and our money to support people on Medicaid, couldn’t we be doing more?”
Founded in 1868 as the Episcopal Church Home, ESLC’s hallmark has been its ability to respond to social needs and change as necessary to provide quality care. The organization employs more than 600 individuals, as well as hundreds of volunteers, in skilled nursing, transitional and rehabilitative care, assisted living, memory care, independent living, senior housing and hospice.
And while the Neighborhood Program is a differentiator for ESLC, the group is looking to grow its offerings in that arena, Ranaletta and McGinness said. The organization has added John Broderick as vice president of senior living. Working in tandem with McGinness, Broderick will oversee that effort and spur interest in community programs, among other things.
Broderick most recently served as senior policy analyst for LeadingAge New York, where he led efforts to secure funding for new senior housing and supportive service programs designed to help seniors age safely in the homes of their choice.
From 2009 to 2015, Broderick was executive director of Shires Housing in Vermont. While in Vermont he had an opportunity to work on a demonstration program in senior housing sites around the state, using a Medicare-funded pilot program that was designed to address people’s connections to the health care system.
“That program can demonstrate and prove that small interventions in people’s health and wellness, and social integration, have an actual dollars and cents impact by reducing unnecessary hospitalizations, improving management of chronic care and in a more simple way, getting people up and moving around and improving their physical conditions,” Broderick said. “Which is one of the core pieces of the Neighborhood Programs.”
Although secondary to the program’s core goal, health care savings can and will play a large role in senior care as the nation’s elderly move through retirement.
A 2016 report from Bipartisan Policy Center notes that on average, Medicare enrollment is expected to rise by 1.6 million annually, leading to a total of nearly 81 million beneficiaries by 2030. The Congressional Budget Office projects federal outlays for Medicaid will rise from $350 billion in 2015 to $642 billion in 2026.
“Far less appreciated than these trends is the alarming scarcity of housing that is safe, affordable and physically suitable for older adults, particularly those with the least financial resources,” the reports states, noting that the situation likely will worsen as the senior population expands. “Millions of older adults understand all too well that their health and well-being depend as much on their housing as they do on their health insurance and monthly Social Security check.”
By tightly linking senior health and housing the U.S. has the potential to improve health outcomes for seniors, the report suggested, as well as reduce costs borne by the health care system and enable millions of Americans to age in place in their own homes and communities.
“‘Aging in place’—where did that come from? Fifteen years we’ve been using ‘aging in place,’” Broderick said. “Well, if you get out to enough places you see some pretty bad aging in place: five-floor walkups, broken down mobile homes. So aging with options and aging with independence, that’s what we should be striving for.”
The changing landscape of health care and senior care has been tremendous, ESLC sources said, especially in the last decade. The organization has stayed ahead of these shifts and continues to look for new opportunities to serve seniors in the community.
“I just think we’re in a pretty unique place. We’re not the biggest in town. We don’t want to be the biggest in town,” Ranaletta said. “I think we want to be the best. And we want to be the one pushing the edge and progressing to where we think the future’s going.”
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