Loren Ranaletta likes to tell the story of a man in his late 70s who moved into an apartment at Beatrice Place, part of Episcopal Senior Life Communities. The man had cared for his wife for several years, and when she succumbed to dementia, he sought the independent living community.

“He is like a kid in college,” said Ranaletta, president of Episcopal Church Home Foundation and former CEO of Episcopal Senior Life Communities. “He runs the billiard tournament. He made the staff buy a shuffleboard table. He runs a shuffleboard league. He has created a whole new existence for himself.”
Ranaletta said the man is a vivid example of how older adults are leaving their family residences and remaking lives in new homes and staying independent even if their overall wellness makes that difficult.
But that adaptation is a two-way street. As adults in their 60s to 90s adjust to new living arrangements, organizations must anticipate and react to what seniors want and need.
From independent living through skilled nursing, communities can respond with an array of choices that help individuals manage chronic disease — whether living on their own or with some level of assistance — meet needs of people with dementia, help residents keep up with technology and provide stimulating activities.

“Baby boomers are really the future of our business, and they have grown up with choices and they want choices,” said Lisa Marcello, president and CEO of Episcopal Senior Life Communities. “They’re looking to maintain a lifestyle they always had, and that includes choice. It’s very important to be able to meet many needs with many choices.”
Each option needs to further the individual’s sense of independence and control, said Deidre Klapka, an executive director with Watermark Retirement Communities, which has nine Legacy communities in Rochester.
“They want to still feel like they are able to thrive and make their own decisions,” she said.
To foster that sense, Klapka said Legacy communities already focus on education through Watermark University, which offers regular classes taught by staff, residents or family members.
Klapka said that Legacy sites have added a tech concierge because technology will be a bigger part of residents’ lives.

“The family’s expectations are that somebody is there to help [the resident] if their cell phone is broken or if they want to set up some sort of a TV program and the family can’t always get here in time,” said Klapka, who is based at Legacy at Clover Blossom. “The tech concierge will go around and make sure the residents can work through some of their frustration with the newer technology.”
Klapka said the average age of Legacy residents is in the 80s, but younger people are moving in. She said 40% of residents still drive, and they are starting to show up with electric cars. As a result, Watermark is moving to install charging stations. “We’re trying to accommodate everybody. We’re going to see growth in the (electric) car field, which is what we’re starting to see now.”
Technology also can be a way to help people who want to live as independently as possible as they move through a continuum of care.
“Home care can certainly support that,” said Suzanne Turchetti, president of HCR Home Care. “I think technology will be a huge piece of senior caregiving as we move forward.”
Individuals needing extra attention may be able to stay longer in an independent or enhanced living arrangement by working with a home care or personal care agency. Telehealth is also increasingly becoming a way to help older adults age in place.
The remote monitoring, which became a healthcare staple during the pandemic, is a way to keep an eye on a chronic disease. About 60% of Americans have one chronic illness, and 40% have two or more according to the Centers for Disease Control and Prevention. Such illnesses are major factors in people losing their independence.

“For a patient with congestive heart failure a 5-pound weight gain can mean something that could put them back into the hospital,” Turchetti said. “Monitoring them closely while they’re at home through the telehealth technology is something that is extremely helpful.”
A device like a tablet computer sends an alert if readings are outside the norm. “It’s very sophisticated technology. It triggers a phone call to a nurse immediately so they can address what the issue is.”
HCR has its own telehealth department, which Turchetti said the agency does as a best practice. But, she said, Medicare does not reimburse for its use, and it requires reliable internet access that isn’t available in all areas.
Individuals who need more intense care may find communities differentiate themselves based on specialty.
Anticipating an increase in the need to care for people with dementia, St. John’s is building on its rehabilitation program to accommodate people with failing cognition.

“What we’re seeing in a large gym, with a lot of stuff going on, it was really difficult for some those folks to follow a rehab program,” said CEO Charlie Runyon.
A dementia specialist works with physical therapists to develop specialized programs. In some cases, participants from other independent or assisted living communities are discharged from the hospital to St. John’s on a short-term basis for rehab. “We’ve already had some folks we’ve admitted back to those assisted living facilities,” he said.
Runyon said partnering with other agencies or living communities can help them learn what older adults need.
“You’ve got to find those avenues where people are willing and able to express their concerns and their issues and what they’re looking for. You have to ask and you’ve got to listen. And then if you can provide the service, you figure it out.”
At Episcopal Senior Life Communities (ESLC), Beatrice Place grew out of the need for moderate-income people who don’t qualify for public assistance to find affordable options.
“It’s the people who are socially engaged who really don’t have a lot of the resources that we have to find a better way for them to age in the community,” Ranaletta said.
Beatrice Place opened in 2013 in Greece and there are six other senior housing locations, including locations in Honeoye Falls and Geneseo. The community-based model invites neighborhood residents to social and educational programs on site, strengthening connections and creating a supportive network for all involved.
ESLC is working to establish housing in Irondequoit. Ranaletta said ESLC will survey all seniors living near one its sites and blend their needs and ideas with residents to create opportunities to socialize around shared interests.
“I feel we have done a very, very good job of trying to listen to people and then give them what they find a value,” he said. “If somebody applies to any one of our programs and we say no, we ask the question, why can’t we accept them … and then use that as a means to think about future option.”
Patti Singer is a freelance writer in Rochester. Contact her at [email protected]