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Wellness Community for the Emerging Middle Market

ICAA, the International Council on Active Aging, released their latest forum report on July 6, 2021. The forum convened over 70 industry thought leaders this May, generating a re-imagined model of senior living for the emerging middle market. The resulting report highlights the importance of a wellness focus in senior living communities seeking to attract middle-income residents from the boomer generation, as well as those born prior to the 1946-1964 period.

According to ICAA’s report, creating a new model of senior living that fits the needs and priorities of this population means providing relevant, value-based options and lifestyle experiences. Due to the increased diversity and higher expectations of this demographic compared to previous generations, ICAA reports that senior living organizations should focus on finding a niche to distinguish their community according to a specific set of needs and desired lifestyle options.

Redefining “Wellness”

To most professionals in the industry, the importance of a wellness focus is hardly news—indeed, adapting to COVID-19 has highlighted the need for multi-tiered innovation in balancing support for the physical side of health with the broader human concerns of social connection and spiritual well-being. Even so, the details of ICAA’s report suggest that even the industry’s working definition of “wellness” may be in need of further examination, particularly in terms of how it draws from and applies to the emerging generation of elders.

In considering both the enormous opportunity and the practical constraints of serving this population, ICAA’s definition of wellness is centered around specific, identity-based needs and preferences unique to boomers and other middle-income seniors. First and foremost in ICAA’s list of key phrases describing the middle market is a single word: value.

In terms of generational culture, this is partly a nod to what may be the dominant identity-based criterium for these prospective residents—however, placing a focus on value is also a necessary acknowledgement of their available resources. Across the senior living industry thus far, models of wellness community have been built on a price point that dramatically outpaces the middle market’s annual income. Specifically, ICAA reports a 2018 median of $64,023 for those 64 and older. With that in mind, if the senior living industry is to succeed in both serving this population’s needs and leveraging the enormous market potential toward an acceptable profit margin, a new industry model of wellness community is clearly in order.

Multidimensional Wellness and Community Engagement

According to ICAA’s forum report press release, “value and choice fuel the decision-making of people with middle incomes.” Therefore, senior communities aimed at the middle market must do more than simply streamline the budget of current wellness paradigms. They must instead create a model of value that includes greater levels of choice and autonomy, foundationally redefining the structures that support a wellness-based senior lifestyle to ensure both financial accessibility and identity congruence.

To support this shift, ICAA’s report offers a detailed conceptual framework for reimagining senior wellness communities, complete with the lifestyle specifics of what is most important to this particular demographic. In redefining the term “wellness” for this emerging market, ICAA offers for consideration the following dimensions of wellness for middle-income seniors: physical, emotional, spiritual, intellectual, social, environmental, and vocational.

Historically, the vocational aspect of wellness has been perhaps the most overlooked, and the ICAA report indicates that this must change for the emerging market. While a sense of purpose is often considered fundamental to human identity in general, it is also specific to the identity and needs of middle-income seniors, many of whom are likely to engage in paid work out of desire or need, or perhaps a little of both. For elders in this group, paid work may serve not only to make senior living options more financially accessible, but also to maintain a level of self-reliance and active living that is culturally important to them. Even those who do not engage in paid work are likely to expect a high level of resident engagement. In the evolving industry conversation, this again speaks to a collective increase in awareness of the universal human need for connection and purpose within one’s community at any age.

Living with Agency and Purpose

In considering their options for senior living, elders from this demographic tend to expect that they will be involved in decision-making for on-site activities as well as for events coordinated with the larger community. As a corollary to this, providing adaptive environments will be central to satisfying their expectations for autonomy and choice in community planning. In residential and business environments alike, incorporating flexibility into common spaces adds value, which makes it a common lifestyle choice for middle-income people throughout their lives. A room that can be adapted for multiple purposes becomes a more efficient use of space and resources, and middle-income seniors will expect this flexibility as a matter of course. Instead of focusing primarily on an elegant aesthetic, the design emphasis for this market will be more intentionally based on comfort, function, and sustainability.

On the more subjective side of value, autonomy and individual choice are also enormously important to this demographic. From options as broad as space for entertaining and initiating community events to those as individual as ordering food from an à la carte menu, boomers and other middle-income seniors will be looking for clear signs of divergence from the cookie-cutter approach of the past. Accordingly, many industry leaders have introduced a further shift—rather than maintaining a closed residential community that is largely defined by its physical boundaries, some facilities will offer foods and services that are open to non-residents through fee-based access, providing additional budget revenue as well as a two-way interface with the broader outside community. Residents may additionally benefit from flexible pricing plans for dining, and are likely to appreciate the inclusion of casual options such as on-site bistros and coffee shops.

AgeTech Solutions for Efficiency

In terms of cost-effectiveness and value on the business side, increased use of supportive technologies will be key to focusing budget resources on residents’ desired level of quality and choice. Non-essential support staff may be replaced with adaptive and labor-saving technologies to assist with tasks such as deliveries and security. While these services are essential to community integrity, they do not require the level of human skill that applies to wellness priorities, and in eliminating unnecessary personnel, senior living organizations can create an enormous increase in resource efficiency. The initial investment in technology, while potentially substantial, quickly pays for itself. This offsetting of needless payroll costs then allows administrators to prioritize the recruitment of loyal, wellness-oriented staff who can be well-compensated even within a value-based budget.

Industry leaders weighing in on ICAA’s forum report also expect that technology-based options will replace the usual nursing care and disability assistance model for the middle market. The prevailing wisdom here is that the boomer and middle-income senior population are likely to choose senior living communities at a younger age and in better health than those who enter in their eighties because of a need for residential support. Some middle-market organizations may choose to eliminate on-site care options altogether, substituting reliable telehealth technologies and local provider referrals, while others may retain private-pay options for in-apartment assistance and on-site clinic care.

Preserving Access and Flexibility

Cutting back on in-house healthcare services is an area of enormous streamlining potential, but it may also be an area where care is needed to avoid inadvertently substituting ableism for ageism. Private-pay options, if offered, must be as efficient and cost-effective as any part of the community structure that impacts the organization’s own budget—mainly to ensure that on-site options will remain genuinely accessible to residents through any unexpected shifts in ability or health circumstances. While streamlining costs will be essential in serving the middle market population, sustaining one’s chosen lifestyle is also listed as “very important” to this group in ICAA’s forum report.

For seniors whose idea of value places security and continuity over maximizing lifestyle options, having stress-free contingency options in the event of unexpected health challenges may be an important factor in choosing a community. Appealing to the desire to stay in one’s chosen community through unforeseen circumstances could be a useful niche marketing point.

For many active seniors choosing a community from a state of health and vitality, such contingency plans simply won’t be a deciding factor. As a general rule, though, if a community is built from the beginning on the principle of accommodating the broadest possible range of abilities for its design, this inclusive perspective may at some point preserve lifestyle stability and continuity for even the most previously able-bodied of residents. Word-of-mouth is powerful capital in this industry, and for some organizations, it may still be good for business to build ability-related flexibility in somewhere.

In terms of keeping this cost-effective, there may be considerable wisdom to be drawn from senior living organizations centered around lifelong ability affinities, such as residential communities for Deaf or Blind seniors. Organizations built around specific abilities and challenges not shared by the broader population typically employ durable supports to ensure that residents can maintain a balance of support and autonomy at their baseline. However, such organizations also maintain flexible supports to ensure that a system is already in place to continue meeting those needs even if an individual’s ability level unexpectedly changes.

While flexible supports are already part of the existing model for many types of senior living communities, there is likely room for improvement, particularly in terms of efficiency and in the context of serving a younger and healthier population. Finding a comfortable balance between value and flexibility will be one of many worthwhile challenges as each senior living organization finds its place in the emerging market.

ICAA will be providing more information on this topic at their November 2021 virtual conference, titled Wellness: The Great Reset.

About the Author

Wenona Kimbro is the Associate Editor of SeniorTrade Media. She is passionate about life quality for seniors, and writes on this topic from a broad intersectional perspective. Wenona has an MFA in creative writing from Pacific University, preceded by a BA in applied linguistics from Portland State University. Wenona’s writing regularly draws on her professional background in caregiving, memory care support, dis/ability support, mental health care coordination, and advocacy for individuals with intellectual disability. She has matrilineal blood ties to the Cherokee, Choctaw, and Chickasaw tribes, and is interested in learning from tribal models for aging well. She also brings an LGBTQ+ lens to her work, informed by both educational and personal experience.



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