SENIOR LIVING
OPTIONS FOR OLDER ADULTS Deciding about senior living options, for yourself or a loved one, is described as one of the most difficult decisions a person will make. As the number of U.S. seniors increases, so do the choices—and the COVID-19 pandemic has made the process even more complex. Three Chicago-based senior living executives shared their current insights with Crain’s Content Studio. ANDREW AGINS is senior vice president – asset management for Anthology Senior Living, which operates 21 independent living, assisted living and memory support residences throughout the Midwest, Texas and Connecticut. He oversees investment and management strategies across all properties. He holds an MBA from Northwestern University’s Kellogg School of Management and previously worked in commercial real estate.
contribute and we can accomplish far more together.
turnover, which of course helps reduce the pressure on recruiting.
Kelly Hutchison: Home Instead provides caregivers that go into private homes. Their assistance allows seniors to remain independent and safe in their own home, surrounded by their own possessions and memories. Our services support seniors so they can perform activities of daily living. We provide different levels of service and flexible schedules.
NADIA GEIGLER is CEO of The Admiral at the Lake, a continuing care and lifecare community on Chicago’s North Side for residents 62 years and older. She joined The Admiral in 2016 as COO, after working in aging services since 1999. A licensed nursing home administrator, she holds a master’s degree in nonprofit administration from North Park University.
Andrew Agins: Anthology Senior Living is a developer, owner and operator of senior living communities across the United States. We specialize in independent living, assisted living and memory care communities. As a truly vertically integrated organization, we operate with deep expertise in the senior living space. For example, when we design a new community, we have team members from our construction, clinical, marketing and programming departments sit around a table to collaborate on the optimal unit mix, preferred amenity spaces and building footprint. We invest in our communities for the long term, using high-end materials and bestin-class technology. These upfront investments enhance our resident and team member experiences. We started operating our first communities in mid-2019. Today, Anthology operates 21 communities, with several new openings planned for the end of 2020 and early 2021. We’re growing quickly but thoughtfully.
Agins: Our top priority is always the safety and well-being of our residents and team members. Since the pandemic began, we’ve put in place comprehensive COVID-19 safety measures, and made free, onsite testing available for all residents and team members. We increased hourly pay and benefits for our staff, to aid their personal financial security. We partnered with peer operators to purchase bulk orders of PPE. These efforts helped mitigate the threat of COVID-19 within our communities. To foster resident engagement, we’ve been promoting safe social interaction. For example, we ordered Amazon Echo Dots for residents to facilitate community-wide games, trivia and announcements. We organized socially distanced activities such as fitness classes, book clubs and contests on our golf simulators. We also have been working with our culinary team to create safe dining options.
KELLY HUTCHISON is the 16-year owner/operator of the Elk Grove Village franchise office of Home Instead Senior Care, the world’s leading provider of personalized in-home care. His office serves seniors throughout Cook and DuPage counties. He holds an MBA from the University of Michigan’s Stephen M. Ross School of Business and previously worked as a management consultant in the health care industry. What role does your organization play in the senior living space? Nadia Geigler: The Admiral at the Lake is a vibrant community of adults 62 and older who believe in leading full and authentic lives of purpose. Our community offers a
What’s the most pressing issue for your organization currently, and how are you addressing it?
“THE MOST PRESSING ISSUE WE HAVE RIGHT NOW IS IN HOW WE POSITION THE ORGANIZATION FOR WHATEVER THE ‘NEW NORMAL’ WILL BE IN THE WAKE OF THE COVID-19 PANDEMIC.” —NADIA GEIGLER, THE ADMIRAL AT THE LAKE full continuum of care and services as well as amenities and programs to support abundant living. We believe our role in the senior living space is to create an engaged and expansive community of residents, staff, family and community members because every person has something to
Hutchison: Our most pressing issue is a shortage of professional, caring applicants to join our staff. The COVID-19 pandemic made recruiting harder. We have new and innovative ways to attract and recruit applicants, as well as to retain the tenured staff. I’m happy to say we have very low
Geigler: The most pressing issue we have right now is in how we position the organization for whatever the “new normal” will be in the wake of the COVID-19 pandemic. Over the course of this year, our organization and its members have proactively embraced and driven change designed to care for the community. We’re still practicing these skills and have included dreaming for our future and the new ways we might live out our mission and purpose. What are some recent regulatory changes, and how are they impacting your business? Geigler: Changes to regulations and guidance from various regulatory bodies has been a huge part of this year. Because we’ve remained close to public health experts throughout the course of the pandemic, our organization has been positively impacted. We were able to make informed decisions and act in the best interest of the community because we were educated and remained agile. For example, current regulations have allowances for safe practices around gatherings, dining and other services which our community is enjoying. Hutchison: The Family First Coronavirus Response Act, the first COVID-19 relief package passed by the U.S. Congress, was great for
Home Instead. It gave us the flexibility to retain workers with emergency paid sick leave when they were impacted by quarantines, experienced COVID-19 symptoms or other restrictions. Because we’re a laborintensive service, changes made by local, state and federal policy makers have a direct and immediate impact on the business, our employees and our senior clients. Agins: Each of the 11 states we operate in have different guidelines for performing resident care, and for addressing COVID-19. Therefore, the regulatory environment can be quite challenging to navigate. Fortunately, we have a brilliant legal team that evaluates all regulatory changes. Additionally, earlier this year,
Hutchison: We immediately closed the office. Now we use VOIP telephony and Zoom to conduct administrative functions. Managers conduct briefings each morning. These are essential virtual meetings and focus on setting priorities and communicating with managers. One big accomplishment was converting our entire in-person recruiting process to an online process. Going virtual with a document-intensive process was tough, but our HR team innovated. We got the right tools in place and made necessary process adjustments. What are you doing to keep your staff—and clients—safe amidst the pandemic?
“FROM THE BEGINNING WE KNEW GOOD COMMUNICATION WITH EMPLOYEES AND CLIENTS ABOUT COVID-19 RISKS WAS ESSENTIAL.” —KELLY HUTCHISON, HOME INSTEAD SENIOR CARE Anthology hired a consultant who has experience writing and executing infection control policies for a large health care system. Together, we work to deliver the best health care practices to our residents. Since the pandemic began, what changes have you made to your operations, services or other? Geigler: During the pandemic we made a number of changes to our operations to ensure we could provide quality services and access to amenities that met the individual needs of residents whenever possible. We offered room service both for dining as well as entertainment— books, movies, puzzles, etc.— assistance with grocery shopping, private transportation to medical appointments, support in connecting with friends and family members virtually and other activities. For staff, we offered convenience boxes of fresh produce, dairy, bread and other items to keep them from having to go to the grocery store. We also provided free meals, snacks and beverages, hero pay and other activities to show our deep appreciation for the many sacrifices being made to provide top-quality care and support to our residents.
Hutchison: The first mad scramble was to secure PPE. In March there was nothing! We used everything from OfferUp to industrial supply giants to Home Depot to secure PPE. We also developed our own staffing rules and procedures that isolate, track and trace. From the beginning we knew good communication with employees and clients about COVID-19 risks was essential. We serve seniors, and COVID-19 is more lethal for seniors. The early focus on stakeholder education helped. Clients and families were willing to make necessary adjustments to say, isolate due to a potential exposure, when they knew we were working hard to protect them from a communicable virus. We also provided additional training to our caregivers and employees. Agins: We perform health screens of our residents twice a day, and screen all staff prior to every shift. All team members wear PPE when in the community. In early May, we formed partnerships with several labs to offer free, ongoing testing to all community members. We’ve changed the way we interact with prospective residents, adopting technology traditionally used in highend multifamily space to develop virtual tours, where prospective residents can view our buildings and
SPONSORED CONTENT amenities. All new residents must test negative for COVID-19 within 48 hours before moving in. Today, less than 0.5 percent of our residents have active cases. Those that do are properly quarantined, while our staff—equipped with PPE—provide meals and care. The vast majority of residents are free to enjoy their communities. Geigler: We employ proper use of PPE, regular health screens and proactive testing strategies. We also issue broad and frequent education and communication to all members about how to engage with the community in ways that are safe and appropriate, and ensure that we protect the jobs and compensation levels of employees. We also provide safe ways for staff to travel to and from work, convenience boxes of fresh foods for both residents and staff who wished to avoid the grocery store, and other supports designed to limit exposure. What’s the number one consideration for older adults and their families when making decisions about senior living? Hutchison: Determine first if the older adult wants to remain in their home. If so, consider if the home is safe enough for them to age in place. If the home is safe to age in place, are they willing to spend time and money to make modifications to make it safe—for example, install a ramp, grab bars or emergency and fall prevention alert system, which can be very expensive. If the home and its memories are important, research shows that older adults remain happier at home as they age. Regardless of where people live in their later years, it’s important that they not become isolated. Agins: Prospective residents look for an engaging environment with opportunities for social interaction, great food, amenities and activities, while their adult children typically seek the best health care. We cater to both sets of needs. Prospective residents are “wowed” by our independent and assisted living units with full kitchens and in-unit washers and dryers—a rarity for senior living. Over 40 percent of each community is dedicated to amenity spaces, including bistros, gyms, theaters and salons. We partner with a best-inclass culinary provider that prepares meals from scratch with locally sourced, seasonal ingredients. Family members are delighted with our quality of care. Communities within our portfolio offer 24/7 nursing, and staff certified caregivers at ratios above state requirements. Physicians, therapists and trainers are brought in on demand. Anthology communities host quarterly care conferences for families. Our communities schedule a full calendar of safe daily activities that engage the mind, body and spirit. Geigler: The most important consideration is the culture among residents and staff. Of course, the services, amenities and pricing are
very important factors but nothing can replace the experience of being in a community where there’s a strong culture fit among all members. How are you using technology to benefit your organization and/or clients? Hutchison: Our biggest move was to introduce a Home Care Tablet. Imagine an iPad for seniors with content, controls and connectivity, combined with the ability to bring Home Instead’s management into the home! Via one-touch video calling, we can manage daily tasks, work toward care goals and immediately check on changes in condition. It’s a tremendous tool that enhances the care we already provide. Another technology offering is our operating system. It tracks the location of our employees. Our clients and their families have peace of mind knowing with certainty that someone is there with their loved one. Geigler: The last several months have given us opportunities to use technology in new and expansive ways to connect members of The Admiral at the Lake with each other and with people outside of this community for social connection, relationship building, shared learning, entertainment and even exercise! We continue to use our “Ask Admiral” customized Alexa skill to help build social connections and to disseminate information throughout the community. Agins: Our communities are built with high-end tech infrastructure, similar to what one would find in a modern high-rise apartment building in downtown Chicago. On the programming side, we use IN2L, which is a large, moveable flatscreen with more than 4,000 content applications designed specifically for seniors. We provide family members with an app so they can follow their loved one’s meal choices, wellness assessments and daily activities. On the wellness side, all residents and team members in our new developments wear a small bracelet that provides fall detection, and alerts staff precisely when and where a resident has tripped. This bracelet also provides access to various areas of the community. Additionally, dedicated training tools for our staff help them become proficient in areas like dementia care. This high-tech focus not only provides
Agins: Prior to a prospective resident signing a lease at one of our communities, there’s a “discovery” process. During this process, the prospective resident and their family discuss their interests, hobbies, history, medical needs and future goals with our team. Some of our residents would like to learn how to play an instrument, teach a lecture series or join a walking club. Our team curates a plan for every resident so they can continue to explore new things in life. We encourage our residents to continue creating their life story at Anthology. Many of these new experiences are facilitated by our amenities and activities that are specifically designed for seniors. For example, we offer art rooms, libraries, fitness equipment, exercise classes, yoga classes and beautiful lap pools in some communities. These resources are designed to promote healthy interactions, growth and wellness for our residents. Geigler: Our role as an organization is to partner with residents to ensure our community remains vibrant and connected. Our current and prospective residents know best what programs, events, gatherings and entertainment have the most meaning. Hutchison: Our services prevent isolation. While COVID-19 has caused seniors in some facilities to be cut off from family and visitors, our caregivers are one-on-one. Caregivers ensure that meds are taken, mealtime is shared, ask how the senior slept last night and prepare an enjoyable activity for the day. One-on-one care by Home Instead fosters deep, affectionate bonds. Our Home Care Tablet offers a connected virtual experience tailored for older adults and one-touch video calling with loved ones—really anyone they wish. This technology allows a virtual visit by managers with just one touch. It’s interactive, stimulates the senior and reduces TV watching. What are your organization’s short-term goals for dealing with the current pandemic? Geigler: Our goals remain the same as they were before the pandemic—to care for the whole person, to grow and attract talent, to nurture our culture and foster engagement, and to leverage resources and relationships. These are both operational goals and aspirational goals that bring clarity
“WE PROVIDE FAMILY MEMBERS WITH AN APP SO THEY CAN FOLLOW THEIR LOVED ONE’S MEAL CHOICES, WELLNESS ASSESSMENTS AND DAILY ACTIVITIES.” —ANDREW AGINS, ANTHOLOGY SENIOR LIVING great resident experiences but also helps ease the minds of their loved ones and family members. What’s your organization doing to enhance older adults’ lifestyle experiences?
and provide direction, especially in the midst of a pandemic. How we accomplish these goals has shifted as needed to ensure that the safety of the community remains a top priority. In many cases, these shifts have led to some great changes and more creative
thinking which will benefit us for a long time. Hutchison: Our first is to maintain PPE inventories. Another is to help our managers have productive and rewarding jobs while working from home—in many cases, while raising families and dealing with remote learning. We also want to keep the mindset of our frontline service workers focused on safety and protocols that prevent the spread of COVID-19. Every time an employee reports a cough we need to communicate and, if needed, act to prevent COVID-19. Daily, intentional communication is more important now than ever before.
ANDREW AGINS
SVP - Asset Management Anthology Senior Living aagins@ca-ventures.com 312-754-8826
In light of the pandemic and other factors, what’s the longterm outlook for senior living? Agins: The 75+ age cohort in the United States is expected to double from 20 million in 2015 to 41 million in 2035. Additionally, only 7.5 percent of the 75+ population currently lives in senior housing. If that penetration rate goes up by just one percent, we’ll have a massive shortage of senior housing. Therefore, there’s a large runway for the senior living industry to grow. The new wave of senior housing will continue to borrow from other property types. We’re already seeing innovative programming, improved amenity spaces, healthier food options and a better marriage of technology and health care. These enhancements are driven by the infrastructure and physical build of the communities. This is why being a developer, owner and operator is so exciting for Anthology Senior Living.
NADIA GEIGLER
CEO The Admiral at the Lake ngeigler@admiral.kendal.org 773-654-5109
Geigler: The measured value in senior living comes with the assurance and peace of mind that comes in a lifecare community like The Admiral at the Lake and in the services provided, particularly those included in our full health care continuum. What can sometimes be less obvious is the great value that comes in belonging to a community of people who make life more interesting, provide socialization and friendships and who give support to one another in a way that cannot be replicated in one’s own home. Hutchison: COVID-19 has shown us that home is the place to be for seniors. Seniors living in facilities and health care institutions were needlessly exposed to the virus by careless housing decisions. Most senior living facilities are still closed to family and friends, and their residents are isolated. Long-term isolation impairs cognition. Our caregivers offer companionship and keep seniors safe in the comfort of their own homes. Seniors feel safe with one-on-one caregivers who are trained and educated in the prevention of communicable diseases. The long-term outlook for in-home senior living is tremendous. Innovative technologies and easy-toinstall home safety modifications will make aging in place easier.
KELLY HUTCHISON
Owner Home Instead Senior Care kelly.hutchison@homeinstead.com 847-690-9825