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“Change is afoot,” said Colin Milner, founder and CEO of the International Council on Active Aging (ICAA), talking about “Aging Well: The Great Disruptor” at the Annual Conference of AMDA – The Society for Post-Acute and Long-Term Care Medicine in April. This was true before the pandemic, he noted, but the need for change has taken on a new urgency.
There was a time when few people lived to be 65, Mr. Milner said, but as we live longer, life becomes less predictable. He pointed out that many people are working longer, retiring gradually, or continuing to work long after traditional retirement age. More older adults still have parents to care for, or they are caregivers for children and grandchildren.
However, with less predictability comes greater human potential. “We need to realize this potential, embrace it, discover it, and utilize it,” said Mr. Milner. “The question is, ‘Do you want to live better longer?’ And the answer changes everything. The answer is driving change toward aging well.”
Two months after the Society’s Annual Conference, with the pandemic still raging, Caring sat down with Colin Milner to talk about COVID-19’s impact on wellness. “All of what’s going on has changed the world,” he said. “Some people see it as the end of the world, and others see it as no big deal. We need to focus on the reality, not the hype.” He said, “At the end of the day, it’s not about numbers. The goal is to try to help as many people as possible to see that life goes on. How we are responding to this pandemic will be crucial to enabling people to still have quality of life.”
There are two words people need to embrace to maintain sanity in these chaotic times, Mr. Milner said: resilience and adaptation. “Trying to resist change is a losing battle. Communities will need to adapt … to things such as social distancing. They will need to create a safe space that allows people to do the things they like but in a different manner,” he said. This means efforts such as spreading people out, enabling better air flow in public spaces, and having options for people to dine inside or outside.
Looking forward, Mr. Milner said, “we will see more of a balance between online and in-person services. As things settle down, we will see a hybrid of the two.” He also predicted, “We will see communities creating well-being with new technology,” such as ultraviolet-C lighting and air filtration to prevent contamination and the spread of infections, and other innovations. These elements will come front and center to enable buildings to be as conducive to safe, healthy living as possible. He observed, “Those that don’t will see people leaving because they are looking for safer environments.”
If everyone is doing what they’re supposed to be doing, Mr. Milner said, “you can minimize opportunities for transmission, but this virus will still be there for a while.” The challenge will be to create ways for residents to socialize safely that don’t make them feel isolated or restricted. This requires balancing risk and safety, Mr. Milner said. “You can’t keep people locked down month after month and think there won’t be consequences. We need to be thinking about how to create environments that promote safety but enable residents to enjoy socialization, engagement, and quality of life.”
Communities and facilities will be “doing a grave disservice to their residents if they don’t make wellness front and center now.” He especially predicts an uptick in “anything that helps manage mental health” – from yoga and meditation to the use of cannabis and alternative therapies. He added, “We also will see Zoom calls and technology used for activities, spiritual engagements, classes, and skills learning.”
All this means going beyond providing people with what they need to live. “We want to provide safety, but people want to be active, happy, and sane. This is a challenge, but all we can do is learn from each other and adapt.”
The Move to Aging Well
There is an opportunity to reverse individuals back to the stage of active adulthood, Mr. Milner said. This doesn’t mean running a marathon, although he told the story of a 100-year-old man who did. Simply being physically and mentally active and engaged in life can make a difference. “We are seeing changes in attitude from people about active aging.” He said that 85% of people from ages 40 to 90 don’t see themselves as old and “they seek to embrace their potential.” However, he stressed that the greatest barrier to creating a better, longer life is how we currently conceive old age. To move forward, he said, “we need to shatter the status quo.”
This means embracing new opportunities, Mr. Milner suggested. “We need to develop new models to fill the expectations gap associated with aging well.” However, he stressed, “We are challenged from the onset if we have dated thinking: ‘Maybe my residents can’t do that.’” In fact, he observed, “the new normal is that individuals of any age are doing things that used to be thought of as being for the young.” That is, we need to help people attain what they want and not make assumptions about their goals and interests.
Currently, attitudes about aging are changing. People seek to embrace their potential and live better, longer.
All this means new rules and new industries, Mr. Milner said, and creating a demand for new products and programs. “We are in a new time, and as we look to the future the question is, ‘Where are there opportunities?’ and to build models to address them. We need to fill the gaps between what we provide in terms of services and what seniors are looking for.” What they are looking for, he suggested, is prevention: “Consumers are now spending more money to ward off the effects of aging than they spend on drugs to treat chronic disease.”
Wellness communities are popping up, said Mr. Milner, because there is a need. But wellness means different things to different people and organizations. The International Council on Active Aging, he noted, defines wellness as “derived from our ability to understand, accept, and act upon our capacity to lead a purpose-filled and engaged life. In doing so, we can embrace our potential (physical, emotional, spiritual, intellectual, social, environmental, vocational) to pursue and optimize life’s possibilities.”
The Business of Wellness
Increasingly, owners, operators, and other stakeholders are seeing the value of wellness from a business standpoint. Mr. Milner pointed to the results of “Visions of the Future,” the 2018 ICAA active-aging industry trends survey, which showed that 94% of industry leaders say providing lifestyle/wellness programming is an extremely/very important strategy for growing their business. This involves, he said, multidimensional wellness efforts, increased activities staff, and investment in training. The ICAA survey showed that this growth is happening, albeit slowly. At the same time, he noted, while everyone is talking about the importance of wellness, only 59% of senior communities see themselves as moving to become a wellness community with care. Nonetheless, post-COVID-19, we should watch for a growing focus on wellness, Mr. Milner suggested. “Wellness is no longer something that is coming; it is here. But we face challenges to delivering it and incorporating it in our organizations.”
One key gap he observed is between how the senior-living industry executives view the importance of wellness versus its value. According to Mr. Milner, the vast majority see wellness as very or extremely important, but only about half see it as effective. “We should start the conversation to help bridge this gap,” he suggested. “We can engage staff and residents, define wellness, create a wellness mission and vision statement, create and use the language of wellness, and make education our foundation.” Then, he said, we can create a person-centered approach to all aspects of our organizations. “Wellness offers an integrated approach to person-centered solutions.”
A “one-size-fits all approach won’t work,” Mr. Milner said. Rather, he suggested, “a wellness culture emphasizes self-knowledge and personal responsibility for all areas of health and well-being.” This means considering not only what we can offer older adults but what offerings they actually want. “We need to think about what your residents want to and can do versus what they can’t do.” For instance, he noted, if they want to swim with sharks, virtual reality can help them do this. “This requires an investment, but we need to find things that engage people and then invest in health and wellness.”
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