————-

The following is a guest blog entry from Larry Carlson. Larry is an advisor, board member, and author of Avandell: Reimagining the Dementia Experience. A longtime CEO in senior living, he now writes and speaks about helping older adults finish strong — living with purpose, vitality, and impact in their third age.

————-

Mary Jane turns into the circular drive of the senior living community that will now be home. A moving truck follows close behind. She pulls to the entrance and turns off the engine. Inside that truck are the furniture, artwork and boxes accumulated over a lifetime. But Mary Jane is bringing far more with her than what is packed in those boxes.

For decades, she ran a business. She served on the school board. She chaired a capital campaign at her church. She organized meals when neighbors were sick. She raised three children. People sought her advice. When something needed to get done, they called her.

The doors to her new community open. The receptionist welcomes her warmly. There are flowers waiting in her apartment. She is shown the dining venues, fitness center and gathering spaces. The dining room host explains how to make a dinner reservation.  The concierge shows her how to sign up for programs and arrange transportation.

Everyone is gracious. Everything has been designed around her. And yet, something subtle may have happened in the transition.

Yesterday, people asked for her judgment. Today, we’re asking for her preferences.

WE’VE COME A LONG WAY

I have spent much of my career in senior living, and I have watched our field change enormously. Much of that change has been for the better.

We moved away from an institutional model in which older adults were too often viewed primarily through the lens of what they needed. We replaced institutional schedules with choice. Facilities became communities. Food service became dining. Activities became engagement. We built environments that offered greater independence, personalization and hospitality.

More recently, we have become increasingly sophisticated about the consumer experience. We listen more carefully to what prospective residents want. We offer more choices. We think about convenience, hospitality, wellness and lifestyle. We measure satisfaction and continually look for ways to create a better resident experience.

We should be proud of that evolution.

But I wonder if we’re finished.

What if the next step in senior living isn’t simply creating an even better consumer experience? What if it is rethinking the role residents themselves occupy within the community?

What if the next evolution is from consumer to citizen?

CHOICE IS NOT THE SAME AS AGENCY

The word consumer carries an assumption. Consumers receive something created by someone else. They choose among floor plans. They select dining options. They decide which programs interest them. They choose whether to use the fitness center, attend a lecture or take the shuttle into town.

Those choices matter. Having control over one’s daily life matters enormously.

But choice and agency aren’t quite the same thing.

Choice asks, Which of these options would you like?

Agency asks, What role can I have in shaping the options themselves?

That’s a different relationship. And it may be especially important when we consider the people now entering our communities.

They have spent 70, 80 or more years being far more than consumers. They have been executives and teachers, nurses and entrepreneurs, parents and grandparents, volunteers and board members. They have led organizations, built businesses, served churches and synagogues, coached teams, supported nonprofits and strengthened neighborhoods.

They have made decisions. Solved problems. Accepted responsibility. Influenced institutions. Helped other people. Then one day they cross the threshold into senior living.

Why would we assume that a lifetime of agency should suddenly become primarily a lifetime of preference?

WHAT IF WE THOUGHT ABOUT CITIZENSHIP INSTEAD?  

I’m not using citizenship in its governmental or legal sense. Nor am I suggesting another name for resident engagement.

I mean something more fundamental.

Citizens belong to a community. They have a stake in its well-being. They have a voice in its life. They contribute something of themselves. And they have an investment in making the community better.

That last part matters.

To be clear, I’m not suggesting that residents become owners, board members or members of some sort of homeowners association. Nor am I suggesting that responsibility for operating the community somehow shifts from management to residents. Senior living organizations have boards, leaders and team members with very real fiduciary, regulatory and operational responsibilities. Citizenship doesn’t blur those lines. It simply recognizes that living in a community can mean more than receiving what the organization provides. It is reciprocal. A community has responsibilities to its citizens, but citizens also have something to contribute to their community.

That shifts the underlying question.

Instead of only asking, What can we do for residents? we begin asking, What can residents do with us?

Instead of simply creating community for people, we begin imagining how we might create community with them.

That’s more than engagement. It’s belonging with consequence.

THE PARADOX OF HOSPITALITY

There is an interesting tension here for an industry that has worked hard—and rightly so—to embrace hospitality.

Hospitality was an enormous step forward. We wanted people entering senior living to experience warmth, welcome, service and choice rather than institutional routines.

But hospitality contains an assumption of its own.

There is a host.

And there is a guest.

That makes perfect sense when I check into a hotel for four nights. I am a guest, and I hope the people who work there create an exceptional experience for me.

But what happens when I sell my house, move my furniture, change my address and come to live somewhere for perhaps the next 10 or 15 years? At what point do I stop being your guest? At what point does this become my community, too?

Citizenship gives us another way to think about that relationship.

It doesn’t require abandoning hospitality or consumer experience. Residents still deserve exceptional service, meaningful choices, beautiful environments and personalized experiences.

Citizenship builds upon those accomplishments.

Perhaps the evolution looks something like this:

INSTITUTION → HOSPITALITY → CITIZENSHIP

The institutional model essentially said: We’ll take care of you.

The hospitality model added: We’ll create an excellent experience for you.

Citizenship adds something else: You belong here. Your voice matters. What you bring matters. And this community is partly yours to shape.

WHAT IF WE’RE NOT FINISHED? 

There are significant implications to thinking this way. It could change how we market senior living and the story we tell prospective residents. It could change the questions we ask during the sales process. And it could challenge us to examine what agency, voice and contribution really mean once someone becomes part of the community.

Those are questions worth exploring, and I’ll turn to them in the next two articles in this series.

But before getting to the answers, perhaps we need to sit with the larger question. Senior living has made tremendous progress by asking how we can create better experiences for the people who choose our communities.

Maybe the next evolution begins with a different question:

What would change if we stopped asking only how to create a better resident experience—and started asking how to create a community worth being a citizen of?