Podcast: Roundtable Talk

QUOTES

“The village model was created to serve that missing middle, the middle class.” (Barbara)

“Most of the villages are volunteer first, so it incorporates neighbor helping neighbor.” (Barbara)

“Villages connect the dots. They start in a community. It’s very organically grown from the community.” (Barbara)

“At the end of the day, we all want purpose.” (Barbara)

“People are living in their own homes. More importantly, people are living in their community.” (Barbara)

“We are not silos anymore. We cannot just be in this community and not serve everyone.” (Barbara)

“Money should not be an option. We want to make sure we reach all the underserved and underreached populations within a community.” (Barbara)

NOTES

Barbara Sullivan is the National Director of the Village to Village Network and a longtime advocate for aging in place. With a background in nonprofit leadership, long-term care administration, and gerontology, she has been involved in the village movement since 2007.

The Village to Village Network supports the creation and sustainability of grassroots, volunteer-driven communities—or “villages”—that empower older adults to remain in their homes while staying engaged, connected and supported by neighbors.

Barbara first became involved in the village movement after assisted living residents in Northern Virginia asked her to help start one. 

Her early career influence came from her father, a Congressman and elder law attorney, which helped shape her understanding of aging policy.  

The village model serves the “missing middle”—those who are too wealthy to qualify for public assistance but not wealthy enough for private senior living options.

Villages rely heavily on volunteers and grassroots support to help older adults stay independent, engaged and connected.

A major strength of the model is its flexibility—villages can range from 14 square blocks to 14 square miles and adapt to their communities’ needs.

The COVID-19 pandemic highlighted the importance of villages in combating social isolation and ensuring continuity of care.

Programs like GoGo Grandparent and partnerships with organizations like Goodwin Living help expand access to transportation and cognitive wellness.

Most villages charge modest or no dues and offer scholarships or “pay what you can” memberships to remain inclusive.

Villages build strategic partnerships with healthcare systems, faith communities, and public agencies to extend their reach and impact.

Barbara hopes to see 500 more villages created in the next 10 years and emphasizes the importance of community-based solutions in meeting the demands of an aging population.

QUOTES

“Inclusion is a feeling. If you ask someone, ‘Do you feel included?’ there usually isn’t a set of metrics, it comes from a feeling that can be nurtured and fostered.” (Marvell)

“Diversity really is a choice. Unless those decisions are made courageously, diversity may not show up.” (Marvell)

“You can Google a lot of things. You can ChatGPT a lot of things. But this is purposely a space for people to be posed with questions that allow them to look inwardly.” (Marvell)

“If staff can’t feel safe coming into the organization in a whole host of ways, then we really have lost the battle already for retaining the best talent.” (Marvell)

“You can’t pour anything from an empty cup. If there’s nothing to pour out, there’s nothing to give.” (Marvell)

“Each time a caregiver engages with a loved one, they’re giving of themselves. We also recognize you can’t give from an empty cup.” (Marvell)

“Longevity is inextricably tied to inclusion. The longer we live, the more influence there will be on our paths—and that is tied to the diversity of experience.” (Marvell)

“Inclusion is about planning the welcome party. You’ve got to know who’s coming and make sure they feel like they belong once they arrive.” (Marvell)

“If 90% of your age- and income-qualified prospects are staying home and you aren’t considering some sort of at-home offshoot of your community, you’re missing an opportunity.” (Marvell)

“Leadership succession is not just about finding the next CEO, it’s about preparing your organization for the day you’re not there.” (Marvell)

“If the board asks, ‘What’s the succession plan?’ and all you have is a name on a paper for FMLA, then you don’t have a real plan.” (Marvell)

“Recognizing your strengths are throughout your organization and tapping into them—that’s how you grow your team and your impact.” (Marvell)

 

NOTES

Marvell Adams, Jr. is a nationally respected leader in aging services with over 20 years of experience ranging from nursing home administrator to CEO. He’s known for advancing equity and inclusion across senior living and long-term care sectors through visionary leadership and collaborative action.

Marvell is the founder of W. Lawson, a consulting firm focused on creating inclusive, equitable environments in aging services. He also serves as CEO of Caregiver Action Network, a national nonprofit providing free resources to family caregivers across the U.S.

At W. Lawson, Marvell co-leads the Longevity and Inclusion Alliance Fellows Program, a virtual leadership initiative designed to help aging services professionals embed diversity, equity, inclusion, and belonging (DEIB) into their communities. The program is intentionally immersive, centering self-reflection, safe dialogue, and peer-to-peer learning. Under Marvell’s leadership, 

Caregiver Action Network supports more than 105 million unpaid family caregivers through resources, advocacy, and partnerships—especially as caregiving needs accelerate across generations and cultures.

Inclusion is more than a metric, it’s a feeling. Creating inclusive communities starts by fostering spaces where people can bring their whole selves.

Diversity is a conscious decision. Leaders must make bold, intentional choices to hire, serve, and represent diverse voices.

Many older adults are rejecting traditional senior living; providers must adapt by integrating at-home and intergenerational models of engagement.

Leadership succession should begin before retirement is near. “Preparing the organization for when you’re not there” is key to long-term resilience.

Most caregivers don’t plan to become caregivers—they’re thrust into it. Support must be immediate, empathetic, and culturally competent.

“You can’t pour anything from an empty cup.” Caregivers must prioritize their own well-being to sustainably care for others.

Caregiver Action Network is innovating through partnerships like its new Innovation Council, connecting startups and tech solutions to real caregiver needs.

Inclusion in action means planning a true welcome—tailored support, cultural sensitivity, and community integration—not just marketing promises.

QUOTES

“Frailty is a clinical syndrome that requires diagnosis and warrants both prevention and treatment.” (Dr. Fried)

“It’s important to teach kids the habit of being physically active because once you learn that as a child, it’s with you for life.” (Dr. Fried)

“We’ve created the long lives part, but we have not created the ‘with health’ part for most people.” (Dr. Fried)

“Older people want to make a difference, want to leave a legacy of goodness, but there are not roles at scale for that.” (Dr. Fried)

“Public health delivers 70% of a population’s health, medical care 20%. You can’t have health unless you have both sides of that health coin.” (Dr. Fried)

“Loneliness has been described as analogous to hunger — your body telling you that you need meaningful social connection.” (Dr. Fried)

“One of the strongest risk factors for heart disease, lung disease and dementia is air pollution — the fourth leading cause of death in the world.” (Dr. Fried)

“We block our opportunity to collectively thrive through the narrative that old people are only dependent and sick.” (Dr. Fried)

“The challenge is not that we don’t know what to do — it’s that we haven’t built the systems to deliver it to every community.” (Dr. Fried)

“If we invest in preventing chronic diseases at every age and stage of life, the return on investment is immense.” (Dr. Fried)

“Each generation needs the other generation in their life.” (Dr. Fried)

NOTES

Dr. Linda Fried is a globally recognized public health leader, geriatrician and Dean of Columbia University’s Mailman School of Public Health. She is a pioneer in the science of healthy aging and frailty, with decades of groundbreaking research and advocacy work.

The Mailman School of Public Health at Columbia University is one of the world’s leading public health institutions. Under Dr. Fried’s leadership, the school has emphasized healthy longevity, public health innovation, and the importance of building equitable health systems for all ages.

Dr. Fried chaired the Global Roadmap for Healthy Longevity, a major initiative from the U.S. National Academy of Medicine. She also developed Experience Corps, a program that empowers older adults to help children succeed in public schools, while promoting health and purpose in later life. Her work continues to shape how we design systems, communities and policies for a longer, healthier life course.

Frailty is a diagnosable medical syndrome that can be prevented or reversed, especially through physical activity and social engagement.

A meaningful definition of frailty helped unlock better care strategies, interventions and clinical awareness.

Public health delivers the majority of population-level health outcomes—and must be redesigned to meet the realities of longer lives.

Intergenerational connection benefits both older and younger people and helps address rising loneliness across age groups.

Aging in place requires supportive infrastructure: mobility services, home modifications, in-home clinical visits and strong internet access.

A third stage of life—marked by contribution, purpose and health—is possible, but requires roles that value older adults’ skills and wisdom.

The myth that investing in older adults comes at the expense of younger people is harmful and false; collective thriving is achievable.

Longevity should be seen as an opportunity for all of society to benefit—not as a burden.

QUOTES

“So much of this work is nonlinear. You start out with a plan and then if you’re keeping your eyes open, the road starts to curve pretty fast.” (Dr. Kamber)

“We’re really about using technology to change the way we age because the longevity revolution in America is this slow-moving demographic shift, but it’s changing everything.” (Dr. Kamber)

“We’ve got 700 sites where people are teaching our programs around the country. It’s really become a labor of love.” (Dr. Kamber)

“Outreach is so important to really recruiting people. Even giving away a world-class program for free, you have to get out there and ask people to come.” (Dr. Kamber)

“People are full of this intense potential. And we forget that there’s no change in that as we get older.” (Dr. Kamber)

“Technology is such a tiny piece of it, but it is a little bit like taking the cork out of the bottle sometimes.” (Dr. Kamber)

“The biggest myth is that people can’t learn… that somehow there’s something wrong when in fact, it’s just that your kid is acting like a jerk.” (Dr. Kamber)

“We paid extra to have nice millwork made with teak on the walls. It’s like a social club for cool people. It just happens to be free.” (Dr. Kamber)

“Great design is an antidote to ageism.” (Dr. Kamber)

“The healthy aging part of this is the socialization of their physical activity… It’s really unleashed an opportunity for people to think about their health in a social context.” (Dr. Kamber)

“If you’re patient and you’re persistent and you’re a person with integrity… you’re gonna end up in a good place.” (Dr. Kamber)

NOTES

Dr. Tom Kamber is a national leader in aging and technology, and the founder of Older Adults Technology Services (OATS) and Senior Planet. He’s a lifelong social activist dedicated to empowering older adults through digital literacy and inclusion.

OATS, a nonprofit affiliate of AARP, provides technology education and support to older adults through its Senior Planet programs. With a presence in 700 locations across 35 states, OATS combines tech training, wellness, and social connection to help people thrive in the digital age.

OATS began after a woman asked Tom for internet help post-9/11; that simple moment sparked a national movement.

Senior Planet offers programs focused on five impact areas: financial security, social engagement, health and wellness, creative expression, and civic participation.

The most popular offering? Fitness classes like “Morning Stretch,” which regularly attracts 500–600 participants.

OATS doesn’t charge for classes to remove financial barriers and ensure inclusivity.

Their model includes licensing curriculum to local organizations for broader reach and sustainability.

The biggest myth about older adults and tech is that they can’t learn. It’s more about opportunity than ability.

Social connection is often the top reason people join Senior Planet, with digital tools helping them stay in touch.

OATS’s design philosophy includes building beautiful, functional spaces that reflect the dignity and potential of older adults.

AI and smart home tech are reshaping how older adults live and age, but safety, access, and education are key challenges.

 

QUOTES

“I realized that I really enjoyed taking care of older people for a series of reasons. One was you couldn’t really take care of the part without thinking about the whole.” (Dr. Aronson)

“I came up with this notion of elderhood as a sort of equivalence to childhood and adulthood. And I thought that was a reframe that might be helpful for us both as individuals and as a society.” (Dr. Aronson)

“It’s insulting. And when you see this in scientific studies, it absolutely lacks rigor, any evidence of truthfulness, and yet people do it all the time.” (Dr. Aronson)

“We harm our future selves because we create a self-creating, self-perpetuating fear.” (Dr. Aronson)

“It’s the only stage of life where people apologize all the time for existing, for not being able to do things.” (Dr. Aronson)

“Traits we all should have, but not all of us are lucky enough to get it. A sense of humor helps. So really basic things, because it’s very interesting.” (Dr. Aronson)

“There is just a baked-in bias that the people who need the services most are least important.” (Dr. Aronson)

“They blame old age for what was a failure to incorporate aging pharmacology and physiology into their treatment plan.” (Dr. Aronson)

“Training for all health professionals would be proportional to the amount of time they will be spending caring for that population.” (Dr. Aronson)

“Our system doesn’t give us what we want and needs to be totally restructured to prioritize health.” (Dr. Aronson)

NOTES

Dr. Louise Aronson is a geriatrician, educator, and bestselling author of Elderhood. A leading voice in redefining how we view aging, she brings decades of medical practice, personal insight, and cultural critique to her advocacy for older adults.

 Dr. Aronson is a professor of medicine at the University of California, San Francisco (UCSF), where she also directs the campus-wide Health Humanities Initiative. Her work integrates clinical care, education, and the humanities to advance eldercare.

Her book Elderhood reframes aging as a vital, complex life stage deserving the same recognition and nuance we give childhood and adulthood. She’s a thought leader on ageism in medicine and society, and frequently collaborates on innovations in intergenerational programs, healthcare reform, and policy.

Most people don’t plan to work with older adults—but it’s meaningful, intellectually rich, and deeply needed work.

The term “elderhood” positions aging as a legitimate, diverse, and multi-decade stage of life, much like childhood or adulthood.

Society often equates aging with decline, but many older adults thrive by adapting, staying engaged, and embracing their phase of life.

There’s a dangerous tendency to treat everyone over 65 as a monolith, despite the vast range of capabilities and needs.

Health care training devotes years to children and adults, but often just hours to older adults—despite them being the largest group needing care.

Ageism in medicine shows up in subtle and overt ways—from dismissive language to inappropriate treatments based solely on age.

Culture needs to stop writing off older adults; their stories, capabilities, and lives matter and should be reflected in how we design systems and spaces.

Dr. Aronson sees hope in younger generations and entrepreneurs bringing compassion and innovation into the “elder space,” as well as boomers advocating for their own aging experience.

QUOTES

“The one thing 80-year-olds and 20-year-olds have in common is none of them have cars.” (Andrew)

“They do not want to live on what I call an elderly island. It doesn’t matter how nice it is.” (Andrew)

“Done right, it’s what I call a very rare triple win scenario. You don’t see this in business strategy where there are three parties and all of them can win.” (Andrew)

“We need to stop building what we want to build. We need to start building what our retirees actually want.” (Andrew)

“If one out of every 10 residents is wearing the sweatshirt and screaming at the TV in the pub on Saturdays, that’s going to bring the culture.” (Andrew)

“You can’t find a bigger odd couple than universities and senior living providers. They speak two completely different languages.” (Andrew)

“This is not something that just sounds like fun. It’s hard work, and you need to do your homework.” (Andrew)

“Look, we just want more than ‘it’s not a nursing home.’ That was actually fine when really the only other choice was a nursing home. And we had millions of seniors who lived in a nursing home who did not need to be there… but we need to take that next step now.” (Andrew) 

“This whole website is actually my retirement hobby. I started it the first day of my retirement.” (Andrew)

“If you’re not happy with the status quo, go to work for somebody who also isn’t happy with the status quo.” (Andrew)

“If you take them off an elderly island and put them in an intergenerational environment like a college campus, they’re going to be better.”

NOTES

Andrew Carle is a nationally recognized expert in senior living innovation and the founder of UniversityRetirementCommunities.com. He also developed the first academic concentration in senior living administration at George Mason University and now teaches at Georgetown University.

UniversityRetirementCommunities.com is the go-to resource for information on communities that blend lifelong learning with senior living. The site features nearly 90 communities nationwide and serves as a hub for universities, providers, and older adults exploring this innovative model.

Andrew has over three decades of experience as a senior living executive, educator, and consultant. He’s helped shape the university retirement community model, creating a five-point framework that many of today’s most successful communities follow. His retirement “hobby” is helping others launch URCs the right way—by fostering strategic partnerships and prioritizing campus integration.

The best university retirement communities (URCs) combine proximity to campus, structured intergenerational programming, full continuum of care, shared financial interest, and a strong alumni or cultural connection.

Proximity to campus is crucial to keep residents integrated into university life. Said Andrew, “The one thing 80-year-olds and 20-year-olds have in common is none of them have cars.” 

Organic beginnings often inspired URCs, but today they benefit from structured planning and dedicated leadership—like a “dean of residence” to manage university relationships.

“They want active, intellectually stimulating, and intergenerational retirement environments. I just described a college campus.” Boomers are seeking more than traditional senior living options.

Andrew believes URCs might not just promote better aging—they might actually reverse elements of aging by tapping into what he calls the “counterclockwise bump.”

“We invented 32 flavors of ice cream. We’re not going to settle for vanilla,” said Andrew. The industry must cater to diverse interests and identities within the boomer generation.

URCs are thriving because they’re giving retirees exactly what they want. “Howard Schultz said, you know what? People will pay $4 for a cup of coffee,” said Andrew. “You just have to stop making crappy coffee and give people what they want.” 

Successful URCs require university buy-in, but many institutions underestimate the complexity. Andrew stresses: “Educate the educators.”

 

QUOTES

“Senior living pretty much was a watered-down version of a hospital. Nobody had a choice as to when they got up or what they ate. The biggest change has been around person-directed care.” (Larry)

“When I arrived at UMC, we didn’t even own a server. We really did start from the ground up.” (Larry)

“Once the staff really got a taste of how it could impact their quality of life as caregivers, it became self-fulfilling. They became owners and advocates.” (Larry)

“AI is really the wave of the future. If we don’t jump on board at the beginning, we’re going to get left at the curb.” (Larry)

“It’s just not normal to live with 25 other strangers in a locked ward. That’s what pushed us to create something different with Avandell.” (Larry)

“Most places are treating the symptoms of dementia, not the distress that’s causing the symptoms.” (Larry)

“Pain is the number one thing that is underdiagnosed in people who have dementia. Sometimes a Tylenol once a day can change everything.” (Larry)

“Our mantra at UMC was always: Know thy resident.” (Larry)

“We want to live the life we love, or love the life we live. That goes for residents and their families.” (Larry)

“Dealing with dementia is not a hopeless situation. There can be joy in it.” (Larry)

“Don’t be so afraid. Keep moving ahead. Try things. Fail quickly. Move on.” (Larry)

NOTES

Larry Carlson is the retired president and CEO of United Methodist Communities, bringing more than 45 years of leadership and innovation to the senior living industry. During his tenure, he championed tech integration, person-directed care, and a more humane approach to dementia support.

United Methodist Communities (UMC) is a New Jersey-based senior living organization offering independent living, assisted living, memory support, and skilled nursing. UMC is known for its values-based approach and commitment to enhancing the lives of older adults through innovation and compassionate care.

Under Larry’s leadership, UMC built a tech infrastructure from scratch, implemented AI tools in operations and HR, and reimagined memory care through Avandell, a dementia village inspired by the Dutch Hogeweyk model. His book, Avandell: Reimagining the Dementia Experience, reflects his commitment to transforming the narrative around aging and dementia care.

The industry has shifted from institutional care to person-directed care, with more choice, autonomy, and respect for individual preferences.

Technology transformed UMC from the ground up, enabling faster, smarter processes across departments—from admissions to HR onboarding.

AI was a game-changer, reducing administrative tasks and freeing up staff to focus on what matters most: resident experience.

Carlson advocated for failing fast and learning quickly, pushing senior living to be more innovative and less risk-averse.

The creation of Avandell was a response to institutional dementia care models, aiming to normalize life for residents through smaller households and daily autonomy.

Treating the source of distress, not just symptoms, became central to UMC’s dementia care philosophy.

Indoor air quality is a critical but often overlooked element of resident wellness, especially in light of the pandemic.

Virtual family meetings during COVID revealed new ways to strengthen communication, with higher participation and improved transparency.

QUOTES

“You’re only as young as your spine is flexible.” (Terry)

“When you start to avoid activities, your body kind of goes along with it and stops working in a youthful way.” (Terry)

“I’m on the tracks, off the tracks, and I think that’s real for most people.” (Terry)

“I have to remember that I’m not as young on the outside as I feel on the inside.” (Terry)

“I’d much rather age naturally. And yeah, it’s no fun, but I’m not alone in it.” (Terry)

“Enjoy each phase you’re in because movies and television are telling us stories about life, and it requires all age groups to tell these stories.” (Terry)

“We all have value. And that’s what you need to focus on—your own value.” (Terry)

“I’m enough. I’m whole just the way I am. I can stop being a chameleon.” (Terry)

NOTES

Terry Farrell is an actress best known for her role as Jadzia Dax on Star Trek: Deep Space Nine and as Reggie on Becker. A former model turned sci-fi icon, Terry is also an advocate for self-acceptance, aging authentically, and embracing life’s many chapters.

After stepping away from acting to be a full-time mom, Terry is re-entering the entertainment world with a renewed sense of purpose and personal authenticity. She lives in New Mexico and hopes to pursue meaningful roles that reflect who she is today—whether in television, film, or even on stage.

Terry credits yoga and movement as essential for both mental and physical wellness as we age.

Terry embraces aging naturally, resisting industry pressure to look younger through surgery or cosmetic alterations.

After a long break to raise her son, Terry is re-entering the entertainment industry with new priorities, looking for roles that reflect her true age and life stage.

Terry believes culture is evolving and there are more opportunities now for actors of all ages, thanks in part to movements like #MeToo and greater diversity in storytelling.

Terry reflects on her modeling and early acting days, acknowledging the harmful body image pressures she endured and how she’s worked to let those go.

She finds encouragement seeing actresses her age on screen and admires projects that show women aging authentically, like Capote vs. The Swans.

Sci-fi storytelling, particularly Star Trek, helped Terry explore and embody themes of longevity, identity, and empathy, both on and off screen.

QUOTES

“A man’s got to know his limitations. And I knew that it would have made for a great story. But I was happiest in consulting, where I’ve been for 35 years.” (Scott)

“If you think about the organizations that have gotten themselves into trouble in our field, it’s usually because all three—strategy, vision, and innovation—have not occurred.” (Scott)

“When a CEO says to me, ‘I’m really not that good at vision or I’m uncomfortable with it,’ that’s when it can be addressed. It’s when they don’t that you end up in a situation where one, two, or all three are missing.” (Scott)

“Innovation isn’t just people sitting around thinking about cool stuff. It could happen, but it really takes work.” (Scott)

“If you look at the number of villages that have developed over the last 15 and 20 years, it’s phenomenal. But if you look at the business model, in a very rare instance, it doesn’t succeed without fundraising donations. So the business model is flawed.” (Scott)

“When I tell you that people hate nursing homes, I’m not exaggerating. If you get a group of new nursing home administrators in a room and you ask them about the potential for them to end up in a nursing home, most of them will say, ‘I’d rather be dead.’” (Scott)

“Most of the nursing home beds in the United States, including in the not-for-profit sector, are semi-private. That’s a euphemism—because there’s really nothing private about them. It’s inhuman. And actually, there’s a difference between inhuman and inhumane. It’s both.” (Scott)

“We have to focus because this is a heavy lift—societally a heavy lift—but it’s also a huge opportunity. If we don’t do these things, if we don’t focus, it’s the for-profit sector that’s going to take it away.” (Scott)

“The nonprofit governance model is a failed model because board members don’t ask tough questions. When you talk to them, it’s clear they’re critical thinkers in their profession, but when they get into the boardroom, that willingness disappears.” (Scott)

“You want to be ageist around a baby boomer? You’re going to pay the price.” (Scott)

“We should stop feeling the necessity to invent and instead look around. Take something that’s already there and figure out how to scale it.” (Scott)

“If I had to talk to my younger self, I’d say, ‘Get to know yourself, Scott. Don’t spend so much time trying to achieve. Spend some time trying to understand you, because then you might achieve more.’” (Scott)

NOTES

Scott Townsley is a senior living strategist and consultant with over 35 years of experience helping organizations navigate challenges and embrace innovation. A former attorney and long-time industry leader, he founded Third Age, was a partner at Clifton Larson Allen, and now serves as Senior Advisor to Trilogy Consulting.

Trilogy Consulting provides strategic guidance to nonprofit senior living organizations, focusing on vision, strategy, and innovation. The firm helps organizations adapt to industry shifts, rethink traditional models, and implement forward-thinking solutions to better serve aging populations. Trilogy Connect, a related initiative, fosters collaboration and knowledge-sharing among senior living leaders.

Trilogy emphasizes the intersection of strategy, vision, and innovation, noting that organizations that fail to integrate all three often struggle.

Scott began his career as a dishwasher in a senior living community, later becoming its general counsel and ultimately being offered the CEO position.

Lack of vision and innovation hinders the senior living industry. Many organizations operate on outdated models without adapting to changing demographics and consumer expectations, leading to financial and operational challenges.

Innovation requires commitment, not just ideas. True innovation isn’t just about brainstorming new concepts—it requires structure, investment, and a willingness to rethink outdated business models.

The nonprofit governance model is failing. Board members often avoid asking tough questions, which weakens decision-making. Compensation for board members could create a stronger sense of responsibility and accountability.

People hate nursing homes. Research shows that public perception of nursing homes is overwhelmingly negative, and even industry professionals often say they would rather die than live in one.

Semi-private nursing home rooms are inhumane. The standard practice of placing two, three, or even four people in a room is outdated and unacceptable. Small-house models like Green House have addressed this issue, but widespread adoption has been slow due to myths about financial feasibility.

Age-in-place programs need better messaging. Many Continuing Care at Home (CCaH) programs market themselves like long-term care insurance, which is a turnoff to consumers. Instead, they should emphasize their ability to keep people out of nursing homes.

The nonprofit senior living sector is losing ground to for-profit operators. If nonprofit organizations don’t adapt, they risk becoming irrelevant as for-profit providers scale faster and respond more aggressively to market demands.

The industry underutilizes data. Senior living communities could benefit from predictive modeling to anticipate residents’ needs, yet the sector remains far behind in leveraging data for proactive decision-making.

QUOTES

“Most people fell into these occupations. And once they started working in them, they discovered that they loved them.”  (Dr. Stone) 

“If we don’t invest in people, we are not going to get to the quality outcomes that we talk about.”  (Dr. Stone) 

“The best recruitment strategy is to retain, because the more that you retain your staff, the less you have to recruit.”  (Dr. Stone) 

“Technology hasn’t yet had a meaningful impact on frontline workforce challenges. We need to be more intentional about how we use it to support, not replace, the people doing the work.”  (Dr. Stone) 

“Taking the keys away from an older adult is one of the most disempowering things you can do. If self-driving cars can provide mobility while ensuring safety, I’m all for it.”  (Dr. Stone) 

“We’ve made strides in gerontology, but ageism and structural inequities still make it hard to attract people to the field.”  (Dr. Stone) 

“We are a muddling-through society. We inch forward incrementally, but we do eventually get there.”  (Dr. Stone) 

“We still have most people who think that Medicare covers long-term care. After 50 years in this field, that misconception still persists.”  (Dr. Stone) 

“I believe in public-private partnerships. The federal government should play a role in financing long-term care, but we also need private sector innovation.”  (Dr. Stone) 

“I have learned that change takes a long time and that it is more of a journey than a destination.”  (Dr. Stone) 

“On my best days, I remind myself: keep your eye on the prize. It’s easy to get discouraged, but progress is always happening, even if slowly.”  (Dr. Stone) 

NOTES

Dr. Robyn Stone is a nationally recognized expert in aging policy and long-term care. As Senior Vice President of Research at LeadingAge and Co-Director of the LeadingAge LTSS Center, she has dedicated her career to improving services, research, and policy that support older adults, particularly those with lower incomes.

LeadingAge is a nonprofit organization dedicated to advancing policies, practices, and research that support aging services. Through the LTSS Center, LeadingAge bridges the gap between policy, research, and real-world implementation to improve care quality, workforce development, and access to affordable housing for older adults.

Dr. Stone has spent 50 years in the field of aging, working in federal policy, nonprofit leadership, and research. She served in the Clinton administration’s health care reform task force and was part of the Pepper Commission, which explored long-term care financing solutions in 1989.

Her expertise spans workforce challenges, age-friendly communities, policy reform, and applied research to improve care models for older adults.

Aging services is often an “accidental career,” but once people enter the field, they realize they love it. Dr. Stone has spent her career trying to make it a more intentional professional path rather than something people stumble into.

The long-term care workforce crisis is fueled by low wages, structural inequities, and a lack of investment. Many direct-care workers are underpaid and undervalued, despite making up 60-80% of hands-on care. Increasing wages, training, and career pathways is critical to retention.

Technology in aging services hasn’t yet had a major impact on workforce issues. While electronic health records and digital tools help, most technology hasn’t reached frontline caregivers. The real opportunity is designing tech that supports workers rather than replacing them.

Many people still believe Medicare covers long-term care—when it doesn’t. Public understanding of long-term services and supports (LTSS) remains poor, leaving families unprepared. Dr. Stone advocates for better consumer education and policies that make care more affordable.

Self-driving cars could be a game-changer for older adults. Losing the ability to drive is disempowering, and if autonomous vehicles can restore independence while ensuring safety, they could be transformational for aging populations.

The U.S. is still catching up to other countries in how it plans for aging populations. Countries like Singapore and Denmark integrate aging into urban planning, creating built environments that support aging in place. The U.S. has opportunities to learn from these models.

COVID revealed the essential role of long-term care workers but hasn’t led to enough lasting change. While pandemic funding led to temporary workforce investments, sustaining higher wages and better career paths will require long-term policy shifts.

Change in aging policy takes time—but it happens. Dr. Stone sees progress in workforce recognition, gerontology as a field, and culture change in residential care. While she calls herself a “pessimistic optimist,” she believes incremental change leads to lasting impact.