Recent activity on the Crossroads discussion board show that senior centers have a much more expansive role than many think. What will the role be when real Aging in Place/Community becomes the norm for housing and care?

My Aging in Place definition:

Aging in Place is more desirable housing and care using design, tools and technologies through a comprehensive and dynamic management system integrating all resources more efficiently for the lifestyle and dignity of older citizens in the home of their choice.

I believe senior centers will be significant, playing a more comprehensive role with mandates and expectations for tracking and managing seniors and resources in the community. The idea of a passive activity center will be over. The elements of a senior center of the future are:

• Socialization
• Recreation
• Activity organizing
• Wellness- education, training, testing and tracking
• Nutrition - education, training, testing and tracking
• PT, OT and delivery of other care
• General tracking of condition- awareness based on neighborhood familiarity
• Tele-health hub- This is the most significant change and role. Care managers working in the community (in the senior center!) will monitor routines and changes in older households throughout the community through sensors and links in homes. They will be empowered to dispatch services as needed.

The more significant piece will be leveraging the system devised to manage resources to be pro-active. Only when we use our systems and technologies to reduce risk, avoid accidents and prevent acute care episodes will we reap the potential savings and increases in health and well being that Aging in Place promises. Models are available from places like England where health management is a community issue, monitoring centers are civic activities and health savings are public responsibility.

Are you ready? My bet is that senior center advocates and staffers are ready and willing to take on this significant role in the way we care for and treat our older citizens. Change is in the wind. Bring it ON!

With Earth Day coming up April 22nd, now is a good time to share a lesson from a marketing seminar I went to once. It was "The best time to plant a tree is ten years ago. The next best time is tomorrow morning."  This is not an uncommon lesson: "The early bird gets the worm," "never put off 'til tomorrow what you can do today," etc. The point is not to leave things until the last moment.

This is a particularly good lesson in preparing your home for Aging in Place, because waiting until the last moment pretty much never works.  Worse, waiting is common practice. For whatever reasons....inertia, lack of motivation, plain old procrastination, fear of contractors, unfamiliar processes, unclear images of what it means, a positive sense that it is never going to be me, inability to agree on a course of action, the creeping nature of aging or even denial, VERY few folks who say they want to Age in Place actually prepare for it.

Why is it so particularly bad to wait to prepare your house for Aging in Place? Because the time frame and emotions of health crisis are a lousy match for the home remodeling process. Preparing a home to Age in Place is a specialized part of remodeling called "home modifications." All remodeling is a sometimes anxious process that does not always go well. Remodeling has a bad reputation. It is not the dishonesty depicted in the movie Tin Men. Most remodelers I know have good hearts and intend to please. They also have skills, knowledge and perseverance.

The process of remodeling requires many decisions and a great deal of communication. Contractor types speak a language and understand a process often unfamiliar to clients. Their skills and knowledge are deep in their field. They may not have the skills to communicate clearly to clients. Too often, a mismatch exists between what the contractor plans to do and the client's expectations. In many jobs that go bad, the contractor does what he starts out thinking he is contracted to do and does it well. The problem is the client somehow expected something different. Neither is intentionally at fault, there is just a piece missing. Good communication.

Remodeling is best when all decisions, all costs, all expectations and schedules are known well before the construction begins. Decisions and planning are a significant part of the remodeling process because every home is different, and every client is different.

Sometimes "a client" is of mixed minds. For example, a couple may have different ideas about what is needed, what should be spent, what they like about the home or what they hate about it already. Their aesthetic likes and dislikes may be different as well. Compare this to buying a product that is manufactured. The manufacturer makes all the decisions and puts it into the marketplace. If the company has done its research, the product meets sufficient interest to be successful. With home remodeling, all the decisions are indiviudalized based on needs, priorities, interests, likes, dislikes and budget.

Now imagine the design professional or contractor working with a family enduring a health crisis. Emotions are on edge. Prognosis is unknown. Timeframes and budgets are up in the air. Everyone who should be involved in the decisions may not be available, and even if available, may not have the presence of mind for the meetings and decisions. Couple this emotionally challenging time with the myriad decisions about what to pick and what to do, and then overlay that with drawings, permits, materials, sub contractors and mess, and you get a situation that is almost impossible or destined for disaster. 

I hope this helps you understand why this blog (and my attention) is so focused on influencing folks to plan and prepare before health crisis. What can we do to move the trigger forward?

More specifically, How can this partnership - between me and you at the senior centers who know the clients and have their ear...influence more people to plan?

We are not trying to pull the wool over their eyes or make them buy a product they do not need or want. We are trying to help them get what they want - the chance to age in the home of their choice with dignity. Let's do it together. If they don't plant the tree today, they may not get the chance!     

This blog is about moving to action regarding Aging in Place. The blog is located on a senior center forum.  The obvious first questions are these:

• How do senior centers influence their participants’ behavior?
• And can senior centers encourage clients who want to Age in Place to plan changes to their homes? 

They helped me see that to inspire seniors to act, these factors are important:

1.  Educate. Both centers have lots of informational programming. We can call this education. People want to know, and the senior center makes information available. The centers offer wide range of topics including finance, insurance, and long-term care. There is also art, travel, news, politics, history. Engaged, active people come there to learn - and aging in place can be one of the topics.

2.  Repeat the message so it sinks in. Do you wonder why advertisers play the same commercial so many times in one show? It works. We are more likely to consider, commit, act when we hear basically the same message more than once or even more than a couple times. Advertisers use the same commercial repeatedly, because the imprinting occurs from the repetition. If the message varies too much, then the impact is reduced.

3.  Repeat in multiple formats. There are many types of learners. Some like to hear, some like to see, etc.  Here are two examples.

• I have been taking yoga class for close to 30 years with the same teacher. I love him. He is very clear, and often says the same words many times just the same. Then occasionally I have a different teacher, and something I did not know was unclear becomes different and very clear.
• I cannot read instructions in advance of needing to use them. They pass right through. There are so many ways to present and to say something. When you want everyone to get it, vary the format.
  

This is different from the advice to repeat, above. To get your participants thinking about home modifications, do both!

4.   Facilitate. Make It Easy to Get Started. You will get better results if you provide more than information. Helen thinks barriers to action are inertia, economics and routine. That dovetails with Lorraine’s recognition that facilitating helps people get started. Making things easy gets people past routine and maybe seeing the benefits instead of the cost.         

Exercise is a good example. Tell people to do it, and give them an instructional flyer – or provide the time, space and leader - which works best? Providing the classes works best.

Health matters like screening and flu shots are similar. When readily available, people go for them. Put the research, organizing, and travel on the individual, though, and participation drops like a stone.

The same may be true for home modifications. If senior centers engage patient and knowledgeable facilitators, coaches, and advisors to meet with folks to plan and help oversee their modifications, will more people take the step?