Download - LeadingAge NY 2015 What’s Next?

LeadingAge NY 5/19/15

Richard Rosen | Valerie Mutterperl [email protected] 1

What’s Next?Richard S. Rosen, AIA LEED APPrincipal

Valerie B. Mutterperl, AIASenior Associate

May 19, 2015

LeadingAge NY 2015

Evolving Pattern 1: Health Market Segments

“Boomers” will have health issues and experience the need for care and assistance

At the same time many aspects of health, or the health of many, are likely to be better than in the past

But they (we) WILL age



Evolving Pattern 2: Shift in Where and How Support is Delivered

Access to medical capabilities and information is greatly increased

Continued confluence of events that will result in alternative delivery models and movement away from institutional settings

Increased integration of management/care across settings and time —“Management” is the keystone

Emerging Pattern 3: Businesses that Respond to the Eternal Wish, “I want to stay in my own home,” Will Thrive Increased growth in and efforts

to sell consumers devices that allow aging-in-place

Continued demand for and growth in services and products that facilitate wellness and mobility



Integrating the Needs and Desires

What is Home?

Desire to reduce maintenance

Desire to downsize

Desire for control and autonomy

Where I know my community (bakery, grocery, etc.)

Desire for safety

Emerging Pattern 4: The Divide Deepens

Health, technology access and use, fitness, nutrition are all age and income related

Most data pointing to a deepening divide of rich and poor

Future impact of government debt?

Inflation, housing values, interest rates, shifting the rules of 401(k)s, understanding fees



Emerging Patterns 4, 5, and 6:

Observation of growing interest in “community” and models that support it: Villages, Co-Housing, CCRCs

Sharing Rather Than Owning:

Millenials are setting the example

Economic times = only one driver of this trend

Not just things, also one’s skills?

Experience vs. Things: Always Existed Among Older Adults?

Product Observations from the Field

Assisted Living and Memory Care:

Most of the growth

But there are some undercurrents

Home Care

Increased start-ups by CCRCs

Challenges remain

On campus

Crossing the threshold

Ongoing interest in CCRCs – but still a limited market, risk, high danger under some scenarios



If I Were Queen Of A Forest My Forest Would Have:

Home Care (across the threshold)

Care management, concierge

Housing:

Smaller blocks that fit into most neighborhoods

Not necessarily age restricted

Age defiant residences

Identify NORCs and Emerging NORCs

Consumer communications tools

Key Concepts for the Future

Smaller

Neighborhood integrated

Autonomy for constituents but key support over time

Eliminate “packages” because the average shoe fits no-one

Separate housing from services

Because we can — tools never before available

Because we must — economic times, growing demands, what we can afford, mission



How Much Market Are We Leaving On The Table?

Or who are we failing to serve?

The Challenges – Home Care

Making the leap off-campus

Mass to support infrastructure

Technology

Management

Added offerings

Staffing, wages, consequent fees

Commitment

The Leader, The Will

Resources



The Challenges – Housing

HOUSING YOU OWN AND CONTROL

Understanding essential elements to include

Controlling price, value

Location

NORCS AND OTHER DENSE SETTINGS

No point of control: individuals’ decision

The market, sales, communications

The Challenges: Assessment, Care Management

Structure:

Membership Fee? Fee-for-Service?

Characteristics, what is included, gaining acceptance

Establishing high quality, successful plans and outcomes



Three Business Lines –Alone or Forming One Structure

Key components for the future

Each is showing up as critical components on many CCRC campuses

Assessments assure appropriate services to residents, reduce re-hospitalization even when home care and other services are contracted

How to move them over the threshold?

The Age Wave

Sea Changes

Demographic

Political

Medical

Technological

Societal



Stock market plunge/recession (2008)

In 2014, we asked 200 industry leaders across the country…



Time machine to the future…

Sea Changes | Demographic

Biomedical breakthroughs and advances in disease prevention continue to decrease mortality rates.

2015Major numerical increases in the 85+ world population growth is in countries such as China and India.

2020

The 85+ US population spirals from 3.3 million in 1990 to 23.3 million in 2020, representing an over 600% increase in this vulnerable age group.

2025Japan experiences a 274 percent increase in the 80+ populationbetween 1990 and 2025.

2035Oldest living person celebrates 140th birthday!



Sea Changes | Political

World sees “Third Age Party” established.

2015Republican party splintered-in-half due to infighting regarding social security benefits between the young and the old.

2020State retirement age revised to 75 years in Europe, and Japan.

2025America’s second woman president, Chelsea Clinton,takes the oath.

2035 International “Junger Party” born.

Sea Changes | Medical

Scientists discover means to “Switch off Alzheimer’s gene” -Alzheimer’s disease gene therapy begins. Cancer and AIDS follow.

2015Home testing kits for Alzheimer’s gene fly off of the pharmacy shelves.

2020

Incidence of other conditions such as arthritis and heart disease radically evaporate as Medical/DNA research finally conquers key causes of death in older persons.

2025Special care units occupancy levels plummet.

2035 Life expectancy rises to 150 years+.



Sea Changes | Technological

Bill & Melinda Gates Foundation and Apple/Jobs Foundation fund research for creation of the first “I-Care.”

2015Apple iGlasses provide wearer with streaming data from medication reminders to facial recognition and names.

202030% of single women over the age of 85 have a robotic cat, named Robokoneko.

2025Apple’s iTechnology group beta tests wearable biometric screening called iT Depends.

2035I-CARE Robotics becomes standard feature in new homes… and cars.

Sea Changes | Social

Age segregation declared unconstitutional by Supreme Court.

2015Older consumers resent concept of age segregated housing as an environment of choice.

2020Former Assisted Living communities open doors to all generations requiring care and support.

2025 TIME magazine declares “Is Retirement Dead?”

2035CCRCs demolished under new Federal program called 2-old for you-2.



1985

To put this in perspective: 28 years ago:

Calculators cost $200

There was no global internet.

There were no cell phones.

The first laptop computers had just been introduced.

The most powerful personal computer available was less powerful than your current cell phone.

Compact discs had been developed, but were still several years from mass production; vinyl records were still the dominant form of musical distribution.

Cordless telephones were novel, as were answering machines, and microwave ovens.

How do we look for early predictors of change?



Shift from total control to partnering

Shift from things to experiences



The marketplace wants to stay at home… however they define it.

Aging in Place | Unit Design

medicine cabinet location for access/light

emergency outlet for medical equipment

sheltered balcony

second bedroom option for caregiver

drawer dishwasher

doors swing out for safety

w/d shelving

transfer tub/shower

side-by-side refrigerator

full height “easy reach” pantry cabinet

electric oven with front controls

shower stall with space for portable shower chair

hand held shower wand

“easy reach” linen closet

large windows, low sills

bedroom large enough for two single bed option

Apartment for Life



The Fully Integrated Home

The Fully Integrated Home

Multi-Tasking Countertops

Smart Windows



Accommodating Lifelong Living

Adapt environment to user by moving traditionally fixed items

Maximize individual’s independent performance of daily tasks

Pressalit

Specialized Dementia Design for Cognition

House for Betty®



Demand for existing products will decline as we offer more options and services.

Incremental Re-invention

U.S. Dept. of Veterans AffairsDanville, IL



Rehabilitation and/or Palliative Careis the Focus on Long Term Care

Moorings Park | Wellness Center

Senior consumers will demand the best service and value… whoever provides it.



Leverage CCRC Resources by “Hosting”

C.C. Young: The Point, Center for Arts & Education | Dallas, TX

Leverage Resources | Inviting Broader Community In

Fairhaven Retirement Community | Sykesville, MD Cumberland Woods Village | McCandless, PA



Leverage Resources | Partner or Integrate with Non-Senior Providers

NCPH CCRC | Foster City, CA

Age-Friendly Community | Retail Integration

Crystal Springs Community | Annapolis, MD



Accountable Healthcare

Seniors will expect a continuity of lifestyle.



Choices

Great Room



Lifestyle Homes

Exercise and Yoga Sports and Entertainment Messy Painter

Cou

rtes

y of

Nat

iona

l Sen

ior

Leag

ue.

Culture/Lifestyle Targeted

Lifestyle driven with shared values and experiences

Family may not be support structure

Niche markets

RainbowVision Santa FeSanta Fe, NM

Diversity of Models | Lifestyle Choices



Retiring with friends

Small scale, “in” community

Self-planned and designed

Community reliance for services

Westwood Cohousing, Asheville NC

Harmony Village Cohousing, Golden CO

Diversity of Models | Co-housing

Wild Sage Cohousing, Boulder CO Silver Sage Cohousing, Boulder CO

Villa Buildings

10-12 units / building with parking below

All corner units (4/floor)

Attempts to appeal to cottage customer where density is an issue

Product variety

NewBridge on the CharlesDedham, MA

Diversity of Models | Product Options



What could the futurelook like?

Natural Outback Community sponsored by:

Phoenix University

Dr. Scholl’s & Birkenstock

Apple Computer

The Jerry Garcia Foundation



Our business affiliates Harvard and New York University offer:

Online MBAs… in just 6 weeks

Chess masters

Film-making… you can be the star

Bring back the Dead: Holographic concert

headlined by The Grateful Dead and a reunited virtual Beatles

Intergenerational activities: Recreational storytelling Monthly show and tell days

in various languagesOur grass is greener and we smoke it!



Local native extremist, Ted Nugent, educates you in organic and extreme outback living: Family time - Grow your

own food Join in extreme sports in a

virtual environment Relax with yoga and

meditation, and herbal treatments

Enjoy our multiple locations:

Enjoy the natural luxuries of the fully equipped human habitat biosphere with rainforest, desert, ocean, marsh, and agriculture biomes

High tech vs. low tech living all in one

City Center

Or timeshare them all!



Enjoy our travel partners:

Leave the driving to us

Have your own “cyclopod” and get urban street cred

Enjoy our cloud culture with digital translator connecting people to dialogue, deals and distribution.



Our business partners eBay, Fortune and CraigsList can provide a virtual work environment to stay connected and work for those who can’t find their nest egg.

San Diego Zoo (we let the dolphins go home!)Former World Expo, Shanghai, China

65-72 floors of Freedom Tower, NYCFormer Hyatt Regency, Atlanta, GA… see a vertical farm in the atrium

Visit our locations:



Community Restaurant

CommunityCultural Center

SeniorCenter

MuseumWith Café

SeniorHousing

Ground Floor PACE and

Small HouseSatellite College

Multi-family Housing Above

CommunityHealthClinic

And visit www.neverthatold.org for our newest community in development.



We don’t have to do it alone

We can leave a smaller footprint

We can make a difference in new and unlikely ways

We can have a broader appeal

It can be fun



Thank You

Download - LeadingAge NY 2015 What’s Next?

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