Addie Abushousheh, PhD, executive director of the Association of Households International (AHHI), is an independent consultant and researcher who specializes in senior living environments. Many in the long-term care (LTC) industry know her from her work with Society for the Advancement of Gerontological Environments (SAGE). She recently stepped down as the organization’s treasurer to focus on completing SAGE PLACE (Programming for Living and Achieving Culture Change Environments), a program that helps LTC organizations work through any challenges in their operations, policies, procedures and staffing patterns before they lock themselves into a building design.
Never one to sit still for long, Abushousheh has studied architecture, organizational development, gerontology, research, mediation negotiation and non-profit management. She also has just started her nursing home administrator’s license internship. She says one of the main reasons her life has followed this particular path is the close relationship she had with her best friend—her grandmother. Abushousheh recently shared her thoughts on the current trends in senior living design with Long-Term Living.
TELL US A BIT ABOUT YOURSELF.
One of the reasons that I have taken this particular slant is how close I was with my grandmother. She was my best friend, and I got to live in a nursing home with her for a month. I still stay in nursing homes as much as possible, because there is no better way to learn than fully and completely immersing yourself in the experience. In fact, a lot of people advocate for that now.
I try to base my decisions or establish my evidence base on consumer or stakeholder priorities. I look to the people who are perceived of as doing the best of the best to inform what I’ve put out there for others to digest.
WHAT EVOLUTIONS ARE YOU SEEING IN SENIOR ENVIRONMENTS?
Right now, because of the regulatory climate surrounding skilled nursing and assisted living, what I’m seeing is that the folks who would have years ago lived in skilled nursing are now living in assisted living. This is not necessarily new to the industry, and it has been widely acknowledged. The thing is that we have a lot of leeway and leverage to able to respond to consumer-driven priorities, and I think we’re limiting ourselves right now. I think before we’re locked into a regulatory stronghold in assisted living, we really need to do some digging and take the deep dive into what the priorities will be for people who are going to living in these environments 20 or 30 years from now.
Philosophically, I think we need to stop thinking of people living in these environments as “them,” because honestly it’s our future selves. We are them. And I would advocate starting to have conversations that involve more people. Go into the community that’s surrounding the organization, go into the community within the organization, and involve the least likely characters, such as facilities folks, people who are providing transportation to the assisted living organization, not-for-profits in the area and educational institutions. All of these folks represent potentially really good ties to be made. I don’t think we’re fully capitalizing on that.
We are still seeing new communities of care being built out in the middle of nowhere. And in terms of the upcoming priorities of the Baby Boom population, they don’t really want to be planted out in a cornfield. There’s a real desire to stay involved, engaged and have naturally occurring amenities that downtowns and city centers provide.
Cities have naturally occurring opportunities for intergenerational connections. I don’t see any reason why we should be segregating people of a particular age or ability. We should be accommodating them in their abilities and providing as much opportunity for facilitation and self-sufficiency as possible, and I don’t think that that means you have to take them away from everyone else. I, personally, don’t want that.
WHAT'S HOT IN CCRC DESIGN?
One of the things I was most impressed by recently was a continuing care retirement campus [that] decided to build a full-on community wellness center. It was like the combination of Gold’s Gym with a holistic wellness center. It was someplace that definitely would have been a draw from a social interaction perspective. And that I thought was pretty cool, because that seems like a way for communities to use what they have available to them in terms of their land and their programming as a way to draw people from the surrounding community in, and to draw people from within their own community out.
A lot of things are taking place outside the arena of traditional continuing care that have been gaining more traction. People are creating alternatives if they’re not satisfied with the current selection. So we’re seeing co-housing and co-op and intergenerational communities and some low-income housing that has age-specific or age-friendly features coming into communities.
And then certainly I think that the now-national family care dollars are going to make a difference in terms of the number of people who are really seeking out CCRCs.