proprietary information notice

2 8
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AN N U AL
BY
DESIGN
CON F EREN CE
PROPRIETARY INFORMATION NOTICE:
The attached electronic presentation is the confidential
and/or proprietary information of SFCS Inc. This
document is intended for educational purposes only
and may be shared with each recipient’s internal
organizations only. The information contained herein
may not be copied, disclosed, distributed, or
disseminated, in whole or in part, to any person other
than the intended recipient without the express prior
written consent of SFCS Inc.
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©
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Innovations, Technology,
and the
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Future ofTSenior
Housing
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28 Annual By Design Conference
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February 21, 2013O
Roanoke, VA C
th
© A. Carle, 2013. This presentation is copyrighted and may not be reprinted
or reused without written consent of the author.
Part I:
Global Aging
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Part II: “Nana” Technology
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Part III: The “Next
Generation”
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of
Senior
Housing
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™
Part I: “Global Aging”
©
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Every 8 Seconds a U.S. Baby
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Boomer Turns 65* SIG
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78 million born
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between 1946-1964
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*U. S. Census Bureau
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The Aging of the Boomers
• Pop. age 85+ (“Oldest Old”) expected to more
than triple from 5.7 million (2010) to 19 million
(2050).*
• Age 100+*:
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• U.S. only 43rd of 224 countries in B
% of pop.
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60+ (U.N. 2007).
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• World Population (HSBC G
2004):
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– World Pop. 1900
R= 1.65 Billion.
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– World Pop.
60+ 2050 = 2 Billion.
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C will effect us long
“Global Aging”
before “Global Warming”.
* U.S. Census Bureau
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Individuals who in 1968 thought
they would change the world, by
2028 Actually will:
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• 1900 U.S. Census: 3,536 people age 100+.
• 2050 U.S. Census (Est.): 834,000 age 100+.
• NOT an American phenomenon:
Outcome:
•
•
•
•
•
•
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Travel
Entertainment
Retail
Food
Technology
HEALTHCARE
HOUSING
Largest Strategic Questions?
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1. Who will take care of 2them?
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Glive?
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2. Where will they
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Issue #1:
Collapse of “Three Legged Stool of Caregiving”
Approx. 80% of current senior care is provided
by
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3 friends):
43.5 million unpaid “Caregivers” (family
or
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• Time (already collapsed): Dual-working spouses
means 44% of
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Itime available to dedicate
caregivers are now men*, but combined
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to task may be LESS. (*National Family Caregiver
DE Association)
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B one-fifth of family caregivers live
• Proximity (collapsing): Nearly
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more than an hour away*,
with percent expected to increase each
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year.
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• Energy (preparing
to collapse): If your
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Mom is 100…how
old are YOU?
(Family Caregiver Alliance)
• 30+% of family caregivers are over the age
of 65 today. (U.S. Dept. Of Health and Human Services)
Issue #2:
Professional Caregiver Labor Shortage
Retirement of “Boomers”
will create critical gap in
labor pool:
• 35 million more jobs of any
kind than people to fill them by
2030. (GAO)
• 2 million LTC nurses and
nurses aides today, 6 million
needed by 2050. (U.S. DHHS/DOL)
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“Partial” Answers…
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1. Maximize recruitment of new and/or
available workers to Long Term Care:
• “Can’t outsource our seniors!”
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Individuals 65+ will be one-fifth of U.S.
D pop. by 2030.
2. Look to older adults to keep working:
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B •
(U.S. Census Bureau)
70% of current workers 50-70 plan to
working during retirement. (AARP)
3. Open borders to legal immigration for
high priority (LTC) jobs.
•
AHCA lobbying “special” visa
for 400K LTC workers/yr.
(Wall Street Journal)
…the rest of the answer.
“The Golden Triangle”
• Congregate Staffing:
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©
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• Group available LTC workers in facility-based environments vs.
“windshield time” delivering care in individual homes.
• Need to decide if supported home care is a right or a privilege.
– Ex: Home and Community Based Services (HCSB).
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E system.
• The most inefficient long term care delivery
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– Gov’t. doesn’t pay for “Home Y
School”.
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• “Nana” Technology :
H seniors to remain
• Utilize technologies thatGallow
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independent longer
and/or
make congregated
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labor more productive.
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• CongregateC
Housing:
™
• Create housing models where seniors
WANT TO LIVE.
– Need to understand Boomer
“Psychographics”.
Part II: “Nana” Technology
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“Microchip-based
technology
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designed,
intended, or that can
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otherwise be used to improve
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Bquality of life for older adults.”
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™
http://en.wikipedia.org/wiki/Nana_technology
- A. Carle (2004)
Technologies Making A Difference TODAY:
Medications Management:
•
#1 cause of hospitalizations
for those 65+. (CDC)
MedMinder™
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1 will become
• 60% of afflicted
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lost (“critical2wandering incident).
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• Up toIG
half (47%) may die if not
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found
E within 24 hours. (Alz. Assoc.)
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www.medminder.com
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Alz. Wandering:©
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Navistar™ GPS Shoe
B www.aetrex.com
Technologies Making A Difference TODAY:
Health & Wellness Monitoring:
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• Bedroom, Bath, Med Cabinet, Kitchen
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• “Reports” emergencies to caregiver
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Provides “Telehealth”: H
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•Temperature, BP, Weight
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“Communicates” with
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GrandCare channel
or HOME BASE :
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• Reminders
Uses sensors to establish baseline of
“Normal” Activity:
• Video/Photo’s
• Greetings
www.grandcare.com
Technologies For TOMORROW…
Falls:
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1-of-2 individuals 80+.
#1 cause of death due to
injury for those 70+. (CDC)
Need to go from “Alerts” to
“Avoidance”.
“Self Parking Walker”HT
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• Significant % of falls
related to “transfer”
to/from walker.
• Remote/voice
controlled.
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Carnegie Mellon
www.cmu.edu
“Smart Shoes”3©
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Jim Collins (Boston University)
• 1/3 of falls
related to vestibular
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G disorders in elderly.
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balance
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E Study: 73-year olds had
•DPilot
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B same balance as 23-year olds.
“Nana” Technology…cont’d
Health & Wellness Monitoring:
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“Magic Medicine Cabinet™ ” “Smart Shirt”
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(Accenture Corp.)
• Face recognition.
• “iTextiles”.
• Voice communication.
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D•EVital Signs & Safety Alerts.
(Sensatex, Inc.)
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Technologies for tomorrow…ROBOTICS:
At Home:
“AR” - Assistant Robot
(Tokyo University)
•
http://www.youtube.com/watch?v=--wEgmNzs0w
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•
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Sweeps, does laundry,
load/store dishes.
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LTC - Back Injuries:
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#1 cause of health care worker comp
claims.
#1 cause of permanently “lost” LTC
worker.
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“RI-MAN™”
(Riken Labs)
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• Can
“See”, “Hear”, “Smell”.
B• Currently
lifts up to 90 pounds.
• Next phase to be
designed for assistance to Japanese
elderly.
• 24/7/365.
• No injury.
• No lost worker.
• No OT/Agency.
Part III:
The Next Generation of Senior Housing
“Senior Housing” today offers more choices than
© ever*…
•
•
•
•
•
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Independent Living (approx. 7,500 communities).
Assisted Living (approx. 40,000 communities).
CCRC’s (approx. 2,500 communities).
T = 50,000 communities
Projected to double to 100,000+ communities by 2030.
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Have come a long way
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since “Nursing Home”H
as only option.. RIG
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* Various sources including NIC, NCAL, ALFA, AHSA
Photo Courtesy of Sunrise Senior Living
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So What’s The Problem?
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By 2050, there will
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be more than
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TWO BILLION
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people in the world Y
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over the age of 60…
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“And every one
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of them will be
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a unique
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INDIVIDUAL.”
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“When Boomers were
growing up there were
three flavors of ice
cream; now there are a
thousand.”
- Drew Leder, Prof. – Loyola College
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• Boomers will demand even MORE
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choices in senior housing.
• And they have CRITICAL
MASS and
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• Need
a “Portfolio of Products”
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meet
PURCHASING POWER to get it:
• Control more than 70% of wealth in U.S.
(Federal Reserve Board)
• Nursing Homes = “Coke”
• Assisted Living = “Diet Coke”
• CCRC’s = “Cherry Coke”
to
Three more “Boomer” facts to know:
1. Today’s retiree’s want to remain active and
3©
intellectually challenged.
•
•
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2
U.S. cited as having invented concept of the “Golden Years”. Lasted only ONE
generation. (HSCB/Harris Interactive: “The Future of Retirement” worldwide surveys).
More golf courses closed than opened in the U.S. in 2005, for the first time in more
than 50 years.
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B Home:
2. NOT tied to their Family
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• Dell Webb Survey : 59% of
current U.S. 40-49 year olds (Middle Boomers) plan
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to move when they retire.
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• Senior Advantage Real Estate Council Survey:
Only
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Only 16% O
of current retirees want to move to an age
restrictedCcommunity.
• “Escape from Elderly Island”.
3. THEY HAVE NEVER BEEN ALONE.
suburbs.
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• Attended
large High
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Schools.
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Graduated from large
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companies.
• Ready to move/live
together… if we offer
the housing choices
they desire.
• Created large
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The New “Flavors”
of
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Senior Housing…
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Housing for different “Cultures”…
Asian-Americans:
“Aegis Gardens” - Fremont, CA.
• 46 AL, 18 Alz./dementia.
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• Street and room #’s changed to avoidYthe
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number “4”.
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• Aegis Corporate uniforms were
changed from
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blue to maroon.
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• Asian cuisine, includingR
Wok cooking and
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Sushi.
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• Activities include
Tai Chi, Chinese Opera,
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Calligraphy.
• All 50 staff speak Mandarin, Cantonese, or
Japanese.
• Feng Shui consultants involved in architecture.
www.aegisliving.com/locations/gardens
Photo A. Carle
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Housing for different “Orientations”…
“Rainbow Vision” – Santa Fe, NM
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• 60 Condo, 60 IL, 26 AL.
• Dedicate to “Lesbian, Gay, Bisexual, and Transgender” individuals (LGBT’s).
• Billie Jean King Fitness Center & Spa.
• Truman Capote Dining Room.
• “Drag Queen BINGO”.
• At least a dozen similar communities open or in
development since 2005.
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www.rainbowvisionprop.com H
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•“You Are Finally Home”.
Photo Courtesy of Rainbow Vision
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“Holistic” Housing…
Spring Hills Senior Communities:
• 10 communities (FL, OH, NJ, VA)
• “Signature Touches™”
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Appreciation, Creative Writing, Brain Training.
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Body:
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•
Nutrition: Locally grown food,
whole
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grains, heart-smart entrees.
G programs for
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Fitness: Evidence-based
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stretching, balance,
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strength training.
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Spirit:C
Holistic health care, spa, massage,
• Commitment to “Healthy Living”
• Mind: Master Gardening, Art, Music
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•
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chiropractic, mental health counseling,
educational classes, external volunteering.
www.spring-hills.com
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Housing for “Alums”…
“UBRC’s” - University Based
Retirement Communities©
• U.S. Boomers are the most college educated
demographic in history.
(Mature Market Inst.
• More than 100 communities open or in
development.
• Notre Dame, Stanford, Duke, Penn State,
among others.
• “Perfect Storm”:
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•
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• 89% H.S. grad, 29% Bachelor’s or higher.
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Residents gain access to
active,
intellectually
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stimulating, intergenerational environments.
R previous customers
Universities “recycle”
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and gain potential
donors.
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Senior Housing
Providers tap “brand
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loyalty” established 50 years prior to
purchase!
Photo Courtesy of The Village at Penn State
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And in the Future?
“S.S. Assisted Living”?
“Outsourced Seniors”?
• Bea Muller: 89 year-old widow lived
on the QE2 from 2000-2008:
•
•
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(2004) compared cruise ship fees to
assisted living:
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Difference = $11/month.
• Three cruise
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• Nicaragua, South America:
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IG
•S$800/month
rents a beachfront
home, including utilities - and
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D fulltime Housekeeper.
(NBC Nightly News)
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ship companies offering or
establishing “Residential Ships” for
retirees by 2015.
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seniors worried about
“outliving” their savings.
Visited 41 cities, 25 countries, 5
continents each year.
Received all housekeeping, meals, and
activities.
On board hospital and medical staff.
• American Geriatric Society Survey
•
• Many
• Est. 1,000,000 U.S. retirees
currently living in Mexico.
(State Department)
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“Swedish
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proposition:
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Send the
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elderly to IGH
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Thailand”
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February 13, 2013
Related “Niches”:
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My favorite “Niche” community…
Pasco County,3©
FL:
“Nudists
1 of North
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• “Nudist Mecca
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consider creating America”
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American
Association
assisted living DE
for Nude Recreation:
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facility” T B • Est. 50,000 nudists in U.S.
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(July 3, 2008)
• Median Age as high as 55
Final Thoughts…
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In the next two decades individuals20age 65 and
N of every 5
older will come to represent I1Gout
S
U.S. citizens. They will D
beEready
to embrace
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new technologies, new
B forms of retirement,
T
and new forms
H of senior housing…
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Will WE be ready for THEM?
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Questions…
Contact Information:
Andrew Carle, President
Carle Consulting, LLC
Email: [email protected]
Phone: (703) 835-0961
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©
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Executive-in-Residence, Program inBSenior Housing Administration
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George Mason University
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Fairfax, VA
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Email: [email protected] R
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Web: http://seniorhousing.gmu.edu
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Phone: (703) 993-9131
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THANK YOU!