LIVING WELL: Generations

Active for the Ages
Local seniors refuse to go gently into that good night.

Active for the Ages
Local seniors refuse to go gently into that good night.

Robert Brown, 76, began investigating his options for senior living in 2000, when he was still happily ensconced in his Havertown home with his 65-year-old wife, Geraldine. Brown figures he and Geraldine investigated at least 12 different communities in the area before deciding to put down a deposit at Riddle Village in Media.

“All the communities we visited had plusses and minuses,” Robert says, “but Riddle was located near our Havertown home, which meant that we could remain close to our family doctors and dentists. We’re also right next door to Riddle Memorial, which was another big selling point for us. Most importantly, Riddle met our goal of making just one move.”

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Riddle Village is in the category of life-care facilities known as Continuing Care Residential Communities. There are some 2,240 such facilities nationwide, with Pennsylvania having the greatest number of any other state. They are structured to offer three levels of care: residential or independent living, assisted living, and skilled nursing care. Residents enter such facilities when they are still in good health and can still live independently, but are looking to “retire” from the everyday chores of cooking, cleaning and yard work. As age and debilities progress, they move seamlessly into assisted living, where some help is needed in, say, administering medications, bathing, dressing and walking to dining facilities. As needs increase, the skilled nursing facility provides around-the-clock medical supervision and all levels of nursing care.

It is in the area of skilled nursing care within these CCRC’s that one of the biggest changes has occurred in recent years. When Ralph and Loni Smith set out to update their 2005 book, Worry-Free Retirement Living: Choosing a Full-Service Retirement Community (Publish-America, 383 pages), they were surprised by the changes made in the skilled nursing area in such a short period of time.

“Originally, when we wrote the book, we found many of the best retirement communities were still lacking in the area of skilled nursing facilities,” says Ralph Smith. “You were treated royally upon entering this phase of CCRC living, but the food, nutrition, landscape and amenities were sub-par.”

The Smiths believed the skilled nursing segment of CCRC living should look as much as possible like the other levels of care—assisted and residential living—in order to avoid stressing residents with big changes in what they’d been accustomed to in those other facilities. They were surprised to find on their updated survey that some CCRC’s were getting the message and reading it loud and clear.

In the Mix
“Age is a triumph, not a defeat,” trumpets Lorraine DellaFranco, senior vice-president for sales and marketing at Martins Run, a Media-based CCRC and the first retirement community in the nation devoted to Jewish traditions and values. “Retirees today are more educated and know what they want. They’ve been everywhere and they show up with spreadsheets of all the amenities and choices they’ve surveyed.”

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What DellaFranco has learned from these more recent retirees is that they are all looking for more choices and flexibility in order to live the individual lifestyle they’ve been accustomed to their whole lives. And those desires for choices and flexibility extend to the areas of assisted living and skilled nursing care.

“We’ve found that even as our residents move into our assisted living and skilled nursing facilities, they still expect a home-like environment instead of a hospital,” DellaFranco says. “They want common places to gather and socialize, and they want to exercise choices over the food they consume.”

Responding to these changing demands is what is generally referred to as “resident centered care” by researchers such as the Smiths. “The old program was one of regimentation,” says Ralph Smith. “You went to bed at a certain time, you were bathed at a certain time and you were fed at a certain time.”

Smith says the old model called for a nursing station in the middle of the care facility, with living quarters branching off from that station. “It signified that nursing was the focus of care,” Smith says. “There were also limited opportunities to interact with other residents.”

All that has evolved into a more dynamic living experience that experts now say can extend the life of CCRC residents by as much as two to seven years over those who remain in their homes. “We found facilities where the nurse’s station was out of site rather than the central focus,” Smith says. “And the landscape has been redesigned to seem homier, with the central area set up more like living quarters.”

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DellaFranco says the assisted living facility at Martins Run, called the Pines, is set up with private suites and common gathering areas that provide that homelike feel. “This is a big change from the previous medical model,” she says.

The skilled nursing facility, the Meadows, includes more food and nutrition options than the old medical model, as well as opportunities for socializing and intergenerational experiences involving visitations with the young. “Our pet program is one of the most popular,” she notes.

Dr. Raffi Megerian, a geriatrician on the medical staff at Lankenau Hospital, believes the interactive environment of the new and improved CCRC’s is directly responsible for the reported increased average lifespan of their residents. “Social interaction is vital to maintaining both good physical and mental health,” says Megerian. “[And so is] easy and convenient access to all routine needs and healthcare.”

Dr. William Zirker, chief of the division of geriatrics for Crozer-Chester Medical Center, believes what the Browns did in finding a CCRC near their ancestral home was a smart move as well. “Recent studies have shown that people moving locally to a CCRC do better health wise that those who move farther away or out of state,” he says. “Maintaining existing social networks is very important to staying healthy.”

Adds Megerian: “No matter how ready you may be for this, it is still a very big change, and I see evidence of some initial depression and stress in some new residents,” he says. “But being able to stay in touch with old friends and some aspects of your old routine will certainly help reduce the stress and emotional upheaval of such a big move.”

Megerian also believes the progress of such disorders as Alzheimer’s can be slowed by living in facilities that stimulate brain activity. “Remaining socially active is one of the best ways to keep the brain active,” he notes.

In fact, all phases of the CCRC model have changed to meet the demands of a healthier and more active wave of retirees than ever before. Nora Zolna, director of marketing for Riddle Village, says her facility is undergoing expansion to provide for an enlarged fitness and exercise area, and for the addition of a personal trainer on staff.

The same is true for The Quadrangle, a Haverford-based CCRC that is part of the nationwide Sunrise Senior Living group. “Our residents can choose to remain in independent living, even when their needs require the services of our assisted living and skilled nursing facilities, by hiring companion care workers to assist with their increased needs,” says Annette Paccapaniccia, director of sales and marketing for the Quadrangle community. “The only requirement is that residents are able to continue to live safely in that independent setting.”

And Paccapaniccia says residents are coming into the Quadrangle at a much more advanced age than before, due to the prevalence of 55-plus communities, where they are able to interact independently with their own age group for a longer period of their lives.

“I’m seeing an average age of new applicants right around 80 years old now,” she says. “In fact the average age of our Quadrangle residents is 85 years old. But they are still quite active and are requiring a lot in the way of fitness and exercise classes.”

Because almost all quality, accredited and not-for-profit CCRC’s have lengthy waiting lists, seniors need to start their pre-planning early—and visiting the Internet is helpful in that regard.

One helpful place to start is the American Association of Homes and Services for the Aging ( The site contains a directory of life-care facilities that can be searched by alphabet or state, along with an archive of useful articles related to planning and preparation.

The Browns advocate patience and persistence while looking for just the right amenities to suit individual needs. But be ready to act when you find what you’re looking for. For the Browns, that meant finding a place that allowed them to make “just one move for the rest of our lives.”

“I believe they even have an incinerator on the grounds here for when that time comes, too,” Ralph quips.

For up-to-date information on the best senior living communities in the area, click here.

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