Aging, Alzheimer's, Assisted Living, End-of-Life Care, Health & Wellness, Hospice, Long-Term Care, Palliative Care, Senior Services

Institute of Medicine End-of-Life Care Conference March 20

I am super excited to attend this on-line conference (a webinar), open to the public, on Dying in America – what we can do for better communication with patients and their families, what education and development opportunities can be created and implemented, and most of all how we can create a future where palliative and hospice care is serene, comfortable, painless (should the patient wish this), supportive, and honoring free will. See link below for details.

IOM looks deep into end-of-life care.

Assisted Living, Health & Wellness, Mexico Senior Living, Retirement, Senior Living, Senior Services

Mexico’s AMAR Hosts Senior Living Convention w/ North American Investors & Retirees

AMAR, the Mexican Association of Retirement Communities (Asociacion Mexicana de Asistencia en el Retiro), is hosting AMAR’s International Convention 2014 at Rosarita Beach Hotel, Rosarita Beach, Baja California, October 23-25, for North American and Mexican senior housing industry professionals and the public. Rosarito Beach is 20 miles south of San Diego, CA in Mexico.

The event focus, part of a continuing dialogue, is how to attract a portion of North American Baby Boomers over the coming years to senior-friendly, affordable destinations in Mexico with ideal weather,  health services, infrastructure, and proximity to the U.S. It is anticipated that of 100 million boomers in Canada and the U.S., 4 million will consider living in Mexico. According to Internet statistics, there are currently 1,400,000 to 1,600,000 U.S. citizens living in Mexico, not all retirees.

Experienced Canadian and U.S. senior living developers, operators, and executives will meet to discuss collaboration possibilities with Mexican developers and investors.

Among the 22 scheduled speakers are Americans Martin Lakatos, VP and developer for California based Front Porch Development Company; Patricia Will, CEO of Belmont Village Senior Living (23 Assisted Living properties across the U.S. and one in development in Mexico City); and Matthew J. Downs of the Center for Medicare Portability. Javier Govi, Founder & CEO of AMAR; Ignacio Bernal of FONATUR (a Mexican government entity which plans and develops top tourist destinations); and Rodrigo Contreras Mejia of PROMEXICO (a Mexican government trust for international trade and investment) will be among the speakers from Mexico.

Subjects will include elements for successful operation of CCRC’s, active senior living, and Alzheimer’s and dementia care with holistic/wellness-based concepts, eco-friendly LEED-certified construction, universal design, and health information technology. Topics will also include the state of MOM and POP projects, aging in place communities where services come to you, and Medicare in Mexico. (Medicare is not yet accessible outside the U.S. unless under rare circumstances. American seniors can purchase Medigap emergency plans C, D, F, G, M, or N with a $250 deductible).

Lic. Javier Govi, Founder & CEO AMAR
Lic. Javier Govi, Founder & CEO AMAR

When asked about the current state of senior living and its future in Mexico, AMAR’s Javier Govi stated, “We currently cater to the mom and pop market, the parents of baby boomers. We are simultaneously transitioning to meet the needs of boomers who have begun to retire. We have spent years studying this market, looking at the history, and visualizing the future. The important components for boomers will be wellness, fitness, and a holistic approach.”

An adjunct part of the event is the 50+ Expo and Workshops for Healthy Living where the public can learn about senior living options in Mexico.

AMAR Friends Foundation, which helps retirees find independent or assisted living in Mexico, is sponsoring the 50+ Expo. Seminars are designed “to answer questions from banking to moving belongings, and what is involved in obtaining a residential visa,” added Govi. The expo also includes product displays and music. The foundation will soon be providing social service projects for poor elderly Mexicans through its North American volunteers. See

AMAR, founded in 2007, is the first national Mexican non-profit organization committed to educate and collaborate with Mexican government regulatory agencies and business executives in Mexico and North America on the potential of the senior housing industry in Mexico.

For more information on the event go to, write, or call San Diego, CA number (619)564-4007.

Assisted Living, Ecuador, Ecuador Senior Living, Health & Wellness

International Day of Older Persons in Cuenca, Ecuador

sweethearts from Sayusi
sweethearts from Sayusi


October 1 is International Day of Older Persons. It has been recognized as such since the acceptance of a UN decree December 14, 1990.

According to the World Health Organization, an arm of the U.N., there are 600 million persons around the world who are 60 or over. By 2025 the number of older adults is expected to double, and by 2050, there will be 2 billion, the vast majority of whom will be from developing nations.

One such developing nation is Ecuador which celebrates this day with parades and festivities in cities nationwide.

Seniors in Ecuador, whether from privileged backgrounds or farming communities, participate with gusto.

In Cuenca, an Andean city, the province of Azuay, the city, national government social services (MIES), assisted living homes, and the University of Older Adults participate. Yesterday, according to MIES, over 1000 seniors marched in the parade from the corner of Borrero in front of a MIES office, all the way down Calle Larga, a main city street, to the Banco Central, about a 1/2 mile away. In the courtyard of the Banco Central there was dancing, a senior band, a play, Ecuadorian food, and handicrafts made by seniors.

Below are photos of the memorable event…

University of Older Adults for "active, healthy, and productive aging"
University of Older Adults for “active, healthy, and productive aging”


Graduates of the University of Older Adults
Graduates of the University of Older Adults
Seniors from Plentitud Assisted Living led by their dedicated administrator Dolores with pin on lapel
Seniors from Plentitud Assisted Living led by their dedicated administrator Dolores with pin on lapel
real life sweethearts...
real life sweethearts…



senior band from a pueblo outside the city
senior band from a pueblo outside the city



crafts handmade by seniors for sale
crafts handmade by seniors for sale
more handicrafts
more handicrafts
made with love
made with love
precious lady making a straw hat
precious lady making a straw hat
cuy aka roasted guinea pig, a favorite Cuencano food
cuy aka roasted guinea pig, a favorite Cuencano food
pork and potato/corn patties prepared by Plentitud Assisted Living
pork and potato/corn patties prepared by Plentitud Assisted Living




listening to music
listening to music
Pedro Calle, MIES sociologist w/ Lcda Yolanda Arias, MIES Senior Analyst
Pedro Calle, MIES sociologist w/ Lcda Yolanda Arias, MIES Senior Analyst


Alzheimer's, Assisted Living, Health & Wellness, Senior Services

Interior Design for Alzheimer’s/Memory Care Communities – A Successful British Experiment

For almost two decades, especially since I served as night time administrator and marketing director at an Alzheimer’s campus in southern California, I’ve been focused on universal design – how to create a safe, practical, healthful, and inviting environment not only for those requiring memory care, but for anyone, even those of us fortunate enough to be well.

What could be better than an immaculate, welcoming, protective atmosphere where ever you live?

Yesterday I viewed a video about interior redesign of a dementia wing at Elmhurst, an assisted living village in England. I like much of what was chosen. I might not have chosen laminate flooring even if it looks great and is easy to clean, I don’t find it eco-friendly.  I may have choosen linoleum, cork, or wood instead as there is no off gassing. These green products might be safer for falls.  But I imagine there may have been budget considerations. Other than that, a fine redesign job. Based on a visual site visit, even from afar, I would consider recommending this community focused on wellness.

Note the energy of light features, especially the use of skylights and large windows, and the secure garden area.  Also note the reason red prompts were chosen for the bathroom, and cerulean blue gray for the dining room plates. There is valuable information in the video at the link below.

   please don’t be shocked by the red, there is an excellent reason for the choice


Assisted Living, Health & Wellness, Retirement, Senior Living

New Zealand Retirement Village Produces Charming “Happy” Video

In case you missed it, the Diane Isaac Retirement Village in Christchurch, New Zealand has re-created a famous music video with its residents and staff. Note the feelings you receive from the performers, and, the high living standards oceans away. Wellness anyone?! I’m still smiling.

Here’s the You Tube video:

The video is also embedded in an article via Senior Planet… 
Assisted Living, Health & Wellness, Senior Living, Senior Services

PBS and Scan Foundation Host Long-Term Care Discussion

Very exciting senior care news…

Today, in Washington, D.C., PBS and the Scan Foundation (health insurance for the 65+ crowd) host a conversation about long-term care models from around the world.  Panelists will discuss the possibility of successfully implementing some of these models, as well as regional ones, across the U.S. The taping event is sold out but keep your eyes open for the air date. Wish I could be there!

Here is the official announcement:

The PBS NewsHour’s Hari Sreenivasan will lead an exploration of long-term care, from across the global village to Main Street U.S.A. After looking at different models for providing long-term care and benefiting from expert commentary, the event will aim to answer the question: can what works there, work here?

The conversation will feature:

An interview with Dr. Bruce Chernof, President & Chief Executive Officer of The SCAN Foundation and former chair of the federal Commission on Long-Term Care
Video and expert discussion of models for long-term care, including examples from California, Minnesota, Washington, D.C., Finland and Taiwan
We will be joined by:

Dr. Laura N. Gitlin, Director, Center for Innovative Care in Aging, Johns Hopkins University
Howard Gleckman, Resident Fellow, The Urban Institute
Jennie Chin Hansen, Chief Executive Officer, American Geriatrics Society
Dr. Mark McClellan, Director, Health Care Innovation and Value Initiative, The Brookings Institution
Dr. E. Percil Stanford, President, Folding Voice LLC
Debra Bailey Whitman, Executive Vice President, Policy, Strategy and International Affairs, AARP

Assisted Living, Health & Wellness, Senior Living, Senior Services

John Gonzales on Emeritus Senior Living Exposure

Here below is a well considered article by Assisted Living insider John Gonzales brought to my attention by Steve Moran’s Senior Living Forum.   It is worth reading…

Dangerous Bridges – – A Commentary on the PBS Expose of Emeritus Assisted Living — 31 July 2013

I asked John, who has become one of my favorite writers if he would be willing to write an insiders perspective. This is what he sent me and it is terrific. – Steve Moran

When I was asked to write this commentary, I assumed I too would take the familiar position dictated by my “corporate instinct” and rush to the defense of our industry, because one of our own was being attacked. “Let him without sin cast the first stone,” right? Those of us who can claim the moniker of senior housing “veteran” know all too well the challenges we face with a transient employee base, 24/7 operations and the risks and potential for human error inherent in an industry that seeks the promotion of decision making and independence in a frail population.

After all, who among us can claim to be deficiency free in 100% of our surveys? Anyone receive a call or letter from a current or former employee complaining about being short staffed? Anyone else make decisions driven in large part by the requirement to make the bottom line?

I think we can agree that perfection may be something we strive for, but the reality of achieving and maintaining it is rare in any business. When I read and saw the expose on Emeritus, I felt that many of the criticisms arguably fell into the category of “reasonable imperfection.” Human error will be here as long as there are humans. I touched on this in my piece, “The Dirty Secret about Assisted Living.”

Come with me on a little metaphorical trip. You’re driving with your family when you come upon a sign that states, “Warning – Structurally Deficient Bridge Ahead! – US Dept. of Transportation” Would you drive yourself and loved ones over the oncoming bridge span? Maybe, if you were being chased by an angry international drug cartel firing bullets at your vehicle and this was the only escape. How about a bridge with the same warning sign that happens to be part of your daily commute? Fact: one in nine bridges in our nation are currently classified as “structurally deficient.” That’s roughly 66,000 bridges, on which more than 260 million trips are made each day. But, according to the Federal Highway Administration, the fact that a bridge is classified as “structurally deficient” does not imply that it is unsafe. I imagine that the people who lost friends and family in 1997 when the Interstate 35 Bridge collapsed in downtown Minneapolis might disagree.

Using the above scenario, replace the “bridges” with Assisted Living communities; cars and their passengers with residents; and the number of trips across the bridge with resident days. In our industry, we have to “do it right” 100% of the time – each day a resident lives in our community (each trip across the bridge) has to be safe. Does a survey deficiency, a complaint, a fall or medication error make a community unsafe? Does it make all communities unsafe? No. But I imagine that many of the family members of residents who’ve experienced negative outcomes – like those featured in the PBS documentary – might disagree.

Now, here’s where I take leave of my comfort zone. Maybe it’s my Jerry Maguire moment, although I hope not…I don’t like Tom Cruise movies in general. There are several very troubling issues highlighted in the PBS expose that from all appearances seem to be driven – either intentionally or not – from Emeritus’ corporate office. The either tacit or overt direction to disregard state regulations to expedite move ins, the low priority given to staff training, and the culture of revenue over residents are egregious and shameful.

Having worked in nearly every community-level position before moving into regional and corporate roles in the industry, I can tell you that there are many executives in our industry that have lost sight of our residents – if they ever had it. If you have a passion for seniors and work in this industry, hearing the term, “heads in the beds” should make you nauseous. A corporation can create brochures and beautifully crafted mission statements, but – as I point out in, “Pop Rocks for Dinner,” this is meaningless unless backed up with actions and resources. One truth I’ve learned in my 27 years in senior housing is that there are far too many people sitting around corporate conference room tables that shouldn’t be there. I can give you a few names if you’d like.

Before you think me naïve, I am all too well aware that this is a business; and no one benefits from a poorly run or failing business; not the residents, not the staff, not the stake holders – not us. I’m continually reminding colleagues that this business requires a constant balancing of the head and the heart; of compassion and business sense. If, as a community, regional or corporate level manager, you are not in a constant state of conflict, then you’re doing something wrong – something is out of balance. Ladies and gentlemen of the jury, something appears to be dramatically out of balance at Emeritus, and it’s to our collective shame.

I hope and pray that this public exposure of what can and will happen when a company gets out of balance, placing the desires of shareholders over the needs and rights of the residents, will be a wake-up call for our industry – especially for those of us fortunate enough to work in the decision-making positions of senior housing. A former company executive with whom I worked, would often respond to my residents-should-come-first objections to bottom-line driven decisions, with the trite phrase, “We follow the golden rule. Whoever has the gold makes the rules.” Hmm, maybe that should have been on our brochure. Besides, aren’t the residents really the ones with the gold? Someone forgot to tell me that our mission statement to “do the right thing” stopped at the door to the conference room.

What’s your mission statement? Is it being lived out? Prioritized? Funded?

No doubt this publicity will prompt renewed calls for federal oversight of our business, or for increased state regulations. If you’ve been in senior housing for any length of time, you know that the states are struggling to keep up with adequate oversight of assisted living. This lax oversight creates an opportunity for some providers to skirt safeguards and regulations in favor of greater expense control, occupancy growth and increased revenues. But, we can do better. Our staff deserve it. Our residents deserve it. Our shareholders deserve it.

I remember when our industry reached out and began serving the dementia population by developing secured care units and alarmed wings within our assisted living communities. We ratcheted up the stakes by expanding the scope of our services, and increased our rates as well as our risk. Caring for the most vulnerable of the senior population – those with high physical and mental needs – requires even more heart, compassion and care – but even more – it requires additional training, resources and a clear understanding and acceptance by providers of this great responsibility.

Many of us saw this evolution as a huge opportunity to provide innovative services and programs to a population that had been under served, in an environment that still promoted independence and dignity. I know many communities are striving to do just this. Unfortunately, some in our industry are all too eager to accept the increased revenue without ensuring their ability (or willingness) to provide the necessary resources under mounting pressure to perform financially.

Perhaps because of ignorance, perhaps driven by greed, and perhaps because of a disconnect that occurs once a company becomes too large to ensure that its vision, mission and priorities to the field aren’t distorted as it filters through the many layers of management; but for some providers, accepting higher acuity residents and those afflicted with dementia and related diseases – and all that goes with this – may have been going a bridge too far.