This article is sponsored by Sentrics. In this Voices interview, Senior Housing News sits down with LE3Solutions Principal Consultant Sara Kyle to learn the four facets of senior living engagement, how operators can re-imagine their common areas and outdoor spaces to create deeper engagement and how COVID-19 has helped many communities tap into new skills that have changed the way they build community and socialization.
Senior Housing News: You have a varied background, including a PhD in kinesiology. Chart for us the journey from kinesiology to what you do now at LE3. Is there anything specific from that background that you’re able to draw on here?
Sara Kyle: I got involved in the resident world via kinesiology, starting with internships. My first experience was working in cardiac rehab, witnessing older adults come in and recover from open-heart surgeries, watching the body repair itself predominately through movement. In graduate school, I completed an internship based on senior recreation, working at a local rec center, which is where I got my feet wet in resident programming.
I started my PhD determined to be a professor. But I always had this passion for older adults. Ironically my first course was group dynamics with a 78-year-old professor named Dr. Bettye Myers. She defied every ageist stereotype. She captivated me. I am not clinical. I say that all the time. I’m not a therapist by trade, but what I do find is that the foundation of lifelong movement, and how it relates to longevity and helping people live the life they want, fascinates me.
That speaks to a certain principle of fundamentals in working with people, specifically senior residents. I know you look at engagement through four facets of life. What are they?
Resilience, autonomy, purpose, connectedness.
For engagement to work, the principal thing is to know someone as an individual. What I am trying to urge is that instead of just looking at what someone did physically or socially, use those four facets, which drive quality of life. That gives a more complete story of engagement, rather than just looking at a resident’s participation in a group or activity setting.
I think the problem with engagement is that it’s such a soft science. We use anecdotal information, and we do not put quantitative metrics around the discipline. But you absolutely can. Resilience, for instance, is someone’s ability to cope with whatever life throws at them. You learn from past experiences and end up stronger, more equipped to deal with what is next.
The next one is autonomy. How much self-governance do I have in my life? Am I able to make choices on my own? And do I want to make those choices?
Purpose is simple: Why do you get up? What is the passion that awakens you each morning? Why do you want to complete the day? And the last one is connectedness: all the ways in which I matter to other people. The sense that people need me and I need people, and what we gain from that responsibility.
How have those four facets changed since the pandemic, and how has your ability to help residents capture them changed as well?
We as an industry weren’t focused on these before. We talked about autonomy and it was a big word that we liked to use, but I don’t think that we really understood it the way we understand it now. The same thing with “purpose.” When normal things are taken away from you, you dig in a little deeper and self-reflect.
In fact, some skills, traits and gifts that people possess have emerged. We’ve seen people fulfill a purpose, based upon the needs of a community in COVID — checking on a neighbor, calling a friend, selling masks, writing. There’s still a feeling of connectedness, even if you can’t physically see someone. That’s why we keep saying we’re physically distanced, but socially connected.
That has to be a large part of the value of LE3.
Yes. At LE3, we look at different ways to measure engagement, quantify it and create programs that are innovative. We ask, “What is the vision of engagement? What do we want it to be? What does it look like when someone is engaged versus not engaged? What are the business metrics that are affected when people are engaged or not engaged?”
LE3 is intentional on helping communities build new engagement options based on resident feedback. Not just feedback on time at move-in, but continuous. People are ever evolving, and because of that it is important to understand how a transition moving into senior living can spark new interests and decrease others now that new options are presented.
Lastly, how people interact in a group setting versus how they crafted a route in their own home can be different.
What practices have you seen adopted with residents during COVID that you think should become permanent?
Meeting people where they are — literally. When we explained the past model, we created programs and calendars that gave people one option, and we tried to put enough variety on that calendar to meet the needs of 100+ different people. We would post this schedule in various places and wait for people to show up at the designated location.
What’s changed is we now go to the people where they are. When you go to people, you see who they are very differently. We’ve engaged them in their own space in new ways. I believe it has made us more focused on the resident than ever before. What are we learning? We’re learning that people have a lot more talents that we needed to rely on or gave them credit for.
We’ve also seen how they have worked together as a community. They’ve shared experiences and stories, and they’ve contacted their neighbors, they’ve written to each other, and helped each other learn technology, such as FaceTime or Zoom. Residents are going in and tutoring other residents. In some cases they are able to reduce the one-on one tutoring that could fall on staff.
You’re talking about people doing things in their own space. Obviously, among the four facets, connectedness is difficult during the pandemic. Where is this engagement happening most in terms of physical location within a community?
Everywhere. We’re relying on every bit of space we have outside. I know it’s going to start getting cooler, but we’ve been able to use outdoor spaces that we didn’t think of before. Not only is it more space, and it’s outdoors where there’s clean air, but being outdoors has significant benefits. Sunlight offers great benefits for our bodies, including the vitamin D.
We’ve started to look at spaces, redesign them and repurpose them. We’re asking ourselves how we can use spaces to bring community together in a physically distanced way. Patio dining, meditation areas with koi ponds and utilizing water features. Even well-lit walking trails free of trip hazards and uneven surfaces, and lots of benches for rest stops are becoming more common. Operators are realizing that outside of their communities, many people use outdoor spaces through multiple seasons, and they should too.
Despite the obvious advantages of being outdoors, we know that a lot of engagement must also take place inside, including in each resident’s unit. What to you is the big-picture lesson of what communities can do to engage residents more strategically?
Flip the model. Stop focusing on large group participation as the one metric. If you look at the last four to five months and say, we didn’t have group participation, then essentially what you’re saying is, we didn’t have engagement. The opposite of that is we know that we’ve had an immense amount of engagement, it just looks different. Just because you didn’t have someone who came to the walking class doesn’t mean they’re not walking every day. The idea is to look at participation differently. We need to look at how individuals spend their time, what they’re doing, and then relate that back to quality of life, purpose, connectedness, autonomy. Engagement is much bigger than just a single department now.
As you said, one of the challenges that we have is that a lot of communities are still sheltering in place, and that makes things like walking, or even outside activities, difficult. I will say that the pandemic has taught me that in-room engagement is no longer a passive activity. All people, not just older people, are starting to engage with friends, family and the activities that make them happy via technology. They are using their phones, tablets and TVs to access exercise, music, telehealth services. No matter what it is, residents want more of it.
Technology has truly expanded to meet the needs of residents. In-room channels, connected devices, even applications accessible over the TV now make in-room engagement easier for residents who either can’t or choose to stay in their own units. And more communities are offering everything from community information to activities over easy-to-use devices like the TV. They are even broadcasting events into resident rooms that used to be reserved as group activities. The possibilities are endless when communities leverage the technology that’s already here.
How do communities balance this technology surge with socialization? And how do families feel about this new trend?
Used strategically, technology can help everyone. Giving residents the ability to view and register for activities online, or plan their menu choices, gives them a sense of independence and autonomy while giving caregivers more time to focus on resident needs.
Because technology leaves a bread crumb trail, so to speak, sophisticated technologies can capture usage and assess trends. Information about a resident’s level of socialization can be captured automatically rather than via pen and paper. AI-based tools can feed content to residents based on activity. And all of this information is available to family members. It’s a whole new level of transparency we haven’t seen before.
It’s exciting to think about the possibilities we can offer residents that we couldn’t offer even a year ago.
Editor’s note: This interview has been edited for length and clarity.
Sentrics delivers a comprehensive suite of data-driven solutions that provide a 360-degree view of residents to help senior living communities transform their operations from reactive to proactive care. To find out how, visit Sentrics.net.
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