Rampant Consumer Confusion Creates Opportunities for Senior Living Innovation

More than one-third (35%) of U.S. adults do “not know” how they view the aging services sector.

That’s according to recently released findings from a national public opinion survey conducted by LeadingAge.

“These numbers suggest the sector does not face an extreme public perception crisis — but there is a real need and opportunity to improve the public’s understanding of the field,” LeadingAge authors stated in their executive summary of the research findings.


I appreciate the italics in that sentence and agree that there is a significant business opportunity in addressing the need for consumer education about aging services options and assistance in navigating this complex marketplace.

In this week’s exclusive, members-only SHN+ Update, I analyze this issue and offer key takeaways, including:

— Some senior living providers are creating business models with a consumer education component


— Lack of consumer clarity on the sector is hurting innovation and investment

— Shortcomings in the aging services infrastructure may require government intervention

Addressing a market problem

The findings of the LeadingAge survey reminded me of what Anne Tumlinson told me earlier this year. In addition to being CEO of ATI Advisory, Tumlinson started the Daughterhood initiative to support family caregivers.

“The No. 1 thing that I hear about in the work we do with Daughterhood is, ‘Where do I go?’” she said, in an interview for our Vision Series. “This isn’t so much about health care as it is about, ‘My mom, she’s showing signs of dementia, and she lives alone, and I don’t even know where to go.’”

Consumers are not sure what they think about the U.S. aging services sector because they are not sure what the sector even encompasses — and when they need to access providers, they do not know where to start.

Herein lies the business opportunity for organizations that can educate and advise consumers about the sector either before they have urgent needs or as they are first interacting with the aging services market.

It’s an opportunity that James Lee and his business partners are moving to seize. They have acquired a two-building, 32-unit assisted living community near San Antonio, which they are poised to open under the Bella Groves brand. But, along with providing on-site memory care, the Bella Groves business model calls for the creation of an education company, as my colleague Tim Regan reported this week.

As an executive director, Lee observed that “100% of the time,” residents were only arriving in a senior living community at or near the end of their journey with dementia — and they and their families often had experienced a lot of “heartache” along the way, as they struggled to understand the disease and navigate the care ecosystem.

In other words, Lee observed “a market problem that wasn’t being addressed” and is seeking to fill that gap. The plan is for the memory care community to also function as an education center, operating on a membership model.

For $20 a month, families that are early in a dementia journey can access curated educational resources and gain access to Bella Groves’ dementia care methodology.

“Without Bella Groves, what you would be forced to do is, you’re going to go into Google, you won’t even know what to search — you’ll just start with keywords like dementia, Alzheimer’s, and you’ll go down the rabbit hole, and you may get good resources, you may not, but the entire process is going to feel as overwhelming as the diagnosis itself,” Lee said.

At a higher membership level of $1,500 a month, Bella Groves plans to offer an assessment of the individual with dementia, an at-home care plan, and access to a care app, along with ongoing supervision and coordination from Bella Groves’ care experts.

The strategy also calls for a B2B play, in which Bella Groves provides dementia training to area home care providers and other businesses, including mom-and-pop memory care providers.

“Most of our industry has perceived care as the most important thing we do, and I actually disagree,” Lee said. “I think care is one of the things that we do. But education is the most important thing that we do.”

In other words, care can be delivered only on a limited, hands-on basis; education forms the basis for family members, residents and an entire care team to work together using “a shared methodology and a shared approach.”

A vision for aging services infrastructure

The Bella Groves model is still unproven, but I’m compelled by the attempt to seize the education opportunity that exists.

I also believe that this type of model is even more attractive as senior living providers are seeking to diversify their service lines, to be less dependent on occupancy as the sole driver of revenue. So, I hope and expect that other senior living providers will also bring more consumer advisory services to market.

That said, Anne Tumlinson is skeptical that senior living providers or any private-sector businesses can truly solve the problem of consumer confusion about aging services options.

Labor is one impediment: Providing senior housing and care is already labor-intensive and providers are facing workforce shortages, so taking on another labor-intensive service like one-on-one consumer consultation could be an impossible lift.

She believes that the federal government should be the driving force in creating a community hub where people go when they have needs related to aging services.

“When functional decline or cognitive decline is on the horizon, there’s no single place for someone to go to get their needs assessed, determine what services are needed, where to get those services, how to interact with that service system, or how to get things set up,” she said. “My vision is that in the future, if your parent is having an issue or your spouse is having an issue, or you’re having an issue, you know where to go … My vision for this place is for it to be well known and well understood.”

She compared this network of community hubs to the interstate highway system — government-funded infrastructure that creates pathways of care. And having senior living providers or other health care providers create and run this system would be unworkable, like tasking car manufacturers with creating the nation’s highways, she said.

Without such hubs, she pointed out that innovation in aging services is being stymied. While huge amounts of venture capital are pouring into the so-called longevity economy to drive new technology and new models of care delivery, the market is too inefficient to support all this innovation.

“It’s like trying to sell textbooks and everyone is homeschooling,” she said.

She argued that private sector innovation is sometimes contingent on public sector infrastructure being in place; FedEx and UPS are only possible because they were preceded by the U.S. Postal Service.

Tumlinson believes “we’re closer than we’ve ever been” to reaching her vision or something similar to it, citing the Biden Administration’s inclusion of aging services needs in its legislative agenda.

Of course, we’re still seeing the battle over that agenda; today, LeadingAge is hosting a call to push for the Senate to “keep and expand” aging services investments in the Build Back Better bill.

Given political polarization, I’m doubtful that federal lawmakers in the foreseeable future can collaborate on anything as ambitious as an “interstate highway system” for aging services. Still, demographics will increase pressure on the federal government to address the housing and care needs of older adults.

I do think that in the near-term, public/private collaboration is one route toward a more comprehensible and consumer-friendly aging services system.

Medicare Advantage is one case in point. MA plans are helping to drive care coordination; as insurers like UCare invest in value-based service providers like Lifespark — which has a senior living platform — I can see older adults receiving more education and guidance about their options, and assistance in navigating the provider landscape.

Programs of All-Inclusive Care for the Elderly (PACE) are another example of how older adults can receive trustworthy resources to help guide their aging journey, in community centers similar to the ones that Tumlinson proposes. The expansion of for-profit PACE provider InnovAge shows the business potential in this model; Tumlinson noted that accessing PACE remains difficult for people who are not on Medicaid, but I can envision expansion of PACE access in the future.

So, I see various paths toward increasing consumer education related to aging services. As senior living providers draft their strategic plans, I think that they should consider how they can play a role in meeting this market need, whether that be through MA, PACE, novel approaches like Bella Groves’, or some other means.

Without such efforts to clear up confusion, aging services providers of all kinds will continue to be at the mercy of consumers’ internet searches and information they pick up from unreliable sources, and will be serving too many customers that arrive with their physical and financial wellbeing already compromised.

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