Mather CEO Leary: ‘Remarkable’ Data Supports New Senior Living Wellness Paradigm

Despite the challenges posed by Covid-19, independent living residents of life plan communities maintained their wellbeing to a remarkable extent last year.

That’s according to Mather CEO Mary Leary, who spoke with Senior Housing News about the latest findings from the longitudinal Age Well Study, released this week.

“The findings showed that residents, on average, exhibited very low levels of stress and high levels of resilience during the pandemic, with average stress levels among residents being 1.33 on a scale of 1 to 5, which we believe is remarkable,” she said. “Average resiliency was 4.3 on a scale of 5, which is also remarkable.”

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The results suggest that life plan community owners and operators can take pride in how they performed during the pandemic, but also indicate ways that senior living providers can better promote wellness going forward.

One route toward improvement could be through the adoption of a new “person-centric wellness model” that Mather and the Mather Institute introduced in Sept. 2021, as an alternative to the six dimensions of wellness model that has been prevalent in senior living for decades. The latest Age Well findings support the effectiveness of the new model.

And, the Age Well findings provide further evidence that senior living organizations have a positive story to tell about their role in the pandemic and the wellbeing of their residents during this time — countering media narratives that often conflated senior living and nursing homes and painted a bleak picture.

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The latest round of the Age Well Study involved more than 3,000 residents at life plan communities affiliated with 122 organizations, 60% of which were single-site and 40% were multi-site.

Evolving wellness models

Mather, the Mather Institute and partners including Northwestern University first launched the Age Well Study as a “landmark” effort to track wellness indicators in the same group of independent living residents over a five-year period.

Of course, the research team could not have anticipated that a global pandemic would occur during the study. But they adjusted to the advent of Covid-19 by focusing their most recent round of the survey on the pandemic, including by investigating “factors that may be associated with stress and resilience,” according to the findings report released this week.

Respondents’ stress was measured through questions such as “I am confident about my ability to handle problems,” while levels of resilience were determined through questions such as “I tend to recover quickly after difficult times like this one.”

In addition to the findings showing overall low levels of stress and high levels of resilience, the survey revealed distinctions among different demographic groups among the residents.

For example, women tended to exhibit greater resilience than men, while residents older than 85 and those with two or more chronic disease symptoms skewed lower on resilience.

These findings can help inform how life plan communities approach their wellness initiatives, said Leary and Dr. Cate O’Brien, vice president and director of Mather Institute. Programs geared toward women might emphasize coping mechanisms related to stress, for instance, given that despite their higher average resilience score, women also had higher average levels of stress than men.

Source: Age Well Study Report

Certain personality traits, such as neuroticism and extroversion, also correlated with differing susceptibility to stress and probability of resilience. And religious beliefs, income, presence of depressive symptoms and other factors all also play a role in an individual’s stress and resilience.

And coping mechanisms also have a sometimes complicated relationship with stress and resilience. Talking with friends and family was associated with increased resilience but had no association with stress; talking to a mental health provider was associated with increased stress; and screen time on devices such as smartphones and tablets was associated with increased stress but also with increased resilience.

Interpreting these results is sometimes challenging. For instance, the researchers are not sure whether residents were stressed by the experience of seeing a mental health provider, or whether they were seeing a mental health provider because they were stressed — and the survey also did not gauge whether stress receded over time for these residents.

Source: Age Well Study Report

With regard to screen time, Leary said, “We’re thinking that hearing about all the challenges associated with the pandemic may have increased stress, while gaining knowledge to help mitigate Covid may have built resilience.”

The upshot is that while knowing patterns and trends can help senior living deliver wellness programs more effectively, a wellness model ideally should be as individualized as possible. This is a core tenet of the person-centric model recently proposed by Mather and Mather Institute.

“We wanted to move away from giving people a more prescriptive approach — ‘do x amount of physical activities, do x amount of spiritual [activities] — and toward a model that recognized and allowed for that individuality,” O’Brien said.

Because Mather developed the person-centric wellness model while the Age Well Study was ongoing, the research team was able to include questions to address some facets of the new model.

Specifically, the survey posed questions related to autonomy, affiliation and achievement. Rooted in research, these “3 As” are the key drivers of wellbeing in the person-centric model.

Having a greater sense of autonomy, affiliation and achievement was tied to lower stress and greater resilience, the survey showed.

There are various ways that senior living providers can create or adjust their operations to foster the 3 As, some of which are explained in the latest Age Well Study report.

Autonomy can be fostered by increasing the number of choices in educational and experiential programs. With regard to achievement, providers could consider turning passive experiences such as lectures into more organized programs, with certificates of completion for residents who participate in all the related events. And affiliation can be promoted by building in more time for discussion during or after events.

Leary and O’Brien are gratified to see a growing body of evidence supporting the person-centric wellness model.

“We’ve been doing not just this study but others as well and have been finding, across these studies, a lot of additional data points which validate or give additional strength to the evidence behind the wellness model that we’ve created,” O’Brien said.

They also are encouraged by the interest that other providers have shown in the model, including a boost to the wellness coaching initiative that Mather developed in conjunction with Wake Forest University and Virginia Tech.

And Mather is continuing to evolve its own wellness offerings at its communities near Chicago and in Tucson, Arizona, and under development in Tysons, Virginia.

Leary teased a “creative arts and creative aging” forum in works, in collaboration with the Kennedy Center, Georgetown University, the National Institutes of Health and other organizations. A goal is to examine how to promote and facilitate older adults’ greater involvement in the arts.

A positive story for senior living

Throughout the pandemic, many senior living leaders have expressed concern that the sector’s reputation has taken an unfair beating due to skewed media coverage. News reports have not always distinguished senior living communities from nursing homes, in stories focused on high rates of infection and death, resident isolation and other issues.

In the early months of the pandemic, Aegis Living CEO Dwayne Clark described Covid-19 as a “three-front war,” with one front being the battle to maintain the industry’s reputation; Bickford Senior Living EVP Alan Fairbanks said, “As an industry, we have to get ahead of this so we can tell the accurate story.”

More recently, data has started to emerge that helps senior living organizations tell a more positive story, including a study showing that two-thirds of independent living communities reported no Covid-19 deaths in 2020, and IL residents were as safe as older adults living in non-congregate settings.

These latest Age Well findings also help make the case for senior living, Leary and O’Brien said.

There are some caveats — independent living residents likely had a greater ability to connect with family and friends compared with residents in higher levels of care, and strong relationships correlated with greater resiliency, Leary noted. Still, she highlighted that utilizing technology and other alternative methods of staying connected with loved ones helped senior living residents maintain a sense of connection to their loved ones.

And O’Brien emphasized that the findings not only highlight the strengths of life plan communities but challenge a common media narrative portraying older adults as vulnerable and at-risk.

While older adults are more physically at risk of severe Covid-19 infection, this does not tell the whole story.

“This just adds more to the research that suggests that in terms of emotional resilience, older adults are often more resilient than other age groups,” O’Brien said. “Older adults are resilient. I think that’s an important message from the study.”

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