Long-Term Care

Preparing for baby boomers

Contemporary Long-Term Care Weekly, January 29, 2009

Take a look at today’s nursing home and think about how you’d want it to look if you were staying there. Would it look the same as it does now?

Preparing for baby boomers means a big physical and environmental change for nursing homes.

“We haven’t done a lot of talking about [preparing for baby boomers]. We’re still busy taking care of our elder patients that we’ve got now, and everyone is talking about that group, but when you think of the baby boomers coming in, they’re different,” says Cathleen A. Bergeron, RN, MSHA, CDONA/LTC, Massachusetts chapter president of the National Association Directors of Nursing Administration in Long Term Care.

The baby boomers have higher expectations and are more vocal about care.

“If you look at our clientele now, the people who are vocal about the elders are the daughters and the sons; they are our residents of the future,” says Bergeron.

“The first thing everybody needs to understand is there is no baby boomer,” Robyn I. Stone, DrPH, executive director at the Institute for the Future of Aging Services and senior vice president of research at the American Association of Homes and Services for the Aging in Washington, DC.

“They are not a homogeneous group; they’re very different depending on the age cohort,” Stone says.

Older baby boomers often have different wants and needs than younger baby boomers, she says, adding that they also might differ in terms of economic situation and lifestyle.

Individuals are accustomed to their personal lifestyle and social preferences, and facilities need to be able to adapt to those preferences, Stone says. Today’s typical nursing home resident comes directly from the hospital for postacute care, Stone says, adding that “there [isn’t] a lot of choice there; they just need to go somewhere.”

Facilities’ first priority should be quality of care. “The baby boomers will want more choices in terms of options of places to go,” Stone says. In the past, expectations for nursing homes have been relatively low, she explains.

“I think with a lot of the work that’s being done now on looking at quality and raising the issues to consumers, [baby boomers] will be interested in understanding what kind of quality is being provided,” Stone says, adding that facilities should not only provide better quality, but be able to demonstrate that as well. “How are they going to develop a marketing advantage in terms of quality of care and quality of life?” she says.

The concept of culture change plays a role in appealing to baby boomers because it provides:

  • New models of noninstitutional environments
  • Resident-centered staffing
  • Family involvement in decision-making

“In general, I think you’re going to see that people tend to be more highly educated than they were in the past, and they’re going to be much more interested in looking at the fine elements of what is being offered in the nursing home,” Stone says.

Culture change
The concept of a culture change and organizing an environment that focuses on independence will be a factor for baby boomers choosing nursing homes, Stone says.

It’s important to provide these residents an opportunity to:

  • Schedule desired meal times
  • Request meals
  • Schedule desired bathing times
  • Grab desired snacks from the refrigerators
  • Have access to certain types of technology, such as computers and flat screen TVs
  • Create a flexible sleep schedule
  • Engage in appropriate social activities 

The physical environment
The physical environment is important to baby boomers, and private rooms will have the most appeal. “[Baby boomers] have bigger homes and won’t want to be sharing a bedroom with strangers,” says Bergeron.

Baby boomers might also expect to have:

  • Plants
  • Pets
  • More windows
  • Access to various outside areas
  • Vacation appeal

“[Baby boomers are] going to want to think they’re on vacation, but in a therapeutic environment,” Bergeron explains. “That means a high-tech, highgloss approach.”

High-tech advances might include:

  • Rubberized floors to prevent injuries from falls
  • Ceiling-mounted lifts
  • Moving horizontal walkways or scooter systems
  • Security screens to monitor staff members and residents
  • Electronic charting
  • Beeper technology to alert the nurse which call bell is activated
  • Alternative therapies, such as massage, music, and aromatherapy
  • Automated systems, such as medication and food carts

“We’re going to have to automate a lot of systems because we may have limited resources at the bedside to provide direct care,” Bergeron says.

Staff training“[Facilities] need to be thinking about how to develop a system that is much more consumer-friendly,” Stone says. “At the same time, they’re going to see a much higher-acuity resident population, because the lower-acuity people won’t be in nursing homes; they’re going to be in the community somewhere.”

Because of that, nursing homes are going to need a staff that is more skilled in taking care of very sick people, including postacute care.

“In addition, they’ll need to know a lot more about how to deal with dementia and how to create healthy environments for people with dementia,” Stone says.

Know your residents
“It’s really important for nursing homes to understand their markets and to know more about the people that live in their community,” Stone says.

Facilities need to adjust the way they run depending on the types of residents they receive. “I think it’s going to have to be [a financially reasonable] change. Otherwise, nursing homes won’t stay in business because of competition, and some facilities might not be able to draw in residents,” Bergeron says, adding that “the rules that we have now will have to be bent.”



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