Joan’s Journey: ‘Comfort Zones’ Important for Successful Senior Living

Welcome, Joan’s Journeyers. In our last two blogs (read them here and here), we took an up-front and personal look at illness, dying and death at senior living. Prospective residents need to consciously explore their feelings in order to know their comfort zones. The bottom line for families is to discuss this topic among themselves, and with marketers and administrators of senior living communities.Comfort Zones are Vital in Senior Living

Along my search for senior living, I walked down a long hallway and a quite elderly woman in a wheelchair, pushed by an aide, was heading in my direction. The woman’s face was deformed as though she had a stroke. I felt pained as I glanced at her. To my great surprise, she smiled a big, beautiful smile—as she looked directly at me. She then said as she passed, “Your shirt is such a lovely shade of violet. It goes beautifully with your hair.”

Instantly, this bright, observant woman no longer looked deformed. Her kind eyes and thoughtful comment touched my heart. This woman, despite the adversities she faces, reached out to me, a stranger in her residence, to make me feel comfortable. And she succeeded.

I chose to live in a senior community that does not differentiate by function or medical condition. All financially qualified seniors who meet the admissions criteria are welcome. Fortunately for me, I worked for 11 years in a children’s hospital and am comfortable around walkers, wheel chairs, oxygen tanks and caregivers. For others, this type of community may be beyond their comfort zones.

Comfort zones vary among individuals. Categories of senior communities range from:

  1. Completely independent folks at 55+years;
  2. Physically challenged individuals;
  3. Mentally and\or cognitively challenged individuals; and
  4. Those in need of hospice care.

Some communities separate these functions, while others combine conditions. The key to successful senior living is to know residence categories before a decision is made, and know where one’s comfort zones lie.

In the next Joan’s Journey, we move from inside the senior residence to senior living as part of its neighborhood, city, state and country. We explore the two-way street of visitors who come to senior communities and external community participation.

Thanks to the many Journeyers who posted comments discussing their experiences and thoughts regarding illness, dying and death in senior communities. In the Comments Box below, and I invite you to continue to share your experiences. Until our next  blog in mid-November,, enjoy the journey day-by-day.

Joan London, a former Houston Chronicle correspondent and noted magazine writer/editor, specializes in freelance writing/editing of issues relating to seniors. London moved to a senior community in Southern California, where she has enhanced her quality of life and is close to her children and grandchildren. Read about her entire journey here.

Do Seniors Need to Worry About Ebola?

Turn on any newscast in America, put on a talk radio station or open your local newspaper, and there’s one word sure to come up: Ebola.

Plenty of news surrounding the virus is valid. There has been an epidemic in West Africa, with thousands of deaths. There has also been a small handful of cases in the United States. But there’s also been plenty of over-the-top hype—you may have heard various sources claim that the disease can be spread by being on the same plane or subway as someone carrying the virus. Considering Ebola can’t spread through the air, these claims are all highly unlikely, to put it mildly.Syringe

But, still, the virus is out there, and has caused a degree of panic across the country. And, seeing as seniors are more at risk for many viruses and diseases, it only makes sense to raise the question: Should older adults be concerned about contracting Ebola?

To put it bluntly, no. At least, not unless they have been in some pretty remarkable circumstances. And there’s certainly no need to worry more about Ebola than other viruses that cause problems each and every year.

Instead of Ebola, Worry About the Flu

While Ebola has received most of the news coverage, it’s once again flu season, which should be a red flag for seniors and their caregivers. The Centers for Disease Control estimates that 90 percent of America’s seasonal flu-related deaths occur in people 65 and older. But there are simple ways to help combat these problems:

  • Get a flu shot.
  • Follow basic health and hygiene habits, such as washing your hands and covering your coughs.
  • If you exhibit any flu symptoms, get to a doctor.

As we’ve previously discussed on the blog, the CDC is also strongly encouraging family caregivers to get flu shots. Seniors are more susceptible to getting the flu than most segments of the population, making it even more important for those who care for older adults to get the vaccination, protecting themselves and those for whom they care.

By following these steps, seniors and their caregivers can take precautions against a disease that poses a major threat—and can ignore some of the news regarding a disease which poses virtually no threat.






Our Hopes, Our Values: A Look Inside celebrated its five-year anniversary this year. What was once a two-person startup company that met in coffeehouses in Seattle and Kirkland now has 20-plus employees in office space spanning two floors in Seattle’s Eastlake neighborhood. With this milestone came the realization that it was time to revisit our company values to determine whether they still reflect how our company operates.

While other companies may have a top-down approach to setting values, at, it is an employee-driven approach. This approach is reflective of the attitude that is found in the startup world as opposed to well-established corporations or state agencies. The employees expect more from a company than just a paycheck; we expect a workplace where we truly want to spend every working day. Otherwise, what is the point of working here?Members of the Values Team

Every Monday morning for the past two months, our values team met for discussion. No management positions sat at the table, and each department had a representative. Working from a list of 100-plus value words that the entire company submitted, our task was to use the words as inspiration for our new value statements.

The brainstorming wasn’t difficult, grouping similar words together, but there were moments when our HR representative was forced to break the awkward silence because no one was sure of what to say next. And in keeping with the sense of laidback personalities around the table, no one felt the need to take charge or dominate the conversation. What the discussions revealed was agreement on the concepts but disagreement on the word choice.

Though the values are still pending final review by the team and management, what this process showed was the values adopted five years ago are still current. We are still dedicated to quality or embracing change, but we could benefit from refinement and additions. We still encourage balance between our work and personal life, but also, being a dog-friendly company is a value that everyone agreed should be called out!

When it came time to our core purpose statement, which is still in draft stage, an hour-and-a-half meeting came down to a 10-word statement of purpose. What these discussions showed was how to best summarize the dual-natured work we do: connecting seniors with a senior retirement community while improving the marketing of senior living providers.

Stay tuned as we unveil our new company values in a couple weeks.

The Robert Frost Guide to the Fall

Fall is a beautiful time of year. But for seniors and their caregivers, much work accompanies the crisp afternoons. Fall is the time to make preparations to ready your yard and landscaping for the cold to come. With a bit of preparation—and inspiration from Robert Frost—you and your plants will weather the winter happy and healthy.

Leaves are Beautiful—and Dangerous for SeniorsRobert Frost Historic Site

O hushed October morning mild
Thy leaves have ripened to the fall;
To-morrow’s wind, if it be wild
Should waste them all

Frost is right; the October leaves on a tree are beautiful and impermanent. A stiff wind may waste the beauty. But when those beautiful leaves fall to the ground, they also become dangerous and slippery. Keep your walkways clear to reduce your risk of falling. If you compost, cover the surface with a generous layer of the leaves you pick up. They will keep the compost the appropriate temperature and will soon become dirt themselves.

Be careful when raking your leaves—raking sends people to emergency rooms each year. Here are quick tips to avoid injury:

  • Warm up with some light exercise and stretching before going outside.
  • Wear gloves to prevent blisters.
  • Bend at the knees, not the waist.
  • Prevent stress injuries by regularly changing how you hold the rake and how you stand.
  • Avoid twisting motions like throwing leaves over your shoulder—they put undue stress on your back.
  • Don’t overfill leaf bags, and be aware that if the leaves are wet, they will be even heavier.
  • It’s better to take another trip rather than hurt your back.

Use the Crisp Fall Mornings to Ready Your Home

The crows above the forest call;
To-morrow they may form and go
O hushed October morning mild
Begin the hours of this day slow

In these lines, Frost wants to stretch the beautiful fall days and let autumn’s glory unfurl ever so slowly. Begin the hours of your day gently and start your home maintenance on the inside. Here are some easy home maintenance tips:

  • Place markers along paths that will stick above the snow. They will be your guide when you are shoveling, protecting your garden beds.
  • Make sure your outdoor lighting is providing bright light—replace burnt-out bulbs.
  • Clean your gutters when the leaves have all fallen and check your drainpipes for leaks.
  • Before the first frost, bring in your garden hose and shut off water to outside taps to prevent pipe bursts.
  • Check the sealant around windows and doors, and secure all vents and openings, to keep the wet and cold out.
  • Be careful when using ladders while doing your maintenance. Don’t climb in wet shoes and make sure all safety locks and braces are in place. All four legs should be on a firm, level surface.

Protect Your Plants from the Winter to Come

Make the day seem to us less brief
Hearts not averse to being beguiled
Beguile us in the way you know;
Release one leaf at break of day;
At noon release another leaf;

In lines 9-13, the Pulitzer Prize-winning poet captures the splendor of the season. Fall is magical. It transfixes us as leaves fall, one by one. But don’t gaze at the beauty too long or your plants won’t make it to spring. Here’s your checklist for helping your plants survive the winter:

  • Bring potted plants indoors so their roots don’t freeze.
  • Protect sensitive outdoor plants by wrapping them in plastic or burlap. Small plants can hide under overturned pots or buckets.
  • Mulch is great for keeping roots from freezing and keeping in moisture during the dry winter. Get hardwood shredded mulch from your local garden supply store and spread it 2-3 inches deep around the base of each plant.

Clearing the Fall Foliage for Fantastic Color

One from our trees, one far away;
Retard the sun with gentle mist;
Enchant the land with amethyst

Fall is the time to pluck spent blooms and pull out dead annuals. Do the clearing work now so you savor the radiant color.

Remove dead branches and trim branches that hang over your house. Branches become heavy with snow, and you don’t want them to break and fall. Make sure to look up before cutting branches and be careful to stay away from power lines.

Remember, most plants do not need pruning, because pruning encourages growth. The exception is roses: cut roses to a third of their height after the first frost. Don’t worry, they will grow back more beautiful than ever, adding their radiant colors to the spring to come.

Don’t Do It All Yourself

Slow, slow!

With “Slow, slow!” on line 17, Frost cautions the reader. Savor both his words—and the season. Don’t feel the need to tackle all the seasonal preparation today or by yourself.

Hire a professional to examine your chimney and furnace, and get the neighborhood teenager to clean your gutters. Now is also the best time to hire someone to keep your sidewalks shoveled and de-iced. Prepaying now might mean you get clean sidewalks first.


For the grapes’ sake, if they were all
Whose leaves already are burnt with frost
Whose clustered fruit must else be lost–
For the grapes’ sake along the wall

Frost was born in San Francisco, a land of two seasons, but he was transfixed by the fall and has become associated with the splendor of New England.

Enjoy October—both the poem and the season—and be prepared for the winter to come.

October by Robert Frost

O hushed October morning mild
Thy leaves have ripened to the fall;
To-morrow’s wind, if it be wild
Should waste them all
The crows above the forest call;
To-morrow they may form and go
hushed October morning mild
Begin the hours of this day slow
Make the day seem to us less brief
Hearts not averse to being beguiled
Beguile us in the way you know;
Release one leaf at break of day;
At noon release another leaf;
One from our trees, one far away;
Retard the sun with gentle mist;
Enchant the land with amethyst
Slow, slow!
For the grapes’ sake, if they were all
Whose leaves already are burnt with frost
Whose clustered fruit must else be lost–
For the grapes’ sake along the wall

Shayne Fitz-Coy is the Co-CEO and President of Alert-1, an aging-in-place technology company headquartered in Williamsport, Pennsylvania with offices nationwide. Shayne is an NAHB Certified Aging in Place Specialist. Unlike Robert Frost (who dropped out), Shayne graduated from Harvard College. When it comes to writing however, Frost comes out on top.

The Last Stop: It’s the Little Things

Life goes on for me at my retirement community. Nothing too dramatic. I listen to the world news, the national news, the weather traumas, and know how fortunate I am to be living in this safe, comfortable environment in Colorado. Yet with that said, I still Margery's friends work on a puzzleam aware that every day offers a personal choice, a decision and an opportunity.

It’s the little things that I plan to share with my readers in this essay. Little things such as how I manage my meal choices, the leaving of friends and how a new friend resolved his personal complication. No matter how one simplifies one’s life, living is never without decisions.

Read more about the little things that make a difference in Margery’s life in “Part 12: It’s the Little Things.”

This post was written by Margery Fridstein, an author and retired psychotherapist who lives in a CCRC outside of Denver, CO. She is chronicling her experience in the monthly series, “The Last Stop With Margery Fridstein.”

Who Rocks Aging Better?

Who do you think is rocking aging better: Meryl Streep or Madonna?

There is at least one thing these two leading ladies share in common: They’re not letting aging slow them down. Many older adults are living more active lifestyles these days. For more about enjoying an active lifestyle throughout your older years, check out these resources: Honored as One of Washington’s Fastest-Growing Companies!

We are proud and honored to be listed as one of Washington State’s 100 fastest-growing private companies, as ranked by the Puget Sound Business Journal!, which is based in Seattle, ranks 69th on the PSBJ’s annual list. In all, the 100 companies combined to record more than $2.08 billion in revenue in 2013. In order to qualify for consideration, companies must have recorded at least $500,000 in revenue in 2011 and demonstrated revenue growth through 2013.

All companies must be privately held during the reporting period and be headquartered in Washington State. Additionally, they may not be subsidiaries of other companies. Revenue growth is calculated as a percentage between 2011 and 2013, and this figure is used to determine each company’s

This represents the third such recognition in a string of awards and honors received by us in recent months, which COO Jay Goldstein attributes to the company’s strong culture and commitment to success.

“The credit for this accomplishment goes to everyone in our company,” Goldstein says.  “None of this would be possible without the hard work, intelligent insights, and focus on customers (both consumers and providers) that each of our team members brings to every day.”

Earlier this year, we earned a spot in the prestigious Inc. 5000 for 2014, landing at number 678 among 5,000 innovative, successful enterprises. Additionally, we were recognized in the 23rd annual National Mature Media Awards Program by the Mature Market Resource Center, earning a Silver Award for the National Media Division in the Web Site Category.

“We’ve put the customer at the forefront from day one, and it’s allowed us to envision and execute innovative programs, like our Best Senior Living Awards program, the industry’s only quantitative-based evaluation system for senior living communities,” says CEO Chris Rodde. “We’re honored to receive a distinction so well-deserved by our dedicated team.”

Through our directory of more than 80,000 senior living communities, the innovative Best Senior Living Awards program, thousands of expert-written articles and free Care Advisor service, aids more than three million seniors and their families in their search for senior housing every year. We are proud of what we do each and every day here, proud of our growth and recognition, and invite you to find out what sets us apart!

Joan’s Journey: Famous 1873 Poem Describes Senior Living

Ron. Harriette. Jerry. Three names commonly used in today’s Western countries. Common names, yes—but unique to each individual who answered to the words. For me, “Ron,” “Harriette”  and “Jerry” are the names of folks whose memories evoke smiles on my face and joy in my heartJoan's friend Harriette (left)

These three folks, “like ships passing in the night,” touched my life ever so briefly along my journey of senior living at Holiday Villa East (HVE). Within six months of my arrival, each had passed away. But their friendship, kindness, intelligence and grace, under the most difficult of circumstances, will remain with me forever.

Welcome, Joan’s Journeyers. In our last blog, I was completely upfront about the life-cycle experience of illness, dying and death at senior living. I chose this topic for discussion because I believe it’s extremely important for a senior and his or her family to consciously explore one’s feelings of all aspects of senior community living—before one makes a choice of residence. A past blog, “Senior Communities Embrace Life, Even at the End,” posted on Oct. 1, discussed this topic.

Our current blog advances further to personally highlight three fabulous folks who experienced illness, dying and death while living in a senior community.

Learn more about Ron, Harriette and Jerry, and the impact they had on Joan’s life, visit the latest installment of Joan’s Journey, “Part 23: Famous 1873 Poem Describes Senior Living.

Joan London, a former Houston Chronicle correspondent and noted magazine writer/editor, specializes in freelance writing/editing of issues relating to seniors. London moved to a senior community in Southern California, where she has enhanced her quality of life and is close to her children and grandchildren. Follow her series, Joan’s Journey, on

CMS to Overhaul Nursing Home Compare

It seems the Centers for Medicare and Medicaid Services (CMS) has been paying attention. While the agency’s five-star rating system for nursing homes has always been the subject of a fair share of criticism, new concerns started gaining speed in the media within the past few months. At the beginning of September, we reported on criticisms surrounding the self-reporting measures and other practices leading some experts to say that they doubt the integrity of the rating system as a true barometer of quality of care.

IMPACT Act aims to improve quality ratings for skilled nursing facilities

On Oct. 6, President Obama signed the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, which aims to improve quality through increased transparency and standardized assessments in several areas surrounding critical care issues across skilled nursing facilities, home health agencies, long-term care hospitals, inpatient rehabilitation facilities, and other post-acute care (PAC) providers. Nursing Home Compare overhauls rating system

IMPACT will allow both payments and patient outcomes to be compared across these providers, fueling the development and public reporting of quality measures and facilitating the provision of new PAC payment models, to be presented to Congress by the Medicare Payment Advisory Commission (MedPAC), according to Long-Term Living Magazine.

New changes directly address recent criticisms

But in direct relation to the current five-star rating system used by CMS to grade skilled nursing facilities, there are some big changes coming, many targeted specifically at areas of concern recently addressed in the media. IMPACT, it’s worth noting, however, was first introduced back on June 26 and enrolled as a bill on Sept. 18.

Long-Term Living Magazine summarizes some of the changes that will occur as a result of the passing of the IMPACT Act of 2014:

  • More quality measures will be added to the rating system, beginning in January 2015, including re-hospitalization rates and anti-psychotic drug use.
  • Staffing data will be gathered directly from payroll records rather than through self-report.
  • Scoring methods will be re-evaluated to ensure they accurately represent the quality of providers earning these ratings.
  • A national auditing system will be rolled out to verify information reported through on-site visits.

New measures taken to verify formerly self-reported data, such as staffing ratios and staff turnover rates, are particularly welcomed by critics. Cheryl Phillips, MD, LeadingAge’s senior vice president of public policy and advocacy, tells Long-Term Living Magazine that staffing is one of the most accurate indicators of quality in long-term care settings.

Self-reported quality measures overshadow accuracy

In fact, it’s the self-reporting measures which the debate has primarily centered on in recent months. The controversy surrounding the hotly debated Medicare star-rating system heated up again after the U.S. Department of Health and Human Services Office of Inspector General released an August 2014 report finding that in a random sampling of 209 nursing homes, only 53 percent of allegations of elderly abuse, neglect, or exploitation are reported to federal agencies.

As self-reporting is currently the relied-upon method the CMS utilizes to gather data which determines a skilled nursing facility’s star rating, this naturally casts a shadow over the perceived accuracy of the ratings.

Sweeping changes to data collection and verification to begin in January 2015

While the improvements are expected to take at least one year to implement, consumers will begin to have access to more legitimate, verified data beginning in January. Nursing homes will begin reporting staffing ratios quarterly, and this information will be verified through payroll documents.

Also beginning in January, nursing homes will be rated on the percentage of residents:

  • Receiving anti-psychotic drugs
  • Re-admitted to a hospital
  • Discharged (released) from nursing home care

Most importantly, the system will eventually provide consumers access to this deeper data, such as staff turnover rates and other quality measures. While the additional measures will begin to be incorporated in 2015, this new data won’t actually be reflected in nursing home ratings until 2016.

These changes represent an increasing demand among today’s savvier consumers for high-quality, independent data that provides a true standard metric for navigating the challenges in decision-making when it comes to placing an aging loved one in senior housing. This is the need aims to address with the Best Senior Living Awards, an independent rating system for assisted living, independent living, and other senior housing options to provide families with a standard metric and valid, third-party ratings from experts to aid the decision-making process.

Big Changes to Assisted Living Laws in California

California Gov. Jerry Brown just signed into law 10 of 14 bills aimed at protecting assisted living residents in the state. According to the Sacramento Business Journal, the laws are “designed to address what some say is a crisis of care in assisted living facilities across the state.” The new laws span a variety of components of assisted living, such as additional training requirements for owners of assisted living communities, to statutory rights for residents, and perhaps the most critical change: State regulators now have the ability to suspend admissions to an assisted living community which has received a number of violations deemed to pose a risk to the health and/or safety of residents.

Increased fines and stricter training requirements New California Assisted Living Laws

U-T San Diego notes that the largest fine is now $15,000—for violations resulting in the death of a resident—a marked increase from just $150. This particular bill, focusing on increased fines, was co-authored by Assemblyman Brian Maienschein, R-San Diego, and it applies to all community care facilities in the state, not just assisted living communities. U-T San Diego brought attention to the markedly low fines for serious injury and death in a series of articles which highlighted 27 deaths and hundreds of injuries caused to residents in senior living communities in San Diego county alone, allegedly caused by abuse and neglect. U-T San Diego calls this series of bills “the state’s most sweeping overhaul of the industry in nearly three decades.”

The entire reform package was initiated earlier this year, sponsored by California Advocates for Nursing Home Reform, which released its own report last year with some concerning details about residential care in California. Legislators were motivated by this and other reports concerning a lack of adequate oversight in the senior living industry.

Here’s a look at the 10 bills signed into law by Gov. Brown and the focus of each:

  • SB 1153 by Senator Mark Leno (D-San Francisco) – This bill permits state regulators to suspend admissions to a residential care community with violations that place resident health and safety at risk.
  • AB 1570 by Assemblymember Wesley Chesbro (D-Arcata) – This bill outlines increased training requirements for owners of residential care communities in the state, as well as direct care staff.
  • SB 911 by Senator Marty Block (D-San Diego) – Similar to AB 1570, this bill increases training requirements for administrators of residential care communities (rather than licensees) and direct care staff who perform specific duties.
  • SB 1382 by Senator Marty Block (D-San Diego) – Another bill relating to increased training requirements, this bill addresses increased requirements for licensees (owners), administrators, and direct care staff.
  • AB 1751 by Assemblymember Richard H. Bloom (D-Santa Monica) – The signing of this law means that residents in California assisted living communities must now have representation on governing boards of residential care facilities as well as quarterly reporting of financial statements.
  • AB 1899 by Assemblymember Cheryl Brown (D-San Bernardino) – This law, in response to an incident occurring in response to the abandonment of 19 residents at a senior living community at Valley Springs Manor in Castro Valley, now prohibits the reinstating of a license to any licensee who abandons a facility and therefore places residents’ health and safety at risk.
  • B 2044 by Assemblymember Freddie Rodriguez (D-Pomona) – This bill addresses specific staffing requirements for residential care communities, along with health and safety requirements.
  • AB 2171 by Assemblymember Bob Wieckowski (D-Fremont) – Establishes statutory rights for residents, and requires the display of resident rights within the senior living community.
  • AB 2231 by Assemblymember Richard S. Gordon (D-Menlo Park) – Re-instates a previous program which provides property tax deferment for seniors and the disabled.
  • SB 895 by Senator Ellen Corbett (D-Hayward) – The signing of this bill means that residential care communities must now rectify licensing deficiencies within 10 days after notification.

Changes are beneficial for residents

These new requirements will now mandate that a CPR-certified staff member be on site at all times. Additionally, senior living community operators are now prohibited from punishing a staff member for calling 911 to obtain help for a resident facing a serious or emergent health concern. Previously, this was discouraged by some operators who believed it to reflect poorly on the community’s ability to provide adequate care, and, in some cases, was discouraged due to the impact transport would create for the community’s occupancy levels. In any case, staff members may now feel confident in seeking the necessary help for residents in emergent situations without fear of repercussion.