Senior Living Engagement and Wellness with Jim Concotelli MSW, Ph.D.

Dr. Jim Concotelli recently retired after over 30 years in the senior housing industry. He worked in senior leadership positions for several of the largest management companies developing holistic wellness programs and memory care service models. Several of Jim’s programs won national recognition including three Argentum “Best of the Best” awards and an International Council on Active Aging “Innovators Award.” Many of these programs are still active in senior living communities around the US. Currently, his company Living Wise and Well, provides consulting services and online mind/body classes.

Hanh Brown: [00:00:00] Today, my guest is Jim . He’s worked in the healthcare and senior housing settings with a focus on whole person, wellness and activity, program development, administration, and evaluation for all levels of care.

[00:01:27] He recently retired from 30 years in the senior housing industry, working on resident engagement. So tell us Jim, about how your journey and the changes that you saw in wellness programming over the years.

Jim Concotelli MSW: [00:01:41] Oh, well, first of all, thank you so much for this opportunity, hon. I’ve watched a lot of your videos and your guests, and so I’m honored to be on to that list.

[00:01:50] So thank you for the opportunity. Well, it’s interesting. You get to a point in your life and you start to look back at decades and you start to. Look at some of the things that influenced you to become who you were as a professional. And then as you enter for myself entering the corporate arena and being involved in the largest management companies and senior housing.

[00:02:13] And watching how their programs develop and how they impact residents and staff really with hindsight, have an opportunity to really gain some perspective. So I don’t want to go back too far, but really for me, I have to, because it was in graduate school, looking back now how fortunate I was and how blessed I was to have the mentors that I had and the opportunities that I had.

[00:02:40] And just briefly, but. One of my mentors was Virginia Bell who developed the best friends program, which is now an internationally recognized program for working with individuals that are memory impaired that have dementia or Alzheimer’s. So I had an opportunity to work with her for over a year. She was developing that program.

[00:03:02] Also had an opportunity to research in a nursing home for two years when I was in graduate school. And that was. A really interesting project in that. It was a lot of participant observation. So three times a week for about six or eight hours a day, I was in a rural nursing home interviewing residents and staff and family members and looking at how families are involved and how residents are involved and how staff’s involved.

[00:03:31] All physicians are involved in day to day decision-making. So again, not knowing at that time that that was just going to help me really understand a great deal about aging and about working in the senior care industry. And then really the last great opportunity that I had was to go to China with the first organized group of aging professionals, to be accepted into China, to actually have opportunities to meet with government officials.
[00:04:01] And to her, their senior centers obviously go to their parks and see how active so many of their seniors are every day. And to also visit what they call homes for the elderly, without families. And there weren’t very many of those because we know when China, so much of the tradition is to take care of your parents.

[00:04:22] And so usually those without children really needed that additional support. And the one thing that I took with me, I think that stuck with me and helped me in developing programs was it’s called young Shen, which is nourish life. And it’s a very holistic perspective of how you take care of yourself and take care of your health.

[00:04:44] How you relate with your family and the responsibility of taking care and social relationships with your community. But most importantly, the self care that’s part of that young Shan, which we see Tai-Chi and she gong and, you know, Chinese medicine. So looking back that just set me up in a really fortunate way to start to move into the senior housing industry.

[00:05:10] When I first started, I had, again, an opportunity to live in a CCRC community for 60 days. So my first job where I was director of programs, my wife and I just because of circumstances with us moving ended up living in the community for two months. Again, looking back what a blessing that was learned so much because I’m eating my meals every day with the residents.

[00:05:35] Anytime I’m going in or out of the building, I’m interacting with the residents. So I really got a very personal view of kind of the perspective that residents have moving in and living in a retirement community. How does that relate to programming? And the way programming has developed and resident engagement over the years is that when I first started in that retirement community, you know, they had a basic calendar of events and so they had outings and they had some exercise.

[00:06:03] But there really wasn’t kind of a model or a structure to the calendar of events. And so that’s where I started to develop more of a wellness perspective, whole person, wellness and programming. And really the model that I took was from the national. Wellness Institute. They had a six dimension model of wellness where we talk about physical, intellectual, social, purposeful, spiritual engagement.

[00:06:30] And so we started to devise kind of that model as a lens in which we looked through our calendar and developed our programs. And so after a couple of years in that community, I was offered an opportunity to work in a corporate position with a company that had started with 25 communities. And over a 10 year period of working with them, developed into a company that owned and managed a hundred communities.

[00:06:57] And so took kind of that basic program and moved it out into this larger arena, into all of these companies. And I saw at that time going to conferences that many people were starting to move in that direction. So it was a very positive influence. I think on developing that type of program, the marketing folks were always very happy to see.

[00:07:20] Kind of that wide variety of activities. So when they were bringing prospects into the community, they could point at all of the different dimensions of wellness and all of the different programs offered under each of those. So it was very opportunistic for a new resident to say, Oh, well, I do like to still go out to the community.

[00:07:41] So I still want to go to plays or musicals, or I still want to go to the farmer’s market. And of course, The physical dimension being so important to have a wide variety of exercises and opportunities in particularly for strength and balance, because we know as we get older that we really have to take care of our legs and our balance and our strength to maintain our health.

[00:08:06] So over the years I saw the international council on active aging that was formed. I think, back in the nineties. They adopted that whole person wellness model, they added in environment. So it became like a seventh dimension. And then I think that through kind of the research that was being done on successful aging at that time, which was the MacArthur study and a book written by a doctor’s role in successful aging, kind of.

[00:08:34] It gave evidence and credence to like how important it is to have a broad array of interests and opportunities to stay engaged and stay involved, not only in your personal health, but in your community and your social relationships. Just lastly, I think right now, We all know the challenges with COVID-19 and what it’s done to our retirement community.

[00:08:59] So many of those calendars have just gone out the window at this point, because it’s hard to gather in large groups. Many of the residents still are not able to do that. So it becomes more individualized person centered programming and more hallway types of programs. I think as we get further along with understanding and being able to manage kind of the health consequences and the prevention that’s necessary, there are some changes now starting to happen in some of the communities where they’re starting to open up a little bit more.

Hanh Brown: [00:09:34] Yeah. The amenities that you described with regard to wellness and physical activities and engagement. Those are all selling points, right? Those are the positives of why you go into the senior living communities to be vibrant, healthy, engaged will unfortunately social distancing across the world. Now limiting those amenities in senior living communities.

[00:09:58] So I guess we all have to come up with a new narrative as far as what the value proposition is to a loved ones. Going into senior living is a challenge.

Jim Concotelli MSW: [00:10:09] Well, it is a challenge because now safety has risen to the top. So when a prospect now is doing a virtual tour, not very many are actually coming in for a live walk through.

[00:10:20] So, so much of what sales and marketing is doing now is video chats and virtual tours. And the amenities still. I know, like in my local gym here, you know, it’s open, but there’s not as much participation. And there are strict, um, kind of guidelines that CDC promotes in relationship to wearing masks and cleaning equipment, but just participation has dropped down a lot.

[00:10:46] So not being in a lot of retirement communities right now, but speaking with individuals that are still working in the industry, they are challenged with the pools, just sitting there, the fitness centers, just sitting there. And even I have siblings that are retired and living in gated communities, and they’re not going back to the fitness center.

[00:11:06] They basically started to design a home fitness program and walking a lot. And so, yeah, it’s beautiful amenities that a lot of these communities have. And hopefully as we get more knowledge about COVID and more kind of in tune to the necessary precautions, we’ll be able to slowly open those amenities back up.

[00:11:27] But it is a large selling point, you know, depending on the type of community, is it an entry fee? Where it’s a large campus. Usually those have the best amenities that they might have a golf course. They might have tennis. They have a very nice fitness center and usually personal trainers. They have a lot of space for like an art studio or for a wood crafting studio.

[00:11:53] And I’m sure that those residents are. Taking as many precautions that are necessary, but no it’s part of their purpose and part of their meaning to be able to participate in their own engagement that relates to their fitness or relates to the meaning or purpose that they have. And I know that they’re intelligent and creative and the staff, they are heroes, the work that they’ve done in these communities.

[00:12:17] It’s just amazing to see some of the creativity that’s come out in some of the staff. To keep the residents engaged and active and as many ways in a safe way that they can.

Hanh Brown: [00:12:28] Absolutely. They are a blessing to our parents and grandparents and the older adults, and God bless them for continuing to protect, engage and take care of all the baby bloomers.

[00:12:39] So very thankful for that. All right. Well, let’s see.

[00:12:45] What do you think is the most important behavior aspect for the baby boomers to focus on when it comes to wellness and aging?

Jim Concotelli MSW: [00:12:53] That’s a great question. And I’ve spent my career doing due diligence and following the research and trying to identify the best guidelines for healthy aging, successful aging, whatever the term might be.

[00:13:10] And I think some of the. Best work that I mentioned, Rohan Kahn’s work that was done through the MacArthur study and following people over long periods of time is a good model, but probably the most current is Dan Buettner’s work on the blue zones. So anybody’s listening has not looked at his work.

[00:13:29] There’s a lot that’s available online, or he has several books that are available. And basically his study, he went to some of the hotspots in the world that had the longevity more so than any other places. So they live longer and they had better health, both of those combined and what he found and what I kind of modeled my lifestyle after is first of all, physical activity.

[00:13:56] Walking is great. And it can be enough as long as you’re getting outside, anytime that you can, or at least hitting in the steps that you need every day. That’s a good first place to start. And then I think strengths is really important. As I mentioned earlier, especially for balance to keep your legs strong, to keep your agility.

[00:14:16] And even your upper body strength in your hands to be able to manipulate. And she ain’t be able to move things and put things up on a shelf. So you got to keep your body strong and you’ve got to keep it healthy and keep it active. That’s probably foremost the other components that I’ve seen. If we look at the blue zones and we look at kind of, you tease out.

[00:14:38] Through other research, you know, what are the most important socialization is really important. And we all know that we have to really pay attention, especially now, how do we stay connected? A lot of it needs to be online or texting or emails or phone calls, but staying connected, having a social network of some close friends and family that you can communicate with.

[00:15:02] I don’t think there’s anybody alive right now that doesn’t have some downtimes right now. And just, it’s a little bit blue about how long is this going to go on? And there’s just periods. And so you need to have some friends that you can chat with about that and help each other. Keep a positive attitude and keep looking forward and keep doing the things that are necessary for you.

[00:15:22] And then, so then we look at brain health. Especially when we’re looking at some of the challenges, age, being the number one risk factor for dementia or cognitive challenges as we get older. So to have some mental stimulation, to have things that you’re interested in that you’d like to read, or you like to watch documentaries or whatever kind of stimulation that you can get mentally to keep yourself sharp and engaged.

[00:15:51] That’s important. And then I think what I’ve seen a lot is meaning and purpose. So something like when you get up in the morning, you start thinking about like, Oh, I can’t wait till I go start on this art project, or I’m working on a poem, you know, something in your mind as you get up in the morning that motivates you to get going and to get engaged.

[00:16:13] And so to have something meaningful, one thing like in the blue zones is gardening. I mean, that’s just, you’re getting the physical activity. You’re getting the kind of meaning and purpose of planning, you know,

Hanh Brown: [00:16:28] the beauty of the transformation.

Jim Concotelli MSW: [00:16:33] Exactly. That’s a key point. So you’re watching seeds grow.

[00:16:36] You’re watching them mature. You’re watching them produce your tomatoes, your cucumbers or herbs that you can take to cook with. I have a small garden space. We live in a townhouse, but I have a small garden space with some raised beds. And. One of the fun things I’ve done in the last two or three weeks is I picked tomatoes and I go knock on my neighbor’s door.

[00:16:56] Like, Hey, you know, because my wife and I can only eat so many, but it’s great to go share with my neighbors. And we chit chat for 10, 15 minutes and we kind of get some social time and I get to share the beauty and the bounty of my garden and in the blue zones, that was a key factor too, because many of those were rural communities.

[00:17:15] And so. Guardian is you say not only like watching nature, transform, but the physical activity and the purpose and the planning. I’d be remiss if I didn’t say spirituality, because that’s

Hanh Brown: [00:17:28] that’s the thing mind, that’s like the biggest one, without that it’s very difficult to be successful in the other components.

[00:17:35] Right? You talk about exercise, healthy food engagement, adequate sleep, and so forth. But the spiritual aspect is the strength that you need to be successful with the others.

Jim Concotelli MSW: [00:17:48] Yes. I couldn’t agree more, whatever your faith is, whatever your practice is. It’s something that those that are deeply engaged in the spiritual aspect of their life.

[00:18:00] You do it every day, in some ways, whether it’s praying or whether it’s meditating, but it is a filter that you live your life through. So it impacts your attitude and your openness and your faith and your hope in the future. And so, yes, spirituality is so, so important. You know, when I went to China and I actually went to India as well.

[00:18:25] Doing some research on aging, like in India. A lot of times my wife and I we’d sit down to dinner someplace. And the first part of the conversation ended up being about yoga or spirituality. I mean, it’s just an everyday conversational topic in a lot of our Eastern cultures. And I think that that just lends itself to how important that aspect is.

[00:18:47] And you mentioned nutrition. I mean, I think that there’s a lot of discussion about nutrition and there’s a lot of research and there can be a lot of opinions and really important conversation around that. But I think we all have to find balance for ourselves. And I just think generally whole foods, if you look at the Mediterranean diet is the most researched and most promoted type of diet, and that’s generally eating whole foods and.

[00:19:14] Eating local, fresh foods, as much as you can and keeping a good balanced diet. So those are kind of the key factors. And I mentioned before, I just think, like you said, spirituality and meaning and purpose, because the one thing that I noticed in working in retirement communities and working particularly in.

[00:19:33] Nursing home settings, is that at some point in time, I mean, ADI unfortunately is an a program to slow down and we do lose some of our, you know, depending on kind of the projectory of your lifestyle and how you age, but at some point. Toward the end of our lives. We really it’s more about emotional and spiritual health.

[00:19:55] I think that that’s where we kind of end up. It’s like, how do you feel? How do you relate to people? And how important is your faith and your spirituality to take you through kind of the last phases of your life?

Hanh Brown: [00:20:10] I agree wholeheartedly because I’ve seen it. And I experienced that myself and how I. Speak to that in my own mind to analyze or come up with an analogy, is that your body declines?

[00:20:22] Right? So there’s limitations. Well, driving has been taken away from you. I mean, that’s a big freedom that you’ve had, who knows 60, 70 plus years. And perhaps you might need a Walker or wheelchair. So physical strength is limited. So there’s a lot of limitation that now you have to face. So I believe the only component in your life right now that will allow you to be as imaginative or stretch as far as you can or want to is your spirituality.

[00:20:52] And I think that’s so important. I think if anything, that’s like the biggest component with wellness and aging in every age, but I think it’s more so important or recognize is the later part of your life. And I’m just glad that like you’re talking about it. And I think that needs to have more awareness and education and affirmation to the folks that perhaps are not there yet.

[00:21:17] But the sooner you recognize that you have a more flourish life before you get there?

Jim Concotelli MSW: [00:21:23] Yeah, no. I mean a personal story. My father passed away probably it’s been about 20 years now, but he was 97 when he passed away, he was born in Italy, raised the old ways came to the United States, worked as a laborer, worked hard, all his life, retired in his sixties.

[00:21:40] And then took a part-time job just to kind of keep active. And he was very healthy. I think it was 95. He was still driving, going to the swimming pool, just very active, going to the potlucks at the senior centers. And my mom had passed away a few years earlier, so he still was staying socially engaged and then.

[00:22:01] It got to the point where, because my family home, the laundry was in the basement. So that became one of the first challenges. And the second challenges was cooking for himself. I mean, he just got tired of cooking for himself. And so that’s when we started talking about finding retirement community. But one of the things that I remember most about my dad is that he Italian Catholic.

[00:22:25] So he went to church every day that he could. And when he couldn’t, he’d watch it on TV. And he had a personal prayer book that, uh, I think it was like a st. Francis prayer book and that was beside him every morning. And that was what he did first was to read something out of that prayer book. And so his health really didn’t decline until like the last six months.

[00:22:47] But I remember him still singing songs that. We’re familiar from church and still looking at that prayer book was right on the table next to his bed. And so that was a good kind of model for me. And a good reminder how important your spirituality is as you move. And like you said, at any age, but particularly at the end of your life.
[00:23:10] Really your connection. So what’s going to come next. So, yeah, I agree.

Hanh Brown: [00:23:14] Well, let’s talk about technology a bit. So what role do you see technology playing in senior housing and aging in place going forward?

Jim Concotelli MSW: [00:23:22] Yeah, I mean, technologies you think back, we started with pagers and then. We got into iPhones and Samsung and other companies that produce these.

[00:23:34] And so they had a huge impact on how we live our lives. Younger generations basically live on their phone, everything they do on their phone. I work in some arenas with some younger generations. And if it’s not a text, they hardly look at it. I mean, even email is kind of like, not that important to them.

[00:23:55] So as we move forward, I mean, definitely. I think we found with this virus, how important telemedicine is. My wife’s had a couple challenges where she needed to see if she can get a doctor’s appointment. Well, it was all done over her iPad. It was talking to the doctor like we’re talking. And I think in retirement communities in particular, because safety and health is risen to the highest priority through this pandemic.

[00:24:22] That, having those connections within that community to be able to speak to health professionals via technology when visits to the office are maybe quite a challenge or not even possible. So I think telemedicine is big. I noticed that when I was in the industry, some of the smaller management companies, weren’t able to really put the resources into, you know, like in-room TV systems or to make sure that there were iPads available for some of their residents or they purchased some type of program or software.

[00:24:58] Where they could have communication through technology with their families. I think a lot of them are trying to move in that direction. Now your larger companies have kind of had those types of opportunities. I think that that industry is just going to grow more and more. And fortunately, there’s so many really great entrepreneurs that are out there helping the senior living industry integrate.

[00:25:23] New technology and new programs that are coming along all the time. Every day. We can’t even imagine where we’re going to be in five or 10 years with technology it’s grown so fast. But I think that particularly I’ve even seen recently where like more offs where residents can get information and use kiosk and also kind of the opportunity to, I saw something recently where.

[00:25:50] And there are some companies that have computers and screens that are mobile, that they can take into a resident’s room and they can listen to music or they can watch a movie or they can communicate through wifi to get on the internet and reach out to their family. So I think right now that’s so important to keep that.

[00:26:09] And then kind of your voice activated commands. We have several companies that have those where through the iCloud and through wifi, you can simply ask a question and I mean, so many even homes, and I think apartments eventually in a lot of our retirement communities will be tied into that voice activated system.

[00:26:31] So for turning on lights and in what a blessing to be lying in bed, Not be all that comfortable to be able to see in the dark insight, turn on the bathroom light, and you’d be able to get up and walk in the bathroom. I mean, that’s a miracle for us to have that opportunity.

Hanh Brown: [00:26:47] Absolutely. You know, everything you described that is huge for engagement, right.

[00:26:53] Engagement equals technology. That’s what allows folks to have access to their family, to the outside world entertainment, maybe even exercising. That’s huge and telemedicine is a huge component. And to me, I think 5g network is going to be huge across the board in senior living as well.

Jim Concotelli MSW: [00:27:13] Yeah. Since I’ve retired, I’ve continued to consult and teach classes, wellness classes in retirement communities, but all of it’s on zoom.

[00:27:21] Now, all of my classes and some local communities are just not equipped. They don’t have the capability because we can’t have large groups in your kind of multipurpose room. The companies that have the capability for me to do a zoom class that’s then broadcast through. You know, an in-house TV system that goes into every resident’s apartment.

[00:27:47] Those are the companies that are able to keep engagement up at a higher much needed.

Hanh Brown: [00:27:52] Absolutely. And I think that’s, what’s going to make a difference. For retaining your residents and also increasing your occupancy, is the technology and engagement particularly now?

Jim Concotelli MSW: [00:28:04] Yes. Yeah, definitely. And like you said before, it’s all about engagement.

[00:28:08] Technology is such a, such a helping hand and keep us all engaged in so many ways. So very important.

Hanh Brown: [00:28:14] Yes. Well, thank you. I’m very blessed to have you come in here and share with us your journey, your expertise, and for me, hope, I think that’s what we got to strive for is. Getting out of this being better, stronger in adding more value to our older adults.

[00:28:32] So thank you so much. I really appreciate your time. Thank you so much for joining us this week.

You can reach Dr. Concotelli on LinkedIn at: https://www.linkedin.com/in/jim-concotelli-msw-ph-d-59bb7b74/