An Important Shift in the Conversation
The phrase person-centered may seem overly familiar, but when paired with the word wellness, it represents a recent and important shift in the conversation about quality of life for elders.
The more familiar term, person-centered care, has gradually become common among skilled nursing and assisted living organizations, as well as medical standards of practice. However, as the term itself suggests, it is a concept that mainly applies when wellness is already compromised. In that case, the focus on individual persons is certainly vital to ensuring positive outcomes for elders needing such services. However, providing person-centered care is not the same thing as providing wellness community that prevents illness and injury through consistent, active engagement in intellectual, social, and fitness activities.
Person-centered care itself is the result of an even earlier shift in the conversation about the needs of older adults (along with other demographics). Person-centered care is crucially distinguished from the prior concept of patient-centered care, which focuses on the patient as an individual with particular needs and preferences, but not as a whole person in the broader sense of their life beyond the problem at hand.
This peer-reviewed 2016 article, published by the Beijing University of Chinese Medicine School of Nursing, examines the differences in detail. The paper clarifies that “the word ‘person’ shall be interpreted as possessing a will that enables rational deliberation on action. Consequently, the concept of freedom is an imperative aspect of personhood, that is, being free to do things and take responsibilities for choices made.”
As awareness of elders’ need for greater agency in decision-making has grown, “person-centered” has become the preferred term. In particular, the above-described aspect of responsibility underscores a profound shift in approach. Numerous works of fiction and non-fiction have depicted scenarios in which elders—on the basis of age alone—are presumed by family members or care providers to be unable to determine what’s best for them. These days, the conversation has shifted to reflect what elders have been saying for generations. Person-centered services prioritize the notion that elders deserve the same freedom as others, including the right to decline advice or take risks in the name of self-determination.
The ensuing focus of the healthcare system and senior living communities on person-centered services has provided an important foundation for the kinds of wellness communities that are now overwhelmingly desired by boomers, middle-market elders, and countless others. Not only do elders want to live in a community that helps them stay active physically and socially, but they want to be engaged at the level of planning and facilitating activities. Potential residents want to be literally at the “center” of what is going on in their communities, to have a central role in community development as well as personal decision-making.
For organizations looking to support the burgeoning influx of older adults seeking a community aimed at keeping them healthy and active, person-centered wellness will be an important organizing principle. As described further in this blog post, value is a crucial consideration, but lifestyle is a very close second.
So, what exactly constitutes wellness? According to the Global Wellness Institute’s definitions page, wellness is defined as “the active pursuit of activities, choices and lifestyles that lead to a state of holistic health.” Moreover, the issues brought up by the International Council on Active Aging (ICAA) in their May 2021 forum report underscore the importance of redefining wellness concepts according to elder’s specific needs and expectations.
This remains an ongoing conversation across the senior living industry, and is not without contention. Some organizations are still loyal to the established models for nursing homes, assisted living, and independent living communities, while others express curiosity about possibilities aimed at greater overall well-being for elders. For the latter group, ICAA suggests that a prudent approach to meeting these changed expectations is to choose a niche approach to a specific wellness lifestyle model, and market services accordingly.
In this vein, there is plenty of space for each approach. Ashton Applewhite, renowned author and anti-aging activist, often points out that heterogeneity across groups increases with age. This underscores the need for person-centered wellness to truly focus on individuals, without lumping them into generational or even age-based categories. If it is necessary to categorize one’s target population, lifestyle categories appear to be the more viable choice in today’s market.
Another set of assumptions, pointed out here by Virginia Tech professor Toni Calasanti, is that the common (yet vague) classification of people as “seniors” tends to presume whiteness and middle-class status. Predictably, this can skew the industry toward primarily serving that population, when wellness community is needed across all elder demographics. This 2020 article stems from a collaboration between Innovation in Aging and The Gerontological Society of America. It presents the Person-Centered Wellness Home (PCWH) as a much-needed alternative to the Patient-Centered Medical Home (PCMH), and particularly discusses how this model can bridge wellness gaps in underserved communities, promoting greater health among elder populations in those regions.
In the context of competition between self-proclaimed wellness communities, the issue of wellness-washing has become a growing problem, one that stretches across multiple industries. Like the related term “greenwashing,” in which companies exploit consumers’ environmental concerns without making good on their eco-friendly claims, many organizations have jumped on the wellness bandwagon without demonstrating a real commitment to wellness outcomes. However, according to this 2021 Forbes article, “wellness is not small and it’s not temporary…. Consumers have become more astute at deciphering what is organic and sincere content versus what is an advertisement.”
Ergo, companies taking a cynical view of the public’s desire for wellness, exploiting it as a means for simply promoting products or riding trends, may soon find their approach backfiring. Which means that organizations genuinely promoting wellness in their industries, services, and products have a lot to gain.
With respect to this industry, elders looking for genuine wellness community are likewise becoming more astute at sussing out the real priorities of an organization. According to ICAA, the population that is newly exploring senior living is generally unimpressed by posh environments or luxury features. They are more interested in social connection, quality activities, tasty food that supports good health, and an atmosphere of community, autonomy, and personal freedom. In other words, person-centered wellness.
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