In the multi-faceted world of senior living there are many balls to keep in the air as we design and provide services for the older adults who choose to make their home with us. Keeping the living spaces and their adjoining environments attractive and marketable, providing choice and quality in dining, creating systems that provide for safety and security, and providing programs that complement and enhance resident lives are only a few of the “balls” that senior living administrators have going. To even produce a well-rounded calendar feels like a great accomplishment in this environment. But is this enough?
Wendy Lustbader, a noted author on aging, recently wrote about interviews she conducted with residents of CCRCs. While many were happy with their choice she notes,
. . .it was striking that each unhappy CCRC resident told me that they felt their lives had devolved into a series of entertainments. One man explained that he was insulted by the sight of the daily calendar posted in the lobby as though he needed to be “kept busy” through a program of activities. He said it seemed as if he were staying at a perpetual resort, rather than living his true life. “This is too empty for me,” he continued. “I need to be useful. Here, I can’t even mow the lawn.”*
Another resident she interviewed remarked, “Attending a program is not living.” She described the weekly, facilitated current events discussion as a far cry from the spirited, engaged conversation she was used to having with friends in her neighborhood and community before she moved into the retirement community. And she reported that the only place she felt truly at home was her church, where she was known and accepted.
While there were probably many good reasons behind their choice to move to such a community, they were lamenting the loss of meaning and purpose and the loss of the multiple connections they had known in their lives before that move. These are spiritual issues and for the sake of the long-term flourishing of residents, senior living communities need to address them.
Spirituality is sometimes difficult to define and for that reason two responses predominate in the retirement community world: we hire a chaplain and put spirituality in that domain or we ignore it as a concept too diffuse for us to adequately address. Hiring a chaplain can be a wonderful first step in addressing the spiritual needs of residents. But it tends to put spiritual needs into the domain of religion, and ignores those who don’t practice a religion, or those who have spiritual needs not met by a religious practice. And ignoring it leads to complaints like those quoted above.
I’ve used two tools to think about how spirituality can infuse and shape the life of retirement communities. The first one is a re-working of the standard wellness circle used by many senior living wellness programs, where spirituality is one piece among many other pie shaped pieces. Instead, I’ve reworked the circle so that spirituality is in the center as its own circle, which touches all the other pie pieces and connects them. This diagram reminds us that spirituality is at the heart of everything we do as we serve residents and is the connecting factor in all that we do.
Along with the diagram I use this definition of spirituality.
Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature and to the significant or sacred [emphases added].**
This definition provides lenses to examine our programs. The first is the lens of meaning and purpose. Viktor Frankl says that we experience meaning by: 1) doing a deed or creating a work; 2) by experiencing nature, culture, beauty and the uniqueness of others; 3) by choosing our attitude. These arenas of meaning can lead us to look at our programs in new ways. What opportunities are we providing for “doing a deed”—providing a helping hand within our community or without it? Are we encouraging creative endeavors that involve creating a work, either individually or with others? Are the experiences we’re providing creating new ways of experiencing nature, culture, beauty or one another? And are seeking to create a community ethos that encourages the practice of virtues like kindness and generosity, and encouraging residents to choose positive attitudes even in the midst of difficult circumstances?
The second lens for looking at programming is through the lens of connectedness. When residents move into our communities they are experiencing the rupture of many long-term connections and in the midst of that are trying to form new connections within their new community. How do we meet them at that vulnerable point? Are we creating places where stories and experiences can be exchanged and where all can know and be known? How do we help them connect to places on our campus and in the wider community where their unique gifts can be used for the greater good? Are we working to provide places for deeper conversation that go beyond the superficial—the weather, the meals being served, the chronic aches and pains?
Meaning and purpose and connectedness go hand in hand. Our experiences of meaning are deepened when they are shared experiences. And our connectedness often occurs around a shared experience. In providing senior living we have the opportunity to create not only physical places for older adults to live, but to create true communities of purpose and meaning and connection. Wendy Lustbader noted in 1999 that “it is easier to live with the mandatory activity of work and child-rearing than to create voluntary purpose every day. In the long run, days that are empty of obligation are exhausting.” Today she says, “I see now how living environments can be crucial in helping us remain connected with life-enhancing obligations, purposes that give us spirit for enduring physical travail and inevitable losses.”
So this is our challenge: to engage the spirit in our programming so that the spirit of our residents is strengthened as they go through the last days of their lives. This endeavor goes far beyond creating a calendar. It is endeavor that can inform every aspect of our operation as we wrestle with the ways of encouraging meaning and purpose and connectedness for everyone in our organization. Wrestling with these questions will put us in touch with why we’re in this business and we’ll greatly enhance our ability to serve residents in life affirming and enhancing ways.
*This and following quotes from Wendy Lustbader are from her article, ““It All Depends on What You Mean by Home,” Generations, Winter, 2013-2014 (37:4).
**Definition from Consensus Conference: Improving the quality of Spiritual Care as a Dimension of Palliative Care, held Feb. 17-18, 2009, Pasadena, CA. Sponsored by the Archstone Foundation.