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The Business of Aging

Sections The Business of Aging
Businesses Eye Potential in a Growing Over-65 Population

Don Anderson

Don Anderson says older people enjoy cruises, but not necessarily the same ones younger travelers do.

More than a half-century later, the Baby Boom has become the retirement boom — and the numbers are striking.
At the turn of the century, just over a decade ago, the U.S. was home to 35 million people age 65 or older. Since then, the number has risen to almost 42 million — a nearly 20% increase — and the 65+ crowd in America is expected to soar to 79.7 million by 2040, according to the U.S. Census Bureau.
“All our health and science advances mean people are living longer,” Jason Harris said. “Many are healthy and don’t foresee any kind of health traumas, or maybe they’ve already had that hip-replacement surgery, and they look at that as a wake-up call — ‘we’re getting there, but we’re healthy … what if we live another 15 or 20 years? What will our quality of life be?’”
As founder and lead carpenter at Baystate Accessibility Remodelers, Harris takes that question seriously. His firm specializes in creating safe and accessible residential spaces for seniors and people recovering form injury or living with a disability.
The modifications run the gamut from bathroom fixes such as grab bars, modified toilet heights, and walk-in showers to widening doorways and building ramps and chair lifts for people using wheelchairs, all the way up to completely remodeling kitchens for wheelchair accessibility or building additions for in-law apartments so an older person can move back in with their children.
“Our job really runs the gamut from minor modifications to full-blown remodeling,” Harris said. “The Baby Boomer generation is a working generation, and a lot of them have assets, and a lot of them have over time invested in retirement and other things, including their homes. When they start getting into that age category, people might consider aging in place, rather than moving into institutional care. They own their home, and they want to put one more investment into their home and stay there because all the things important to them are around them.”
Harris’ company is just one example of a business that stands to benefit from the rapidly aging population. According to the monthly marketing report Selling to Seniors, people 50 and over control 77% of all financial assets in the U.S., own almost 50% of all credit cards, and account for more than 50% of discretionary spending power.
With that in mind, here are just a few of the kinds of businesses that stand to benefit from the proliferation of America’s golden-age population.

Living Well
Harris and his wife, Cindy (Baystate’s president), don’t cater only to the elderly with their home modifications; many times, their services help patients readjust to home life after an injury or disability.
“Many times we’re following the path of the occupational therapist or physical therapist who comes into the home when someone’s been in a rehab situation. They check the person’s medical history and come up with a roadmap and say, ‘these are the things they need,’ and when we get in there and do the home evaluation, we can talk to them and make sure we get the medical side of it, make sure we understand their issues,” Harris said.
But in many cases, customers are relatively healthy, yet recognize a coming need to upgrade their home to keep them safe living in it.
“They’re really looking at the value of what they could potentially invest into their home,” he told BusinessWest. “They’ve already made a commitment, and now they’re just saying, ‘this is just the next level of investing in the house.’”
Millions of seniors and their families struggle with the decision of whether to stay in their home or move to a residential-care setting, he noted.
“There’s a lot of expense that goes into moving into any kind of institution — whether they like that environment or not, there’s a lot of costs,” Harris said. “They need to decide whether the financial investment is something that’s possible, and also, do they want to move away from everything they’re comfortable with, or make some modification to their home? That’s what we have to consider to when we talk to potential clients; we understand that a lot of emotion goes into making that decision to stay home or move into an institution.”
For seniors who are healthy and ambulatory, the Boomers are known as a generation that wants to remain active, and they’re increasingly seeking out fitness and wellness options to help them stay in shape.
Take yoga, for instance. Karoun Charkoudian opened a yoga studio in Springfield in 2009 and will soon celebrate the one-year anniversary of her business, Karoun Yoga, in its new West Springfield location. From day one, she said, seniors have made up a solid percentage of her business.
“We’ve had a lot of retired folks in here, and definitely more and more seniors, especially for our gentle classes,” she told BusinessWest. “That’s definitely been the case.”
She said older people tend to enjoy yoga because it brings fitness benefits without a high impact on their joints. “It really helps alleviate a lot of arthritic pain and joint pain, that kind of thing. In my opinion, it’s a safer way to get stronger — and they definitely get stronger, and they work on their balance. It’s a better way for the senior population to do that.”
As general awareness of yoga continues to increase, Charkoudian said, studios like hers will continue to benefit from a growing older population.
“With our beginner class or gentler class, at that level it absolutely works,” she added. “It’s effective for all the benefits they’re looking for.”

All Aboard

The retirement years are often synonymous with travel, and today’s seniors have some specific ideas of where they want to visit. To hear Don Anderson, owner of the Cruise Store in East Longmeadow, tell it, they’re not flocking to Caribbean beaches.
“Certain types of trips lend themselves more to seniors,” he said. “For instance, on Alaskan cruises, typically much of the clientele — but certainly not all — are seniors. There’s more awareness of Alaska; it’s on people’s lists — ‘one day I want to see the glaciers, see Alaska, travel inland.’”
Another hot choice among senior clients are river cruises. “Older people don’t necessarily want the flashy, 2,000-ton cruise ships, but maybe something that handles 100 or 200 people, tops. They might want to spend overnights visiting the beaches of Normandy, overnights in Paris, Budapest, Prague,” Anderson said.
“Other big items on the bucket lists are national parks — and we were impacted by the government shutdown,” he continued. “Older people also want to travel overseas to Europe or Ireland, but don’t want to drive on the opposite side of the road and contend with that sort of stuff, so they like escorted trips.”
When seniors travel, they often do so alone or in pairs, but a growing trend involves larger groups and cross-generational travel — where older customers arrange to cruise with their children and, sometimes, their grandkids.
“They have disposable income, but their kids go where the jobs are, so the kids live in different parts of the country. So, as a coming-home type of event, they pick a cruise ship, which caters to different generations. They can spend quality time with their kids and kids’ spouses or significant others, and the ships have kids’ programs. Some seniors with disposable income put their money toward getting everyone together on board, doing things together, eating as a family together. We’re seeing an increase in that, with multi-generational trips initiated by the parent or grandparent.”
In any case, with family or not, “seniors are saying, ‘now is our time; now is the time to do it,’ and they like the idea of a company like ours, where we set it up but don’t charge service fees; they love that.”
But, like other types of businesses that cater to different generations, Anderson said, “you can’t sell the wrong product to the wrong people; certain trips lend themselves to certain clientele.”
As tens of millions of Baby Boomers sail into retirement, that bit of wisdom will continue to ring true.

Joseph Bednar can be reached at [email protected]

Sections The Business of Aging
JGS Strategic Initiative Continues a Tradition of Culture Change

Martin Baicker and Susan Halpern

Martin Baicker and Susan Halpern both used the word ‘transformational’ to describe Jewish Geriatric Services’ plans to adopt the so-called small-house model.

Martin Baicker calls it “the continuation of a journey that started years ago.”
That’s how he chose to describe a strategic initiative at Longmeadow-based Jewish Geriatric Services (JGS), which he serves as president and CEO, to adopt what’s known as the “small-house model of care” into some of its facilities.
The ‘small house,’ or ‘Green House’ model, as it’s also called, involves a more personal, home-like setting for elder care, one that represents the next iteration of ongoing culture change within the industry — and at JGS, said Baicker.
“This furthers a long tradition of caring and embracing culture change — our board is forward-thinking and has always wanted to be on the cusp of what is the latest thinking in terms of care for seniors,” he explained, adding that the ‘journey’ he mentioned started in the ’90s, with movement from the traditional nursing-home setting and operating philosophy to something known as the “neighborhood model.”
This was an effort to “de-institutionalize” nursing homes and make them more home-like, he noted, adding that it involved everything from incorporating carpeting and softer colors on the walls to adding amenities such as common areas, fish tanks, and solariums, to creating a sense of neighborhood by assigning facilities names, such as the ‘New York Unit,’ given to the short-term-care unit.
The small-house model goes further, and, as the name suggests, involves placing 10 to 20 private rooms in a setting that approximates a small house, he continued, noting that the private rooms would be supported by a central living room, or hearth, as well as a dining room and full kitchen.
“People will have their privacy in the rooms, but they can go out to the central living area, or hearth, to engage other residents, visit with family, to have activities — it’s like a home, it’s like a living room,” Baicker told BusinessWest, adding that the concept will first be adopted for a new short-term-care rehabilitation center, and will then be phased into the long-term-care facility, the Julian J. Leavitt Family Jewish Nursing Home.
But the small-house model involves much more than facilities design, said Baicker, adding that it also requires a change in philosophy and operational design that begins with self-directed work teams committed to providing services when and how residents want them.
“The small-house model provides flexibility and choice for each resident,” he explained, “with a personalized team of multi-skilled staff, along with an environment that encourages residents to be an active participant in their care and treatment.”
Susan Halpern, vice president of Philanthropy for JGS, agreed.
The JGS team

The JGS team, left to right: Marty Baicker (president and CEO), Susan Kline (chairman of the board), Susan Halpern (VP of philanthropy), Randy Locklin (JGS project manager), Martin Siefering (principal at Perkins Eastman and project director), Eric Dalen (architectural team leader at Perkins Eastman), Katherine Cienciala (project manager at Perkins Eastman), Paul Steidl (Perkins Eastman), Bob Petroff (executive vice president and administrator of the Julian J. Leavitt Family Jewish Nursing Home), and Karen Johnson (VP of human resources). Missing from photo: Ed Roman (JGS CEO).

“We feel that this is the most transformational thing that we’ve done here since we moved to our Longmeadow campus in the early ’70s,” she said, adding that the scope and potential impact of the initiative should resonate when JGS launches a capital campaign to fund the initiative in the near future.
For this issue, BusinessWest takes an in-depth look at the small-house model of care, and at JGS’s work to stay at what Baicker called the “cutting edge” of advances in the delivery of care in the nursing-home setting.

At Home with the Idea
Baicker said the decision to move ahead aggressively with adoption of the small-house model was one of many suggestions forwarded by a committee assembled by JGS called the Future Vision Task Force.
The group, comprised of board members, key constituents, and JGS staff, spent more than a year researching innovative ways of providing elder care and making recommendations to the full board, he went on.
These suggestions included movement into palliative care, expanding and enhancing technology, general campus-wide enhancements and improvements, and expanding the adult-day-health program with a dementia specialty.
Topping the list, however, was incorporation of the small-house model into both the nursing home and a new short-term-care rehabilitation center.
The small-house model differs from a traditional nursing home — designed much like a hospital with long corridors, rooms on both sides, and a central nursing station — in terms of facility size, interior design, organizational structure, staffing patterns, and methods of delivering skilled professional services, said Baicker, adding that units are designed from the ground up to look and feel like a real home.
“Our goal is to transform how care is delivered at JGS,” he said, adding that, while the model has been embraced in many areas of the country, it is still relatively new to Western Mass., with Mary’s Meadow in Holyoke, a facility operated by the Sisters of Providence Health System, being the only small-house facility currently operating in Greater Springfield.
Beyond the dramatic departure from traditional nursing-home design, the small-house model represents significant change in overall operating philosophy, said Baicker, adding that this evolution, if you will, is “about enhancing dignity and providing JGS residents with cutting-edge rehabilitation and long-term care.”
He summed up this evolving approach with the phrase “resident-directed model of care.”
“The small-house model provides flexibility and choice for each resident with a personalized team of multi-skilled staff, along with an environment that encourages residents to be an active participant in their care and treatments,” he said.
Elaborating, he said that, historically, and in the traditional nursing-home model, residents work around the schedule of the staff. In the small-house model, the staff works around the schedule of the residents.
“To me, it’s about dignity and choice,” he went on. “People can choose to wake up when they want to wake up, not when people tell them to wake up. They can eat when they want, bathe when they want … it’s a philosophical change that’s a work in progress; we want this to be like their home.”
There will be an organizational, or structural, change to accompany the philosophical change, he told BusinessWest, adding that at the heart of this development will be self-directed work teams that represent a dramatic departure from the traditional staffing hierarchy at nursing homes.
“What’s going to change in the small-house model is you’re going to flatten that hierarchy,” he went on, adding that certified nursing assistants (CNAs) will be providing most of the care. “We’ll create a cross-trained, multi-skilled position; these individuals will do traditional things that CNAs have done in the past — the personal care they’ve provided — but in our model, they’ll also do other things. They’ll provide some activities, they’ll do laundry, and in some models, they’ll cook.
“They will spend a lot more time with the residents because they’re in the house doing all these other tasks,” he continued. “The CNAs will spend the bulk of their time with the residents, which is important, because if their condition changes, they’ll notice it first.”
The small house will be a self-contained unit in every sense of that phrase, he said, adding that the self-directed teams will make their own schedules, and there will be much more engagement between the residents and the staff.
“This will be a great place for staff to work,” Baicker noted. “They’ll work in the same place every day and with the same residents every day. And when that happens, it’s almost like they become family members.”
To assist with implementation of these sweeping changes, JGS has assembled a team of experts to work with the staff. The company has selected the architectural firm Perkins Eastman, an international leader in the design of elder-care living facilities, and designer of several small-house facilities. Additionally, JGS has engaged Judith Rabig, one of the foremost experts on culture change and small-house design, to assist with the planning process. Rabig is a nurse and gerontologist who has created plans for more than 20 small houses across the country. She is also the director of the National Alliance of Small Houses.

Room for Improvement
Baicker and Kimball Halpern told BusinessWest that there are no timetables in place yet for the capital campaign or the start of construction, although the project has reached the design phase. And the overall price tag for the initiative has yet to be determined.
What is known is that GJS is committed to continuing a tradition of being at the forefront of change and innovation in elder care, and movement to the small-house format is merely the latest example of this philosophy.
As Baicker said, it’s simply the continuation of a journey.

George O’Brien can be reached at [email protected]

Sections The Business of Aging
Footit Health Care Store Offers Products to Enhance People’s Lives

Marc and Kathleen Lucas

Marc and Kathleen Lucas say the name they gave their business years ago — Footit Health Care Store — speaks volumes about its product lines and overall mission.

When Footit Surgical Supplies Inc. opened in 1953, medical equipment was in its infancy and people had to use their own money to pay for things like wheelchairs and walkers.
“Medicare didn’t exist, and most people didn’t live long enough to need a lot of the things available today, so there weren’t many choices,” said Marc Lucas, who, with his wife, Kathleen Lucas, bought the business from Wallace P. Footit in 1991.
But over the next few decades, sweeping changes in medicine, insurance, and other sectors extended life expectancy and created a new focus on health, wellness, and staying active, which led to a remarkable array of new products.
In 1991, the Lucases changed the name of their business to Footit Health Care Store, which reflects the wide variety of products and services offered in the 4,000 square foot facility in West Springfield.
In addition to walkers, canes, wheelchairs, scooters, incontinence products, and items to help people who are aging, have a disability, or have had surgery, the store is filled with ingenious products to make life easier and more enjoyable. They range from orthopedic bed pillows to waterproof cast covers that allow children or adults with broken limbs to go swimming and/or bathe with ease; from diffusers for people who love the smell of burning candles but don’t want the smoke, to clothing in hard-to-find sizes, such as bras with cup sizes up to J and shoes of all types, including dress and athletic styles in widths up to 6E.
In addition, there are bath products, salves for dry skin, and a custom car seat cushion for people with bad backs. The rear portion is bent to match the shape of a person’s lumbar spine, and Footit allows customers to borrow one at no charge before they purchase the product.
The company has always kept pace with new developments in health care. It was the first in the area to carry lamps that emit a special type of light to help with seasonal affective disorder (commonly known as SAD), which can make people tired and depressed during the winter due to lack of sunlight.
“Years ago, a few psychologists sent people to our store for the lamps. We looked into it and got one that people could rent,” said Kathleen, adding that, although the lamps come in a variety of styles today, a decade ago they were very large and unattractive.
Other products are versatile, such as a no-rinse shampoo that can be applied directly to the hair, then towel dried after being rubbed in. “It comes in a bottle or inside a shower cap. You put the cap on, massage the head, then remove it, comb, and style your hair,” Kathleen said. “Our products include a toilet seat that heats up, washes you with warm water, and blows you dry with the touch of a button.”

Growing Demand
Marc said people are living longer and healthier lives than they did in the past. “They want to maintain their lifestyles and remain in their homes as long as possible rather than going into nursing homes,” he told BusinessWest.
In most cases, that means they and/or their caretakers need to purchase equipment to make it possible for them to remain independent. Although they may have to pay for it themselves, Marc said it is cost-effective, because assisted-living facilities typically cost between $2,500 and $5,000 a month, and nursing homes cost about $10,000 a month.
Kathleen’s 93-year-old mother lives with the couple, and they have installed a stairway elevator in their home and have a lift chair that can raise someone from a sitting to standing position, along with other aids, such as several types of walkers.
But Kathleen said the most immediate need people must deal with is making their bathroom accessible, which can be done with equipment such as a shower chair, raised toilet seat, or removable shower grip bar that adheres to vinyl or tile walls via suction.
Scooters and travel chairs, which are a lightweight version of a wheelchair, also allow people to remain active in the community.
“Trends are changing, and our product selection mirrors this,” Kathleen said, as she showed off a 19-pound travel-style wheelchair that is easy to lift in and out of a car. “In the past, people with mobility issues stayed home, but now they want to get out and live normally.”
Other products that make it possible are lazy-susan-style car seats that swivel, and an adaptive device that helps people with arthritis to open a car door. In fact, there is a plethora of seemingly unlimited choices and styles of medical equipment. “We carry about 125 different canes,” said Kathleen, offering just one example. “Some people want ones that are pretty, while others want canes that can fold and fit into their purse.”
Footit also carries clothing for women who have had mastectomies, which includes bras, camisoles, and bathing suits. “There has been a lot of change in mastectomy products since we opened,” she said. “Back then, prostheses were very heavy and didn’t feel natural, and insurance only allowed women two bras a year to hold them. Now many insurance companies will pay for three bras every six months, and some of them are gorgeous. We also do bra fitting for people who want to be more comfortable.”
Footit has a shoe department, and although the styles are limited, there is footwear for people with diabetes and shoes for people with wide feet. “As people get older, their feet get wider, and having the right shoes is important because they want to keep moving,” said Marc, who is a certified orthotist.
But their most popular product is compression stockings for men and women. “When we first opened, the ones for women looked like granny stockings. But today they are sheer and come in a wide variety of colors and patterns,” Marc said.
However, it’s not just the products they carry that have made them successful. It’s the personal service they provide and their attention to detail. “We have always made sure that everyone knows exactly what will be covered by insurance,” Marc said.

Gradual Shift
Footit’s foray into the field of healthcare products began when he was a college student. He was working part-time as a delivery boy for Springfield Medical Supply, and when it announced it was closing, he borrowed $350, bought the store’s inventory, and became an entrepreneur.
“He sold his products to doctors,” Kathleen said. “He went door to door and supplied them with unusual items, such as corset-style back braces for women and trusses for men with hernias.”
She added that Footit was imaginative and willing to try new products, and it quickly developed a following. “Wally knew everyone in the area who was in the medical field, and found a need for things that other people might have missed.”
Marc agreed, adding that, when local doctors retired, Footit bought their medical equipment, then resold it to other physicians. “Wally was innovative in the way he approached business,” he said.
A decade after Footit opened his business, hospital stays became shorter, and a national trend toward home-based recovery began. So he continued to expand his inventory, and in 1963 opened a retail store at the ‘X’ in Springfield’s Forest Park. “He had grown up in the neighborhood, and the X was the place to shop at that time,” Kathleen said.
As demand for healthcare products grew, Footit’s business became important to the area. “If people had surgery and needed a walker, back brace, compression stockings, ostomy supplies, or products for their feet like moleskin or an arch support, they had to go to a medical-supply store to get it, and Wally’s compassion, sense of humor, and longtime relationships with area medical professionals made Footit Surgical Supplies a favorite for local doctors who prescribed products for their patients,” Kathleen said. “His advertising slogan was ‘your doctor knows us,’ because they truly did.”
When the owner of Vernon Medical Supply in Springfield retired, Footit purchased that business, which allowed him to add a new product line to his inventory. “It was located on Vernon Street, which is now Boland Way, and the company dated back to the turn of the century,” Kathleen said. “They made orthotics, prostheses, artificial legs, braces, and trusses. Wally moved their equipment, but continued the operation.”
Footit was dedicated to his customers, and after Marc and Kathleen purchased the business in September 1991, he did all he could to help them become successful, including working at the store for a month. They also found allies in loyal medical-supply salespeople who told them which products to buy. In addition, a salesman urged Marc to become certified in orthotics long before insurance companies required it for third-party payments.
The couple made some changes, and in 1994, when the need for more space and parking became apparent, they moved Footit Health Care Store to Memorial Avenue in West Springfield, where they are located today.
Marc and Kathleen are proud of the service they provide and the number of products they carry, which appeal to a wide range of people.
“In the past, people only came to us because they needed something after surgery,” Marc said. “Now, they come because they want a healthy lifestyle.”
Kathleen agreed, but insisted that their mission remains unchanged. “We take great pride in being a leader in the community and helping to restore dignity and independence to people. Footit has solved problems since 1953, and we want to be here for another 60 years,” she said. “We also want to educate the community about products that are available to enhance their lives. It’s all part of what we do.”