Predicting happiness and success in a senior living community possible?

How good are we at preventing loneliness?





Predicting happiness in retirement living requires learning from happy retirees. We sent our first community survey to a carefully chosen CCRC last year (read about it here). The surprise was the level of loneliness reported by survey respondents.  Respondents reported being happy “most of the time” (100%).  Only 7% were not engaged in the CCRC. Yet, 20% also reported they “are often lonely.” A majority were lonely at least sometimes. Even with apparently good engagement, loneliness is still a complaint. But why? 

The community is an upscale Continuing Care Retirement Community (CCRC) in an economically prosperous university city. We expected this community to score high on social engagement, happiness, and loneliness prevention. Is it like Meat Loaf sings? “Two out of three, ain’t bad.”

We believe the primary benefit of a CCRC (or other types of Senior Housing Communities) is loneliness avoidance. Why bother moving to a community if you’re still going to be lonely and isolated? We want all three.

Our lonely survey respondents also reported engagement with the community.  This suggests social engagement alone may not be the perfect antidote to loneliness. How can we be both socially active and often still lonely?  Is it the level of engagement?  Are community activities offered not satisfying?  Is independent living too independent?  What’s not working in typical community programs in our fight against loneliness? How do some individuals transition well into a senior living community and others don’t connect? Why do some turn (or stay) negative? Rather than embracing new experiences and new friends, why do some choose to mourn a previous life and lost friends? The survey results only prompted more questions.

So we began looking for answers.

How Well Individuals Adjust To The CCRC Life

We found a study, “A Typology of New Residents’ Adjustment to Continuing Care Retirement Communities” by Liat Ayalon, Ph.D. and Ohad Greed, MSW. It was published in 2015 by The Gerontologist. This study, based in Israel, looked at how well individuals adjusted to living in a Continuing Care Retirement Community (CCRC). Ayalon and Greed enable predicting happiness or success by finding what happy residents have in common. Why do some individuals transition well into a CCRC while others never fully embrace or enjoy their life in a CCRC?   

Whereas CCRCs allow a segment of older adults to truly enjoy the opportunity for a new beginning in old age, for others, the transition does not pose a major change from past life experiences and is not viewed with the same level of enthusiasm.” – A Typology of New Residents’ Adjustment to Continuing Care Retirement Communities

Study Conclusion

What was Ayalon’s conclusion? The study found that those who were thriving after the transition were characterized by the following:

  • Their transition to the CCRC is a clean break from past experiences.
  • It’s a fresh start. They express limited desire to explore the outside community or to maintain contacts with individuals in their old community.
  • Successful residents don’t have one foot in the past nor are they living in the potential dreams of the future.
  • They are present-oriented and fully engaged in the activities and opportunities the CCRC offers.

Those least satisfied with the transition to the CCRC expressed a strong sense of not belonging in the CCRC. They focus more on the past or future than the present.

Some of these conclusions fight commonly held beliefs, but we found they struck a chord with a valuable analog.

Is it just like the initial adjustment to College?

We often compare a CCRC to going back to college. After reading this study we looked for comparable studies for the college life transition. Did those who truly thrived in their college years also have these same characteristics? Did they fully break with their past and did they live in the present rather than the past or future?  If so, we felt this result would support the validity of Ayalon CCRC study and perhaps be a guide for those planning moves to a CCRC or assisting a loved one with the CCRC transition. Accurately predicting happiness or influencing success after a move would remove a big worry or objection.

We found a college meta-study (a study of studies)  completed in 2006 by National Postsecondary Educational Cooperative, titled “What Matters to Student Success: A Review of the Literature.” This study was much larger in scope than our particular question, but it still hit on the importance of commitment to the here and now. Within the conclusions of what makes a student successful was the following:

“Tinto postulates that students first must separate from the group with which they were formerly associated, such as family members and high school peers, undergo a period of transition “during which the person begins to interact in new ways with the members of the new group into which membership is sought” (Tinto 1993, p. 93), and incorporate or adopt the normative values and behaviors of the new group, or college. For Tinto, students who leave college are those who are unable to effectively distance themselves from their family or community of origin and adopt the values and the behavioral patterns that typify the environment of the institution they are attending.” — 

Success in college typically requires an effective break or separation from former life. This is is wholly consistent with the Ayalon CCRC study. Predicting happiness in college from high school glory doesn’t work.

It’s how we remember college working

This parallels our own memories of who succeeded in college. Intelligence doesn’t assure someone will embrace college life. Those that go home every weekend never seem to find joy in college. Those that try to bring home and high school to college by living with high school friends as roommates never seem to work out. Success seems to require a commitment to and focus on the new college community. College offers new social and academic rules. Reliving high school glory days is an unsuccessful strategy. No one cares where you went to high school. People ask, “What’s your major NOW.” High school apparel disappears from student wardrobes by the time the sophomore year rolls around.

We see and hear parallels in retirement settings. Social status conferred by prior job titles doesn’t mean you can avoid the new social rules of community living with other retirees. It’s a version of what have you done for me lately? It’s the now that counts not the past. You can’t embrace the present while holding on tight to the past. We think time and place orientation do a good job of predicting happiness in a senior living community.

Does the Israeli experience transfer to my country?

There was more to the Ayalon Israeli CCRC study. It is not culturally specific and limited to the cultural context of Israel. (At least not fatally limited.) The college parallel suggests transferability to American CCRCs. It’s a study certainly worth repeating, expanding, and discussing. And there was one surprising category missing from the resident prototypes. (More on that in a future post.)

Ironically, we started out thinking more about retirement communities in the context of complex financial decisions. And we appreciate great design. Both of these now seem easy to evaluate compared to the intangibles of supporting happiness and fighting loneliness and isolation. But Ayalon’s resident prototypes and the college analog appear useful in predicting the potential for a happy CCRC resident.

Summary

What then makes one lonely in a group living environment? Is it the lack of living fully present in the moment rather than the past or future? That’s what the studies seem to suggest. It is also the lack of separation from their former life and fully embracing the new community.

Ayalon and Greed observe there’s also a role for your attitude towards life experiences. Always a critic? Always unhappy or dissatisfied?  Retirement group living is unlikely to be your first happy time. If you enjoy the usual mix of good and bad life experiences but are still searching for that missing element in your life? You can still enjoy the search but count on finding both bumps of joy and ruts of disappointment.

Are there steps that administrators or loved ones can then take to assist with making a better, cleaner transition for those moving into a CCRC? We think there are. We’ve had some interesting brainstorming around the future role of robots and emotionally-responsive Artificial Intelligence (AI).

Our study continues. But we now think there’s a likely model for predicting resident happiness and success. We think the college analogy is even stronger in our mind. Maybe there are some lessons for retirees willing to consciously choose successful strategies to fight loneliness and social decline. And therefore ways that families and community staff may help support success. There may be even some technology opportunities to enable a better future.