By Keith Gray, Director of Applied Research
J+J Flooring Group
Thinking back on the past year, it’s dawned on me that the 2018 SAGE POE was in many ways the centerpiece of my professional work in 2018. My most sincere congratulations go out to the members of the 2018 SAGE POE team: Amy Carpenter, Migette Kaup, Teresa Whittington, Robert Soler, and Fred Worley for their part in creating this wonderful study, and for their passion and commitment to enhancing senior lifestyles.
And what a centerpiece it is!
The 2018 SAGE POE White Paper contains 31 information-filled, thoughtfully written, and beautifully illustrated pages of valuable information that speak exactly to the three themes I mentioned when we rolled out the 2018 SAGE POE at EFA last April: 1) this is important work; 2) that which gets measured gets improved, and; 3) a rising tide lifts all boats.
I’m reminded daily of the importance of this work.
Because of the 2018 SAGE POE, my professional involvement in senior lifestyles has grown beyond my expectations to include people and organizations that were unknown to me a year ago. Among these, many senior lifestyle architects, designers, and community owners and administrators have shared with me that this work matters and is useful to them.
They value this kind of relevant useful information.
The 2018 SAGE POE white paper is, of course, the measurement component of “measure and improve.” The information in this document is an excellent measurement of The Cottage at Cypress Cove.
And while it’s early to evaluate the impact of the 2018 SAGE POE in terms of bricks-and-mortar, organizational and lifestyle improvement, another indication of the SAGE POE’s power to improve is how it has, indirectly, promoted creative thinking another domain of senior lifestyle research.
It’s not widely known, but in fact J+J’s sponsorship of the 2018 SAGE POE catalyzed our co-sponsorship of Perkins Eastman’s groundbreaking Clean Slate Project, which looks to the future of senior living, and how it might evolve under the influence of four emerging macro shocks. You will be hearing much more about Clean Slate in the very near future.
This is a salient example of improvement, which was completely unexpected when this journey began.
One of the key conclusions that I reached while reflecting on my experiences with the 2018 SAGE POE is that to be truly effective, the POE must be effectively communicated. This seems obvious retrospectively, but it’s importance came to the forefront as we thought about the many channels by which this work could and should be shared.
And I’m very pleased to say that we’ve set things in-motion to communicate the 2018 SAGE POE and those that follow, more effectively.
In doing so we’ve engaged the excellent skillset of Sara Marberry, a true thought-leader and marketing and communications professional, who has great expertise in senior living and healthcare design. Sara has been a great help to us, and plans for communicating the SAGE POE, which included revising the SAGE website to enhance access to the POE, are really beginning to gel.
I’m very excited about how our efforts will promote the SAGE POE and SAGE as an organization.
Which leads me ask this question in closing: As we increase awareness of the power of the POE and improve how we share our findings, how do we measure its real impact?
It’s an intriguing question, to be sure. And it’s one that I hope we can begin to answer in 2019.
My final blog as SAGE president will have a “Back to the Future” feel to it. This approach gives us an opportunity to look back with appreciation, while looking forward with expectation. Transition and change tend to bring out the best and the worst in all of us. I will lean into the best!
The end of 2018 marks one of the largest transitions for the SAGE board in recent years. The term limits outlined in the bylaws are having the greatest impact on this transition as three board members and three officers are finishing their final term this year. As we look back, I want to express my sincere gratitude for all that these individuals have meant to me and to the SAGE organization.
Charlie Wilson, Executive Vice President at Buckner, has been a consistent champion of SAGE for the past 11 years. He has served as President, Past President, Vice President and Director during his tenure on the board. Charlie was always the voice of reason and he represented the perspective of the provider in SAGE.
Andrew Alden, Senior Planner/Designer at Eppstein Uhen Architects, has been around from the beginning. He was involved in crafting the first version of the SAGE bylaws in the mid-90s. Andrew has been integral to the success of the Design Showcase and Renovation/Remodel Competition for most of the lifespan of those two events. Andrew has served in all of the officer and director roles over the years. He brought great context to our discussions as we navigated through the SAGE journey. Andrew finishes his term as secretary this year and we are grateful for his guidance in that role.
Russ McLaughlin, architect with AG Architects, is another Sage of SAGE. He most recently served as past president, but also led the organization as president, Vice President and treasurer. Russ steered the SAGE ship through some rough waters and always remained committed to the cause. He is a champion of the SAGE POE process and has carried that banner for many years. He was also a key driver in the Design Showcase jury process.
Teresa Whittington, RN, has served as a director on the board for four years at various times throughout her career. As a registered nurse and dementia specialist committed to person-centered care, she brought a valuable perspective to SAGE. Her involvement in many POEs amplified the unique diversity of SAGE.
Alec Sithong, Design Consultant, came on the board five years ago as my “wing man”, serving as Vice President. He believed when it was difficult to see the future of SAGE. He was the dreamer who thought we could pull off a reception at Environments for Aging with no admin assistant and no money...and very few members! Alec was our linkage to Bestbath and was key in nurturing that amazing relationship over the years.
Fred Worley, former AHJ State of Texas Long Term Care, joined the board six years ago and faithfully represented the regulatory constituency within SAGE. He has been a champion of person-centered care and the household concepts in long term care. His perspective on the SAGE POE teams has been invaluable and his sense of humor has been refreshing.
The challenge of term limits involves the reality of losing experience and history on the board. Term limits do provide organizations with the opportunity to inject new and fresh perspectives to their cause. Transition of leadership does allow for a renewed passion to empower the organization. It enables an organization like SAGE to be sustainable and remain relevant in senior living. This is why I am excited for the future of SAGE.
As a new director on the board, Tammy Sealer, Chief Administrative Officer for Immanuel Senior Living, will bring her provider perspective to SAGE. She has a passion for good design and its impact on the business outcomes of senior living. SAGE has benefited from her involvement in the Design Showcase Jury process in recent years.
Rob Pfauth, Director of Senior Living Planning at ERDMAN, returns to SAGE as a director on the board. I would hesitate to use the “Doc” reference from Back to the Future, to describe his role as he is much calmer and more level headed compared to the Christopher Lloyd character. Rob served as secretary during my early years as president. He was integral in working through the details of the re-invented SAGE website through those years.
Larry Schneider, Partner and Senior Living Planner with Plunkett Raysich Architects, LLP, is not new to SAGE. He was very involved in the Wisconsin state Chapter of SAGE when a majority of the membership value was delivered through state organizations. He has been loyal to the SAGE cause for many years and his involvement in national leadership on the board will expand the influence of his passion for senior living environments.
Ross Leonard, Vice President of Marketing, Commercial Division at Engineered Floors/J+J Flooring, also brings a passion and unique perspective to the board. From our initial brainstorming meeting regarding the financial support of SAGE strategic planning, it was evident that Ross's enthusiasm for the mission of SAGE extended beyond his company's flooring expertise. Ross is a big picture thinker and will bring a strategic thought leadership to the board.
As I transition from president to past president on the board, I am fortunate to have the opportunity to serve alongside these new directors. Our current momentum is encouraging and will provide an impetus for future growth and influence. I am confident the board will continue to rely on all the sages of SAGE to understand the past as we lean into the future.
These days I find myself flying commercially far more than in the past. To manage the craziness of a national practice, I try to enjoy the humor in my flying experiences.
Early in my return to RDG, we were asked to bring an example of a wireless nurse call system to a client meeting. Refusing to check baggage, I loaded everything in my carry-on...including the sample wall device, complete with six foot cord and the little red push button switch. My partners claim the “ignition switch” was dangling out of my carry-on, but that was not the case. Passing through the TSA inspection, I was quickly pulled aside. TSA agents unloaded my carry-on and demanded an explanation regarding this “ignition device”. I calmly explained that it was a nurse call. The TSA agent asked if I expected to call a nurse while on the flight. Oh...the many sarcastic responses that flew through my head! Fortunately and maybe for the first time in my life, none of them came out. Somehow I was able to convince the TSA agent that the cord with the red push button was benign, and our client was able to review the wall device. My fellow travel companions yucked it up during my entire interrogation and this has become a popular story...with all kinds of embellishments.
During a line up for a flight on Southwest, one of my flying companions raised the terrorist threat level to the highest color. He was traveling for the first time after hip replacement surgery. I was in line before his arrival into the “cattle call” line up. As he joined me in line he declared proudly, “I made it through the metal detector and it didn’t go off!” The entire group in the Southwest line up quickly prepared to assault this would be terrorist. I broke all HIIPA rules and revealed his recent surgery and condition, but saved his hide in the process. Note to self...don’t celebrate making it through the TSA process undetected!
Speaking of hip replacements, many of you may know that I also went through this procedure at the end of June. A couple of days prior to my surgery, I was again flying back from a client meeting. The gentleman next to me was watching a video documentary that involved an in-depth surgical procedure...a hip replacement no less! Are you kidding me! Blood, drilling, muscle stretching/cutting...the whole nine yards! I couldn’t look away, but at the same time, I was losing it. This was not the Netflix series I was anticipating in preparation for some time off for rehab! The guy must have noticed I was squirming as he asked, “ are you OK?” I told him of my upcoming procedure. All this young man said was, “Woah...dude” and returned to his gruesome video. Now I felt old...and squeamish. I still couldn’t look away!
My last installment of humor again involved the TSA process. As I am progressing through the line having emptied my pockets of all my worldly possessions, the TSA agent was listing everything that needed to go in the bin...cell phone, money clips, keys, wallet,etc. He then paused, looked at me and asked, “Beverage?” I responded, “No thank you. I just finished a bottle of water, but a beer sounds kind of good.” I thought the TSA agent and his buddy were going to wet their pants in laughter. His buddy did admit that it sounded like he was offering me a beverage. As I collected my possessions they were still laughing. The terms laughter and TSA aren’t usually used in the same sentence...so it was a good day.
I have found that enjoying the humorous things with commercial airline travel makes the long days somewhat bearable. Working with clients who are passionate about doing the right things for their residents and their staff keep this all fulfilling.
Keep flying, keep smiling, and hopefully experience an occasional belly laugh now and then.
Throughout my career, I have been an opponent of heavy-handed, onerous regulations in senior living. I fought the codifying of the ADA Accessibility Guidelines, as that civil law was never intended to fall into the world of codes and regulations. I have resisted the attempts to achieve quality through more regulations, especially in health care. I have worked diligently with other architects, researchers and influencers to achieve equal accommodations and alternative solutions to prescriptive regulations that institutionalize the home environments for older adults.
Why do I share all of my history for opposing institutional regulations? This narrative sets the context within which I entered by recovery period from total hip replacement at the end of June. Prior to my surgery, my loving and caring in-laws brought over walkers, crutches, canes and even those “institutional” toilet risers. In a prideful way, I was convinced that I would not be using those “ageism” devices.
As a follow up to the anterior approach to my hip replacement, the doctors and physical therapists had me up and walking the evening of surgery. Holy Cow! Did that walker come in handy. Some of the parting words that my surgeon gave my wife were, “the worst thing for Mitch would be for him to fall.” Duly noted! For the next week, the walker became my companion, but I was not going to name it!
Upon returning home, nature began calling. If you remember my rejection of the toilet riser, my first “sit down” experience was eye opening. I thought I was sitting on one of those tiny toilets one would find in a child daycare environment. Again…Holy Cow! Very quickly, one of those institutional risers was installed on our residential toilet. Humbling…but this device did eliminate the family assistance in this process and gave me a sense of independence. When I was in the skilled nursing world, we used to fight the installation of those toilet risers. They were undignified. Two people assisting one on and off the toilet doesn’t contribute a whole lot to personal dignity, either. I do have a new appreciation for these assistive devices.
Through my two-week recovery process, I can clearly identify everywhere that a grab bar would have benefited my ambulation. The reality is, during my first week, excessive grab bars would have been beneficial. As I work through my second week of rehab, I am needing those assistive devices less and less. Based on this recent experience, I would love to see someone develop temporary, and safe, grab bars in all of those high-fall-risk, transitional areas within a home environment. There when you need them, gone when you don’t!
This has been a humbling journey as I recover from my hip replacement surgery. The marvels of modern medicine are amazing and are having a positive impact on my return to normal. For most of the residents we serve, each day may be a new normal for them. As I continue to develop and design environments for older adults, I am confident I will lobby for a more empathetic approach to dignity, ambulation and independence.
As I step into my new role as principal at RDG Planning & Design, I am keenly aware that leadership is a responsibility, not a privilege. This responsibility comes with a variety of layers which carry some sense of equal importance. From a fiduciary standpoint, I am responsible to my fellow stockholders for the stewardship of our company’s revenue and resources. To quote one of the RDG founding principals who is no longer with us, “as leaders we must be good at catching fish as well as cleaning fish”, in other words, bringing in the work and executing the work are both part of the leadership role in our firm. Today’s clients will be impacted in a detrimental way if we aren’t business-healthy for the future. As leaders, we are all responsible for continuity of our business and our services.
Although I have embarked in an expanded role at RDG, I must intentionally begin to replace myself from that “continuity” perspective. How can that be? I just got here! This “replacement of self” concept drives another leadership responsibility role that we must carry…the investment in younger talent. This is a reality as I look across the senior living architect landscape to see that many of our lead consultants are aging in place…and I am looking in the mirror as much as I am looking out the window when I make that observation. Thank you, Jim Collins, for that analogy from his book, Good to Great. We must find those dedicated architects and designers who have a passion for impacting the lives of older adults…those who value purpose over position as they refine their careers.
As leaders, we are also responsible for setting the culture within our organizations, including our volunteer opportunities like SAGE. Culture relates to the wake we leave behind as we interact with each other and with those we serve. In leadership, we have to be role models in embracing culture. To borrow a phrase from author, John Maxwell, we have to remain F.A.T. as leaders….Faithful, Available and Teachable. If we want those character traits in those who follow, we must live out that attitude to be followed. A culture that is inquisitive and always learning will be a culture full of humble leaders and followers who make a difference in the lives of people.
Our clients and their residents deserve leaders who answer to a higher calling in our senior living world. Its not about us…its about them. In light of this more humble approach to our profession, I was recently made aware of a potential client’s desire to make a change in their architect. They said they wanted an architect who would listen. This amplified a premise by which I try to live…our value is not in the statements we make, but in the questions we ask. As leaders, we need to monitor our question to statement ratio….the higher, the better. In reality, we should become thought-provoking leaders in senior living…not just thought leaders.
April is always an exciting time of year for our profession and for SAGE. On the 19th of this month, more than 1,000 people will travel to Savannah, Georgia to learn, network and celebrate at the Environments for Aging Conference. I can’t help but reflect back a year ago when Emerald Expositions “listened to the customer” and abandoned the previously planned Las Vegas location for this year’s event. I applauded their flexibility in a blog last year, so I won’t repeat that encouragement…at least too much.
I continue to believe that EFA is the best design-oriented conference for senior living. It is large enough to attract quality speakers with informative content. It is small enough to provide ample networking and relationship-building opportunities without the attendees getting “lost in the crowd”. One can almost satisfy your continuing education requirements by attending the educational sessions at EFA. If you aren’t able to attend this year’s conference, know that the SAGEducation Committee is recruiting EFA presenters to share their content through the SAGE webinar series that happens each month.
Please make sure and attend this year’s session that involves the SAGE POE (Sunday, April 22, 10 AM - 12:15 PM in Room 105). Through the financial support of J+J Flooring Group, this year’s POE will be more robust and informative than ever. This presentation will be the basis for a white paper that is being developed by the POE team. This white paper will be made available to SAGE members at no cost. Thank you to the Emerald team and to The Center for Health Design for giving the POE presentation team a deep dive, two hour time slot at the beginning of the conference.
I must not forget the gathering that will kick off the EFA conference…the SAGE members’ reception. Saturday night, April 21st, SAGE members and their guests will gather to catch up, share stories, while enjoying food and some beverages. This event is made possible by a significant group of sponsors who are committed to SAGE and the principles we espouse. If you areattending EFA and will be in Savannah by 6 pm Saturday evening, please make sure and register for the event. You can learn more and register through THIS LINK. While you are there, please check out our sponsors and give them a shout out for their support.
As you mix and mingle with other industry professionals at EFA, you may be shocked to learn that not all of them are SAGE members...yet! Please encourage all of these "future members" to visit us at Booth 307.
This year, there are 32 SAGE members presenting 26 presentations at EFA--some are presenting multiple times. Let’s make sure and support these dedicated members by attending their sessions. CLICK HERE for a complete list of EFA sessions presented by at least one SAGE member.
I hope to see you in Savannah!
Guest Blogger: Keith Gray, Director of Applied Research, J+J Flooring Group
My career in research spans several decades, across many scientific fields, but I find that elevating the senior lifestyle experience is the most satisfying of all. So, it should come as no surprise how delighted I was to join a SAGE research team, tasked with developing a Post-Occupancy Evaluation (POE) study for a senior community called Cypress Cove--specifically their four household-style memory care areas.
As with most POEs, we were out to determine how effectively the original design met the actual desired outcomes, especially from the perspectives of residents, their families, and staff. However, there is much that makes this POE project exceptional in terms of approach. Previous POEs were typically generated within a few days before a major conference, and at a nearby community, which limits the options for communities to study, and leaves only a few days to sort, classify and analyze data and develop the POE report and presentation.
Some special funding made it possible to do things differently this year. I am pleased that my company, J+J Flooring Group, collaborated with SAGE on both financial and manpower support--based on our company’s commitment to being more than just flooring providers to senior communities.
With no geographical constraints to deal with, SAGE secured participation by an award-winning community in Florida, hundreds of miles from, and three months in advance of, the EFA conference in Savannah. As a result, rather than having a few days to write the report, the SAGE team has almost three months to study the data, write the white paper and develop the presentation for SAGE to present at EFA. That alone promises to yield an excellent report in every way.
But it gets even better. SAGE stepped up with a strong six-member team, including: Amy Carpenter, an architect who specializes in senior living; Migette Kaup, a designer from academia who is also a senior living specialist; Fred Worley, an expert on regulatory affairs; Teresa Whittington, a nurse who oversees the clinical and business operations of the healthcare services areas of a senior-living community; Robert Soler, an expert on circadian lighting; and—yours truly--a materials scientist that has studied the intersection of flooring and human performance for 31 years. This diverse set of specialists brings perhaps an unprecedented range of perspectives for a SAGE POE. On the community side, we were given the full and complete cooperation of administration and staff. We had access to staff, residents and their families, and the entire community.
Another extraordinary advantage we enjoyed was that the lead architect for the original project was able to join us and gave us a thorough briefing on the original design goals for the community. Accordingly, we could structure the POE to focus on those desired outcomes—and learn from the residents and staff if those design goals produced the desired results, which opens the door to forward thinking about an even better design.
The researcher in me couldn’t be more excited. Working together as companies and professionals, the SAGE POE project promises to yield powerful insights for the future. My colleagues and I will be able to study every angle, point and nuance of an environment that was already world-class. This project is living proof how industry collaboration can take the industry farther and faster than any organization can working alone. Make it a point to visit the SAGE exhibit at EFA this April and join us at the presentation to learn the POE results—and get your copy of the SAGE POE whitepaper for a permanent reference resource.
Keith Gray, Director of Applied Research, J+J Flooring
Keith Gray is known for pioneering the launch of evidence-based design research for the flooring industry. With his unique approach to studying the comprehensive effects of flooring on humans, human performance and institutional facility outcomes. Gray leads J+J’s human-centered research initiatives with his keen sense and ability to mine for narrative findings. A scientist and engineer by training, Gray holds more than 50 U.S. and foreign patents. He has been invited to present his findings with global architecture and design firms. Gray holds an advanced degree in polymer science.
# # #
This month marks the one-year anniversary of my return to private practice in architecture. After twenty-four years of being a client, my one year of transition back to a consulting role is complete. The reality is, this is a journey and not a destination.
I have learned a lot about the world of senior living from the consulting perspective and more importantly, I’ve learned a lot about myself. Here are my take aways from this transition year.
I have much less influence on project schedules. As a client, I had the opportunity, and responsibility, to set the pace of our projects. This pace was driven by our operation team’s ability to execute the changes we were developing. I also had the luxury of answering to a private owner, rather than a board. This reality impacted the decision-making process. As a consultant, many factors influence the rhythm of a project and most of them are out of my control. The pressure of “speed to market” is much more prevalent, especially in the rental world of senior living. This pace is exciting and challenging...all at the same time.
As a client in a provider organization, I had experts in finance, operations, clinical services, dietary and marketing at my finger tips...all under one roof. Immediate feedback was available with a similar mindset. In the consulting world, I have had the opportunity to work side by side with some of the best experts in our senior living field. This collaboration looks much different from my client days and I have found these interactions to be thought-provoking and inspirational.
As a client, I was one of the decision-makers, along with other subject matter experts in our organization. I worked for an owner who had the attitude, “if it ain’t broke, then let’s break it”. In reality, I probably “stirred the pot” in keeping that approach alive and well. As a consultant, I have the opportunity to work with the decision-makers. I have been exposed to many different processes with unique organizations, especially in the non-profit world. Fortunately, many of these organizations have a similar passion for quality of that from which I came. At the end of the day, my role as a consultant is to guide and recommend...not to decide for anyone. This has required some adjustment on my part.
My hope is that my twenty-four years of sitting on the client side of the table will give me a greater depth of empathetic listening and a unique understanding of our client needs. I know that as design consultants we can disrupt conventional thinking and ageism as we work with owners who have a passion for making a difference in the lives of older adults. No matter which side of the table we sit, I trust that empathy and understanding will prevail.
This year has begun with a jolt for me. In its first week, I lost two close friends to cancer. Their celebrations of life were six days apart. These type of losses and events cause one to think about relationships. They drive us to evaluate and consider the legacy that each one of us is leaving to our friends, families co-workers and clients. To borrow Henry Cloud’s boat analogy, what type of wake are we leaving as we sail through this life?
The reality is that what we do in senior living isn’t about us as designers, architects, providers and researchers, it’s about making a difference in the lives of people. The experiences that we create in the process and the end products are what matters. The relationships that we impact along the way make all of our efforts worth the necessary sacrifices. The design awards and the recognition we receive should be based on the difference we are making.
As we launch 2018, I am committed more than ever to influencing our profession and the SAGE organization into becoming greater difference-makers. It would also be very rewarding to see the results of our legacy...the relational wake we leave behind...before we are gone.
At a recent presentation I was making to a university board, I was asked to describe the changes I had seen over my 30 years of experience in senior living. This topic was not a part of the PowerPoint I was presenting, but I quickly adapted. My initial response was to set the context of 30 years. When I began my senior living journey, only the owner of our company had a cellular phone…and it was the size of a brick. Very few of our clients had a facsimile machine. One of the younger board members actually looked at me in confusion until I explained that fax was the shorter version. By this point in my response, I was beginning to feel my age.
It donned on me that 30 years ago this year, OBRA 87 came into existence. If you read the history of SAGE, that was milestone legislation that had a significant impact on a more humane approach to long term care and senior living as a whole. OBRA 87 had tremendous influence on how we thought about the environment for seniors. This was about the time that Dr. Bill Thomas had the gall to invite pets into the care environments. He, among others, began talking about scale…not in terms of weight, but in terms of size. We began bringing food to the people rather than herding people to the food. The concept of dining with 10-12 of one’s closest friends, rather than being fed in a cafeteria of 120 became so appealing! Maggie Calkins (founding SAGE Member) encouraged us to stop hiding the toilets! Lori Hiatt challenged the concept of the nursing bunker. David Green (founding SAGE member) gave residents a voice. Betsy Brawley (former SAGE board member) shed light on the visual experience in senior living…pun intended. Rob Mayer gave the regulations an overhaul.
In this name dropping/acknowledging exercise, I have probably missed a number of pioneers in our world. One of the hallmarks of the past thirty years involves the progression from the medical model to the social model to what I would call the experiential model. Actually, I credit Apple for raising our level of awareness when it comes to user experience and quality, which has transcended into so many markets today. Today, we talk about the bathing experience, the admissions experience, the discharge experience, the dining experience, the wellness experience and even the outdoor experience. This all relates to culture. Our built environments can’t create culture, but they can surely enhance the experience.
I am excited to see what the next 30 years will bring in terms of change for the senior living space. At the rate we are progressing, I believe even the next five years will provide for some amazing breakthroughs.
© 2019 The Society for the Advancement of Gerontological Environments. All rights reserved.
The Society for the Advancement of Gerontological Environments is a 501(c)(3) non-profit organization.