The Impact of Fit Seniors

Tom Butler: 0:04

This is the Cycling Over 60 Podcast, season two, episode 13, the impact of Fit Seniors. And I'm your host, Tom Butler. It has been two weeks now of wearing a continuous glucose monitor. The emotion associated with this experience is disappointment. I keep eliminating different foods with the hope that I will keep my blood glucose from spiking. However, I have only had one day that I have been happy with, and that day wasn't really a good day, but it was closer than the other days to having things under control. If you look at the trend of the last 14 days, it is going in the right direction, but it is very, very slow, agonizingly slow.

Tom Butler: 0:57

My weight is the lowest it has been since I started the cycling journey a year ago, so that is very good. However, I seem to be stuck at 215 pounds right now. The biggest problem comes from the fact that I want to have a lot of control over my exercise, to see how adjustments in intensity and duration impact my post-meal glucose spikes. So I'm using the exercise bike after every meal. I'm doing that instead of getting out on the bike. It seemed like riding the bike was actually contributing to glucose spikes. I really miss getting outside on the bike.

Tom Butler: 1:31

I certainly hope this is only going to be a short-term situation. This journey to figure out my blood glucose is certainly the most important factor for improving my long-term health. I am very glad that I'm getting this picture of just how high my glucose levels have been. In addition to the long-term, I believe this is worth it because I think there is ample evidence that suggests that my high glucose levels could be interfering with my ability to get the most out of my training. So while this is a step backwards with time on the bike, I'm hoping that it creates a leap forward when I get this all sorted out. From the beginning of this journey, I have seen the bike as a tool to get healthier and it has been a valuable tool.

Tom Butler: 2:19

I believe that I have certainly gotten healthier over the last year. There are numerous reasons for me to be excited now about the positive impact better health provides for me and for my family, but my fitness journey has also made me curious about what impact there would be if the majority of people my age started getting more active. A friend of mine, kevin McNamara, is a healthcare administrator focused on senior living. You've had some great conversations about the impact of healthy seniors, so I wanted to share his perspective on the podcast. Here is our conversation. I think this is going to be maybe a little bit different of a conversation today, but I'm really interested in having it. It really comes from conversations I've had with Kevin McNamara, who's joining me. Thanks, kevin, for coming on.

Kevin McNamara: 3:03

Yeah, thanks for having me Happy to join you.

Tom Butler: 3:05

I'm really interested. I'm getting healthy, I'm cycling, I'm working on things. I've been the last week or so I've been heavily into trying to figure out how to manage my blood glucose, and all of that's about trying to be more healthy. Some of the conversations that I've had with Kevin have been about what is the impact of being healthy as we get older. Kevin, could you talk a little bit about your background?

Kevin McNamara: 3:33

Yeah, sure, from an education background, I have a business degree and really just went right into senior housing and healthcare right out of college. I spent the last 23 years in senior housing of every level. When I say every level, I mean skilled nursing and rehab, assisted living, independent living, memory care communities. That's my 23 years of background and perspective in aging and healthcare has all been around senior housing.

Tom Butler: 4:08

You say you have a business degree and really you've ended up taking that business degree and becoming a healthcare administrator.

Kevin McNamara: 4:15

Yeah, absolutely. I think that people come into healthcare administration from a variety of directions. Mine was through. I grew up around senior housing. I had some familiarity with it. When I finally made that decision of what I wanted to study, it was business, but it was focused on ultimately being in the senior housing space.

Tom Butler: 4:39

Under a professional background and also the whole industry. There is, I believe and hope to get into this a bit why but there is this interest in senior health and what can contribute to a healthy senior population in the US. That's what your organization does is. It provides care for older individuals.

Kevin McNamara: 5:03

Yeah, absolutely. I think when you go back to the stereotypes of what senior housing is, it's the long-term care nursing home that we might have visited when we were a kid or our great grandparents might have been our grandparents. That was really the most urgent, needs-based type of senior support that was started a long time ago. Fast forward to where we are today. It's changed drastically. People think of a nursing home. It's quite different than it used to be. It's more focused on the rehab side of things. Short stay post-hospitalization that's really the majority, although there is a long-term care component where people are needing nursing services around the clock and it's just too difficult or too expensive to get it at home.

Kevin McNamara: 5:58

Even over the years, other senior housing options started to be developed. There's some debate between who started assisted living, whether it was somebody in Oregon or somebody in Washington, but it really is pretty widely accepted that it was a northwest west coast sort of brainchild, although certainly models of it probably exist in other places. There was people really saying, hey, we can provide support and services in a congregate setting, but it's your own apartment, it's more of a home-like setting and you start to see independent living communities coming online and then, much later. The latest of the group is specialty memory care communities that look a lot different than they did 20 years ago, as we all continue to learn a lot about the aging process and what can make that a better experience, so it's continually changing. What we do today is going to look different in 20 years. We don't even know what those things probably look like, but you can be certain that they will involve a lot of technology and they'll probably involve robots. So yeah, the future is changing for the better in the support services for seniors.

Tom Butler: 7:15

Is it fair to say that you, as somebody that's a healthcare administrator, and the industry as a whole, that you see that there is a difference in the accumulation of lifestyle choices that people make, whether that's positive or negative? Is that something that is really evident in your population?

Kevin McNamara: 7:39

It is, and I would say that when you socioeconomics plays a role in where people are in senior housing and the type of choices they make earlier versus later. And I say that because it's been a number of years. But I was managing a skilled nursing rehab community and I was talking to colleagues and assisted living and independent living and we compared the average age of the people at each of our locations. So in those three different categories of senior living and they were between 87 and 89 was the average of all three locations Interesting? And so you start to think about, well, why is that? Why is the average age of this group of people in an independent living setting, who are still probably getting some support services, the same as the long-term care community? And I think clearly that I'm not a scientist, but looking at things they say, well, it's health. What would lend itself to somebody to live longer in an independent way than to be more chronically ill? And so I think that was just an early eye-opener for me industry-wise. See, there's not a lot of years that separate those different settings. Now there are different types of senior models that tend to get people moving into them earlier, and that's really kind of becoming the new buzz is active adult communities. We go through different catchphrases, but active adult, what does that mean? It's not just active physically, it's active spiritually, it's involved in groups, it's involved in volunteerism. A lot of seniors who are in independent living are still working or running a business or consulting or teaching, and so really, when you look at the term of active adult communities, it's communities are getting very holistic in saying you encourage people to come into this setting maybe earlier than they used to have thought that they would. It's something really take benefit of that, the services that are offered and all of the different options. But the communities I would say are doing that really well are focusing on active fitness programs, really robust offerings with certified, trained fitness professionals that are running programs swimming, biking, dance, yoga, tai Chi, balance programs, nutrition. From the physical fitness and body health side. Those same communities would be fairly robust in education series and lectures and travel. Really would also have somebody, a chaplain, somebody who's running a spiritual program, and so the people are really seeking a holistic experience.

Kevin McNamara: 10:38

Is there really more people, I think, than ever earlier? How can I live longer? Healthier People don't want to live long chronically ill. I haven't met anybody who would say to you I want to live longer if I'm chronically ill. There's a book that came out several years ago called Live Long, die Short by Dr Roger Landry, and it's really the concept of what can you do earlier in life, and even as a senior, to become healthier. To live longer and to die short Meaning not to have a chronic illness that sends you in and out of the hospital, constant treatment and just living in a miserable state, and so I think just more and more there's an emphasis on how people can invest in their total wellness, not just physical fitness, but the whole package, have more quality of life and live healthier.

Tom Butler: 11:35

The CDC has stated that 60% of US adults do not engage in the recommended amount of activity. In addition, 25% of US adults are not active at all. Right, so to talk about that, and I think it's an incredibly interesting concept of live long, die short. Did I get that?

Kevin McNamara: 11:55

right, yeah, you did.

Tom Butler: 11:56

Yeah, I think that's a really interesting perspective and it seems like 60% of adults are not living when it comes to fitness, when it comes to activity, are not living out the recommendations. I've not read the book, but I'm thinking that one of those recommendations is activity. So people being inactive is that something that aligns with what you see in your profession and what, across the industry is assessed?

Kevin McNamara: 12:29

Yeah, I think absolutely. When we hear about different studies or we hear about what the CDC says or practicing physicians, people who are sedentary are typically going to have multiple comorbidities. They're going to have different health issues starting to stack up cholesterol, risk of stroke, heart disease, just so many different things and then you start piling on medications and it's incredible how many people part of this, I think, goes to the health system but medication just getting piled on to address every issue there is. Whereas the concept of exercise is medicine, which you might have talked about in an earlier podcast exercise is medicine. Typically those people are taking less medications, one of something actually really interesting, and I might have a little side note. But oftentimes when people are entering hospice services which is an end of life sort of an expectation that the person might only have about six months to live typically all the medication they're on is stopped and only things that help them to be comfortable stay on as a medication. And we'll often see people with 10, 15, 20 different medications they're taking a day stopped and at least for a period of time and maybe a while, they do a lot better, they improve. Now, that's not medical advice to say go stop what you're taking. But it's sort of this interesting thing where we see so many different physicians for different things. It's kind of the health system challenge where we get things added all different places and we see people that are seeing physicians for so many different chronic disease.

Kevin McNamara: 14:20

I'm sure there are studies that would talk to this, but I would guess that most of those people that lived a fairly sedentary life and that's not to say that we don't all know really healthy people that have a heart attack and die or develop dementia or have a stroke there's certainly those things happen.

Kevin McNamara: 14:39

But when you're talking about this, 60% of people that are sedentary or very low activity, common omers, they've probably got a lot of multiple health issues. I was reading it. There was a study at Harvard and I don't remember what timeframe this was, but they identified that even 15 minutes a day of vigorous exercise would increase your lifespan by three years. And people say even 30 minutes a day, so many days a week of walking also is going to reduce the risk of premature mortality. So I think that there's always those barriers of I don't want to go to the gym and work out with everybody else and I don't know what these different things to do, but sitting is the new smoking. You've probably heard that as well, and so I think that it's really important for people to ask those questions and look at not how they necessarily even how they feel today, but how do they want the last 10, 15 years of life to be? And we see some really difficult years of life for people, that people really struggle and they're not having quality of life.

Tom Butler: 15:52

One of the things that I think is a factor, and I was interested to find a study that was of adults ages 55 to 79.

Tom Butler: 16:01

So that's right in the cycling over 60 group right there and who were cyclists and they had regular activity, they were biking regularly. This was in the UK. They found that the thymus in these individuals functioned like those of someone younger. You know I don't carry around with me the information on what a thymus does, but what they were talking about in this study is that the thymus is important to immune function and it starts to shrink at age 20. So they're finding something that if you do it, if you're active in this activity in this case with cycling, which is what kind of drew my interest but after age 20, you're going to have this shrinkage, but you can delay that or you can offset that by being active. To me this is one of the mechanisms that I think that as we get older, then our immune function can be compromised and I'm thinking that you know again, as an industry or as you personally, in your, in your facilities, the difference of having a strong immune system must be fairly large.

Kevin McNamara: 17:07

Yeah, I think it has to be. And it's no question that as people age, we all know they're more susceptible to the serious side effects of getting the flu or getting any sort of even just a seasonal virus, let alone a pandemic type virus. People's immunity when it's higher, their natural body is able to fight that virus off. They have the backup in their system to fight it if they've got a stronger immunity. We do see people that live in as you progress through the senior living levels of living, that definitely increases the risk of being susceptible to not fighting off an infection, a virus of some kind, and then the complications from there and it just starts a spiral out of control, as you see people that are. They get an infection and then they start an antibiotic and they do that too often and they become antibiotic resistant and you start to. It just escalates from there the complications of trying to recover. So it's very important.

Tom Butler: 18:21

And another thing that I think is important is brain activity, and part of the recommendations for activity I think are to they are to maintain our brain health, our brain function. I know personally that it's tough. Our culture is not built to promote activity as much as it's built to promote productivity, and sitting in front of the computer is one of those things that is a productive thing to do. Culturally, it seems like we do need to get more things that incentivize being physically active, and I think a big part of that is that it keeps our brains young. So, again, that seems like something that has a big impact on maintaining independence.

Kevin McNamara: 19:10

Yeah, it certainly does. I think one of the things that is a byproduct of exercise is often people are doing exercise with other people and so, as you're adding that component of participating with other people, the benefits of socialization with people improves your health and so it's stimulating, it's working your brain. Obviously, we know you're getting more oxygen into your system and your immunity can improve all those benefits. And then that's one of the things we see in in the senior housing space is that oftentimes, even if people can function just fine at home physically, they may be getting isolated. They may not have a network of other people to be involved with, they may not have other people to exercise with. And so one of those built-in benefits that we see in independent living or assisted living or whatever level, is that you've got peers. You've got built-in peers that you're doing, you don't have to do exercise with other people, but you certainly have that built-in easy access, easy opportunity. It's all scheduled, it's all available. There's fitness, state-of-the-art fitness gyms and pool facilities being put into these communities. One really, I think, fun example I managed a continuing care community in downtown Seattle.

Kevin McNamara: 20:37

It's called Skyline and it had every level of living in one campus and the fitness director there would, on an annual basis, do a fitness test voluntary fitness test for residents in independent living and they would do a very structured fitness test of standing, sitting, walking certain distances, bending down, getting the neck up, just a whole variety of things and they were tracking that year by year. People would come back every year to get retested to see how they did from the prior year. We saw people six, seven years in a row that I was there improving their physical function and fitness and strength. Wow, three years. So they might have been in their mid-70s, they might have been in their mid-80s and they improved year after year while they were aging.

Kevin McNamara: 21:28

So we know you don't have to. You know there's never a bad time to start. You can reverse certain things, you can improve your balance, you can improve your strength. We see people that were using a cane and now they're not. Or they were using a walker and maybe they're using a cane, or memory they're not. So there's a great opportunity, even in later years of life, to improve your function, which reduces your risk of traumatic events. I think one of the things that and there's a lot of research on this topic, but related to the impacts of a fall on a person who's an older adult. The risk of serious fracture, serious head trauma. Having a significant fall when you're older is pretty traumatic and it drastically reduces the life expectancy of people if they've fractured a hip or something like that. And so anything people can do to focus on strength and balance, it really does prevent a lot of things.

Tom Butler: 22:35

Well, it's interesting because I think what you're describing is a system, right? Right, they were getting tested every year, but I'm thinking there were also things for them to do. You know, they had the results of their test and then there was also maybe some structure around activities they could plug into that would impact elements of that test that they could focus on. And to me that seems like a pretty important part of it.

Kevin McNamara: 23:03

Yeah, it absolutely is. I mean, I think one of the things where I say there is there's enough going on in any of these communities to keep you busier than you could possibly think you could be, and, of course, it's voluntary, but you could wake up early and there's a fitness class going on. You could go, you know, have breakfast afterwards. There's going to be another fitness class after that. You probably have, in some of these communities, four or five opportunities a day just surrounding fitness, let alone, you know, lecturing, and you know all sorts of different types of things, performances of all kinds, let alone having a gym and a pool right at your disposal all the time. Personal trainers, all those things being built into this system is that you know of having infrastructure in place to try to create, you know, the best opportunity to have access and support to be active.

Tom Butler: 24:00

Do you have a way of maybe conceptualizing and I don't know, maybe this is something that's done as an industry, the senior healthcare industry of looking at what if we reverse things? What if, instead of 60% of people that didn't do the recommended a level of physical activity, we only had 40%, or we only had 30% of people and the majority of people were prioritizing fitness and the economy, the society, whatever, was seeing the results of having a major shift in how many people were staying active into later years? Is there some way to assess, like the national economic impact of that kind of shift?

Kevin McNamara: 24:44

You know, I know there is I don't have the data in front of me, but I do know that 20% of our United States government budget is spent on Medicare and Medicaid.

Kevin McNamara: 24:57

You know it's around $1.3, $1.4 trillion a year is spent on Medicare and Medicaid services.

Kevin McNamara: 25:04

You know that's not just on senior housing, obviously, but it's every service related to hospitalization doctors, pharmacy, all the rest you know we all often talk about. You know there's 10,000 people a day turning 65, the baby boomer population, the workforce, and particularly the healthcare workforce, is not there to fully support that population as it reaches maturity in, you know, people needing to access healthcare services. So I referenced briefly earlier, you're probably going to see a lot of technology and robotics in care delivery in the future. We don't have enough people to be caregivers either at home or in a community. When you talk about so security bankrupting or Medicare or Medicaid not having the funding, really the only way to reverse that is to improve people's health and to utilize the system less. So it has to be a solution as far as how can this largest number of people age through our society and our society not go bankrupt or, you know, not have the people to provide the care and services. So it is all tied together and it's a massive draw in the economy.

Tom Butler: 26:27

Yeah, Again, when you talk about exercise being medicine, it seems like that's figuring out a way to prescribe that and again setting the structures up so that it makes it easier for people to be active. It just seems like there's such a potential for economic impact there.

Kevin McNamara: 26:49

Well, I think you're right. I think, though, that when we talk about what can people do about it, I don't think there's a lack of people telling us that we need to be more active. I don't think I've ever been to the doctor or anybody else who says they ask you if you're active, they ask you what you do. They probably might even say you need to do more. Then, as far as access, if all you did was walked 30 minutes a day, 15 minutes a day, you can make a big difference. Yeah, it's great to have fitness facilities and gyms and instructors and all those things available, whether people are already in a senior community or whether they're not even a senior. Don't wait until you're a senior. I think that the accessibility for fitness is pretty simple, but we often don't do what's simple. We often don't do what we know we're supposed to do or should do.

Tom Butler: 27:47

I think it's true that there are resources around and putting on a pair of shoes and going out and going for a walk, that's a pretty low barrier way of getting in the activity that's recommended. That's right, yeah. At the same time, I do think there's a structural component to it, especially, I think, when people are younger. Some of the structural changes were employed. That would create maybe more of a habit of fitness activity and reward activity. I'd be super open to insurance paying for my bicycle, yeah.

Kevin McNamara: 28:24

I think you certainly can find a lot of employer-provided insurance plans that do pay for a gym membership. They offset a gym membership, the things that you can purchase with a health savings account through your employer. There is a robust, I think, cafeteria plan of options available to people that didn't used to be there. I think it's because people are looking at that more often. Employers actually do have the ability to not hire people who smoke. That's pretty awesome tool that employers have because they know how much that costs their health plan. If they can help have a healthier workforce, they can try to hedge off the impact to the cost to the organization.

Kevin McNamara: 29:13

On the health plan, it's absolutely staggering. Every year when you get a 10%, 15% increase to your employer plan. You know you got to try to not pass that all along to the employee because then they can't afford to be on it. It's spiraling out of control at a much earlier age obviously. I think that's why you're starting to see more employers, more health plans, saying that they'll try to help offset those costs to encourage utilization. The problem is, though, getting people to actually utilize the benefit.

Tom Butler: 29:48

Yeah, it's interesting. I'm guessing that personally, you've heard of Blue Zones.

Kevin McNamara: 29:53

Yes, absolutely.

Tom Butler: 29:55

I'm wondering if, as an industry, that's something that is noticed is what are happening in these populations where there's a lot of longevity.

Kevin McNamara: 30:05

Yeah, when you look at, for example, loma Linda, we know that's one of the closest Blue Zones in the United States. When you look at the healthy living, the diet, the sleep, the rest, people that would be smokers, drinking. Then there's the spiritual component. But there's also the fact that people who are connected to a faith group, they're also getting the benefits of the socialization being a part of a community. When I look at the communities I've operated and we've talked in our different senior housing associations, these are sort of microcosms of trying to create their own Blue Zone. In a sense, we actually have those conversations saying what's going on? These Blue Zones in third world countries out in the middle of a jungle and you've got a Blue Zone population. What have they done?

Kevin McNamara: 31:11

We look at the things that we offer in our communities around nutrition and diet and education, volunteerism, exercise. One of the bigger things that people don't often talk about is just people having a purpose. I would bet, without having the Blue Zone data in front of me, people in those Blue Zones probably feel like they have purpose. They're contributing to their community, tribe, church, city, senior housing community. I think they have a lot of things in common related to being active, being engaged in their community, having a purpose, volunteering that is. I think there's a lot of intention by senior housing operators, both for-profit and non-profit sectors, of what we do. That is focused on sort of recreating that Blue Zone experience.

Tom Butler: 32:14

That's awesome. You had mentioned that we in the past have this conception of senior living or senior communities. I don't know that senior communities would even been a word. When we think of nursing homes, it's like a place that you have to go. When I think of those old concepts, it seems like things have changed so far. From there, it seems like it is a lot about community. Do I have that right?

Kevin McNamara: 32:47

Yeah, you do the interesting thing about any level of senior living, whether it's a full campus that has all the different levels of living, or just a skilled nursing community or an assisted living standing by themselves there is a real sense of community.

Kevin McNamara: 33:06

The staff, the team members that work in those communities become a family with each other and with the resident population. You are really mimicking what it is to be community. You have children's programs coming in and doing activity with residents and performing. You're really trying to not just say this is a place that's separated from society, this is a place that continues to be fully engaged and connected. You're not preventing people, when they move in, from continuing on with their community. People are still going out to the stores they went to. They're still going to their church, they're still going with their friends and families. Those things are all still. You want that just to continue on.

Kevin McNamara: 33:56

Now, obviously there's still a lot of stereotypes that I have to go there. I don't want to go there, I want to stay home. Often that's just based on preconceived historical where were my grandparents or what was the old, stereotypical old folks home? What's really unfortunate is that we see people that move into communities more when it's the needs-based, like it's the have-to. An event happened, a hospitalization, something happened at home. We talk about mobility. Can you go up and down the stairs? Is your house set up to be safely home?

Kevin McNamara: 34:42

Oftentimes, when people have waited to that point, the effects of living home in a more isolated way and often by themselves. At that point, often one of the spouses in the household is no longer living. You're entering in at a harder stage of your life than taking a proactive approach, doing your research ahead of time, going to these communities, learning about them, seeing what they're all about, and realizing it's not really what I thought they were. There's a lot going on here that I didn't realize people do. When I see people move in who have waited maybe too long, they often skip levels of senior living that they wouldn't have had to. Rather than being in independent living you've got to enter at an assisted living level or long-term care or even memory care.

Kevin McNamara: 35:40

When I see people move in in a more planned way, they've done their homework, they've done their research, they've toured communities. Maybe they know people that already live in these places and so they're already familiar with them, and they make that decision before there's a catastrophic event, before it's the have to, before the kids are trying to have the intervention at the doctor's office. This says we keep calling 911, we keep having issues. The risk is high. When people make that decision it's a little more empowering, I think, because they're making decisions before it's a have to, when I see people move into a community at any level, before it's the have to, that support structure that's designed in these communities allows them to thrive. It allows them to live longer, I believe but not only longer, but healthier.

Kevin McNamara: 36:34

It's getting all the benefits of what's there while you can take advantage of it.

Tom Butler: 36:39

And while it can have an impact, sounds like.

Kevin McNamara: 36:41

Yeah, well, it can have an impact.

Tom Butler: 36:44

For a community that has a real continuum of care. Does that start out with housing or condominiums that are part of the community? Does it transition into apartments? What are the different levels in a community that offer the full palette of things?

Kevin McNamara: 37:03

I would say it's all of the above. One of the things they say in the industry is if you've seen one senior housing community, you've seen one, because there is really a little bit of everything for everybody. On more of the rural campus, on Acreage that might be 15 acres or 100 acres, where there are freestanding homes, there are duplexes, cottages, then there would typically be an independent living apartment building and then an assisted living community, memory care community and even skilled nursing rehab. There are campuses that have every one of those things I just mentioned all in one place. If you start to get into more of the urban communities, high-rise, you'd have an independent living, basically like condos, apartment living, and then have your assisted living memory care rehab built in as well. So there really is, especially in the Puget Sound or in an area not too far from a city, you're going to find a little bit of everything to pick from.

Tom Butler: 38:20

Recently or not long ago, I should say I was doing a bike trail down out of Olympia the Shalys Western Trail and there is a pretty large senior community that's just right on the bike trail and I met someone on the bike trail who gets out there every day and it was just a really fun interaction with her. I'm wondering if you have some examples that you can think of of like communities where there's a big focus on fitness, or groups of people that are exercising together, or you had mentioned the staff-run fitness classes and things like that. What are some of the unique examples that you've come across?

Kevin McNamara: 39:07

Sure, well, I would say that typically, if you're looking at any campus setting, whether it's a high-rise campus in the city or a campus outside of the city, you're going to find a huge program surrounding fitness, and those communities are going to have resident-driven committees for everything. You're going to have a committee for everything which has its challenges, from an operator but as people involved. So you're going to have a dining services committee, you're going to have a fitness committee, you're going to have a performance committee or a lecture committee.

Tom Butler: 39:47

You're going to have a gardening committee.

Kevin McNamara: 39:49

You name it, there's a committee, but the benefit that yields that you have people involved in choosing what it is that the community becomes. Yes, staff do the back of the house sort of structure and they might do the mechanics of things, but you really start to have resident-driven community in those settings and so you know, if no one showed up at Tai Chi, Tai Chi wouldn't happen anymore.

Tom Butler: 40:17

Right.

Kevin McNamara: 40:18

And oftentimes some of these things are led by residents. You know I had a community in Seattle where one of the residents led. You know she was a Tai Chi instructor, so she led Tai Chi and that's pretty common in most of these things. So you may have fitness instructors and people who coordinate. You know just the mechanics of those things you know happening, but oftentimes in the best models like that, they're very resident-driven and close to where we are. You've got a lot of examples of those communities. It's called Wesley Choice and you know they have communities around the Puget of Sound that are doing these things the company that I used to work for up in Seattle, transforming Age. They've got campuses around the Puget of Sound and around the country doing this. But whether it's a campus or it's a standalone retirement community or a standalone assisted living community, I've not seen one that didn't have a structure in place for fitness and programming like that.

Tom Butler: 41:23

What do you think about a bicycle day? There are, you know, different levels of bikes. There's, you know, electric bikes, there's trikes, there's electric trikes. Even there's rickshaw type e-bikes, where you could have people that have less mobility actually get in the seat and be taken out for a ride.

Kevin McNamara: 41:47

Yeah, absolutely. I mean, those things are happening.

Tom Butler: 41:50

Okay.

Kevin McNamara: 41:51

Different places around the country. There's actually a. There's a non-profit cyclingwithoutageorg.

Tom Butler: 41:58

Okay.

Kevin McNamara: 41:59

And that. But, just like you said, with rickshaws they are helping communities of all types memory care communities, assisted living communities to purchase rickshaws, okay, and to take people who might not be able to ride their own bike still and to take them bike riding Nice, and that is happening around the Puget Sound today at a community on Vashon Island that got one through a grant. I know there's community up in Redmond that I saw recently that was promoting that, so I don't remember where that started. It might have been Sweden. We see a lot of innovative senior concepts come out of Sweden too, but that is happening and it's amazing to see people, even with cognitive deficits, on a rickshaw going for rides. It's a lot of fun to witness.

Tom Butler: 42:55

I pulled it up while we were talking and there's a link that says being a pilot. So it might be something that I'm going to have to actually go out and do is become a rickshaw pilot, get my pilot's license. But because that does, it just seems like that would be really enjoyable, really rewarding to do that kind of activity.

Kevin McNamara: 43:19

You mentioned earlier, volunteerism is one of the things that really helps people with their total happiness and longevity quality of life. But intergenerational connection is critical to aging well, whether it's kids programs or high school, college or just normally connecting people of all ages, because we don't live in neighborhoods typically that are just one age.

Tom Butler: 43:47

Right.

Kevin McNamara: 43:48

So continuing to connect people with their greater community just the normal average population around them and this has been a really fun way to get people involved, to have an interest in biking, have an interest in volunteering and get them out there to do that.

Tom Butler: 44:06

Well, I'll have to bring that up with the Cascade Bicycle Club as well. They are generously collaborating with me on Cycling Over 60 Project. It would be interesting to see if they have thought about spearheading some volunteerism in this realm as well.

Kevin McNamara: 44:23

You don't have to go very far to find a community that would be willing participant probably.

Tom Butler: 44:29

Nice. So is there anything that you think people would be surprised about, as far as how active senior communities are, that you'd like to highlight?

Kevin McNamara: 44:39

I think, just in general, how much is available for people to do that live in senior communities? It's interesting. I've had conversations with people that say I came in after dinner and mom or dad weren't doing anything and they seemed pretty tired and it's like, well, let's talk through the things they did today. Mealtime in any community is a pretty big socializing event and how many of us are having three meals a day, two and a half to three hours worth of meals with our friends every day, and not that people have to go out to a communal setting? You know there's a lot of people, especially in independent lane. People have kitchens, people can cook, and then you go through the list of things that well, you know there was a fitness class, there was a musical presentation, you know there was something else going on. I'm like they've had a busier social calendar today. Then you can possibly imagine happening, and so you know they've had a long day.

Tom Butler: 45:52

Right right.

Kevin McNamara: 45:53

They wanna watch movie, they wanna chill out. What do we do when we get home?

Kevin McNamara: 45:59

You know, I don't think people have dinner and say let's go, get together with 15 people and do an activity, not on a daily basis, maybe on the week, right? So I think people would just be surprised just the level of engagement that is available to people. And it really, again, does spread all types of engagement. You know it's presenters from lectures, from you know musical performances, crafts, games, you know fitness and typically driven by what people are interested in doing.

Tom Butler: 46:38

It sounds like one of those things that there's a lot of opportunity to be educated about. You know, would you encourage people, as they are planning for retirement and everything, to just visit a facility? How would people like just check it out?

Kevin McNamara: 46:55

Yeah, I think that oftentimes we either end up having to look at communities because a parent or a grandparent or somebody is needing to make that choice. But yeah, I challenge everybody to do their research. Look at what's near you and, you know, go take a tour. I mean, that's what we do. We give people tours, we try to educate people. You can certainly go online and read about anything these days, but I would say, typically the people that we see moving into a continuum, moving into a campus type setting, they did do their research. If they moved into an independent house or duplex or any you know a condo in independent living, they've done their research. These are people that are planners and they've said I want to figure it out now and I'm going to move in somewhere where, at any of these levels of need in the future, it's already figured out. And we always tell people who've done that they've just given their kids the best gift they could possibly have given them. Trying to help figure it out when there's a needs driven decision is very stressful.

Tom Butler: 48:09

Yeah, I can see that.

Kevin McNamara: 48:11

It's really stressful and it's harder to make good decisions and it's just it's really difficult on people. But when I see people say, you know, I'm going to do this early because I just don't want to have to think about it after that, I mean those are typically people that have just really planned it out. I would also say that you know, when we opened up a high rise community up in Seattle and the average age was expected to be 77 moving in there, you know, when we do our research and data projections on the market, you know market studies saying how, about 77 years old? Well, the average age of the people that moved in when it opened were 72. And our finding is that if we build communities that are highly attractive, that have wonderful amenities in place, it does change people's minds about how early they would go somewhere.

Kevin McNamara: 49:04

And I've toured people through a community who were, you know, in their 60s, who were looking for mom and dad who were in their 80s, and they said, well, you know, I don't know about what decision they're going to make, but I think I need to look at this myself and there's sort of this, I think, freeing experience that people have when they're able to make the decision themselves. They do it in a time when they're not in crisis and they say you know, I've just shed all of these responsibilities of maintenance probably housekeeping, cooking if they want, transportation if they want or not and you know, people just say I want to travel more, I don't have to worry about who's going to take care of the house or the maintenance or those things while I'm gone. I'm going to move into this setting. I'm going to free myself up to do more of what I want. So it really is, you know, creating a lot of benefit for people to be able to focus on more of what they want to do, probably focus more on total health, because they're not having to deal with contractors and services at the house or maintenance or you know all these different things.

Kevin McNamara: 50:13

So, yeah, I would encourage people to do some reading up ahead of time. You could go to your local senior center. They've probably got a pretty robust list of things, but now it's just so easy to Google everything you want to.

Tom Butler: 50:28

Yeah.

Kevin McNamara: 50:29

But I would challenge people to go to you know a campus type setting and I would say you know there's older communities that have been reinvented. There's a lot of brand new communities and campuses out there and I think there really is, now more than ever, there is, a setting for everybody.

Tom Butler: 50:49

Well, I really appreciate you taking your time to come on, kevin, and I think that you know, for me there's this element of wanting to stay fit for a long time, you know, later on in life, and what I'm hearing is that a community I'm guessing most communities maybe not all, but most communities are going to understand the value of their community members staying fit, and so there could be a decision to be made. I may be more likely if I'm getting community support and professional support, a facility support, you know. I may be more likely to stay fit longer if I make a transition into a community than by staying what would seem to be independent in my own home. I like that.

Kevin McNamara: 51:39

Yeah, and I think that people realizing that if they're making the decision to move into any of these, they're as independent as they were before. It's not about taking independence away. It's about providing more options, more amenity, more service, more access, and I think that is the thing People often think they've conceded to the fact that they can't stay at home anymore, versus saying I'm going to make this decision because it's just a good decision to make.

Tom Butler: 52:11

Right, right, Well again, thanks so much, Kevin, for taking the time.

Kevin McNamara: 52:14

Absolutely Tom.

Tom Butler: 52:15

I really enjoyed this and take care.

Kevin McNamara: 52:18

Yeah, thanks a lot. Have a great day.

Tom Butler: 52:20

You too. Bye now.

Kevin McNamara: 52:21

Bye.

Tom Butler: 52:30

No doubt about it. There would be so many positive impacts if we started seeing the majority of people being active. If we could find a way to inspire 75% of the senior population to exercise on a regular basis, it would change individual health and there would also be incredible social and economic impacts as well. Hopefully my journey, with all the ups and downs, can help others see that is worth working through tough times and disappointments. I think Kevin presents a compelling picture of independent senior living communities.

Tom Butler: 53:00

Now I can imagine someday an entire senior community made up of cyclists. We can have our own bike shop with assisted bike repair and cleaning base. We could negotiate group energy bar buys to get the best price. We would certainly have bike workshops and presentations from community members about their travel by bike experiences abroad. We could have a bike transport vehicle to take a large group of people to different rides if they want. The fitness center would have bike fitters as well as instruction on how to improve your cycling. Of course, we would need massage therapists and physical therapists to help with recovery from really challenging rides. Maybe a bike share program for those who wouldn't get out as much or in order to try out different bikes.

Tom Butler: 53:45

The location would have to be carefully selected so that we have a significant trail system nearby. Ideally it would be paved trails that would also access some off-road and gravel trails. With all these exceptional cycling resources, we would need to have guest lodging so visitors could join in the fun. So what do you think? Where is the best place to build this kind of cycling utopia? I don't know, Maybe it exists out there somewhere already. Please share your thoughts with me. You can find my email and the show Instagram in the show notes.

Tom Butler: 54:19

I'm also on threads quite a bit now and I'm always looking for more cycling connections there. Until we build our cycling community, I hope you are finding a lot of good cycling companions and awesome routes. And remember, age is just a gear change. Ian deGeneres Game Cycle.