Home » Busi­ness Insights » Assi­sted living moves cent­re sta­ge

28 Febru­a­ry 2018

Assi­sted living moves cent­re sta­ge

Major demo­gra­phic shifts are crea­ting a mar­ket of the future. The Ter­tia­num Group is deve­lo­ping modern resi­den­ti­al and life­style con­cepts for the eld­er­ly and can alrea­dy sha­re its results. In Ter­tia­num Buben­holz in Opfikon, for instan­ce.

It was not all that long ago that care homes used to be some­what soul­less places, which local muni­ci­pa­li­ties ten­ded to build in more remo­te loca­ti­ons, often at the edge of a forest. While their eld­er­ly resi­dents were well cared for medi­cal­ly speaking, they gene­ral­ly found them­sel­ves living some­what out­si­de their vil­la­ge or town.

The expec­ta­ti­ons now pla­ced on assi­sted living are qui­te dif­fe­rent. In our inter­view with Dani­el Wid­mer, who mana­ges the Ter­tia­num Buben­holz resi­den­ti­al care cent­re in Opfikon in the can­ton of Zurich, he exp­lai­ned what solu­ti­ons and offe­rings are best sui­ted to meet today’s resi­dents’ needs and the direc­tion of tra­vel on which the assi­sted living sec­tor is now embar­king. He is enga­ged in imple­men­ting one of the most modern con­cepts for assi­sted living. In so doing, he is not only moving the Ter­tia­num group decisi­ve­ly into the future, but perhaps the ent­i­re assi­sted-living sec­tor as well.

Mr. Wid­mer, how is the assi­sted-living sec­tor evol­ving?
In a word, the focus is moving back to the indi­vi­du­al resi­dents them­sel­ves.

So the are no major tech­no­lo­gi­cal deve­lop­ments, or inde­ed revo­lu­ti­ons, around the cor­ner?
Abso­lute­ly not. Take a good look around our cent­re here. At Ter­tia­num Buben­holz in Opfikon, we have a total of 120 resi­dents living in 59 apart­ments and 43 care rooms. The key point is that the­se peop­le are living here. This is their home. We are not a hospi­tal, nor are we a hotel. In other words, we are not a place whe­re peop­le stay for only limi­ted peri­ods of time and are obli­ged to accept com­pro­mi­ses in order to do so. Our resi­dents come to us to live here. And that obvious­ly means that they bring their lives with them. Their habits, their pre­fe­ren­ces, their envi­ron­ment … Just as they would when they move into an ordi­na­ry apart­ment in a mul­ti-dwel­ling deve­lop­ment.

Are you say­ing that resi­dents at this Ter­tia­num resi­den­ti­al and care cent­re do not live as they would do else­whe­re?
Oh yes they most cer­tain­ly do. As much as pos­si­ble. Ide­al­ly, when a new resi­dent moves in here, he or she takes a com­for­ta­ble apart­ment. Our rents for a wel­co­m­ing place to call home begin at 1 750 francs per month. So the terms we offer are ent­i­re­ly in line with mar­ket con­di­ti­ons. The dif­fe­rence is that they inclu­de some major advan­ta­ges.

And what are they?
Our buil­ding is right in the cent­re of the vil­la­ge. So the loca­ti­on is ide­al in that it allows our resi­dents to live as they have always done. They can do their shop­ping, cook for them­sel­ves, meet their friends and recei­ve visi­tors. The dif­fe­rence is that this buil­ding was desi­gned around the needs of older resi­dents right from the start, with open access to all are­as, ergo­no­mi­c­al­ly desi­gned fix­tures and fit­tings, and a washing machi­ne and tumb­le dri­er in each apart­ment, rather than down in the cel­lar. That enab­les our resi­dents to main­tain an inde­pen­dent way of life for a long time. Then the­re is the safe­ty aspect. Should our help be nee­ded, someo­ne will be avail­ab­le to assist right away. Seven days a week, twen­ty four hours a day.

Don’t the tra­di­tio­nal home-care arran­ge­ments for older peop­le pro­vi­ded by the sta­te pro­vi­de that ser­vice as well?
Not real­ly. We are more fle­xi­ble. Under the tra­di­tio­nal arran­ge­ments, if someo­ne needs help with their house­work or in caring for their part­ner, that assi­stan­ce may not always be avail­ab­le pre­cise­ly bet­ween, say, 3.30 and 5.00 pm. And what if I have a fall at 10 pm? Or I am taken ill at 9.20 in the morning? The most important dif­fe­rence is that our system allows our resi­dents a gre­at degree of self deter­mi­na­ti­on. When a new resi­dent moves in here, we gua­ran­tee that they can remain with us for the rest of their lives, should they so wish. Ide­al­ly, their resi­dence with us will begin with many years of inde­pen­dent living in a com­for­ta­ble apart­ment. Later on, should their need for our ser­vices grow, they can gra­dual­ly draw on the­se up to and inclu­ding full nur­sing care. We also have an acu­te care faci­li­ty. That enab­les cou­ples to con­ti­nue to live tog­e­ther in the same place, even when one of them is unwell. That is a fea­ture which most of our resi­dents great­ly appre­cia­te.

You were say­ing that the focus is moving towards the indi­vi­du­al.
Abso­lute­ly. Our key values are self deter­mi­na­ti­on, inde­pen­dence, digni­ty and respect. They are cen­tral to all the deci­si­ons we make here at Ter­tia­num.

Doesn’t that app­ly nowa­days to all care homes?
Don’t get me wrong. I am not try­ing to sug­gest that anyo­ne working in the care sec­tor lacks respect for their resi­dents. But the systems that have exi­sted hither­to do not tre­at their resi­dents with as much respect as they could. They tend to place cons­traints on them and limit their ran­ge of opti­ons.

«Becau­se we are part of the Ter­tia­num Group, we are able to offer our ser­vices at lower pri­ces than the local muni­ci­pa­li­ty would be able to achie­ve if they pro­vi­ded them them­sel­ves.»

So it’s all about choice?
Self deter­mi­na­ti­on is a key com­po­nent of human digni­ty and thus an important fac­tor in qua­li­ty of life. Many older peop­le today are unab­le to deter­mi­ne the cour­se of their lives as much as they would like. If they encoun­ter health pro­blems, often their only opti­ons are to remain in their homes or to move to a care home. Sin­ce the lat­ter cour­se of action does not appeal to many of them, they opt to remain at home and recei­ve care the­re. If some­thing goes serious­ly wrong and they have to spend time in the acu­te ward of a hospi­tal, they are then told «Now you are going to a care home.» Once they get the­re, they are sub­jec­ted to a more or less rigid dai­ly rou­ti­ne. For examp­le, they are woken at 7 every morning, regard­less of whe­ther they actual­ly want to get up at 4 a.m. or at 10 a.m. That is not how older peop­le want to live their lives.

Ter­tia­num has been offe­ring indi­vi­dua­li­sed ser­vices for qui­te some time now. What is new about Buben­holz?
In the past, Tertianum’s princi­pal focus was on high-cost resi­den­ces at the top end of the mar­ket. The­re would, for examp­le, be a pia­nist on Tues­day after­noons and resi­dents would even dress for­mal­ly for lunch. Here in Opfikon we are ope­ra­ting a public pri­va­te part­nership with the muni­ci­pa­li­ty. Not only do we have to meet clear­ly defi­ned stan­dards of care, but we also have to ope­ra­te very effi­ci­ent­ly and cal­cu­la­te our costs care­ful­ly. Becau­se we are part of the Ter­tia­num Group, we are able to offer our ser­vices at lower pri­ces than the local muni­ci­pa­li­ty would be able to achie­ve if they pro­vi­ded them them­sel­ves. Thanks to the size of our ope­ra­ti­on, we are able to achie­ve signi­fi­cant eco­no­mies of sca­le. From clea­ning, to cate­ring, to main­ten­an­ce we bene­fit from the fact that we ope­ra­te more than 76 resi­den­ti­al care cen­tres, rather than just one or two.

But ser­vice does not come cheap …
Obvious­ly, a lot of things have their pri­ce. A lakesi­de loca­ti­on, attrac­tive, high-qua­li­ty fix­tures and fit­tings, and so on. But that doesn’t necessa­ri­ly app­ly to the true qua­li­ty of life. That is what promp­ted Ter­tia­num to take a dif­fe­rent approach. Ins­tead of down­gra­ding the exi­sting offe­ring, we effec­tively crea­ted a new design, star­ting from scratch. This is the first buil­ding whe­re we have put this con­cept into effect. Our key prio­ri­ties are self deter­mi­na­ti­on and a syste­ma­tic focus on our indi­vi­du­al resi­dents’ needs. They have the opti­on of sim­ply ren­ting an apart­ment and only using our ser­vices when they real­ly need and want them. Self deter­mi­na­ti­on and respect are also cen­tral to the trai­ning we pro­vi­de to our staff, right from the start. They are prac­tised wit­hin the enve­lo­pe of an over­all cost level which ever­yo­ne is able to meet. Digni­ty must never be a func­tion of wealth.

«We need con­cepts which will meet the needs of peop­le who will be living with us ten or twen­ty years from now.»

How are the insights you gain here used wit­hin the Ter­tia­num Group?
A major effort is being made to trans­fer our know how in all direc­tions. On the one hand, the insights we have gai­ned here are being put to use in new Ter­tia­num pro­jects and in the con­ti­nuous impro­ve­ment of exi­sting offe­rings, inclu­ding our own, becau­se we have also not yet achie­ved all our objec­tives. We also trans­fer know how out­si­de the Group and often recei­ve visits from assi­sted-living pro­fes­sio­nals from far and near ali­ke.

How do you see the future? What are your next chal­len­ges?
At pre­sent, we are alrea­dy mee­ting the increa­sing demand for indi­vi­dua­li­ty and self deter­mi­na­ti­on. On that score, we are five or six years ahead of the sec­tor as a who­le. But we are also thin­king about other trends which will affect assi­sted living in the future. One examp­le is assi­sted living offe­rings for peop­le from other cul­tu­ral back­grounds who do not wish to return to their coun­try of ori­gin when they reti­re, as was usual­ly the case until qui­te recent­ly. Of cour­se, the­re are over­ar­ching tem­pla­tes such as care plans and sta­tu­to­ry regu­la­ti­ons but the­se are unli­kely to help us all that much. We need con­cepts for peop­le who are now in their prime and will be living with us ten or twen­ty years from now. For examp­le, ten years ago, who would have thought that we would have to install a WLAN net­work throughout the buil­ding becau­se a lar­ge num­ber of our resi­dents now want to mana­ge their finan­ci­al affairs online?