Sarah Ordover: Why I’d Like To Start The “Third Chapter” Movement To Prevent Social Isolation and Loneliness Among The Elderly
I would start a “Third Chapter” movement to make more socially acceptable the idea of congregate living from about the age of 75 onward. The number one contributor to mental and physical decline is isolation. Research has linked social isolation and loneliness to higher risks for a variety of physical and mental conditions: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death.
People who find themselves unexpectedly alone due to the death of a spouse or partner, separation from friends or family, retirement, loss of mobility, and lack of transportation are at particular risk. And yet, I hear continually “I promised mom I would not move her from her house.” For what? So she can watch television all day and eat over the sink? We’ve got to change the narrative! Moving to a congregate setting is not the end of life, it should be the beginning of a new chapter.
I had the pleasure of interviewing Sarah Ordover. Sarah is a senior living expert with particular specialization in dementia care. Sarah sits on the City of Los Angeles Task Force for Alzheimer’s Los Angeles, and volunteers as a facilitator and public speaker for the organization. She holds CSA and CDC certifications in aging and dementia care, and authors “The Senior Living Insider” blog. As owner of Assisted Living Locators, Los Angeles, a no-cost senior living placement service, Ordover helps families tackle the confusing subject of eldercare honestly and with compassion. Ordover attended American University and New York University. She lives in Los Angeles.
Thank you so much for joining us! Can you tell us what brought you to this specific career path?
I’m 63 years old. I started Assisted Living Locators Los Angeles when I was 58, at a time when most people are winding down their careers. I had moved to Los Angeles and wanted to find a late life career that would allow me to both have a social impact and make money — a double bottom line. In 2012, I had changed the world, or at least my little piece of it by starting a non-profit called the NewBo City Market, a year-round public market and event space that incubates small food entrepreneurs and encourages economic development. I’d always worked in business as a marketing person for various entrepreneurial organizations, large and small, and was hugely successful. It was when I moved from New York City to Cedar Rapids, IA that I learned that my power to create and achieve could be used in ways more meaningful than just making money.
The NewBo City Market opened in 2012 and has become one of the leading incubators in the state for the food segment of the area economy, attracted $40 million in surrounding neighborhood investment, and welcomes 350,000 visitors a year. The impact has both socially and economically has exceeded my wildest dreams.
Starting the NewBo City Market changed my life. When I decided to relocate to Los Angeles after separating from my husband, I knew I had to find a career path that would allow me to continue having that kind of positive, direct impact on people’s lives.
I had struggled through the last years of my father’s life, trying to understand his finances, his illness, some tricky family dynamics and how best to manage the situation. It was an extremely difficult, emotional period. One night, having relocated to Los Angeles, a woman I knew told me about her business helping families find the best care and living solutions for an elderly loved one. I was blown away. I wished I had someone like her to help me when I was dealing with my father. It resonated deeply with me. So, at age 58, I thought “Eureka!,” I had found a new passion and an amazing new career.
How are you and your colleagues in the Elder Care field addressing the challenges brought by COVID-19?
COVID-19 represents a Sophie’s Choice for many families. Should they keep their loved one at home or risk moving them to an assisted living facility. I have one client now whose wife was diagnosed with vascular dementia, and was combative, anxious and lonely in her Hollywood Hills home. We moved her into one of the top memory care communities in Los Angeles where she has shown miraculous improvement. She is talkative, friendly and physically healthier. Her husband calls me at least once a week freaking out over an article he has read about how COVID is ravaging long term care facilities. He is 90 and there is no way he can take care of her. Each week, his daughter and I go through the same exercise of talking him off the ledge.
In your opinion, was is a common mistake that families are making during this time? What would you suggest to address this?
The biggest mistake is that people do not understand the difference between the various types of long-term care and, unfortunately, in COVID-19 reporting, the media is conflating them. There are two types of nursing facilities: skilled nursing facilities (SNFs) and long-term nursing homes. A nursing home provides residential care to patients who need help with meals and their activities of daily life like ambulation, grooming, toileting and medication management. About 70% of patients living in nursing homes are low-income seniors who depend on Medicaid to pay for their board and care. A skilled nursing facility (SNF) helps patients upon discharge from a hospital when they need further medical attention from trained professionals for continued recovery over a limited period of time. It is covered by Medicare or an individual’s private insurance. Assisted living facilities, encompassing independent living, assisted living and memory care communities, also provide meals, 24-hour care and help with activities of daily life but in a residential, non-medical setting. Assisted living communities are usually paid privately by the individual, through long term care insurance or veteran’s aid and attendance.
While the majority of these companies are for-profit, the dynamics underlying the businesses are hugely different. “Understaffing is really the original sin of the nursing home industry in that so many other problems like neglect, like infection control, really stem from it, and that was the case long before this virus showed up,” said Mike Dark, an attorney with California Advocates for Nursing Home Reform.
Assisted living facilities, by contrast, are customer-focused. While profit is a motive, there is a more positive culture about health and healing that results in higher caregiver ratios and more engaged staff.
Can you describe how you or your organization is making a significant social impact today?
Here’s the truth. No one really talks about getting old. I mean really talks about it. About dementia. Incontinence. Chronic illnesses. Loss of independence. Loneliness. All the yucky stuff we sweep under the table and think will never happen to us or our loved ones. Until it does. Baby boomers will be contending with these issues for themselves in a few years but right now they are dealing with their parents. And when their mom or dad has a stroke, a fall or sets the kitchen on fire and they end up in the medical system, it is like being thrown into the deep end of the pool without a life preserver.
Now, I’m not a medical professional, but I have worked with hundreds, probably thousands, of families since I started my business. Sometimes I find a place for a parent to live or help retain home care, but much of my time is spent on the phone helping to sort through what’s going on and providing practical guidance. I work at the most intimate and personal level with families to help solve problems at what is one of the most fraught and confusing times of life.
Are there three things the community/society/politicians can do to help you address the root of the problem you are trying to solve?
First, opening up Medicaid to more types of congregate living. By 2050, the population of people over 85 in the United States will increase by 350%. Most people do not have enough savings or pension and will be dependent on the government to pay for long-term care. Medicaid should be paying for seniors to live in alternative settings besides nursing homes. In some states, there are advances that allow older adults to live in assisted living using Medicaid funds, but that is the exception not the rule. For the life of me, I don’t understand why Medicaid hasn’t been expanded automatically to include assisted living. It provides for a higher quality of life at a lower cost than the medical setting of a nursing facility.
Second, expand the assisted living model to encompass a greater variety of options: social complexes, co-living spaces, kibbutz style housing, specialized housing for different demographic or interest groups, intergenerational housing. These are just a few of the innovative senior living options being experimented with around the world. We need more of them in the United States, promoted and funded with public support.
Finally, we need more education in America on aging. We are all going to get old. It is a subject no one likes to think about, but when you are faced with it, it is like being thrown into the deep end of the pool without a life preserver.
You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.
I would start a “Third Chapter” movement to make more socially acceptable the idea of congregate living from about the age of 75 onward. The number one contributor to mental and physical decline is isolation. Research has linked social isolation and loneliness to higher risks for a variety of physical and mental conditions: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death.
People who find themselves unexpectedly alone due to the death of a spouse or partner, separation from friends or family, retirement, loss of mobility, and lack of transportation are at particular risk. And yet, I hear continually “I promised mom I would not move her from her house.” For what? So she can watch television all day and eat over the sink? We’ve got to change the narrative! Moving to a congregate setting is not the end of life, it should be the beginning of a new chapter.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.” — Margaret Meade
The NewBo City Market was a community-driven initiative, propelled by passionate volunteers who had a vision of how to make their community better. It took four years of hard work before the Market opened, all unpaid, to keep the troops motivated and moving forward and to enlist champions from local and state governments and the business community. We definitely changed our little piece of this planet. Whether launching a big initiative like the NewBo City Market or providing the most personal guidance to someone in need as I do now with Assisted Living Locators, I have learned to measure my by the contributions I make to my fellow human beings.
Thank you so much for all of these great insights!
