David Hewitt has been going to class, studying French and classical music. In an apartment in the next quad, Charlotte Bartlett studies her day planner. Can she squeeze in some exercise between her committee meetings? She looks outside and wonders whether the sun has warmed the chilly morning enough to permit her to jog around campus or if she will be forced to run the stairs in the fitness center. As they head out, Hewitt and Bartlett pick up the latest issue of the newspaper to see what's going on around campus.
The Camera Club is holding a workshop on digital photography. An emeritus professor is giving a lecture on "Middle Age and Renaissance Illuminations."
If it sounds as though Hewitt and Bartlett are typical students, the confusion is understandable. There are, however, some substantial differences. Unlike many college students, they might actually have the time to attend the workshop or lecture, and at eighty-two and eighty-one, respectively, they could be an undergraduate's grandparents.
In fact, they are both residents of Kendal-Crosslands, a continuing-care retirement community (CCRC) in Pennsylvania's Brandywine Valley run by the nonprofit Kendal Corporation and its CEO, John Diffey '70. Kendal—and Diffey—are innovators in the increasingly large world of CCRCs and particularly in one of its growing niche markets: university-linked retirement communities or ULRCs. CCRCs are residential communities for senior citizens that offer independent and assisted living and skilled nursing care at a single facility. Residents pay an entrance fee and a set amount monthly for the duration of their stay, which usually ends with death. ULRCs are a subset of CCRCs that offer various degrees of affiliation with colleges and universities.
Five of the seven retirement communities in Kendal's network are classified as ULRCs. Since 1971, starting with the facility Bartlett and Hewitt call home, Kendal has worked with local communities to develop retirement facilities that follow Quaker principles, including commitment to education, consensus, and dignity for all residents. Kendal provides the know-how to build and operate the retirement community and, once it is running smoothly, turns the facility over to the control of a local board, which usually comprises residents and representatives of local businesses and academic institutions. While operating under the control of the local board, the community remains part of the Kendal network and selects representatives to sit on the corporation's board of directors.
The Kendal Corporation's headquarters is in an old, stone farmhouse on the edge of the wooded Crosslands campus. Although the movement into ULRCs predated Diffey's 1992 arrival at Kendal, he has become closely associated with the movement and Kendal's commitment to pioneering new techniques and ideas for retirement communities. In a manner not unlike that of a proud father showing off family portraits, he stops in the hallway outside his door to point out the framed photographs of each of Kendal's communities.
Kendal was founded at the urging of the local Quaker meeting; the inaugural Longwood campus, with its whitewashed, farmhouse-style buildings, is captured in the first photograph. Within a few years, the founders faced a crisis: Residents were outliving the standard actuarial tables' predictions.
Kendal responded by building Crosslands, with a higher ratio of independent-living quarters to assisted-living and skilled-nursing beds. When it opened in 1977, the new Kendal at Crosslands merged with the adjoining Longwood campus to create the Kendal-Crosslands community. Based on the early experience of Kendal and other pioneers, today's CCRCs use actuarial tables that are specifically designed for CCRCs and incorporate the extended life expectancies of residents, which, through self-selection or higher quality of life, are at least a year longer than the standard tables predict.
Despite links with the University of Delaware and West Chester University, Kendal-Crosslands is not a ULRC by most definitions because it is miles from the nearest university, and the connections were developed later in the community's life. Diffey points to the next photograph, which shows an idyllic campus nestled in rolling hills. This is Kendal at Hanover, which opened in 1991 less than three miles north of Dartmouth College's green. For Kendal at Hanover, connecting to the college was always part of the plan. Kendal residents worked with Dartmouth officials to develop the Institute for Lifelong Education at Dartmouth. With its Hanover campus, Kendal emerged as a leader in the new not-for-profit ULRC industry. The community attracted alumni, professors, and interested retirees who had no previous affiliation with the college.
In the following years, Kendal opened four more communities closely associated with colleges. "They're innovators, period. They're considered a leading-edge provider," says Douglas Pace, the Director of Assisted Living and Continuing Care for the American Association of Homes and Services for the Aging. The agency, which represents hundreds of not-for-profit CCRCs, recognized Diffey with its 2006 Award of Honor, the organization's highest commendation. "Diffey is a visionary," says Pace.
It's a vision informed by humanitarian ideals. Diffey has expanded Kendal's advocacy and humanitarian role, among other things, establishing Kendal Outreach, which helps develop best practices for geriatric care. For example, Kendal Outreach participated in a recently completed seven-year study that resulted in new FDA guidelines for bed restraints in order to reduce injury or death among nonambulatory elderly people.
Diffey traces his commitment to social justice and helping others to his years as an undergraduate at Duke, though at the time he thought he would advance those goals as a civil-rights lawyer. Sitting in his office, he reminisces about the intellectual and activist culture of Duke in the late 1960s, marked by late-night, dorm-room conversations about social responsibility and civil rights. In particular, he remembers the Silent Vigil that followed Martin Luther King Jr.'s assassination in April 1968 as a defining moment in his development.
When some Duke students responded to King's assassination by demanding, among other things, wage increases for the university's nonacademic employees, he joined them in their nonviolent protest on the Chapel Quad. "The culminating moment came Easter Sunday," Diffey recalls, "when all the townies from Durham came to services at the Duke Chapel and walked past the scraggly bunch of kids, not particularly seeing the purpose of their being there." Then, he adds, after the service, Dean of the Chapel James Cleland led the choir out singing "We Shall Overcome" and joined the students in protest.
"The folks from Durham were transformed. When they came back out, you could see the looks of respect and admiration for what the Duke students were doing," Diffey says in a tone that betrays the emotion he still feels about events that happened nearly forty years ago. "When people go back to that period at alumni events, it's more about that event than about basketball games."
By graduation, Diffey had lost interest in the law, instead wanting to be more hands-on in helping others. He began working and raising money for nonprofit organizations, including the March of Dimes. His post-graduate experiences inspired him to apply to business school, and he received his M.B.A. from Emory University in 1976. After that he got jobs at a geriatric facility connected with Emory and then at Carol Woods, a CCRC in Chapel Hill. In both positions he worked with the local universities and with the elderly; those experiences, he believes, made him a good fit for Kendal as it was developing ULRCs.
Although not a Quaker himself, Diffey sees a great deal of harmony between Quaker values and his own leadership ethic. Quakerism, which was founded in seventeenth-century England as an alternative to the complex, institutional Christian churches of the time, values inclusion to the extent that all decisions must be arrived at through consensus—which might sound daunting to most CEOs, but does not faze Diffey. "Leadership is more about inspiration and inclusion than it is about telling people what to do," Diffey says. "What Kendal does and how we operate and how Quakers think about resolving conflict is remarkably similar to best practices I was taught in my M.B.A. program."
Diffey's leadership has helped guide Kendal from a small nonprofit organization just starting to outgrow its base in southeast Pennsylvania into a nationally recognized star in its field. "Kendal is one of the forerunners of consciously setting out to create ULRCs," says Ronald Manheimer, director of the University of North Carolina's Center for Creative Retirement, adding that the field has begun to blossom and diversify in recent years. Manheimer says the current popularity of ULRCs derives from the lifelong-learning movement that flourished as the many college-educated members of the G.I. generation retired.
Pace agrees. "The collegiate atmosphere is one of the strongest selling points people who are marketing [ULRCs] use. Because, typically, if you're moving into independent living, you're not moving there for the medical part of the facility, you're moving for the social aspect."
Today, experts say there are anywhere from thirty to 100 ULRCs, depending on how the term is defined. Duke is connected to two retirement communities: The Forest at Duke, situated a few miles from campus, and Galloway Ridge, located at Fearrington Village in Pittsboro, North Carolina, south of Chapel Hill, and affiliated with Duke University Health System.
On an unseasonably warm winter day, Bartlett, Hewitt, and Elizabeth Mather, another resident, are gathered around a table in the coffee shop just outside the community dining hall. Other residents pass through on their way to lunch, and the din of animated conversation resounds around the small room. Residents usually eat one meal each day in the dining hall and prepare the rest in their apartments.
Bartlett is a dynamo, darting from topic to topic; Mather punctuates her points with wit and precision; and Hewitt, the most reserved of the three, exhibits an almost scholarly manner. But as they talk about themselves, the similarities in their personal histories emerge. All are retired, white-collar professionals. All have traveled extensively. And, it gradually emerges, all are Quakers.
But not everyone at Kendal is Quaker, they immediately rush to say. For a moment, they strain to think of the residents who would seem to be most at odds with pacifist Quakerism.
"We now have three ex-admirals!" Mather exclaims.
"And a retired three-star general!" Bartlett adds excitedly.
Nevertheless, Quakerism, a non-hierarchical religion that Diffey describes as "seeking, rather than doctrinal," informs life at Kendal.
"The most important Quaker value is the importance of everybody having the opportunity to express their opinions—everybody is listened to," Bartlett says.
"In the effort to seek some diversity, to value the notion of diversity," Mather adds. This emphasis on diversity is manifested in Kendal's pricing plans, which are weighted so that the high costs for larger units help subsidize the lowest-cost units. Comprehensive fee structures serve two purposes: They eliminate the à la carte approach to retirement living that can tack on unanticipated medical and living expenses as residents age, and they generate subsidies that can serve as supplements or cover a resident's insolvency.
This notion of inclusion spills over to the medical care provided. Unlike most modern nursing facilities that segregate cognitively impaired residents from the general population, Kendal places residents who require nursing care in the same facility, regardless of their level of mental and physical ability. Geriatric studies consistently show that cognitively impaired older people decline more rapidly if surrounded only by other cognitively impaired people.
In keeping with the effort to avoid the stigmatization and isolation the elderly often experience, Kendal communities seek to make their health centers—including the assisted-living and nursing-care units—homelike and deinstitutionalized. They do this in part by avoiding the trappings of an institution—staff uniforms, PA systems, linoleum floors, and isolation from daily routines. Instead, residents are encouraged to bring their own furniture and decorations into their rooms, which are arranged in small clusters near the main dining hall.
Education helps to fulfill the value of "seeking" in Quakerism and is a central tenet for Kendal, Diffey says. "Some people will go to places on a golf course or on tennis courts, but there are a lot of people whose vision of retirement is active, intellectual engagement," he says. "They'd like to be in an environment—their own alma mater perhaps preferably, but not necessarily—where they are constantly engaged intellectually."
But the synergies between Kendal and the local universities do not begin and end in the classroom. Residents of Kendal at Oberlin, for instance, provide a knowledgeable and enthusiastic audience for conservatory seniors, who are required to give a final recital in order to graduate. Kendal at Ithaca residents participated in a large study of senior quality-of-life and health conducted by Ithaca College and Cornell University. And they serve as volunteers in Cornell's library, arboretum, and athletic programs.
Despite the often mutually beneficial arrangement, some observers still see room for improvement. The opportunity for education through links with universities like Cornell "is a really big part of life at Kendal," says Dale Corson, president emeritus of Cornell and one of Kendal at Ithaca's founders. "But Kendal is not as big a part of Cornell's life as it could be." He says he'd like to see Cornell make greater use of the resources, expertise, and life experience provided by the kind of retirees who opt to live at Kendal.
John Krout, the director of the Ithaca College Gerontology Institute, agrees that ties could be stronger but points out that "a lot of CCRCs build in university towns because it's a great marketing tool and, sometimes, they market to alumni. That doesn't necessarily mean that there's a strong programmatic linkage with the university," he says. "Kendal doesn't build with an eye toward intergenerational programming with students. [But] it may happen, depending on who knows who at the college."
In some cases, the residents aren't waiting for Kendal or colleges to set the agenda. They're taking the initiative themselves. At Ithaca, residents developed an entire educational program on the Kendal campus. Called the Lyceum, it features guest and resident speakers for individual talks and for entire courses. At Crosslands, residents teach classes to each other and hold a series called Pre-Kendal Memories, during which a resident gives brief recollections from his or her life before coming to Kendal.
As Manheimer suggests, there is a strong correlation between the educational attainment of retirees and their interest in continuing education at Kendal. The relatively high cost of entry (from around $100,000 for the smallest units to $600,000 for the largest, compared with an industry average of about $143,000) and monthly fees (typically ranging from $2,000 to $5,000) also limit Kendal residents to the financially well-off. The Kendal communities are overwhelmingly white, which is distressing to many residents—and to Diffey, himself—because it is contrary to Kendal's values. Diffey says he believes that this fact is less a product of economics and more one of personal comfort and self-selection. He is optimistic that the increased minority hiring in academe will translate into more interested minority retirees in the future.
The handwringing over lack of racial diversity reminds a visitor of the other similarities between Kendal and a university. In fact, the similarities are everywhere. Watching the residents live and dine in close proximity, engage in activities and learn together, and exist without too much responsibility, an observer could easily imagine them as college students—minus the all-nighters and pressure to make good grades. "What I love about Kendal," says Bartlett, "is the freedom to do anything I want, and make any choice I want, without any pressure to do otherwise."
Kendal does not force connections, says Diffey. "This is not a cruise ship. We create the conditions that allow people to have a fulfilling life, but we don't create the fulfilling life. They do."
Combining educational opportunities with Quaker emphasis on inclusiveness, John Diffey and his Kendal Corporation are transforming the nature of retirement
November 30, 2006