Abraham Maslow’s Hierarchy of Needs pyramid shows that an individual cannot fulfill their highest aspirations for a meaningful life (the top of the pyramid) until their most fundamental needs of safety, food and shelter are met. On a basic level, the role of aging services providers is to ensure that residents have access to a safe place to live, nutritious meals, and support with their activities of daily living. However, providers must move beyond just the base of the pyramid to help every resident live purposefully each day.

To move from providing only the most basic of needs (shelter, safety and physiological support) providers need to understand how optimizing their engagement strategy can move them up on Maslow’s pyramid. Having the opportunity to pursue a purposeful life means that every resident should be offered activities of engagement that are uniquely tailored to meet their current needs and individual interests. When engagement is prioritized by a community’s management team, staff can then help each resident reach new levels of Maslow’s pyramid by cultivating a sense of belonging and self-esteem that come from being deeply understood and valued as a unique person.

How can a provider measure how successfully they are supporting purposeful living? It comes by creating a strategy that supports engagement. Following Maslow’s framework, let’s think of a pyramid with different stages:  

First, providers must accept the fact that there is significant room for improvement when it comes to engagement. According to a 2015 CDC Report, older adults in senior living communities are only receiving 11 minutes of meaningful engagement per day outside of assistance with their activities of daily living. To reach the highest level of Maslow’s pyramid, providers need to focus on supporting autonomy, spontaneity, and individualized interests in their engagement programming. By doing this, every resident becomes an active participant in decision-making in partnership with staff which raises their self-esteem allowing them to live purposefully in their community no matter their needs or interests.

Second, we need to recognize as an industry that there are many opportunities to provide engagement that is person-centered by accurately matching it with a resident’s current needs and preferences. How many residents today truly receive engagement based on who they are and their cognitive or physical potential? Purposeful living is offered when staff understand a resident is and subsequently builds an engagement plan that supports their individuality. They must also know when and how to adjust the plan when a resident is not responding to it.

Third and sometimes most important: Do providers know about and focus on the residents that need the most engagement? Everyone needs meaningful engagement to support their purpose in life but there are many cases when a resident will need extra attention, and may not always be able to advocate for it. These types of situations represent a risk and opportunity for quality of life and our business.

Think of these stories:

•      Marie isn’t visited by her family, she doesn’t come out much of her room and isn’t very “social” – by being isolated, she is beginning to show signs of depression
•      John suffers from mild cognitive impairment and is getting more overwhelmed in large group programs. He has difficulty following the course of the discussion and the distraction from other participants sometimes feels like an aggression – by being placed in what feels like an aggressive situation, he is very likely to respond verbally or physically in a way that some might call a troublesome “behavior”
•      Eric is thriving despite his loss of mobility and vision thanks to the new volunteer program of the community. It helps him enjoy his day, especially as the visits happen at the end of the afternoon, a time when “he wants to go back home.” When Spring break arrives and the student volunteers do not appear, Eric waits for them impatiently. After several days of missed visits, Eric decides to search for his volunteer friend and due to his poor mobility and vision falls after walking down the corridor.

In each of these situations, with a tailored engagement plan built on the current functional needs and unique preferences of the older adult unnecessary pain and discomfort could have been avoided. The goal each day should be that residents like Marie, John and Eric can live purposefully by always receiving the right amount of attention at the right time.