1. Living Longer Better at Spanish Cove Don Blose, CEO/Executive Administrator Debbie Miller, Director of Wellness

2. Large Scale Impact of LLB $17 trillion debt Medicare population will double Unsustainable cost if not addressed

3. Wellness: Mission Critical Leads to longer, healthier & happier lives – Live long but die peacefully & quickly Helps maintain higher occupancy Reduces preventable hospitalizations Can improve recovery time if hospitalized For CCRC’s, can reduce duration of more expensive AL or nursing care stays Improves financial bottom line

4. Wellness is Everyone’s Responsibility Can help make an older body feel younger Provides a healthy focus for community members Emphasizes an ounce of prevention is worth a pound of cure – Vaccinations (influenza, pneumococcal, shingles) – Stronger hearts, bodies & better endurance – Better balance – Increases social interaction Promotes ‘Finishing Well’ Reminds community members 1) they are important, 2) you love them and 3) want them around for a long time!

5. Wellness Director Challenge Increase by one year, the average age for which a community member loses their independence.

6. Responding to the Challenge (What do you do when you are a department of 1 or 2?) Seek Partners (nursing departments, public health, health systems, staff from other departments) Form a Living Longer Better Committee (include residents and staff) Assess your community Provide feedback to residents on assessment results Identify at least one area for improvement & develop an intervention for improved results Perform follow up assessment to measure success Celebrate accomplishments

7. Spanish Cove Assessment Simple test to measure strength, endurance, balance, flexibility & cognitive functioning – Also collects individual demographic and anthropometric measures like weight/height, blood pressure, etc.. Allows you to do age-group comparisons against national norms Incorporates 10 stations (takes approx 1 hour for each resident) Requires outside assistance (nursing department or other volunteer help)

8. Assessment Overview 1.30 Sec Arm Curl Test 2.30 Sec Chair Stand Test 3.2-Minute Step Test 4.Chair Sit&Reach Test 5.Back Scratch Test 6.8-Ft up-and-go Test 7.Hand Grip Strength 8.6-Minute Walk Test 9.Cognitive Test

9. Assessment Day

11. Cove Fitness Test Comparisons Spanish Cove Test – Avg. Score 8-foot up & go – Measures agility/dynamic balance Men 65-69 - 5 seconds Men 70-74 - 5 seconds Men 75-79 - 5 seconds Men 80-84 - 7 seconds Men 85-89 - 7 seconds Men 90+ - 8 seconds Nationwide – Normal range 8-foot up & go – Measures agility/dynamic balance Men 65-69 - 4.3-5.9 sec Men 70-74 – 4.4-6.2 sec Men 75-79 – 4.6-7.2 sec Men 80-84 – 5.2-7.6 sec Men 85-89 – 5.5-8.9 sec Men 90+ - 6.2-10.0 sec

12. Cove Fitness Test Comparisons Spanish Cove Test – Avg. Score 2 Minute Step – Measures Aerobic endurance Women 60-64 - 108 steps Women 65-59 - 125 steps Women 70-74 - 115 steps Women 75-79 - 89 steps Women 80-84 - 103 steps Women 85-89 - 98 steps Women 90+ - 84 steps Nationwide – Norman Range Avg. Steps 2 Minute Step – Measures Aerobic Endurance Women 60-64 - 75-107 Women 65-69 - 73-107 Women70-74 - 68-101 Women 75-79 - 68-100 Women 80-84 - 60-90 Women 85-89 - 55-85 Women 90+ - 44-72 Low # 25%, High #75%

13. Cove Fitness Test Comparisons Spanish Cove Test – Avg. Score Arm Curl – Measures upper body strength Women 60-64 - 28 Women 65-69 - 16 Women 70-74 - 15 Women 75-79 - 15 Women 80-84 - 15 Women 85-89 - 15 Women 90+ - 14 Nationwide - Normal Range Arm Curl – Measures upper body strength Women 60-64 - 13-19 Women 65-69 - 12-18 Women 70-74 - 12-17 Women 75-79 - 11-17 Women 80-84 - 10-16 Women 85-89 - 10-15 Women 90+ - 8-13

14. Senior Fitness Test Comparisons Spanish Cove Test- Avg.Score Chair Stand –Measures Lower body strength Women 60-64 - 24 Women 65-69 - 13 Women 70-74 - 14 Women 75-79 - 13 Women 80-84 - 13 Women 85-89 - 12 Women 90+ - 10 National Average – Normal Range Chair Stand - Measures Lower body strength Women 60-64 - 12-17 Women 65-69 - 11-16 Women 70-74 - 10-15 Women 75-79 - 10-15 Women 80-84 - 9-14 Women 85-89 - 8-13 Women 90+ - 4-11

15. Cove Fitness Test Comparisons Spanish Cove –Test Avg. Score Chair Stand – # Stands Measures lower body strength Men 65-69 - 18 Men 70-74 - 18 Men 75-79 - 16 Men 80-84 - 12 Men 85-89 - 11 Men 90+ - 11 Nationwide – Normal Range Chair Stand – # of Stands – Measures lower body strength Men 65-69 - 12 - 18 Men 70-74 - 12 - 17 Men 75-79 - 11 - 17 Men 80-84 - 10 - 15 Men 85-89 - 8 - 14 Men 90+ - 7 - 12

16. Intervention Review results with your Living Longer Better Committee Choose a focus area & goals – Spanish Cove focused on improving your BMI – Better than average for most other areas tested Develop a plan of action & startup date – Education – first step for kickoff – Organize/reorganize current activities to help meet goals (we added a special boot camp for seniors) Conduct follow up assessment to identify improvement

17. Boot Camp

18. My Plate Valentine & Boot Camp

19. Next Steps for Spanish Cove Conduct annual/biannual assessment Work with UCO Nursing/Kinesiology and others to track effectiveness of intervention and milestones of success – increasing average age when someone loses independence – Reducing chronic health conditions & their impact – Reducing preventable hospitalizations/re-hospitalizations – Impact on costs Broaden scope to include people from outside our community (city of Yukon)

20. We Challenge You! To assess your community To compare yourself to other communities To help your community members ‘finish well’ and live longer better To celebrate your success!

21. Contact Information Don Blose dblose@spanishcove.com Debbie Miller dmiller@spanishcove.com