SOME VITAL STATISTICS: PROFILING OUR RETIREMENT COMMUNITY AND ITS RESIDENTS

         Since the beginning of 2020, Nancy and I have been living in Sequoias Portola Valley (SPV), a Continuous Care Retirement Community located on the San Francisco Peninsula. Founded in the mid-1960s by the Presbyterian Church as secure residential quarters for its elderly parishioners, today SPV is owned and operated by Sequoia Living, a non-profit, non-denominational corporation also managing multiple other Bay-Area elder-care facilities.

         At the end of August, 2025:

• SPV has 290 total residents: 237 in Independent Living, 53 in Advanced Care (Skilled Nursing, Assisted Living and Memory Care.)
• There are 52 couples and 186 singles. 205 residents (72% of the total population) are female.
• 91% of our residents are aged 80 or above. (59% aged 80 to 89 + 32% aged 90 and older.)
• The average entry age is 82; average resident age, 87; average number of years of residence at death, 13; average age at death, 93.
• 32 new residents joined our community in 2024; 25 residents died that same year.

         SPV’s resident population illustrates the final stage of aging because, for virtually all residents, this will be our last home. Moreover, our age ranges match or exceed current average American life expectancies. For example, at 82 years of age, I have an average life expectancy of 7 more years; at 81, Nancy has 9. Our families’ genetic profiles and our individual medical histories might slightly skew these projections. Matching the resident-population profile to national demographic statistics, most of us have probably already entered the last decade of our lives.

         It’s important to acknowledge that SPV is not a typical elder community. Our residents are exceptionally privileged in the quantity and quality of support services we receive. Nearly 200 managers and staff work on-site to keep us safe and comfortable. But despite our exceptional advantages, we are a compact, observable concentration of elders in our final phase of aging. I hope our experiences may be interesting and informative for others.   

WHAT’S KEEPING US TICKING? DISTINGUISHING FEATURES OF OUR COMMUNITY RESIDENTS’ FINAL PHASE OF AGING

         When I try to capture the defining character of our current elder community, two earmarks strike me as most revealing: residents’ declining health and a simultaneous boom in our campus activities. At first mention, this pairing might seem counter-intuitive, even incompatible. On closer inspection, I believe it’s synergistic.

         Pervasive Health Challenges

         Our residents are exhibiting wear-and-tear. With impaired hearing and eyesight, joint replacements, short-term memory loss, diminished mobility, flexibility and stamina, we’re showing our age. Nancy says “I’m like an old car. Every now and then, I need a little patch-up. Until one day, that won’t be enough. And I’m okay with that.”   

         Most of us have experienced falls and related injuries, often involving fractures, hospitalization and rehabilitation. Many of us have had chronic diseases, including cancer, heart conditions or neurological ailments.

         Lines of Defense

         Our campus is designed for elder safety and convenience: one-story garden apartments, an arterial pedestrian colonnade, gentle ramps, lots of railings. Resident falls are the primary enemy. So while decline is inevitable, the playing field is literally kept level.

         More important, our community is blessed with outstanding medical services. These encompass quick-responding clinical nurses in our Independent Living neighborhood and a complex medical team serving Advanced Care. Accidents and flare-ups are quickly detected and diagnosed. If minor, treatment can be administered on-the-spot; if serious, EMTs can be summoned within short minutes, for quick transfer to Stanford’s Emergency Room.

         Upon return from injuries or conditions requiring hospital treatment, there’s a full menu of on-campus rehab services, including Skilled Nursing in our Health Center followed by outpatient Physical and Occupational Therapy. (In our elder-care environment, the latter therapy emphasizes restoration of daily living skills: sitting and standing, dressing, showering and toileting, supervised walking.) Some medical services can be delivered in our apartments. Residents’ familiarity and on-going relationships with trusted service providers encourages embarrassed fall victims to accept treatment and rehabilitation patients to persist in offered therapy. Persistence is crucial since our elder bodies heal more slowly. It also greatly helps that kindly caring is deliberately emphasized, in addition to technical proficiency, when selecting and training campus medical staff.

         What about the Burst of Residents’ Energy?

         The currently charged activity level is undeniable. Resident leaders are coordinating, organizing, staffing, publicizing and presenting education and entertainment programs featuring external professionals and intramural amateurs. Every month there are lectures, movies, classical and popular musical performances, theatrical presentations, art workshops and exhibitions. The on-campus lending library is humming. Simultaneously, SPV management is sponsoring on-campus holiday festivals as well as resident excursions to regional performances, museums and restaurants and shopping.

         I’m not a social psychologist, so I have no scientific basis for the following impressions. But as a resident myself, I have repeatedly observed campus neighbors’ enthusiastic engagement in this expanding bounty of activities.

         A small cadre of perhaps 20 resident dynamos does most of the leadership work. Most others are content to be group participants or spectators. But those audiences are keen and loyal. Every day and most evenings, our campus is hosting performances, meetings and games.

         Individuals’ motivations for such faithful participation are personal and a tad sensitive. Perhaps some are still making up for lost time after COVID isolation. Many probably welcome the easy socialization invited by group activities. The fact that only half of our residents still drive their own cars limits their access to off-campus venues, even with management organizing excursions and with our fleet of complementary transports. This reduced mobility may contribute to residents’ eager receptivity to on-campus substitutes. And the combination of professional and amateur presenters offers stimulating variety.

         How to Reconcile Declining Mobility with Expanding Engagement

         Weaving together physical disabilities with enthusiasm for activities, I detect a tacit resident strategy of adaptation and adjustment. Some of us can no longer play tennis or golf, but croquet is friendly, slow-motion and near. Lap-swimming may be beyond our stamina, but aquatic exercise classes constitute a feasible fallback, particularly with Louis, our affable coach, and a four-foot-deep pool. Further afield, long-distance hiking or biking vacations may now be too ambitious, but several residents find ocean and river cruises accessible and attractive. On and around campus, solo and group walking and hiking are a daily fitness ritual.

         Our SPV Play Readers troupe illustrates this creative seniors’ accommodation.

         Actors in their 80s and 90s lack retentiveness to memorize lots of lines, so instead Play Readers perform monthly staged readings. With impaired mobility, they can’t jump around a stage making entrances and exits, so they sit in chairs and read their parts. Community audiences include many members with hearing impairments, so performances are audio-enhanced. For fans trapped in their apartments, video recordings transmit the shows. This rep company is in its third season of monthly performances. Membership is steadily increasing.

         In addition to education and entertainment activities, advisory committees keep our Resident Association Board informed of a wide range of campus developments: health care, dining services, public-spaces design, structural facilities, landscape, emergency preparedness, technical improvements, new-residents’ welcoming and town relations.

         Smaller informal clubs are also flourishing. Five bridge groups, mahjong tables, book clubs, gardening, oenophiles, croquet and bocce enthusiasts all convene regularly.  

         Here’s one more possible explanation for the perceived synergy between residents’ declining health and expanding community energies. For years, medical specialists have been telling Nancy and me that a positive patient attitude is a crucial contributor to healing. (My radiation-oncologist used to confide that, within five minutes of new cancer patients and their accompanying families walking into his clinic, he could tell from their preconceptions about their disease and its treatment whether they were likely to recover or not.) I think it is not beyond reason that SPV residents may be consciously or subconsciously reaching out to campus group activities to help them counter or control decline and disabilities. Delaying deceleration by staying engaged.    

LOOKING AHEAD

         Our SPV Retirement Community has created a broadly nurturing environment for final-phase aging. 93% of all residents report overall satisfaction with living here. The two key benefits that I’ve profiled are effective, on-site medical care and residents’ vibrant engagement in campus activities. Other encouragements doubtlessly include cordial, interesting fellow residents, hard-working professional managers and staff, a handsome 47-acre campus and serene Portola Valley surroundings.

         That said, complacency would definitely be premature. There is no reason to assume that this combination of positive influences will be permanent. There is early evidence of concerning institutional challenges. Any of them could disrupt and compromise our community’s valued harmony and equilibrium.

         Our SPV Executive Director has alerted residents to imbalanced operating revenues and expenditures. Due largely to increasing skilled-nursing costs and long-deferred maintenance, this unsustainable budget deficit is already provoking reductions in campus staffing and services – nursing, security and complementary off-site transport. Further increases in residents’ monthly fees may be imposed. While specific scale-backs may seem modest and absorbable, if reductions become more pervasive and visible, residents may come to believe they are being deprived of the full package of benefits they contracted for upon entry. And of course reduced staffing positions and hours will work a hardship on employees’ livelihoods and morale.

         There is also implicit tension between current residents’ preference for a comforting, familiar living environment and the SPV Marketing Department’s mission to remain competitive with other communities by accommodating prospective residents’ changing tastes. These differences go beyond public-space decorations and furnishings. Loud, unrelenting construction work on apartment reconfigurations is steadily rattling campus apartments.  

         Much more costly and disruptive is likely to be infrastructure updating encompassing water-supply and plumbing, heating and air-conditioning, electrical wiring and telecommunications. Our beautiful campus was basically constructed with 1960s’ operating systems, now steadily requiring repair or replacement.

         Two sets of potential natural disasters present a serious physical danger to our campus and its occupants. Wildfires in the surrounding Santa Cruz Mountains have become more frequent and destructive. Earthquakes are increasingly projected in the adjacent San Andreas Fault, a mere 100 yards from our property line. Evacuation routes are severely limited. In the event of major damage to campus structures, long-term substitute housing for residents would be problematic and reconstruction costly and protracted.    

         One invaluable resource is available close-at-hand to help address all of these institutional challenges: the SPV resident population that’s the subject of this post. Our community is rich in professional experience and expertise: former accountants, architects, bankers, corporate executives, engineers, lawyers, medical specialists, scientists and Stanford professors — all on-site, personally knowledgeable about campus conditions, and well-qualified to collaborate with corporate management, free of charge, on practical problem-solving. Residents’ motivation could hardly be higher. These are our final homes and our final days. In financial terms, we are core investors and stakeholders, no mere tenants. Our entry fees contribute a major share of SPV’s capital-improvements resources. Our monthly fees constitute the chief resource covering our community’s operating expenses. Our charitable contributions finance campus employees’ annual holiday gifts and family scholarships.

         There is recent encouraging precedent for successful mobilization of this participatory decision-making. SPV’s resident leaders worked closely and confidentially with Sequoia Living’s headquarters and local managers, partnering to conduct the search for our new Executive Director. The result was unanimous Search-Committee selection of the best available candidate. Sequoia Living’s CEO has publicly saluted this cordial collaboration and recommended its adaptation by other CCRCs within the corporation’s portfolio. Skillful residents can make pivotal contributions to strengthening and sustaining our exceptional community.   

         Forward together.