Rethinking Care: What Makes Life Worth Living as We Age (Part I)

We’ve been fortunate to meet some remarkable experts in the aging space, including Benjamin Surmi, a social gerontologist whose insights have shaped much of our thinking at Joe & Bella.

Benjamin Surmi, VP of Innovation, Culture and Training at Koelsch Communities

Benjamin helped us understand the power of universal design: the idea that great products are designed to benefit the most people possible, instead of being designed to meet specific needs of smaller groups of people. It’s why our clothing is engineered and branded for all people of all ages and abilities.

He’s also the VP of Education and Culture at Koelsch Communities, a group of 39 exceptional senior-living communities. (My grandmother lived at one in her final year, with dignity, respect, and exceptional care.)

Benjamin sat down with us to talk about aging, dignity, and what matters most as we grow older.

Please read and share with anyone navigating these questions.
– Jimmy Zollo, Cofounder & CEO, Joe & Bella

What follows is an edited conversation with social gerontologist Benjamin Sumi, exploring how we think about aging, dignity, and care.

What are the signs that it might be time to start considering a care community?

Benjamin: Before we talk about signs, let's reframe the question itself. Most families start with safety: How do we keep Mom safe? That's pragmatic, but it misses something essential.

We are not alive to take medication. We are not alive to avoid risk.

The real question is: What makes Mom come alive? Where does she find joy? How is she contributing to the world around her? The goal isn't to keep someone breathing—it's to help them keep living.

Here's what I see too often: an elder living alone, drowning in chores they can't keep up with, isolated because they no longer drive, disconnected from their church or synagogue. Maybe they can't read anymore and don't know about audiobooks. There's nothing left that feeds their soul.

If someone's home can no longer support them in living for what matters, it's time to have a conversation.

Safety fits into this picture, but as a supporting character—not the lead. If someone loves cooking but risks burning down the house, maybe they move somewhere they can keep cooking with a little supervision. If they love painting at the park but shouldn't be driving, a community might restore that freedom through transportation.

And here's the part nobody talks about: caregivers matter too. If you're so exhausted from caregiving that you can't be a friend, a spouse, a son or daughter, if you're showing up with anger instead of love, then something needs to change. You can't pour from an empty cup, and resentment is poison for everyone involved.

The litmus test is simple: Can we still do what we're alive to do? If not, it's time to explore help—together.

What questions should families ask when evaluating a care community?

Benjamin: Forget the questions for a moment. Your first job is to visit and meet the people who actually live there.

Not just the sales team. The residents.

Are these people you'd enjoy having dinner with? Would you look forward to breakfast with them? Would you go on a trip with them? Because that's exactly what's being offered here.

Taste the food—several times. Food is one of the last great pleasures of life for many elders. When other joys fade, a wonderful meal still adds color and anticipation to the day. Is this food you'd want to eat every day?

Sit in on activities. Are they thoughtful? Is there genuine laughter and connection, or does it feel like adult daycare? You'll know the difference immediately. A good community treats residents like the accomplished adults they are—not like children to be managed.

Talk to the staff. Ask how long they've worked there and what they love about it. If a community won't let you do any of this—won't let you just be there and experience life alongside residents—that tells you everything.

A care community isn't a product. It's a living, breathing mini-town. You're not buying an apartment; you're joining a community.

Once you've done that, then ask the practical questions:

• What exactly does my monthly fee include—and what costs extra?
  
• How often do rates increase?
  
• Can I hire my own additional caregiver if I want?
  
• Can my granddaughter stay overnight for a week?
  
• What are the policies around alcohol, leaving the building, doing my own laundry?

Ask about things that matter to you, even things you'd never imagine have policies. You'll be surprised.

Finally, research who owns and operates the community. Is it a family-owned company with decades of experience, or a real estate investment firm that just acquired it? How long has the executive director been there? High turnover in leadership often signals deeper problems.

Many families think their only options are full-time home care or a care community. What else is out there?

Benjamin: There's actually a whole spectrum of options most families don't know about.

Adult Day Programs

Adult day programs exist in many communities: run by nonprofits, churches, synagogues, or senior living organizations. You drop your loved one off for several hours while you work or handle other responsibilities. Perfect for families who are managing fine at night but need daytime support.

Respite Stay

Respite stays let your loved one stay in a senior living community for a couple weeks while you rest, travel, or recover from your own health issue. Some families use this regularly as a support system; others use it as a trial run before a longer-term decision.

Here's something critical that most caregivers don't plan for:

What happens if you have a medical emergency? Caregivers have a significantly higher risk of dying before their loved one – that's how stressful this work is. A backup plan isn't pessimistic; it's responsible. Some families pre-enroll their loved one at a community so they can transition quickly if something happens.

Now, about full-time home care versus a community: the real question isn't where but what kind of life.

I once visited a home where the husband was so proud of caring for his wife himself. He'd researched everything, read every article. But his wife ,clearly a woman who'd always taken pride in her appearance, sat in a bathrobe with matted hair, bored out of her mind.

Three meals and a bath twice a week isn't a life worth living.

In a care community, she would have been dressed beautifully every day, hair done, surrounded by peers who shared her interests and experiences.

The question isn't home versus community. The question is: What environment will help this person come alive? Sometimes that's home with a few hours of daily help. Sometimes that's a community full of friends and activities. The answer is different for everyone.

Is there such a thing as moving too early or waiting too long?

Benjamin: This depends entirely on what you mean by "care community."

Active adult communities and independent living are just lifestyle choices—like choosing between a suburban house and a city apartment. There's no "too early" for deciding you'd rather have maintenance-free living and a built-in social scene.

It's too early to move if the move prevents you from doing what matters most to you. If your six dogs are your life and the apartment doesn't allow them, wait. If your grandchildren live next door and you see them daily, think hard about what you'd be giving up.

It's too late if you've already lost something you didn't have to lose. I've seen people fall and break a hip at home when they would have been steady with a bit more support. I've seen cognitive decline accelerate in isolation when early community engagement might have helped.

For people experiencing memory loss specifically, there's something to consider: moving earlier, while they can still learn new routines and form new relationships, often leads to better long-term adjustment. Waiting until they can't remember where the dining room is makes everything harder.

But here's what I really want to say: My agenda isn't home care or community care. My agenda is helping people do what they love, be with people who stimulate them, and contribute good to the world.

Someone whose calling is hours of daily prayer might thrive alone in a quiet home with a garden. Someone whose gift is encouraging others and bringing laughter into people's lives needs to get into community as soon as possible.

There's no universal right answer. There's only the right answer for this person, at this time, with these values.

Many adult children feel guilty about "giving up" on their parents by moving them to a community. What would you say to them?

Benjamin: Your role is to honor your parent. How exactly that looks is different for every family.

But I need to be direct: There is no timeless principle that says leaving a parent alone in a suburban home is the most honorable thing to do.

I've seen adult children who truly abandon their parents: drop them somewhere, set up an auto-draft, and visit twice a year. They don't come to Mother's Day events. They don't send photos for the community newsletter. There's no depth to that relationship.

Sometimes this is the result of decades of parental neglect or abuse. Sometimes it's just selfishness. I can't pretend both situations are the same.

But choosing where your parent lives and who provides their care isn't abandonment. Abandonment is losing sight of their personhood, seeing them as a problem to solve rather than a person to love.

Thinking through care options, researching communities, making hard decisions about what's realistic given your resources? That's honoring your parent. That's taking their wellbeing seriously.

Here's the uncomfortable truth: If you're so exhausted from caregiving that you're snapping at your parent, arguing with them, controlling their movements—if you're at risk of actual abuse because you're sleep-deprived and overwhelmed—getting help isn't abandoning them. It's the opposite.

Most of us need more than just our son or daughter. We need a whole community of people in our lives. When your parent has that, you're freed up to actually be with them—to bring joy and connection instead of just managing logistics.

The real question isn't "Am I giving up?" It's "How do I show up in their life in a way that brings encouragement and refreshment?" Sometimes that means getting support so you can do exactly that.

How long does it typically take a new resident to adjust to living in a care community?

Benjamin: Every family falls somewhere on a spectrum.

Some families will drop their child off at pre-school and say, "Don't call me if they are crying." Same families let their baby cry it out at bedtime. Other families sit in the classroom for weeks, gradually extending the time apart.

Senior living transitions work the same way. Both approaches have merit, and both have risks.

The case for stepping back: Some family members are so present that their loved one never makes friends. They sit in the apartment watching TV together all week. The elder never builds relationships with caregivers because the daughter is always there, watching like a hawk. Staff become afraid to provide care naturally.

The case for staying close: Your presence shows your loved one they haven't been forgotten. You bring treats, join activities, eat meals together. You become part of the community yourself: attending events, sharing photos, maybe even leading a book club. That's the ideal when relationships are healthy.

The honest answer? Adjustment is less about time and more about how the transition was handled.

Did your parent have ownership in the decision? Did they feel their adulthood was being honored, or did they feel violated and treated like a child?

If someone feels stripped of their dignity and authority, the "adjustment period" is really a forgiveness period. That has nothing to do with the community and everything to do with how the change was made.

Some people never adjust. They go to their grave angry about being moved. Families need to face that possibility honestly, especially if the elder adamantly doesn't want the change.

But in a well-chosen community, with a respectful transition, many people adjust quickly. Especially if their home had become a prison of isolation, and suddenly they have friends, purpose, and things to anticipate.

One more thing: Research suggests that what matters most to older adults isn't the activities or the food, instead it's whether they feel at home. Can they get a cup of coffee when they want? Curl up by their favorite lamp? Walk their dog?

So don't pack light. Cover their walls with photographs. Bring their quilts, their special writing table, their tea pot. Don't buy new things thinking you're doing them a favor. They need the familiar.

Making a place feel like home: that's what makes adjustment possible.

This conversation with Benjamin was too meaningful to fit into a single piece. In two weeks, we’ll share Part II — a continuation focused on guilt, adjustment, and how families and elders actually experience the transition into community.

Benjamin Surmi is VP of Innovation, Culture, and Training at Koelsch Communities, a family-owned senior living company caring for 2,000 older adults across 39 communities in eight states. He holds a Master's degree in Social Gerontology and has spent nearly 20 years reimagining what it means to age well.