[Reposted from Senior Living Foresight https://www.seniorlivingforesight.net/]

PIPs and LIPs

Posted by Jack Cumming | Feb 13, 2025 | Leadership, Life Enrichment

By Jack Cumming

Admirably, the residents of Carolina Meadows wrote a musical with catchy tunes and clever lyrics. The one that has seemed most to resonate with residents is a reference to PIPs. If you’re not familiar with that term, it stands for “previously important persons.” You may know a few.

Do You Know a PIP?

Sometimes a PIP comes into residence and immediately expects to run the place. That happens mostly among residents, not employees. At nearly all CCRCs, residents are free to make suggestions, but it’s the business leadership who make decisions. For employees, it’s a workplace, not a community.

Resident suggestions are often greeted with, “We’ll have to see if there’s any room in the budget.” Of course, that means that it won’t be considered this year, since the budget is fixed for the year. Maybe next year.

That can be disconcerting for a newcomer who didn’t understand beforehand the limitations applying to residents. Residents can’t work in the CCRC where they live. They can’t tip employees for outstanding service. They can serve on resident committees or the resident council, but their deliberations are merely advisory. If there’s a central office, corporate approval may also be needed.

Transparency

Moreover, residents are expected to be fully transparent about their finances, but they are only privy to provider financials to the extent that the provider is willing to share. Residents have to demonstrate their wealth to qualify for entrance. They are also solicited for donations to sustain in residence those among their neighbors whose funds run out.

Thus, there is a power imbalance between providers who make the rules and residents who are expected to conform … cheerfully. That’s not the case in cooperative organizations, like the cooperative housing that is common in some cities, but almost no CCRCs are cooperatively minded. It’s rare that not-for-profit CCRC corporations even have voting members other than to centralize control and authority. Would senior living better serve its mission if community were emphasized more than facility governance?

What’s a LIP?

That brings us to LIPs. That’s a term that can apply to some executive directors and their staffs. LIPs is an acronym for “locally important persons.” An executive director may feel overwhelmed by the weight of responsibility. That challenge may translate into an imperiously protective posture, in which suggestions or observations may be perceived as a threat. Personal loyalty is then expected from staff and residents alike. The LIP may simply not be fully qualified for the most important job in senior living.

For instance, an executive director might promulgate a code of conduct for residents, purportedly developed, as one recent case puts it, with “input from members of the board of directors, the residents’ council and the leadership team ….” This example is not at Carolina Meadows, which is known for excellence in leadership. Identity is withheld to protect the innocent.

The code of conduct is a new development. The community may give input, but the promulgation is by the executive director solely on personal authority. Most readers know that references to the “leadership team” do not include residents unless they are loyal friends of the executive director.

Others on the board or resident council when asked for input may have individual qualms, but they are unlikely collegially to oppose authority unless something egregious occurs. Many board members are themselves LIPs since they are frequently local luminaries — lawyers, insurance agents, nurses, et al. — prominent in the community surrounding the CCRC confines.

Communal or Colonial?

If this were a community, as some believe a CCRC to be, would an outsider have the authority to rule on and enforce conduct? The executive director is not a member of the community. Only residents form the community, to the extent that one exists.

Some people, particularly those who have concentrated responsibility, as executive directors do, feel better if they have the semblance of control. It’s comparable to colonial administrators who sought to “civilize” the natives.

The effect can be to make residents responsible for matters that they have no authority to resolve. They are expected to be compliant and never to make trouble, whether the appearance of “trouble” is merely a misunderstanding or a cognitive challenge. For instance, the powerful may say something like, “If these principles are not followed, individuals may be asked to participate in an improvement plan, explore alternative living arrangements within the community, or, if necessary, transition out of the community.”

Transition Out?

That last “transition” can be chilling for residents and their families, especially if entrance fees have already consumed most of the resources needed for lifetime subsistence. If the commitment to lifelong residence with assistance as needed is not rock solid, then there is a question whether anyone can feel safe. Any person who interferes with communal kumbaya and happiness may find themselves out the door. Would it be different if residents, on their own, developed the “code” with only peer disdain as a consequence for nonconformity?

Are you a LIP or something more? Comment below to let us know how you feel about residents who may become too visible or too troublesome or disloyal. What if you were a family member and your resident mother’s little dog misbehaved? How much responsibility is consistent with the expectations for aging residents? How can we best assure prospects that they’ll be safe and secure?