Episode 8:3 Len Fishman on The Forgotten Middle and Challenges of Co-Housing

Len Fishman has worn many hats—Director of the Gerontology Institute at UMass Boston, CEO of New England’s largest non-profit senior living provider, and CEO/President of LeadingAge. Listen to his reflections on decades of experience in long-term services and support, and predictions on future challenges and opportunities.

About Len

Len Fishman served as director of the Gerontology Institute at UMass Boston until his retirement in 2021. The Institute is the research, policy, and public service arm of UMass Boston’s gerontology program, one of the oldest and largest aging studies programs in the world. Its main areas of focus are health and health care, long-term services and support, economic security, productive aging, and demography—with a special emphasis on low-income and minority older adults.

From 2000 to 2012, Len was CEO of Hebrew SeniorLife, New England’s largest non-profit provider of senior housing and health care. During his tenure, HSL became an affiliate of Harvard Medical School, serving as the school’s clinical research and academic teaching site in geriatrics.

Before joining HSL, Len was president of Leading Age, in Washington D.C., which represents 6,000 non-profit senior housing and health care providers, serving over two million seniors in the U.S. and Canada.

Key Takeaways

• One of the big societal changes in aging is people living longer.Within a little over 100 years, we have increased the human lifespan by over 50%. Most of the institutions that govern our lives were created when the human lifespan was much shorter. Now, however, people expect to experience another chapter in their lives.
• Home care has changed dramatically over the last 20 years, and much more is now being spent on home and community-based services and adult day care.
• Two thirds of the Medicaid budget is allocated to home and community-based services, up from one third. As a result, nursing home reimbursement has stagnated, and the state of the industry is dire. Occupancy is at historically low levels.
• Co-housing has not gained traction in the U.S., but there is a trend towards multigenerational housing.