Providers Forge Separate Paths to Memory Care Success

Memory care is set to boom, but not all operators are jumping on the trend in the same way. Some providers are ramping up development of stand-alone memory care models, while others are expanding existing facilities or building new ones to add memory care to existing senior housing communities.

The majority of senior housing leaders believe memory care will experience the most growth in the coming year, according to a recent survey by Lancaster Pollard. Out of the 244 respondents, 58% were for-profit providers and 71% identified themselves as either CEOs, CFOs or owners.

And the trend certainly isn’t limited to the for-profit world, according to data from specialty investment bank Ziegler, which specializes in working with nonprofit organizations.

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“Ziegler is observing an increased focus among providers with regard to developing specialized memory care units for those with dementia or Alzheimer’s,” said Lisa McCracken, senior vice president of senior living research and development at Ziegler, noting that the 2014 LeadingAge Ziegler 150 showed roughly 75% of the largest nonprofit multi-site providers have specialized memory support units within their communities. And that increases to roughly 90% among the largest 50 not-for-profit multi-site organizations in the United States.

An aware, aging population

Projected demographics are playing a key role in driving this trend.

“With the projected increases in individuals who have cognitive impairments, and the decreasing number of caregivers, we do not expect that this pattern will go away anytime soon,” she said.

The number of Americans with Alzheimer’s disease and other dementias will grow each year as the size and proportion of the U.S. population age 65 and older continue to increase. By 2025, the number of people age 65 and older with Alzheimer’s disease is estimated to reach 7.1 million — a 40% increase from the 5.1 million age 65 and older affected in 2015, according to data from the Alzheimer’s Association. By 2050, the number of people age 65 and older with Alzheimer’s disease may nearly triple, from 5.1 million to a projected 13.8 million.

Increased public awareness surrounding dementia-related diseases is also driving demand for the product, said Sue Plasterr, corporate vice president at Irving, Texas-based Greystone Communities.

“When Ronald Reagan made public that he had Alzheimer’s Disease — that was a big step,” she said. “It got more people in the public talking about it.” While some providers are addressing the growing demand for memory care by developing stand-alone facilities, others are finding value in adding memory care to existing senior living models. And both approaches have merit, industry members say.

Stand-alone benefits

Stand-alone memory care communities, such as those operated by California-based Silverado Care, can offer distinct benefits and likely will become more common in the coming years, said Kim Butrum, RN, GNP, the company’s senior vice president of clinical services.

For instance, a standalone memory care community might have a greater ability to create spaces specifically for the needs of people with dementia rather than spaces that are appropriate for various types of residents or activities, she said.

It’s a point echoed by Mary Underwood, vice president of memory care and resident experience at Maplewood Senior Living. The Connecticut-based company operates assisted living, memory care and continuing care retirement communities (CCRCs), including standalone memory care facilities such as Maplewood at Stony Hill in Bethel, Conn.

The company places a premium on having large, dedicated spaces that are specifically designed for various activities. For instance, the Bethel community includes an art room appointed with supplies and decorated with watercolors and a classroom complete with a SMART Board.

The customized settings foster a greater sense of dignity for residents and enable high-quality programming—including Spanish classes—that has increased engagement, said Greg Smith, Maplewood chairman and CEO.

The Stony Hill building also is unlike a typical assisted living community in that it includes a full array of amenities on each floor. In an AL community, the first level might include a bistro, ancillary spaces such as an art studio or classroom, and common spaces, while the upper floors are all apartments. Visitors walking out of the elevator on any floor at Stony Hill should feel as though they are walking through the front door of the building, because the first-floor common spaces have been replicated on each level, explains Smith.

Such a layout might not maximize rental revenue but it enables residents to have more convenient access to amenities and fosters a more therapeutically intimate and consistently engaging environment, Smith said.

Joining a continuum of care

Despite the success Maplewood has achieved at Stony Hill, Smith does not believe that it will be the only or even dominant type of memory care community in the future. The company embeds memory care within a larger continuum at its CCRCs, and has created a “Tides” program that offers memory care to those who do not require a secured environment.

“Memory care can’t be looked at in black and white terms, that you’re in memory care or traditional assisted living,” noted Underwood. “A lot of our folks fall in between. The disease can last 20 years. You need to look at memory care as flexible, what level are you?”

Some providers are developing specialty units within assisted living, and a number of providers are offering similar services within a skilled care setting, said McCracken, with Ziegler.

“As providers continue to enhance and reinvest in their communities, a common repositioning in recent years has been to carve out these specialty programs and units,” McCracken said.

Many of Greystone’s continuing care retirement community (CCRC) clients and sponsors are building larger memory care facilities, or adding memory care within the CCRC, Plasterr said.

In a continuing care setting, a memory care component offers many benefits, she said.

“Frequently if one spouse moves into memory care the other spouse will visit often,” she said. “If spouses can’t drive after dark or drive at all, in a CCRC they are able to walk over and see their loved one in the same community.”

In addition, having memory care in addition to other senior housing products can help make residents more comfortable, she said.

“It helps seniors to understand what challenges their friends are having,” she said. “And, it helps them feel like they’re working with the same people. The executive director is going to be the same — then moving into memory care isn’t another big disruption or change.”

Whether to offer memory care as part of a continuum of care setting or as a stand-alone facility really depends on the local market, industry members agreed during a recent webinar on the market outlook for 2015, hosted by Senior Housing News.

“It’s a great service and product for those who need it,” said Brian Beckwith, CEO of Formation Capital, noting the “great demand” for memory care.

But ultimately, “it comes down to the local market,” he said, noting some markets might be oversaturated. “It can be a valuable add to another facility. But you have to be very careful about putting the right facility in the right place.”

Written by Cassandra Dowell and by Tim Mullaney

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