How Evidence-Based Dining Programs Will Drive Memory Care Move-Ins

Today’s senior living decision-maker — often the adult child of a potential resident — grew up in the 1960s and 1970s, a time when television still fell into the category of “cutting-edge technology” and “making an informed decision” meant employing a mix of anecdotal evidence and national ranking systems.

That generation is now aging into the role of senior living residents, and Generation Y and millennials are entering the decision-making role. The habits of these younger generations will propel a significant shift in how senior living providers build their dining offerings, a new report from Senior Housing News shows.

That’s because as consumers, this next generation of decision-makers is increasingly data-driven. Indeed, tomorrow’s senior-living buyer might already be today’s daycare or preschool decision-maker. While they choose schools for their children in part using time-tested methods, they also make decisions based on the mountain of new data now available.

These people will likely bring to senior living these same expectations for evidence-based programming, and that puts new demands on senior living providers, including in dementia dining, where proof of a successful program is often hard to come by.

“We’re just constantly plowing through data and collecting data on all the angles of care, yet if you got most providers in a room and said, ‘What are two of your really hot issues with families and residents?’ they would probably tell you it was the activities program and the dining,” says Frank Wehr, COO of McLean, Virginia-based Artis Senior Living. “And I would say that in my years of experience, there are very few of us who are actually collecting data.”

They would be well served to start. Senior care providers today can really only measure the effectiveness of a memory care dining program through fairly simple metrics, such as resident weight loss and gain, required food inventory and food cost. But that is very different from what is available for parents making schooling decisions for their children.

In 2013, Indianapolis-based education reform organization EdChoice published “More Than Scores: An Analysis of Why and How Parents Choose Private Schools.” Findings showed that parents used a number of data points to make their decisions, including the student-teacher ratio, school accreditation, curriculum and course descriptions, college acceptance rate and the availability of religious instruction.

Further, 93% of parents answered that they would be willing to take three or more time-consuming steps to obtain the information they were searching for to choose a school.

A host of studies since 2016 show that today’s young parents make school choices using a range of data points, depending on their needs and interests, including college admissions, graduation rates, extracurricular activities, student body makeup, academic rankings, extended teacher hours and test scores.

One 2017 study — “Do Parents Value School Effectiveness?” — suggested that parents will make decisions based on data even if they sometimes don’t know what data to look for.

These consumer trends portend the future of memory care dining. In the coming years, operators will have to show quantitative proof of a program’s effectiveness.

‘Staggering growth rate’

One company shaping that future is Compass Group. The foodservice and support services company — which owns Atlanta-based Morrison Community Living — doesn’t merely use data to inform dining decisions. It has its own data department and is pushing the way forward to a world of data-driven dining.

“Ninety percent of the data in the world today has been generated in the last two years,” says Compass Group Director of Analytics Max Mosky, who oversees data for Morrison. “That’s a staggering growth rate.”

Compass Group began investing in data analytics capabilities in 2014, and today runs a database that measures nearly 100 operational and organizational attributes on nearly 600 communities nationwide. They use this data, along with machine learning and predictive data models, to determine everything from where new communities should open to how to build the kind of regional food menus already in vogue.

At one system of five communities, Morrison used an evidence-based system to restructure its food delivery process. In doing so, they were able to reduce cost by a factor of about 5%. Mosky anticipates Morrison moving toward data collection via smart technologies that will help providers improve resident health and quality of life as well as organizational occupancy and length of stay.

Wehr of Artis, meanwhile, believes that access to both more data around dining and better systems for collecting and tracking what is now more anecdotal — such as likes and dislikes among residents — will give them greater flexibility to implement new menus and diet trends more quickly, because the data will help them increase the speed of ordering and decrease cost.

As of now, most families are not seeking this granular level of proof that a program works.

“I don’t think that’s necessarily where loved ones are today,” says Rob Bobbitt, national director of dining services at Watermark Retirement Communities. “They don’t say, ‘This is amazing — how did you do it? I need to understand it. I need to study it.’ No. The adult child is relieved that they’ve been able to find a solution for their loved one.”

One thing that memory care dining programs already do have is research. Lots of it. Senior living providers and dining services companies are increasingly building and adjusting their memory care programs based on research and data, and consistently searching for best practices to provide the best dining to dementia residents.

Examples include:

• Abe’s Garden: Co-author and participant in 2018 study “Quality Improvement System to Manage Feeding Assistance Care in Assisted-Living” and uses an approach which incorporates elements of Hearthstone Institute’s I’m Still Here® and Alzheimer’s Resource Center of Connecticut’s Dining with FriendsTM model.
• Belmont Village Senior Living: Built its memory care dining program based on the work of former USC Dean of Occupational Therapy Claudia Allen and “Alzheimer’s Disease: Activity-Focused Care” by Carly Hellen.
• Presbyterian SeniorCare Network: Built its program around in-house research conducted in the early 1990s, producing a report called “Design for Dementia Care: A Retrospective Look at the Woodside Place Model,” and uses the study by Murphy, Holmes and Brooks, and another by dementia experts Jennifer Brush and Margaret Calkins.
• Sodexo, USA: Collaborated on a 2017 study “How and Why the Five Senses Matter for Quality of Life: A Guide for Long-Term Care Communities Everywhere.”
• Watermark Retirement Communities: Built its Thrive Dining finger-food program around two outside studies (“The Deep Seated Issue of Choice,” from 2010, and “Texture-modified meat and carrot products for elderly people with dysphagia,” from 2007) as well as in-house surveys of caregivers.

To further augment a program’s empirical foundation, providers are also branding their memory care programs, including in dining. Watermark has Thrive Dining. Belmont Village’s memory care dining area is called Josephine’s Cafe, named after founder Patricia Will’s mother-in-law Josephine Will. Morrison calls its program “Dignified Dining.”

As the generations change, providers should expect more and more families to go beyond names and anecdotes. They will want data that backs up everything that providers do, including in dining.

“More and more I’m finding that the clients that I work with want data,” says Beth Cooper, senior hospitality manager of Morrison. “They want proof that a program works. … We are going to have to provide that data in order to be viable, marketplace-wise. And we don’t have a whole lot of that data right now. We have some of it. But I think it’s going to be a non-negotiable down the road.”

This article draws from the new report, “The Race for Evidence-based Memory Care Dining.” Click here to access the complete report, which digs deep into the wave of data-driven, evidence-based memory care dining programs that are sweeping the industry.

Written by Jack Silverstein