Senior living operators are currently preparing in anticipation of a demand wave for memory care services — and not only for residents currently living with Alzheimer’s or dementia.
Assisted living residents are living with more than 14 chronic conditions, on average; and no doubt some of them are related to cognitive decline. And while many of these residents may not yet need full-blown memory care services, operators are embracing the idea that they can still benefit from memory care services in the years preceding a potential diagnosis.
How operators instill brain health outside of memory care varies. But the unifying theme is that all residents can stand to benefit from some cognitive support, even if minimal. At the very least, they could learn skills that could serve them well should they ever have a dementia or Alzheimer’s diagnosis.
“If you have a really robust program, if you’re proactive about it, if you’re destigmatizing the whole notion … it can work in your favor,” Asbury Communities Senior Director of Wellbeing and Brain Health Sue Paul said during a panel discussion at the recent SHN BRAIN conference in Washington, D.C.
‘Everybody should be invited’
Among the biggest ways senior living operators are making memory care more holistic is by extending those services and ways of thinking — or at least, parts of them — to other neighborhoods of the community.
It’s no secret that, sometimes, there is an immediate barrier to doing so. Senior living residents and their families often carry a healthy fear of cognitive decline. Even the words “memory care” or “dementia” alone can evoke feelings of worry and fear.
But operators’ efforts to extend memory care services to other parts of their communities are naught without buy-in and understanding from the people living in those communities.
Lisa Holloway, vice president of Health Services at Kendal Corp., takes the philosophy that every person is still “temporarily able.” By that, she means that, regardless of current ability, everyone will eventually find themselves in need of a higher level of care if they live long enough. Memory care and mental acuity is no exception to that rule.
One way to defeat a stigma is through learning and teaching. That’s why Kendal residents are not only learning, but also educating each other on the ups and downs of living with a different level of cognitive ability.
“It is important that there’s education from an IL perspective, and those residents are the ones that are providing that education so there’s assimilation and acceptance,” Holloway said.
She added: “Folks are engaged with their neighbors, helping them to stay as active and engaged in the community as long as they’re able to — and I think that really does make a difference.”
While Brightview Senior Living brands its dementia under the moniker of Wellspring Village, the company’s memory care efforts are wider and include taking the whole community into account. Every Brightview community focuses first on being residents’ homes, according to Corporate Director of Dementia Care Cole Smith.
“We do have a specialized neighborhood that is secure for the people living with dementia that need … but honestly, if you’re doing activities and programming and having community events, everyone should be invited,” he said.
Smith added that the company also tries to get into the perspective of memory care residents. For example, a person not living with cognitive impairment might use various tools to signal a server at a restaurant — eye contact, then a hand wave, then maybe even calling to them from across the room.
Memory care residents follow the same pattern of “increasing the intensity and duration of your behavior to get your needs met,” Smith said — they are just using different ways to get there.
“It’s their language,” he said. “It’s their way of saying something in this isn’t working for me.”
That perspective also extends to how communities are designed. Smith stressed that operators should try to make spaces in IL and AL wings more welcoming and accessible for residents living with memory care.
For example, operators should design their communities with easy-to-see lighting cues and carpets that won’t distract someone living with different cognitive abilities.
“Ultimately, our communities are their homes, so they should be able to independently navigate them,” Smith said.
Going bigger on brain health
The pandemic and all of its early restrictions on move-ins and socialization laid bare the industry’s need to prioritize connection, learning and purpose, according to Smith — and “if we don’t have it, we decline faster.”
“Making sure your IL, AL and other areas are looking at brain health — whether it’s diet, exercise or brain exercises — is huge,” Smith said.
At Asbury’s communities, residents are focusing on prioritizing their own brain health, a catch-all term that encompasses mental ability and wellbeing.
For example, the organization has a brain health program called Kinnections and a brain health center. The center is set on a 134-acre campus designed for both mental and physical engagement, with space for cutting-edge tech and even a 22-foot rock wall and a boxing studio. Asbury also employs brain health coaches who personally aid residents in that journey.
“They think of it like anything else,” Paul said. “Like working on their heart health, they work on their brain health.”
In particular, the organization is getting residents on board with being more empathetic with one another so that they can help regulate and notice each others’ behaviors, according to Paul.
“We’ve taught the residents, ‘Do you have insight into your own social behavior?’ [such as] how you react when your soup is cold or this person is talking too much.” she added. “You have to know your own social awareness, and then gently remind others and recognize that they’re going through some struggles.”
Asbury also gives residents and their families plans on dealing with their dementia as it progresses over time. The organization also focuses on the “low-hanging fruit” of lifestyle factors or dietary practices that could help delay the onset of dementia.
“It gives them hope and tangible actionable items,” Paul said. “I think that’s the best thing: Can you give them actionable consumable plans?”