To keep up with the changing resident profile of the incoming baby boomer generation, senior living companies are hitting the refresh button on memory care programming .
Operators are taking stale concepts and remixing or innovating on them to offer more meaningful programming and amenities to residents in the quest to realize a big wave of looming demand in the years ahead.
From memory care programs set on real working farmsteads to Montessori-rooted approaches, operators are taking their own paths to accomplish the same goal: Enhance and enrich the lives of memory care residents to give them a sense of purpose.
“We’re here to give purpose,” said Michelle Cornelius, who is the vice president of memory care engagement for Cogir Senior Living. “We can’t assume just because it’s a task it’s purposeful. So finding out from every resident what it is that gives them meaning to life, and then figuring out what we can do to support that.”
Acts Retirement Life-Communities and Cogir Senior Living both subscribe to the Montessori teaching method, which focuses on giving people freedom of expression and autonomy through a specially prepared environment and certain kinds of activities and chores. Both operators adapted the approach for residents living with dementia using practices based on rehabilitative principles of completing tasks and repetitive actions with built-in external cues and encouraging residents to rely on their memory, where possible.
Both providers also follow the “Best Friends Approach” to memory care, which focuses on compassion, empathy and respect for residents living with different cognitive abilities. But programming must be thoughtful and vibrant, not just things the old and stale standards of bingo, ball-tossing and birthday parties.
“You don’t just bring people in a room and then suddenly something just starts,” said Acts Retirement Corporate Director of Memory Care Julie Ackley during the recent SHN BRAIN conference in Washington. “We make it very intentional … that’s part of the relational piece as well as offering choice.”
Sacramento, California-based Cogir Senior Living operates over 60 communities, 36 of which have dedicated memory care offerings at three tiers of programming. Fort Washington, Pennsylvania-based Acts Retirement is one of the largest nonprofit operators of life plan communities in the country, with 26, of which 16 have memory care-designated neighborhoods.
As a trained art therapist, Ackley has personally created different programming options that come with a script for staff to follow and enhance programming.
“We have to give the skill set to our team so that they can adapt the complexion of the residents in front of them,” Ackley said.
Smaller organizations, including Kansas City, Missouri-based Prairie Elder Care, partner with local community groups to help drive meaningful engagement of memory care residents. Michala Gibson, who is the co-founder of Prairie Elder Care, said the partnerships were born out of necessity due to Covid-19 pandemic-related staffing shortages.
Prairie Elder Care operates a memory care community on a farmstead and offers adult day programming and in-home care, blending farm life with engagement and outdoor recreation for residents. The small homes take a unique approach to memory care by housing residents on real working farms with animals and plenty to do and see.
“We had to get creative with how we keep our residents engaged and support our staff,” Gibson said. “People are hungry for exposure because I think there’s still that stigma of what dementia is.”
Those partnerships included netting volunteers that assist with programmatic engagement from local churches and schools and that helped “take the load off” from care partners.
Gibson said the physical layout of the farmstead home helps memory care residents stay on track and focus on their respective tasks, with a design that eschews unneeded stimuli..
Physical layout can often impact memory care residents, according to Cornelius. For example, residents left to their own devices in a kitchen might eat cookie dough instead of bake cookies because they saw plates — not bowls,aprons and mixing spoons — before them.
To help memory care residents excel, Cornelius urged operators to be attentive to the environment in which programming is taking place, with an emphasis on ensuring staff are trained on specific queues or behaviors.
“It’s constant training and coaching and having them put themselves in the shoes of the person with dementia saying, ‘What would you think if you walked in right now,’ Cornelius said.
Promoting staff buy-in to drive life enrichment
In November of last year, Cogir merged with Cadence Living. In order to drive programming effectively in a memory care setting, operators need staff to get onboard with values, principles and vision.
Cornelius said some programming approaches for memory care, like the “Best Friends” model, can be carried over in how operators interact with frontline staff. To enhance training, Cornelius said leaders at Cogir’s memory care communities will conduct training centered on roleplaying to identify proper care techniques of dementia patients.
In practical application of care to memory care residents, Cornelius said Cogir leadership attempts to recognize staff that excel within the unit, often turning that staffer into a trainer to offer their perspective on memory care to other employees.
“If they have learned a new tip about a resident, I don’t want to be the one to share it,” Cornelius said. “I want to empower them to learn what works and to have them tell their other coworkers about it.”
For Acts Retirement, and other operators, many veteran staffers have spent decades in their respective roles and promoting change can be an adjustment for those familiar with routine. Ackley said that it “takes a team approach” to get staff to get onboard with new programming or initiatives.
“It starts with me rolling up my sleeves and demonstrating this is the change I want to see in how you are engaging with your residents with purpose,” she said.
The other key component, Ackley said, is educating regional leadership and executive directors to help foster an environment in which staff with accept change.
“We need to help the team members understand what’s in it for them,” Ackley said. “This is greater job satisfaction, a greater sense of efficacy and higher morale. I think it all plays into it.”
Gibson noted that the company is working on a study on what engagement looks like for residents dealing with late-stage dementia.
“Our goal is that we’re able to make those connections where you see them , see the twinkle in their eye, and it’s hard,” Gibson said. “How do we get to a deeper level where it’s more about are they being heard and valued?”