It’s no secret the demand for memory care is great and expected to grow in the coming years as the baby boomers age into senior housing. But getting there will still be a challenge.
Even as older adults seek senior living, there is no guarantee that they will want what today’s memory care operators are offering. And although much is being learned about the diagnosis and treatment of Alzheimer’s and dementia, it remains a challenging product type, even for seasoned senior living operators.
“Looking across the country at the services that are delivered. I think we as an industry are doing better than we were, but I think there’s room for improvement,” said Loren Shook, co-founder and CEO of Silverado, during a recent Memory Care Business webinar.
Silverado and other operators are focused on a variety of initiatives to improve memory care, including by trying to better diagnose and treat Alzheimer’s and dementia in its early stages. At the same time, they are specializing in providing more personalized care, as Sage Oak Assisted Living and Memory Care is doing with its newly launched Curated Care program.
To Sage Oak CEO Loe Hornbuckle, the current period is one of “transition” for memory care operations. But as operators pioneer new techniques, he believes they are helping to create the next generation of memory care.
“There’s kind of this new wave of pioneers,” he said. “What we’re trying to do is create an experience that’s incredibly personalized.”
Specialized memory care gains appeal
One of the bigger trends in memory care over the last few years has been operators specializing in certain techniques, treatments and offerings to better serve their residents.
Dallas, Texas-based Sage Oak is about 90 days into piloting of the Curated Care program. The idea behind it, Hornbuckle said, is to create an experience that’s “incredibly personalized.”
The program groups residents with similar outcomes and abilities into specific households. For example, one household might have residents needing a certain kind of care, or residents living with similar kinds of cognitive issues.
Hornbuckle said that residents living in memory care are often grouped by level of ability at the “company” level. By taking the Curated Care approach, Sage Oak can offer the kind of hands-on care that keeps older adults out of nursing homes for longer.
Hornbuckle and Sage Oak hope to break the stigma surrounding memory care, which often leads to people putting their family members in assisted living despite memory care being the better option, he added.
“One of the hardest conversations you can really have with a family is if they’re in assisted living, and you encourage them to move to a dementia care setting,” he said. “But if you have a really high-functioning setting to offer, and you have different offerings of memory care products, then you can create this very personalized experience.”
The approach is also positioning Sage Oak to be prepared for the increased demand for personalization options that baby boomers are asking for, he added.
Silverado also specializes in different stages of Alzheimer’s. Of note is the company’s Nexus concept, which is meant for residents living in the early stage of Alzheimer’s or dementia.
At Silverado, master’s-level social workers and clinicians lead support groups for residents in the early stages of cognitive decline to give them a space to talk through what they are experiencing and feeling. Shook said that residents who participate see a decrease in depression and are more engaged and social.
Based on a Silverado study validated by the University of California, the approach led to a 60% improvement in cognition out of 730 cases.
“It’s not a cure. But it also serves to slow up the progression of the disease,” Shook said. “So putting people in the right group, giving them the right stimulation where they can be successful, is important.”
Far too often, memory care residents are parked in front of televisions or given infantilizing activities or objects to keep them busy. But doing so can hurt rather than help residents’ conditions.
“People are not going through a second childhood, when they are memory impaired,” Shook said.
To that end, Silverado does not use baby dolls, robotic pets or crayons in its communities, instead opting for real-world objects that are relevant to residents and their lives, such as purses and paintbrushes. Silverado also encourages residents to become involved in their communities through volunteerism, including by helping their peers who may have more care needs and help with cognition.
“Really allowing people to have a normalized environment and an active personal, purposeful engagement program is so important,” he added.
Hornbuckle agreed that residents do well with personalized care. But he differed from Shook on robotic pets, noting that he thinks they – along with virtual reality and gamified activities – can help create supportive and engaging environments for residents.
“Ultimately, it’s about trying to give your residents what they need as best you can. You’re never going to be perfect at individualization,” he said.
Lofty challenges
As in past years, staffing continues to be among the memory care sector’s top challenges.
Silverado has significantly invested in its training programs to help recover from workforce challenges of the last few years. To facilitate the needed training, the operator hired a full-time trainer, brought on nurses and caregiver mentors for nurses exiting acute care that are wanting to connect with residents.
Additional training is having to change as well in order to accommodate a younger population, Shook said, with some residents as young as 50 beginning to enter senior housing.
Hornbuckle noted that at this time, leadership roles are probably the most difficult to hire for, especially executive directors.
“I think our challenge has been and will continue to be what I like to call a ‘who’ problem. And that’s that we need the right people to take care of folks,” he said.
Memory care presents a unique struggle for workers, where they have to “get fulfillment a different way” due to less overall recognition from residents, Hornbuckle said.
A more recent challenge for the industry comes from a need to educate prospects and their families. Throughout the pandemic, older adults and their loved ones have begun to do much more research online. But as they do so, they are potentially running into misinformation.
Silverado connects family members with a “family champion” – someone who had a family member move into a Silverado community – to assuage fears and help answer questions.
Another challenge for memory care operators is that, as the sector has become more of a mainstay real estate type, it has also garnered more scrutiny. That can be seen in the recent Washington Post articles that highlighted elopements within memory care and assisted living.
As families have questions about these and other issues, Hornbuckle said there is an understandable impulse to want to come across as an expert. But “the best companies don’t position themselves as experts,” he added.
“We position ourselves as guides that are going to roll with the punches and be there with you every step of the way,” he said. “As data changes, as best practices change – as things like robotic pets fall in and out of favor – then we’ll pivot to those changes as they come.”
