Challenges in memory care are driven by rising acuity of residents leading to shorter lengths of stay, combined with changing customer demands. These factors have forced senior living providers to think differently about their operations in memory care.
This comes as the senior living customer today continues to change, even within higher acuity assisted living and memory care. With aging demographics, operators that have rebuilt clinical and lifestyle models in assisted living and memory care have been able to capture new demand and build occupancy despite persistent challenges.
“We’re seeing a lot of tailwinds,” said Frontier Senior Living CEO Greg Roderick. “We’re seeing more interest in seeking residency in these communities once again.”
Frontier Senior Living, SRG Senior Living and EverTrue (formerly LSS) are taking steps to evolve memory care services focusing on personalized care, with redesigned programs to normalize life for those living with dementia and cognitive decline rather than infantilizing them.
These operators see the future of senior living memory care focused on value-based care outcomes, more in-depth technology adaptation in operations and a more involved family in a prospect’s move-in and long-term stays.
Demand returns, customer base changing
Operators have reported tailwinds in memory care demand, fueled by programs that blend lifestyle and quality of life with adapted care models. An area of emphasis in memory care that is changing is through the transition process from independent living and assisted living to memory care.
For Brentwood, Missouri-based nonprofit provider EverTrue, the company adapted its memory care program towards a more personalized approach while also putting greater emphasis on assessments at the time of move-in, according to EverTrue Vice President of Life Plan Communities, Midwest Valerie Cooper.
As an industry, Cooper said operators must stop siloing memory care residents and families to only focus on care delivery and coordination and “flip the script” focusing on personal preferences, resident needs and focus on building a holistic profile of each resident to improve programming placement and lifestyle activities.
“We often pigeonhole our residents into that clinical mindset and we need to focus on who they are, who they were and who they still are,” Cooper said.
Frontier Senior Living’s Spark memory care program centers on Montessori-inspired methods in programming and operations all in the name of “creating purpose” for memory care residents. For example, in some instances, Frontier residents are able to lead their own activities and share life skills, where possible, to enrich their daily experiences, Frontier CEO Greg Roderick said.
In order to reach older adults sooner, SRG uses its marketing efforts to position the operator as an independent living provider and with the services and ability in operations to provide care as residents age-in-place, according to SRG Vice President of Memory Care Melissa Dillon.
“It’s the internal transfer that does create our occupancy growth within memory care, which we really have stabilized in the 90% zone,” Dillon said.
Normalizing life in memory care
Senior living providers have often adopted approaches that soothe residents with cognitive decline, but some of these practices could soon become outdated like using wallpaper to emulate bookshelves or giving residents in memory care dolls to care for.
“People living with dementia are not dumb, they just have critical thinking challenges,” Dillon said. “We really need to lean farther back into just making [memory care] normal for them.”
At SRG communities, that means hosting game nights and trivia nights with residents and their families rather than doing activities like a giant parachute in an effort to create engagement activities in which any adult could participate, Dillon added.
To make this shift, Dillon oversaw training efforts and overhauled the way staff work with memory care residents in programming, pivoting operations to focus on different learning groups with ideas centered on programming that fosters “validation” for memory care residents. A key part in getting this new training to stick was being able to conduct “empathy exercises” with staff regularly to ground them in the complexity of delivering memory care services.
“We have different tools in our toolbox, but at its core, it’s really teaching the philosophy so we can apply it individually to different communities,” Dillon added.
This philosophy of creating meaning and purpose, Cooper said, must guide operators as they consider changes to their memory care models. At EverTrue, Cooper said communities focused on training for staff through dementia education to create empathy and patience among new staff. The company also overhauled its technology infrastructure, improving Wi-Fi to improve connectivity for staff as care delivery becomes reliant on electronic health records and online assessment systems.
Because each person’s response to dementia or cognitive decline is different, Cooper said operators must focus on programming that creates unique experiences for memory care residents. For example, the nonprofit provider incorporates horticulture, equine therapy and creating “interest” for residents in memory care was vital to normalizing their daily experiences, Cooper added.
The operators also mentioned the benefits of music therapy in adding depth to programming, allowing residents to listen to music to spark memories and movement in a safe space to express themselves.
“It’s about inclusivity beyond the walls of memory care,” Cooper said.
At Frontier, these types of experiences are also common, with memory care residents able to access outdoor activities and attend programming around some communities that have rabbits and chickens. Frontier also added additional programs including one focused on improving sleep for memory care residents.
Through the company’s Frontier Advantage Network, the operator uses Medicare Advantage participants to capture more value for the care they provide. This creates an “ecosystem” of health care providers that can come into the community, Roderick said.
The Frontier Advantage Network, a value-based care model to improve resident health outcomes and provide reimbursement through Medicare Advantage (MA) adoption of residents. This effort has helped “close the back door” for the Dallas-based operator, and align senior living with health care providers. This has led to greater tour and move-in volume, Roderick added.
New expectations, limited supply
Looking ahead, Cooper sees care delivery in memory care improving to be more proactive than reactive in determining types of dementia that operators deal with.
“We are going to have to be able to take care of more people in the next five years that are living with dementia,” Cooper said.
At the same time, Dillon said memory care residents and their families are now more savvy when seeking out senior living options.
“It will only grow from there in understanding as a customer what it should do and what are you doing versus what your competitor is doing. So I think smart customers are coming,” Dillon said.
While demand is high, Roderick sees a continued shortage of units as development remains muted.
“I think that the capacity that we all have to offer will be full, and there’s going to be a shortage of ability to house more people that need memory care,” Roderick said.
