The senior living industry is at the forefront of new health care research, data and treatments. Given the complexity of their operations, memory care operators are often at the cutting-edge.
In 2023, such operators are innovating on memory care offerings to bring new research-based practices to improve operations and staffing. All the while, they are identifying new ways to reach customers to grow margins.
As acuity levels of residents rise, many operators nationwide have taken stock to either add memory care services, or redefine their offerings to prepare for older adults living with different cognitive abilities. Evidence and research are at the core of their efforts.
Where evidence is key to programming
As memory care operators are crafting new programs and services for residents in the pandemic age, they are doing so with new research and data in hand.
Nashville, Tennessee-based memory care operator Abe’s Garden applies its memory care programming through the Hearthstone Institute, an entity that has been developing evidence-based practices to improve resident engagement for those living with dementia for nearly three decades.
It’s based on a simple philosophy: Every person living with dementia is truly still aware and can experience a high quality of life.
“We’ve been using this for the past eight years and that ‘I’m still here’ approach is instilled throughout our program and is included in our training and early education,” Abe’s Garden Communities Chief Operating Officer Chris Coelho.
Abe’s Garden built its staff training model around the Hearthstone Institute’s tenants, and staff undergo biweekly and monthly training to learn best practices in communicating and engaging those with dementia.
“This is one of the greatest ways we’re able to retain staff on our team,” Coehlo said. “They’re continuously being updated and educated about the best ways to interact with people with dementia.”
Within small team “huddles,” Abe’s Garden conducts training and provides updated information to staff on resident health and nutrition while keeping an eye on each resident’s unique needs.
Alexandria, Virginia-based Goodwin Living caters to residents of all acuity levels, and that can mean providing activities and programming for multiple acuity levels at the same time, according to Goodwin Living Brain Health Program Manager Jessica Fredericksen.
Through partnering with Encore Creativity, the nation’s largest choral arts program for older adults, Goodwin Living created the “Melody Makers” program. It involves bringing memory care and IL residents together once a week for a choral program.
“They’re engaged in movement and in brain-engaging musical activities and they create music together,” Fredericksen said.
That’s proven to be a “great partnership” between IL residents and memory care residents, she added. But Goodwin Living realized a disconnect for some residents not being able to keep up with the fast-paced nature of the “melody makers” program.
That’s when the company created the Brain Cafe, Fredericksen noted, and it brings together clusters of six to eight residents together for approximately four hours having coffee and conversation, mixed in with brain-engaging games.
Through both the Brain Cafe and Melody Makers programming, Fredericksen said the element of social connection drives conversations and helps build bonds between residents and staff.
“It’s a catalyst for engagement and these programs build on that connection and we just need to be able to set the stage and setting for them,” Fredericksen said.
Belmont Village, a Houston, Texas-based senior living provider has remained at the forefront of memory care program creation. That’s in large-part to the work of Beverly Sanborn, who is the vice president of program development at Belmont Village.
Sanborn and the Belmont executive team installed evidence based therapy into programming across all care levels, and one of the most important aspects to getting a program right Sanborn said was the environment in which residents will interact with staff and programming.
Recently, Sanborn said Belmont Village was starting to revamp programming based on that idea of a series of environments, allowing more flexibility between care levels and activities. Most recently, Belmont Village is working on crafting a sensory care level,
“It’s very much a multi-level approach,” Sanborn said. “That’s been very successful and from a marketing point of view, enhanced demand immensely for the programs.”
In order for memory care residents to thrive, programming must lean on a “three-legged stool” of creating moments of actualization, purpose and belonging for residents, Sanborn said.
Without one, a resident can suffer, Sanborn added. Actualization includes spiritual and creative pursuits, while creating purpose and belonging. One of the most important aspects of the model, Sanborn said, is the focus on physical wellbeing and ensuring older adults get the exercise needed to remain healthy.
Operators can succeed by creating a programming calendar based on National Wellness Institute’s six domains of wellness, which include emotional, occupational, physical, social, intellectual, and spiritual aspects, Sanborn said.
“I cannot recommend it highly enough: You have to create a calendar with the embedded domains because what we want is consistency at a high-level of programming,” Sanborn said.
In creating detailed memory care plans, operators can create a sense of belonging and routine for residents, which could help motivate more residents to participate, Sanborn added. Through participation, comes engagement.
That engagement can be as simple as reminiscence, asking residents about past pets and then posing a thought-provoking question about why society has pets in the first place, Sanborn added. Asking provocative questions can help lead to more engagement from residents. Sanborn added that activities like crafts can help get residents to use sequencing to promote learning.
Adapting memory care for the rest of the continuum
Abe’s Garden ran into a common problem many across the country face: Not enough room for all memory care and AL residents. That led Abe’s Garden to create a home care program, rather than pursue physical new development.
With an adult day program on campus and the home care services, Abe’s Garden can now reach more older adults than it ever could before.
“That way we can make our programming more accessible to more people that are choosing to live at home,” Coelho said. “The same engagement we have within our community, we can bring that into their home and we can meet those engagement needs.”
With its “StrongerMemory” program, Goodwin Living created a brain health exercise program developed to target memory and recall in older adults. Participants in the program reported better recall scores through daily repetition, reading, writing and math tasks.
The program is free through donations of the Goodwin Living Foundation, and the program has reached over 16,000 older adults nationwide, Fredericksen said.
In bringing memory care to other areas of the continuum, Sanborn stressed the importance of conducting assessments of new residents to properly adjust care plans for each older adult. Through tracking those assessments, Belmont Village is able to track a resident’s progress and acuity level. Re-assessments occur twice every year, Sanborn said.
“I think the assessment is a key component to knowing how they’re doing, but also to be providing the best program for them,” Sanborn said.
As memory care options continue to be refined by providers, Coelho said engagement and socialization would remain two key areas to watch as the sector evolves.
“We’re seeing more programs that enhance the ability of older adults and help prevent any decline,” Fredericksen added. “It’s about that prevention piece as well as acknowledging people living with dementia and creating opportunities for them to thrive.”
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