Senior housing providers recognize the rapidly growing need for memory care services, with recent industry surveys showing construction booming in this area.
Yet, the future will bring not only more buildings designed for people with dementia but new approaches to care, as operators develop programs out of different schools of thought. For instance, some believe strongly in the merits of standalone facilities while others are offering care that is integrated in a continuum.
While their guiding memory care principles may be different, progressive senior living companies share similar goals of upgrading services and improving residents’ lives. To achieve these objectives, top operators already are forging new approaches that will catch on in the next decade, some of today’s most well-reputed and award-winning memory care providers tell SHN.
These are five key changes to look for in the next decade, according to leaders in the field:
Inventive care settings
Currently, there are “thousands” of nursing homes with memory support floors or secure units, notes Daniel Reingold, President and CEO of RiverSpring Health, a multifaceted senior living and services provider in the Riverdale section of the Bronx, in New York City. While skilled nursing care will continue to be an essential aspect of memory care in the end stages of dementia, people with memory care needs in the future likely will have a broader array of options to choose from, Reingold believes.
“My feeling is there is no one model [for memory care],” he tells SHN. “I think there are multiple models and some we don’t even know about yet, that haven’t been invented.”
For example, Reingold sees some senior living providers purchasing residential property in urban areas and converting it to offer memory care in something like a group home setting. These properties might be scattered throughout a metro area, as an alternative to the model in which a small number of residents—usually about 10—live in homes that all are located on a single campus.
While the so-called “small house” model might increasingly catch on for memory care, there also could be a growing demand for even more intimate settings within nursing communities serving people with dementia, says Presbyterian SeniorCare CEO Paul Winkler.
The Pennsylvania-based provider of retirement communities, home care, senior living and memory care has built a small-scale, affordable housing model utilizing funding from the Department of Housing and Urban Development that fits this need. It consists of 10 enclosed and secured units and is appropriate for couples facing cognitive challenges. It has been successful since launching 15 years ago and could be ripe for replication.
“We don’t have the same model for private pay, couples housing,” notes Winkler.
Better full-continuum care
Many senior living leaders are optimistic that acute care providers and other caregivers across the continuum will become better educated about dementia and will offer increasingly sophisticated memory support.
“I think absolutely, other types of providers will become better at dementia care,” Winkler says.
The challenge for senior living operators will be to tap into this expertise to enhance the medical components of memory care, he adds. For example, providers should think about working with gero-psychiatrists to treat dementia-related depression and bringing on board medical directors who have a dementia specialization.
A greater focus on dementia will be driven largely by the growing ranks of seniors who develop Alzheimer’s and other cognitive conditions, and senior living providers that already are developing best-in-class memory care services will play an essential role in educating other organizations.
For instance, Maplewood Senior Living considers spreading information about its memory care approach part of its mission.
The Connecticut-based provider operates assisted living, memory care and continuing care retirement communities, including standalone memory care facilities such as Maplewood at Stony Hill in Bethel, Conn. (pictured). The company has made its name on high-end residences with a full complement of amenities, and a person-centered care approach based on principles including a focus on humor, developing empathy with residents and fostering autonomy.
Leaders at Maplewood believe strongly in this approach and say that it is not dependent on having the type of high-end facilities that they build. They are willing to share information with providers to maximize the number of people who can receive this type of memory care.
“We provide a specific product and service that might not be for everybody,” Maplewood Chairman and CEO Greg Smith says. “If we can share with [other providers] what we’re doing, not shielding it as a way of being competitive, they can implement some of this.”
Memory care specialists
Caregivers outside the senior living space are not the only ones who will become more specialized in their memory care knowledge and skills — those working within the walls of senior housing communities likely will as well.
“We will begin to see a greater focus on formalized dementia education and specialization for professionals and especially professional caregivers,” predicts Letitia Jackson, vice president of corporate engagement at Senior Star, a company that operates thirteen communities in six states, including independent and assisted living, nursing and memory care. “Instead of simply certified nursing assistants (CNAs) we may see certified dementia care nursing assistants (CDNAs).”
Jackson thinks this credentialing will be driven by a variety of factors, including rising consumer expectations and tighter regulations governing memory care. She already has seen dementia-specific credentialing of nurses and doctors catching on internationally.
These credentials might also be a natural outgrowth as more health care professionals are voluntarily choosing to focus on memory care than in the past.
“From where we were 10 years ago to now, I think there’s more understanding that it is a specialized kind of care,” says Mary Underwood, vice president of memory care and resident experience at Maplewood Senior Living. “I think people now are choosing to do memory care as a career, versus getting stuck in it. Memory care is attracting passionate people, and I think that’s going to make for good care going forward.”
Heading off memory loss
Just as the medical aspects of memory care may become more fine-tuned, providers also will likely develop more effective and rigorous lifestyle programs to slow the development of dementia.
“From my standpoint, I will tell you that the biggest change I’ve seen in the last 10 years is the understanding of the disease as having a long preclinical phase,” says Kim Butrum, RN, GNP, Silverado Care’s senior vice president of clinical services. “There are interventions that can modify when you develop the disease, and that’s a huge game-changer. I think there will be more and more of a focus on these healthy lifestyle factors.”
Silverado is a California-based provider of memory care, home care and hospice services, with locations in six states. Its Nexus program is constructed around a number of these lifestyle factors, including physical activity, social engagement such as volunteering, and cognitive compensation strategies. These include “brain fitness” games that can be played on computers, smart phones or other devices, and are meant to help preserve certain cognitive abilities, such as executive function.
Researchers already have produced evidence that these types of interventions can help combat dementia, Butrum says.
Brain fitness applications are only the tip of the iceberg when it comes to technology that can make a huge positive difference in the lives of those with dementia. In the next decade, tech could revolutionize memory care in seemingly countless ways, helping people remain at home longer and enabling senior living operators to refine their services.
Some cutting-edge work is in the realm of technology that can help people compensate for memory loss. For instance, wearable cameras with facial recognition capabilities could provide people’s names as they approach someone with dementia, says Presbyterian SeniorCare’s Winkler.
Technology that can assess a person’s cognitive load could help inform day-to-day decisions, Winkler adds. This is especially useful because people with early-stage cognitive issues might experience good days and bad days. Depending on what the technology says about how well someone is performing cognitively on a given day, a person might be able to judge whether is safe to drive or perform other hazardous tasks.
Presbyterian SeniorCare has partnered with the Carnegie Mellon University/University of Pittsburgh/National Science Foundation Quality of Life Technology Center on a 10-year funded initiative to help develop and test the latest technologies, so it should have a leading edge perspective on new technologies in the next decade.
Researchers at the Quality of Life Technology Center currently are investigating ways that sensors in everyday objects used in daily living activities could collect information about changes in a senior’s cognitive condition. Other projects include a study on website interfaces that are easier for people with cognitive impairments to use, and an investigation into how video, audio and sensor technologies can help detect depression in people with dementia.
As technology enables more people with dementia to live in their own homes for longer periods of time, memory care might also become increasingly a communal endeavor. The concept of dementia-friendly communities is catching on strongly in Europe, and places like Watertown, Wisc., have begun to embrace the concept, says Winkler.
Dementia-friendly communities incorporate infrastructure changes, such as safe, accessible streets and parks. Additionally, workers like bus drivers and bank clerks receive training in how to serve people with memory needs.
Ultimately, the question may not be how memory care will change in senior living settings in the coming years, but how it will change society as a whole, Winkler points out.
As he puts it, “How do we really create our communities so they’re good places for all of us?”
Written by Tim Mullaney