Providers Look to the Past for Future of Memory Care

Memory care providers have long focused on new and forward looking technology as a way to improve cognitive outcomes and quality of life for those experiencing memory impairment. But one solution growing in popularity across senior living communities nationwide takes the opposite approach: going back in time.

LifeBio, a story gathering tool used in 100 communities nationwide, and The Best Friends Approach, a strategy implemented in more than 60 communities in the U.S. and Canada, seek to encourage senior living staff members to get to know the life stories of memory care residents and to use that knowledge to provide them customized care.

LifeBio has been licensing its story tools to senior living communities through its LifeBio Authorized Organization program since 2006 and has since been licensed at 100 communities in 29 states. The company provides Web- and phone-based training to senior living staff members who then are able to offer the story tools to residents.

Similarly, the Best Friends Approach, implemented across 117 memory care programs in 61 organizations, uses a training program run by Health Professions Press that licenses and trains senior living staff members on this approach. After completing the training, staff members can then bring the approach to their memory care communities and label these communities as Best Friends Environments that use the logo, materials and intellectual property of the Best Friends Approach.

“Traditionally, organizations made decisions, wrote policies and established processes because they were most efficient for staff,” said David Troxel, co-founder of the Best Friends Approach and ABHOW memory care consultant. “That’s why many old models of nursing and dementia care are broken.”

But, operators such as ABHOW have found, with an emphasis on understanding residents’ unique life stories, caregivers are experiencing success with memory care patients, particularly through enhanced resident engagement.

Engagement can help decrease feelings of loneliness, which, studies show, are linked to an increased risk of dementia and cognitive decline. Lonely individuals — those who experience social isolation or have few interactions with others — are twice as likely to develop the type of dementia linked to Alzheimer’s disease later in life compared to those who are not lonely, according to a study by researchers at the Rush Alzheimer’s Disease Center in Chicago.

“That isolation, that loneliness, can be as detrimental as a variety of chronic diseases, such as hypertension and diabetes,” said Khristine Rogers, virtual vice president of memory care in senior living and founder of Get Booming LLC in Golden, Colo. Rogers, who has worked in the memory care field for more than 25 years, has worked with LifeBio for the past year and has both trained and operated memory care programs using the Best Friends Approach.

Providers have experienced success in using LifeBio as a measure to help residents before memory problems kick in — and as a resource if and when those residents develop memory loss. Through LifeBio, seniors are able to document their past in Web-based and physical journals. They can start a biography, record special events and archive family history documents — all of which can be used as a legacy for family members and a resource for caregivers should the seniors develop dementia.

“We’re not just gathering the story but we’re using it to customize activities and conversations you have with that person in the future,” said Beth Sanders, founder and CEO of LifeBio. “Sometimes knowing their past gives you a connection point that helps you get them up and moving.”

For example, a former teacher may respond better to language like “let’s go get your lesson ready,” instead of “let’s go eat.” If staff members know and recognize that a resident used to teach, they’re more likely to use personalized techniques that ultimately provide the resident with better care, Sanders says.

“If you don’t understand who they are, you’re operating with one hand tied behind your back every day,” she said. “Operators are in a more competitive environment where they’ve got to differentiate themselves. Doing a really good job of knowing the whole story of a resident is going to differentiate them.”

Ardenwoods, an independent and assisted living community in Arden, N.C., is a LifeBio Authorized Organization that uses LifeBio 101, a curriculum of eight-week classes that facilitate small group discussions with residents. During the classes, residents are asked specific questions about their past that are meant to guide them through the process of remembering, sharing and writing down their life experiences.

“When you reminisce you’re able to build new highways in your brain for memory, so there’s a cognitive benefit and the friendships they’ve formed in the class are also a benefit,” said Janice Husk, community life services director at Ardenwoods, which is managed by Life Care Services. “We see an improvement in day-to-day memory of people who are in the class. Beyond that, it just helps people to be more engaged in conversation.”

The Best Friends Approach is a similar strategy that uses life stories as a basis for memory care treatment. This approach focuses on training staff members to become “best friends” with residents by learning their life stories and engaging with them on both a structured and spontaneous level. The idea is that staff members know and understand everything about a resident — including likes, dislikes, fears, passions and hobbies — to help that person feel safe, secured and valued, just as a best friend would.

“In senior housing, when the resident feels connected with the team, when they’re happy and not bored, [bad] behaviors go down and cooperation goes up,” Troxel said. “My belief is that the market will reward you when you do a great job.”

Piedmont Gardens in Oakland, Calif., an ABHOW community, is one facility that uses the Best Friends Approach in its memory support program, The Grove. The approach is implemented at each of ABHOW’s nine grove communities and has been successful in terms of resident satisfaction and engagement.

“The Grove has the highest satisfaction scores when compared to any other level of living [within ABHOW communities],” said Melissa B. Honig, ABHOW vice president of clinical services. “Best Friends believe that all residents can grow and have potential, and that makes residents want to engage.”

By using life stories as a means for connecting to residents, engaging with them on a structured and unstructured level and providing them more specialized care, both the Best Friends Approach and LifeBio have helped memory care communities succeed.

“I really push companies and say that by doing a good job, you’ll end up with this therapeutic environment and have much fewer challenging behaviors, happier families and better personal care,” Troxel said.

Written by Emily Study