converting underperforming units or expanding services to
meet the increasing need for memory care. Forward-thinking
companies also are capturing more of the recession-proof Alzheimer’s market and positioning themselves for steady and
increasing demand for memory care services.
right here, right now
The immediate business result for the increasing Alzheimer’s
care need lies in the many small-scale construction projects
that continue to crop up throughout the country. These projects aren’t necessarily part of a master corporate strategy—
“I’m not aware of anybody thinking about it that way,” says
tom grape, president and CEO of Wellesley, Massachusetts-based Benchmark Assisted Living—as much as they are a case-by-case response to local market conditions. But overall, the
numbers are adding up.
Since 2005, the U.S. inventory of memory care units has
grown by 17 percent; assisted living inventory has grown by 6
percent, according to research by the Chicago-based national
investment center for the seniors housing & care industry
(nic).
“The point here is that in recent years the memory care
sector (in terms of units) has grown much faster than the
SecuRING Safe eNvIRONmeNtS
There is no shortage of technological systems available to monitor
residents with dementia. However, providers of dementia care
agree: Even the best technology can’t replace well-qualified,
experienced, and alert staff.
Nonetheless, technology can be a valuable step toward securing
a safe environment for residents with dementia. For example, inns
management group of Newark, Ohio, uses an infrared light beam
system that can be programmed in accordance with individual
habits. The system alerts staff when a resident gets out of bed
or has been in the bathroom longer than usual. This has been a
significant and more discreet improvement over the otherwise
tried-and-true method of having staff members duck their heads
into residents’ doorways several times each night to check on
them, says Beverly donaldson, rnc, the company’s president.
“People with dementia can be very light sleepers, and just like the
rest of us, they get cranky,” says Donaldson. “More people sleeping
without interruptions is a major advantage.”
Regardless of the particular technology a provider may be
interested in pursuing, Donaldson advises paying close attention
to troubleshooting features and procedures. Chances are, any such
system is going to malfunction, she says. Inns Management Group
installs separate lock systems for interior doors versus exterior
exits so that a malfunction need not shut down security altogether,
and has installed extra surge protection at communities prone
to thunderstorms. The communities also
receive 24/7 access to assistance from the
primary security vendor, vigil health solutions
based in British Columbia, Canada. “Now
with online technology, they literally can go
into our software like they’re standing in our
hallway, looking into the [control] cabinet,”
says Donaldson.
assisted living sector,” says michael hargrave, vice president
of NIC MAP.
But there’s a lot more to opening an Alzheimer’s or memory care program than securing the doors and adding staff.
Repurposing space to provide a higher level of care or significantly increasing existing Alzheimer’s capacity inevitably
launches a new business plan for that community. Providers
who pursued that path recommend having foresight beyond
finding the right architect or building contractor.
“When moving from assisted living to dementia care, it’s
important to be focused on more than the physical space,”
Bacon says. “The staffing is very different, the programming
is very different, the dining experience is very different. It is
not just assisted living in a secure environment.”
Loren shook, president and CEO of San Juan Capistrano,
California-based silverado senior Living, built his company
in part by absorbing struggling dementia care programs. He
echoes Bacon’s assessment. “One of the big mistakes operators make is thinking this is a pretty simple way to pick up
the business and fill the units,” Shook says. “It’s not an easy
business to go into, and that’s why we are able to take over
failing operations and make them work.”
scope of services
Providers must focus on whom they will serve before undertaking a conversion of existing space because cognitive disorders assume many forms. For example, many residents will
have multiple dementias at the same time. Different types of
dementia can lead to different behavioral challenges, such as
loss of sexual inhibitions.
“Many operators don’t have enough knowledge to know
what kind of program they need,” Shook asserts. “Do you want
to take the middle stages, where residents can communicate
better? Do you want to keep people through the end of life?
What’s the program you want to achieve?”
For example, a high-functioning resident with dementia
may not need much oversight right away, but research has
shown that six out of 10 seniors with Alzheimer’s disease will
eventually wander. “While we are seeing an increase in com-
petition from communities that provide dementia care, we
have found that oftentimes they are still unable to provide
the exact set of services we provide to our residents and their
families,” she says.
Regarding security measures to prevent wandering, research and experience have shown certain design features to
be universally important in memory care programs, starting
with designating a dedicated, secure area. Brandywine’s goal
is to have each of its Reflections neighborhoods operate as a
fully functional “community within a community” says maria
nadelstumph, vice president of organizational development
and program excellence.
Other essentials include wide hallways and secure outdoor
spaces, to prevent wandering, and a mix of common spaces
