January 24, 2012 |

Delivering a successful model of memory care

Since joining Long-Term Living, I’ve had my share of SNF and senior living site visits. Typically, I see the best of the best, as I’m often invited to cover innovative care models and environments for aging. These owners and operators are eager to show off their facilities. I’m no Pollyanna, though. I have a mentally ill sister who for a time was institutionalized in a facility from the Victorian era—with remnants of Victorian-era care. My grandmother’s nursing home experience could only be described as grim. Friends and strangers alike, when they hear what I do for a living, are quick to share their own—often negative—experiences.

So when I do come across a positive story—and there are many—I’m eager to share it and promote the positive things being done by forward-thinking professionals. Last week, Loren Shook, president and CEO of Silverado Senior Living, gave me and other attendees of an executive workshop on the business of memory care a tour of his company’s San Juan Capistrano, Calif., facility for dementia care. Shook is a dynamic advocate for compassionate, person-centered care with innovative programs and service. He’s a savvy businessman, too, acknowledging that economic rewards follow from quality service.

Silverado promotes some great programs, like pet therapy (dogs and cats have the run of the place); intergenerational activities (there’s a cheerful playground on site); and free meals for visitors. Snacks and beverages are placed on tables throughout the facility to encourage frequent nibbling and hydration. Lighting is soft and warm—to ease the aged eye. Beautiful wood “memory boxes” front each resident’s room, filled with photos and mementos to spark memories and remind caregivers and visitors of the very real person that lives there.

Teddy bears and baby dolls are forbidden in residents’ rooms, says Shook, unless the resident had been an adult collector prior to moving into the community. He finds the practice infantilizing. Instead, a photo collage of the resident’s life is mounted on the wall over each resident’s bed, to again remind caregivers and residents alike of their identities. Shook says this practice also serves as a precautionary measure; overstressed caregivers engaged in the very tough work of caring for the memory impaired will be less likely to inflict harm on a resident when given a visual cue of their humanity.

Doors throughout the facility remain unlocked—again, to facilitate resident freedom and choice. It’s a practice that demands more mindfulness on the part of caregivers. “We take risks that many in this industry are unwilling to do,” says Shook. “And, if you engage people in activities they won’t typically wander.”

A fashionable, fiftyish woman who works as a “family ambassador” at Silverado accompanied our group. She spoke highly of the programs and services available and greeted each resident we passed by name. I figured she was an occasional volunteer looking to do good in the community. Then, about halfway through the tour, we passed through an activity room where a group of residents with advanced dementia were being engaged by therapists. “That’s my husband,” the volunteer noted matter-of-factly, nodding in his direction. I turned to see a handsome, sturdily-built man with dark hair slumped in his chair, eyes dull and disengaged.

The woman went on to tell me that her husband, formerly a successful realtor, had been diagnosed with Alzheimer's at age 51, six years ago. She cared for him alone as long as possible before bringing him to Silverado, where she visits him daily. As if that weren’t a heartbreaking enough story of love and devotion, I later found out that this woman’s mother had been brought to live at the very same facility after her husband had moved in—and she later died there. Considering the burdens this woman has borne, I was moved by her commitment to share her experiences and advice with other families just beginning the often long and painful path of dealing with a loved one’s dementia.

With 91 people on its wait list, the word has spread that Silverado San Juan Capistrano is doing some very good things in its community. And, as its proponents maintain, getting Alzheimer’s disease doesn’t have to be the end of living—for residents or their loved ones.