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October 2017 — Health Care Properties Quarterly — Page 19
Senior Housing & Care
Colorado’s Leader in Senior Living Quality and Innovation
Recognized expertise in memory care, rehabilitation services,
and tailored approaches to hospitality, optimal health and
wellness, and select high quality housing options.
12136 W. Bayaud Ave. #200 Lakewood, CO 80228 303.238.3838
VIVAGE SENIOR LIVING
Full Management Services • Consulting Partner • New
Development & Design Collaboration • Market Positioning
We create models that reflect exciting
lifestyle choices for today’s seniors.
W hat are the guiding prin-
ciples of managing a
successful program for
individuals with memory
loss? An individual with
dementia always is a unique adult
with unique life experiences. As
each experiences steps and pla-
teaus through the memory loss
progression, they are best served by
environments that access individual
interests and abilities, that draw on
the skills and talents of staff, vol-
unteers and involved families. This
focus can create a safe, adaptable
and structured environment full of
good physical and emotional care.
This is possible! Here are four key
factors to start with.
Q Key Factor 1: Avoid “secure unit
isolation syndrome.”While memory
care clients may need to reside in
a secure unit, resist the tendency
to separate this area in every way.
Rather, make deliberate efforts to
connect the residents to the outside
world and the staff to the rest of the
organization.
Memory care units need volun-
teers and friendly visitors through-
out the year, not just during the
holidays. Make the unit a prior-
ity for budgeting entertainers and
therapists, especially art and music
providers. Create a welcoming feel-
ing for volunteers and interns, with
a short, straightforward training on
how to interact, what to expect and
ways to connect to reduce the fear
and stress of being in this special
area; then, don’t abandon them as
they ease into contributing.
Residents on the unit, when able,
want to make contributions, volun-
teer and be part
of the wider com-
munity. Consider
walking programs
in which residents
accompanied by
staff go out from
the unit into the
rest of the build-
ing or campus.
While behavior is
socially accept-
able, allow memory
care residents to
attend the wider
building events, or
allow their families
to bring them to the dining areas
or other parts of the campus. Allow
supervised flow and movement to
help overcome the perceived barrier
of the secure doors and help prevent
“secure unit isolation syndrome.”
Q Key Factor 2: Secure units are not
“out of sight, out of mind.” Secure
units sometimes become dumping
grounds for underperforming staff
and for difficult residents, whose
emotional or physical needs exceed
the criteria. Do not assign to memo-
ry care a staff member who has poor
emotional intelligence, lacks con-
fidence and problem-solving skills
or has questionable accountability
or integrity. Rather, memory care
units need your best staff, with the
greatest savvy, imagination, humor,
warmth, flexibility and compassion.
Memory care staff need each other,
a sense of team, and input from
management to feel successful and
to understand that what they are
providing is highly needed and spe-
cialized. Nursing leadership, market-
ing staff and administrators need
a strong presence, need to know
people by name and need to take
time to listen to the stories of what
is going on in the space. These inter-
actions help reduce stress, increase
retention and help staff feel they are
part of the company and mission.
Q Key Factor 3: It’s relentlessly
about the details. Operating memory
care requires excellence in detail
management. These residents can
no longer navigate many aspects
of their daily lives. Their behaviors
may make it more challenging,
such as dismantling or hiding their
belongings, or rummaging in other
residents’ rooms. The manager and
staff in this space must be the type
of people who care doggedly about
the details. For instance, where is
Mr. Smith’s lost set of teeth? Why
is Miss Ellen not drinking at meals?
Who is banging on the doors at
night and how can we redirect that?
Managing the details requires that
communication increase among all
parties – with families, with staff
and with departments that work in
this area of the building. Informal
communication needs to be as reli-
able as formal channels of commu-
nication. When you keep addressing
the little stuff and immediately work
to make it right, it helps prevent the
bigger issues. Families who are pay-
ing top dollar for their loved one to
live in memory care have concern
whether the staff will take care of
their vulnerable elder; they will not
appreciate any of these details being
ignored. This is a relentless issue in
memory care.
Q Key Factor 4: Memory care often
takes longer to fill. Intensive devel-
opment has changed the landscape
of memory care, with more facilities,
increased competition and differen-
tiation developed on facilities’ repu-
tation for care. It is no longer real-
istic to expect a new memory care
unit to fill within six or 12 months;
this may actually require 18 to 24
months.
Families have options that help
keep someone home longer, for lon-
ger periods of time, such as adult
day care, home care services and
better education of caregivers. This
can lead to new residents who are
farther along in their progression,
which heightens their care needs,
makes it more difficult for them to
integrate and ultimately results in
their stays being shorter.
By allowing a slower rent-up of a
new memory care facility, you avoid
creating defeat from the starting
gate. You allow residents to move in
and integrate more fully with staff
and each other. Programming devel-
ops based on who lives in the space,
and staff can get more seasoned and
build a culture in a more systematic,
calm way. Families will feel this and
make decisions to move in. In turn,
word-of-mouth will spread about the
building’s competencies and your
capacity to care for residents, mov-
ing the census in the right direction
without desperation.
Memory care can feel light, warm
and special, or can feel really
depressing, dark and alienating. Use
these key factors to assess your pro-
grams and operations to help move
them in the right direction.▲
Megan Carnarius
RN, NHA
Principal, Memory
Care Consulting
LLC, Boulder