Too many senior living communities still choose “efficiency” over “effectiveness”.

By Susan Saldibar

Shane Malecha made an unnerving realization while interviewing senior living communities for his father: Too many still choose “efficiency” over “effectiveness”.

After Shane’s father was diagnosed with dementia, the family began to plan for the day when he would need professional help in a senior care community. As he began evaluating local assisted living communities, he noticed two broad assumptions that seemed to prevail across them:

  1. Dismissal of a resident’s rapid decline as “inevitable”. Of course we know that cognitive decline will continue with dementia. But the attitude displayed was that of basically closing the door on anything, outside of their standard programs, that might help slow the progression. Efficiency prevails. And, because of that, they were not especially open to Shane’s own input about his father. And Shane happens to be well versed in therapy. In addition to being a certified physical therapist (with a doctorate in PT), he is Clinical Specialist at Aegis Therapies (a Senior Housing Forum partner).

  2. Cookie cutter exercises, activities and therapy will help everyone. A “one size fits all” approach is easier to implement and, as a result, more efficient. The only problem is that, what works for one person may not be as effective for another. As Shane puts it, “So you have residents doing activities and interventions they may not benefit from or they may not understand because of the way they process verbal instruction.”

I asked Shane why he thinks old assumptions continue to drive communities to choose “efficiency” over “effectiveness”, especially given the trend towards more resident-centered care. “When it comes to cognitive care, providers tend to stay in their comfort zones,” Shane told me. “The attitude is, ‘We know how to deal with it and we have a program that is well established. However, when I observed the program only ¼ or ½ of the residents are actually participating.”

Sometimes the family really does know best.

So, given his less than satisfactory experiences, Shane and his family decided to do the work of the community themselves. They used an application called “My Way,” which essentially allows you to build a profile of an individual that is based on their current lifestyle. (This, by the way, is a tool that is used at Aegis Therapies to create profiles of residents in advance of designing individual therapy programs.) Using the resource, they were able to create their own detailed profile of what their dad likes to do and how he prefers doing it.

He didn’t stop there. Shane continued to conduct his own research on behalf of his dad, he began to compile his own list of things that those with declining cognition can do to help stay as healthy, as long as possible. A few of them really stand out for senior care communities:

  1. Incorporate the individual’s health, work and emotional history into daily therapy.

  2. Use the ACL Cognitive Scale to regularly assess cognitive abilities.

  3. Make sure the residents’ diets are infused with foods, such as raw fruit, vegetable juices, and vitamin K-rich foods, that are known to naturally help slow cognitive decline.

Are senior living communities missing a huge opportunity here?

Shane’s dilemma poses a challenge and an opportunity for senior living communities.

Imagine turning back the clock on Shane’s experience. Imagine if a local memory care community had reached out to Shane and his father and offered to help them with the process of recording his dad’s desired activities, interests and way of doing things? How would they do that? Imagine they had a professional therapy partner, like Aegis, to take the input from the resident and family and tailor therapy to meet their specific physical and emotional touchpoints? They might even have had Shane bring his dad to the community to personally show them how they would tailor a program to meet his needs.

Then, when the time came to decide upon a local memory care community, who do you think Shane would have contacted first? Would it be your community? Something to think about.

There is no “one size fits all” at Aegis Therapies. Aegis builds out their therapy programs based on the individual’s needs and wants, along with extensive input from residents and their families. 

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