“Luxury Senior Living” often misses the mark in memory care. Here’s why.

By Evan Shelton, PhD
Center for Applied Research in Dementia
April 2024

Imagine you’re embarking on a long-anticipated vacation. Maybe you’ve been looking forward to this vacation for months or even years! After getting the travel out of the way, the first day feels like paradise. The amenities, the food, the pool! THIS is the life! Right?

Yes! Well…for a short while, anyway. Let’s be honest—after a week or two of pampered luxury, most of us begin to miss the comfort and sense of belonging of home. By day 14, you might find yourself saying “this has been lovely, but I’m ready to go home now.” Have you ever heard a person with dementia living in memory care say those exact words?

We often idealize vacations in our minds. We think of these trips as wonderful opportunities to relax and disconnect from our responsibilities. So, when it comes time to think about senior living options, it makes sense to look for a “resort-style” community that emphasizes a high-end guest experience. After all, when we are no longer able to live alone, what could be better than a community offering gourmet dishes at every meal, care staff that wait on residents hand-and-foot, and where guests are no longer burdened with the responsibilities of the day-to-day tasks?

Our Environment Shapes Our Reality

At the end of your long vacation, what is it about home that you miss? It probably isn’t just the physical space, or even your own belongings. Home is where we have responsibilities. It’s where we have a purpose, roles to play, and opportunities to stay engaged. Home is where we have control over our space, where we are part of a community, and where we make decisions for ourselves. These are the aspects of home that help us meet our essential human needs for purpose, socialization, independence, and more.

Persons living with dementia have these same needs!

So, how does the senior living industry help persons living with dementia meet these needs? We must think beyond the amenities of the community and think also about the psychological and social impact of the environment on a person. Let’s consider three key areas that can help a person feel at home in senior living: independence, purposeful activity, and socialization.

Independence Matters

Among the most important needs for persons with dementia is the need to remain independent and maintain autonomy. However, in a community where everything is done for and to a person, that person will become increasingly dependent on others. This leads not only to functional decline (“If you don’t use it, you lose it,” as they say), but it also degrades the spirit. We derive a sense of satisfaction and pride from our accomplishments and the decisions we make independently. In the words of Dr. Maria Montessori, “Everything you do for me, you take away from me.”

Instead, successful senior living communities should take the time to discover a person’s remaining strengths and think critically about how these strengths can be used in the delivery of care. For example, if a person can mimic an action, perhaps we can enable them to brush their teeth independently by miming each step of the process. This might seem insignificant but imagine having someone else brush your teeth for you every day. The ability to accomplish personal care tasks as independently as possible means living with more dignity.

Purposeful Activity

Most senior living organizations tout a full activity calendar with ample opportunities for residents to participate, and it’s no surprise—staying engaged in meaningful activities is critical to living well! In fact, everything we do from the moment we wake up to the moment we go to bed at night is “activity.” Let’s think back to the luxury model. At an all-inclusive resort or on a cruise ship, activities are primarily designed to do one thing; entertain.

There is nothing wrong with entertainment! Everyone loves to be entertained for a while. However, if entertainment is the ONLY form of activity, a person is bound to miss activities with purpose. Purposeful activities can be big (e.g., decorating the community for the holidays, collecting donations for the local food bank, teaching children from the local school how to hang their coats on a hanger), or they can be small (e.g., watering the plants, reading the morning announcements, wiping off tables after mealtime, delivering the newspaper to other residents). These types of activities offer a sense of meaning, accomplishment, and self-efficacy. Of course, not everyone will be interested in (or able to complete) every role. This is why—once again—it is important to know the person. Once we know a person’s interests and remaining abilities, we can invite them to participate in activities that are purposeful to them.

Socialization

Imagine moving into a memory care community. On move-in day, you’re greeted by a friendly staff member who tells you about the beautiful patio, the farm-to-table dining experience, and the marble floors. Your belongings are moved to your new room, and your family spends a few hours with you before leaving. Lunch time is approaching, so you leave your room and find the dining room. Some residents are already seated and getting ready to eat. You find a seat, but before you can sit down, someone says “Hey, that’s where Bill sits!”

Now let’s imagine another scenario. On move-in day, you are greeted by a staff member and three residents who say they are part of the welcoming committee. They are all wearing name tags, and they offer you a name tag as well. “The welcoming committee put together a care package for you,” they say. “We put things in there that we thought you might need, like stamps and envelopes, a tv guide, tissues, and some cookies that we made in baking club.” They tell you that everyone is friendly here and that they are here to help if you need anything. “By the way,” they say, “we’ll save you a seat in the dining room. Just look for the table with the green balloon!”

Every human needs a social network. For most of us, “home” doesn’t exist in isolation. Rather, home is embedded in a community. We have ongoing relationships with others who live with us, our neighbors, and other members of the community. We utilize community resources (e.g., library, bank, post office), go to restaurants, local events, and so much more. These aspects of our social network help to keep us engaged, stave off loneliness, and stay connected to the outside world. In a luxury model of senior living, amenities, entertainment, and service can mask the reality of a poor social environment. The “everything-you-need-is-right-here” resort-style approach to senior living can further isolate residents from the broader community.

“We must help the [person] act, think, and will for himself. This is the art of serving the spirit” -Dr. Maria Montessori

Memory Care Quality Checklist

If you’d like help determining whether a community truly enables residents to live purposefully, download our free checklist.

The checklist can be used by families who are helping their loved one choose a community as they go on tours. Professionals can also use this list to gauge successes and opportunities for improvement in their memory care communities. Contact us at info@cen4ard.com to find out how our trainers can help your community embrace these person-centered practices.