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If you have personal experience with Horses and the evolving field of Equine-Assisted Learning (EAL), you are aware of a powerful truism: animals, nature and the non-verbal skills they represent breed an accelerated path toward gaining confidence, patience & knowledge in caregiving.

When our education is tied to verbal language (as it nearly always is), our potential to share and absorb information is limited.  Having completed the Master’s Program of the Erickson School’s Management of Aging Services, I can attest to the intellectual and experiential capacities of Dean Judah Ronch and his Faculty, but even the best of academia would agree that the pinnacle of teaching – when hearts and minds are transformed by information sharing – can’t be planned for – sometimes it happens in spite of our best efforts. Interestingly, it did happen recently at the 3rd Annual Memory Care Summit and can be relayed best by highlighting the book ends of an experience that was shared by all at the South Seas Island Resort in Captiva, FL. We may have traveled to a Summit  titled, “Breaking Away from the Pack,” but the outcome of our time together triggered an alternative thought – What would it mean for our Senior Living Industry if we became a Herd instead of a Pack?

Power Outage – the First Book End

If it is true that “words matter”, then Blind Pass on Captiva Island is living up to its name. Over 700 vacationers and residents were without power for almost 12 hours after an alleged intoxicated driver struck a utility pole on Captiva Drive. The South Seas Island Resort was darkened and without power until 7AM on Tuesday – an hour before the Conference was to begin.  It’s pretty common to get a Maslow reference at a conference event no matter what industry is represented. The “hierarchy of needs” is timeless for obvious reasons – and the survival state that a power outage conjures reminds us that our collective consciousness shifts 180 degrees when our environment dramatically changes.


As I settled in with my morning coffee, I began the Conference ritual of scanning the room for friends and colleagues as they meandered into to the lobby. When I heard attendee Bob Oriol (CEO of Oriol Healthcare) say something to his neighbor about “self-awareness”, a calm fell over me. I accepted that this might not be a typical “business” conference with empty keywords or hashtags.  Bob caught my attention again mid-morning when he asked an important question: “How do we (or should we) differentiate between Dementia problems vs. Thinking problems?” The answer to this admittedly quasi-rhetorical question is much less important than the spirit of the inquiry. If there was a single theme that was about to emerge from the Conference, it was simply that we all need reserves of patience and education in order to prevent and treat what we might want to call a memory spectrum. While the 10 Early Signs and Symptoms of Alzheimer’s provide important cues for a diagnosis, there is a silver-ling on the preventative side of the equation – Active Aging and the dimensions of wellness that it proffers hold the key(s) to better health for old and young alike irrespective of a clinical code or label.

In a healthcare system that has been dominated historically by “specialization”, we are reminded that a disease like Alzheimer’s is becoming so pervasive that it will require us to work together not only across multiple disciplines but also more deeply – at a universal (human) level. It is easy to be complacent about some of the other top ten leading causes of death either because we feel more empowered to prevent them or because the emotional impact of the symptoms and caregiving requirements are perceived as having a different scale and quality. According to the Alzheimer’s Association, friends and family of people with Alzheimer’s and other dementias provided an estimated 17.9 billion hours of unpaid care in 2014 and an estimated 5.3 million Americans of all ages have Alzheimer’s disease as of 2015.

When John Erickson, industry pioneer and founder of the Erickson Companies, took the podium for introductory remarks, I was further comforted to hear him proclaim that “aging-in-place” is not a good solution for what ails us. This is of course the challenge that we have charged ourselves with. On the one-hand, we know that we are building properties (need-driven) having limited lifestyle appeal (whether they have memory programs or not) and on the other hand we recognize that the home and community-based setting is poorly suited for aging services “in-place”.

Memory Care Landscape

As CEO of the National Investment Center, Bob Kramer is in a unique position for sharing data metrics as well as his anecdotal personal insights in witnessing the evolution of the Seniors Housing & Care Industry – and notably its cycles surrounding arguably “payer driven” products and services. After sharing some of the emerging trends pertinent to Memory Care as a property-type, Bob stepped away from the NICMAP data to offer his personal observations and to suggest there are three general provider characteristics differentiating new entrants to the emerging Memory Care sector.

  1. New Business Opportunities – entrants principally driven by recognition of the market demand absent specialized programming (the “danger zone”);
  2. Comfort/Safety/Cleanliness – entrants equally alert to the market opportunity and promoting basic services yet absent specialized care capabilities (the “comfort zone”)  –  and
  3. Ongoing Intense Commitment – entrants representing the genuine attributes of customized quality care, progressive program development and customized environments (the “real deal”).

If there was a single soundbite to use as an umbrella takeaway for the 2016 Summit it would be to charge ahead as group three by focusing on

  1. Education and Training of Staff;
  2. Attention to the Physical Environment;
  3. Investment in Changing Ideas/Culture, and
  4. Engaging residents, families and caregivers in a personal way.

Interestingly, when Ryan Novaczyk and Bill Holman shared their own provider experiences with entering the Memory Care market (representing New Perspective Senior Living and Sagepoint Senior Living, respectively) both relayed how the four point process referenced above has expanded beyond the walls of their planned neighborhoods. In summary, the attributes of great care are universal to all populations.  Both Ryan and Bill represent genuine passion driven providers to learn from and to be emulated – the “real-deal”.

Living with ALZ – the Second Book End

Linda MacCallum and her boyfriend Paul Larson joined Dr. Peter Rabins as guests for our final session.  Linda had suffered multiple concussions throughout her life and began to experience severe memory loss in her late forties.  She was subsequently diagnosed with early onset Alzheimer’s Disease before she was fifty years old. As we listened to her heart wrenching story and she relayed her experiences and emotions, the air became magnetic. After three days of sitting in a confined venue with over fifty other heads, the feeling of a single heart emerged. As I listened to Linda and Paul, my mind’s eye traveled back to comments and questions that I might have made in prior sessions: they all seemed so inconsequential when juxtaposed with her real life story. The survival state that our power outage had conjured may have passed quickly but the human narrative that Linda shared reminded us why were on the island to begin with. I wondered how we would prioritize our daily actions if the spell of these moments lingered. More importantly, what did Linda relay that is actionable for each of us? She needs to have patience, purpose and peace of mind so that she is not a burden to family and friends. She does not want to be reminded of her symptoms and she increasingly wants decisions to be made for her. Perhaps most dramatically, she views the products we provide as being worse than a death sentence.  We need products and solutions that are valued and embraced by individuals like Linda – rather than feared.

Pack vs Herd

Hearing Linda’s emotional story reinforced thinking about why we are in the business we are in and who we really serve.  It ignited the key points presented by Scott Townsley (Industry Professional and Faculty Member) surrounding new Business Models and strategic business directions.  It is clearly a new day for the Senior Living Industry where the traditional product and services approach is being dramatically redefined and redirected by a changing landscape – where who we serve rather than who pays for it drives such change.  We are now well engulfed in the era of the operator who defines our future while the payer influences become subordinate to recognizing and rewarding success.  As we confront these new directions, the “real-deal” providers alert to new ideas, innovation and progressive business development will prevail.  Only by avoiding the “danger zone” and reaching beyond the “comfort zone” will we collectively attain the genuine branding of quality services and compassionate care we strive for.  In coming together, collaboration must displace competition among the “real-deal” constituents to our world.

If collaboration is the driver for marshaling and managing our change landscape, then new technologies and innovation are undoubtedly the fuel sources to fire the engine.  Breaking away from the Pack breeds isolation while cultivating like-minded Herds fosters collaboration and expectedly acceleration.

The most obvious literal distinction between Pack and Herd dynamics is understood by emphasizing the non-predatory and cooperative nature of grazing animals. Of course, the simple contrast of hunting and grazing should be enough to complete the metaphor! When you consider the depth of expertise represented by a Conference like this and couple it with the prescriptive nature of the clear take-away, it becomes evident that we need better distribution channels for knowledge. Summits like this and programs offered by the Erickson School provide an important next step.