Designing a quality memory care program for people living with dementia is more than an activity calendar and a locked hallway, according to speakers during Wednesday’s Pioneer Network virtual symposium, “Envisioning the Future: Dementia Care 2021 and Beyond.”

Implementing a holistic quality framework is the key to creating a person-centered program, they said.

Approximately 42% of assisted living residents have dementia, according to the Centers for Disease Control and Prevention’s National Center for Health Statistics. And according to the National Center for Assisted Living, 14.3% of assisted living communities have a designated dementia care unit, wing or floor, and only 8.7% of assisted living communities are stand-alone properties that solely cater to serving adults with dementia. 

Julie Holt Klinger, senior director of dementia care for Brookdale Senior Living, said a general consensus exists that person-centered practices are the gold standard for dementia care. But because regulations in assisted living vary by state, where providers primarily are regulated, it often falls on providers to create a culture of accountability around executing those standards, she said.

“It’s up to you to make sure you’re doing this the right way,” Holt Klinger said, adding that one of the benefits of having a segregated memory care unit is that it offers the opportunity to truly specialize in that setting. “It gives you the opportunity to focus in on this special population you are serving,” she said.

The gold standard, Holt Klinger added, is having more than a schedule, more than an activity calendar and more than a locked hallway. Knowing the person, she said, is critical to the provision of care and programming.

Doug Pace, director of mission partnerships for the Alzheimer’s Association, agreed.

“Having that lens of knowing the person we are taking care of is really important,” Pace said. “It’s best to put the person before the task and to use every interaction as an opportunity for engagement.”

Holt Klinger advocated for encouraging self-determination and control as well as offering individualized programming based on a person and his or her interests. Move away from large one-size-fits-all groups to smaller, more focused groups based on mutual interests, talents and skills, she advised. 

“Best practices have to move beyond gathering that life story,” Holt Klinger said. “You have to move beyond that to a robust integration into the plan of care and into a plan for engagement for that person.”

A person-centered focus, Pace said, includes a team-based approach to assessment and care planning, medical management, information, education and support. The Alzheimer’s Association put out its Dementia Care Practice Recommendations, which focus on evidence-based practices for long-term care settings. The 56 recommendations were developed to better define quality care across all settings and throughout the course of the disease. 

Achieving quality improvement, he added, can be accomplished by developing a plan, creating short- and long-term goals, including staff members in the process, taking small steps, asking for help, building support and recognizing and celebrating accomplishments.

“It’s a long journey,” Holt Klinger said. “If you’re going to set out and embark on providing memory care, it’s really important to remember it’s not just about the sexy work of creating curriculums and fun programs, it is important to work on policies, procedures and accountability structures as well.”