Silverado and Symphony Senior Living CEOs Envision a New Era of Memory Care


New memory care treatments and diagnostic tools. Promising technology. More resident-centric programming and operations.

These and other advances have propelled memory care into a new era, with executives from two senior living companies, Silverado and Symphony Senior Living, leading the charge in the next evolution of the industry.

The Memory care product type has been hit hard by Covid-19, and industry operators have faced heartbreaking challenges during the darkest days of the pandemic. Although the sector is now on the mend after one of the toughest times in its history, there is a feeling that operators in the industry need to rethink their operations for a new generation of residents.

As he surveys the retirement home landscape, Silverado CEO Loren Shook sees many exciting advancements on the horizon. And foresee a day in the not-too-distant future when industry operators can use these and other tools to dramatically improve resident outcomes.

“We have some tools coming that are really exciting and will help us,” Shook said at the inaugural Senior Housing News BRAIN event in Chicago. “If you’re in independent living or assisted living, and you can tell someone they have pre-dementia, and you can stop that, that’s pretty cool.”

Hard-earned experience

The Covid-19 pandemic has ushered in a new era for memory care operators, in good and bad ways.

For one thing, industry operators may have more staffing, infection control, and scheduling challenges than ever before. On the other hand, these challenges have given some operators a chance to refine their practices and elevate their services.

For Symphony Senior Living, the pandemic created operational chaos early on. Like some other operators, the company quickly “grown” its four memory care communities in Canada, effectively isolating them from the outside world.

At BRAIN, CEO Lisa Brush recalled some of the early challenges of the pandemic, including having a community where three-quarters of workers quit in the same week. Around this time, the company also parted ways with an in-house doctor who kept making in-person visits, despite the need for physical distancing.

But Symphony has emerged from its toughest days during the pandemic with stronger practices as a result and validation that the company can overcome adversity.

“We achieved…everything we know as good memory care providers – guess what? They work, they really work,” Brush said.

Lisa Brush, CEO of Symphony/Blue Lotus Senior Living; photo by Robotoaster for Aging Media Network

Shook said Silverado and the company’s nearly 30 communities faced similar challenges during this time, resulting in new practices for the future.

For example, during the pandemic, the company began to have medical technicians deliver medicine to residents, not nurses as it had done before. Silverado also began managing some functions in its headquarters, shrinking from about 30 business leaders to just three.

“And the result has been a huge improvement in cash flow, collections and family satisfaction,” Shook said.

But like Brush, Shook said the biggest payoff from these challenges was the resilience of the company’s staff.

“If you’ve ever needed a refresher on the heroes you’ve worked with, it was Covid,” he added. “We actually came out a bit stronger.”

New era of memory care

With some of the challenges of the Covid-19 pandemic still close at hand – expenses and personnel to name two big ones – the leaders of both operators see a real need to stay nimble and innovate for the future. And in that regard, the leaders of both companies also see many potential avenues for innovation and disruption to come.

One such avenue is Aducanumab, sold under the brand name Aduhelm. As the treatment for Alzheimer’s disease was approved by the FDA in a controversial move last year, Shook believes it’s an important step in advancing treatment options for residents living with different cognitive challenges.

But he also believes that “the real exciting thing isn’t in the drugs,” but rather in the industry-leading diagnostic tools. For example, Shook said a lot of research was being done to detect and diagnose Alzheimer’s disease and other forms of dementia earlier than today.

“There’s a researcher who’s pretty sure he can tell a pre-symptom if someone has dementia with a test,” Shook said.

Silverado CEO Loren Shook; photo by Robotoaster for Aging Media Network

He added that while much of this research is still under investigation, any effective way to diagnose dementia before an older person shows symptoms would be a “game changer”.

Silverado uses a program called Nexus, which aims to support the brain health of people living with the early stages of dementia. Shook said the program is documented by the University of California, San Diego (UCSD) and he added that there is evidence it can slow the progression of dementia and improve cognition.

Typically, this is treatment initiated when a resident first shows signs of dementia. But with a better diagnostic tool, memory care operators could more effectively mitigate the effects of the disease.

“If you know the pre-symptom that someone has dementia — Alzheimer’s disease, for example — there are things you can do to slow the progression,” Shook said.

He also sees a bigger role for technology in the new era of memory care. Shook noted that artificial intelligence could help detect patterns in gait, eye movement and speech that could detect dementia earlier.

“If you are in trouble of memory [community]and you can, by improving cognition…slow progression, increase quality of life – ADLs are even better than cognition scores – it’s a new day,” he said.

And Shook is heartened that there are also plenty of ways to manage residents without relying on prescription drugs. For example, he said small doses of cannabis edibles can help calm restless memory-care residents.

“For someone who has…a little problem in the afternoon, it’s amazing what a gummy bear will do,” he said.

Brush echoed many of those sentiments and added that any help in detecting dementia earlier and slowing its progression would be a big win for the industry.

“The sooner you can find out, the sooner we’ll have information, so people can make their own decisions,” she said.

Brush also sees a future where these and other advances in memory care can play a role in managing residents in other care settings, such as independent living or assisted living, and helping them to aging in place instead of moving immediately to a memory care facility.

“So I think there will be more interesting environments, not necessarily prettier buildings,” she said.

While Shook doesn’t think any particular treatment or practice will be a magic bullet for memory care issues, he’s excited about all the different advancements that are on the horizon.

“It will be the programming, the commitments and the stimulation in a brain-healthy environment that will make the difference,” Shook said.

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