This article is sponsored by Griffin Living. In this Voices interview, Senior Housing News sits down with Griffin Living CEO and president Paul Griffin III to learn how he sees memory care offerings changing in the coming years. Paul will be one of the keynote speakers at Senior Housing News’ BRAIN conference in July. (Here is our previous Voices discussion, October 2021.)
Senior Housing News: Paul, many senior living communities contain memory care in addition to assisted living, do you expect the ratio of units to change? If so, how much will they change and give us a timeline, please?
Paul Griffin III: For communities that offer both assisted living and memory care options, memory care product offerings typically run roughly a third of the size of the total product. That means that for a 100-unit assisted living building, about 30 of the units would be memory care. That ratio seems to be optimal because the intense caregiving nature of the memory care group makes it difficult to stretch staff and other resources much beyond this.
People in memory care wings need a bit more quiet space than the assisted living residents – too much noise or other stimuli can overwhelm them and exacerbate their symptoms. So we build the memory care units a bit smaller with spaces a bit further apart from each other. You can get smaller groups of residents together and have enough care staff for the smaller breakout groups within the independent units.
From the developer’s perspective, it would be more efficient for us to make our memory care wings larger and the economies of scale better. But at this point, that doesn’t look possible. If we did need to add more memory care units because of market demand, we would create more memory care wings of about the same size, 30 units each with the attached common areas.
Griffin Living includes an indoor-outdoor concept in all its buildings. How does this architectural approach translate into memory care?
Griffin: At Griffin Living, we think a lot about how to create light and a feeling of expansiveness inside the interior of our buildings, bringing the outside world to our residents in both our memory care and assisted living spaces.
It’s important for us to walk in through the front doors, or through our family room areas or our dining room areas, and have a lot of natural glass glazing and light coming in. We also want fresh air in these spaces, which we accomplish through the air conditioning systems with constant fresh air exchanges and high filtration. All of this gives residents the feeling that they’re living outdoors when they’re actually indoors.
How does that indoor-outdoor model help address the care needs that are unique to memory care?
For our memory care residents, the indoor/outdoor model is especially beneficial because they’re less likely to wander outdoors, which can be a safety hazard.
Memory care residents can also get lost inside the building, so we design our memory care wings with the interior hallway shaped like a large doughnut, if you will. That way the residents can never get stuck at the end of a hallway and feel like they don’t know where they are and don’t know how to get out.
During the course of walking in that circle, they would go by each of the residential units as well as the dining room and the activity spaces. They’ll also walk past large glazing areas looking into our interior courtyards with water features, fountains or bird aviaries — points of interest to look into to stop and keep their minds working.
We’re also experimenting with some of the hallway glazing areas providing views outside the building so that memory care residents can better see the world around them. This might help them feel like they haven’t completely left the world, although we have to weigh that against the possibility of them feeling overwhelmed.
We’re trying to use the architecture and technology to create a better lifestyle for all of our residents. The industry does a better job of this in assisted living, where the needs are more similar to what the designers, builders and adult caretaker families can understand from their own experience. The discussion about how to leverage architectural design and technology for memory care residents, with their unique needs, is happening now in the industry.
Griffin Living uses a transitional care model for residents who move into assisted living, and whose needs require increasing care until they move to memory care. How does that work?
Griffin: As we age, in addition to our physical infirmities, many of us develop mild cognitive impairment. Most of these issues will never be acute enough where we need to live in a memory care wing to prevent us hurting ourselves or wandering away.
Yet even when it’s mild, cognitive impairment understandably creates some emotional problems for our residents. They get a little bit unsure of where they are, or what they’re doing, which can be unsettling. What we found is that our caregivers can spend a little bit more time with each of the residents in transitional care, and redirect and remind them of where they are, what they’re doing and that everything is okay and that they’re happy.
Sometimes residents just need more activities to engage the brain, which is a lot of what we offer in transitional care. We found that that’s been well accepted by the families of our residents because they don’t want to feel like they’re putting their loved one into a memory care wing when they’re not sure they really need it — even when they know they need something. Caregivers can spot it when residents become withdrawn, coming to fewer social events like meals or game nights because they can’t quite keep up with the conversation.
A typical transitional care resident is not just somebody who has a wheelchair or walker. Their forgetfulness is becoming an issue. We hope our solution can provide the right amount of support while maintaining as much independence as possible.
What are the top three challenges on the horizon for memory care developers and operators over the next year to 18 months, and how is Griffin planning to address them?
Griffin: The biggest challenge right now is the issue of cost. As we’re working with families going through this major transition to senior living, it is already a very expensive proposition and a large commitment on a family’s part. Think about it a little bit like college tuition. The industry is addressing costs everywhere we can, but the buildings are expensive, the architecture is expensive, the caregiving, the food service, the activities — they’re all expensive.
Now that we’re in an inflationary cycle, our wages are being driven up, which is a good thing for wage-earners. There are more jobs and more opportunities, and they’re being paid more, and they should be paid more. That supply and demand is appropriate. But it makes the labor-intensive work required in a memory care setting very expensive.
I’m sure my colleagues in the industry would agree that over the coming 12 to 36 months, or whatever this inflationary cycle is, it’s going to be really difficult for us to manage our business in positive operating margins as we have to pay what it costs to have caregiving and the residents are only able to pay what they can afford.
What big trends do you predict are coming in memory care over the next 12 or 18 months?
Griffin: The broad strokes are fairly clear: demand will remain strong because memory care is a needs-based business. Memory care wings will remain the same size, or get smaller, to accommodate the right caregiver-to-resident ratios. More senior living providers will introduce transitional care models.
One thing that we’re not talking about as much yet is data collection and privacy around tech innovations in memory care. If, for example, a movement tracker can detect early signs of memory issues by measuring your steps and paths around your apartment, at what point do we intervene and offer care? How do we ensure there’s enough transparency around how data is collected and used? We’re going to see tech bring a lot of improvements to memory care — and some real challenges as well.
Finish this sentence: “The senior housing industry in 2022 will be the year of…”?
Griffin: Focused operations. 2022 will be a very difficult time for senior living operators to navigate, ourselves included. We will have to find new ways to provide the quality our residents and their families expect — the quality that we would want for our own family members — while they want to pay less and we have higher costs. That will require experience and focus to deliver.
Editor’s note: This interview has been edited for length and clarity.
Griffin Living collaborates with both community leaders and capital partners in a diverse portfolio of properties. To learn more, visit griffinliving.com, and be sure to come to BRAIN in Chicago on July 21 to hear Paul Griffin speak further about the changing state of memory care.
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact firstname.lastname@example.org.
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