New Possibilities in Memory Care: The Silverado Story

Please enjoy this preview of the first chapter of "New Possibilities in Memory Care: The Silverado Story."

More than twenty years ago Loren Shook and Steve Winner combined their dreams of a better type of care and formed Silverado. Now, two decades later, their dream has become a reality and helps thousands of people living with memory impairment every day. Loren recently sat down to share his insight as a memory care visionary, discussing Silverado, the state of care and a range of related topics.

What was the impetus for starting Silverado?

The desire to create Silverado came from a number of experiences. One was my own experience searching for care for my dad many years ago. It was disappointing because the options were mediocre at best. I knew there was a better way, but at the time I did not have the resources to change that. Another was my experience growing up at my Uncle and Aunts psychiatric hospital where I saw what was considered state of the art memory care at the time. After I learned about the assisted living industry I felt compelled to do something about the memory impaired population, which I thought was misunderstood and not receiving the dignity, care and quality of life they deserved! As a child, my mother always told me that God had a purpose for me and that it was my job to find out what it was. I feel that my purpose is to serve those with memory impairment. People should have better services and quality of life than my father had!!! This drove me then and it drives me today.

I knew that with great people, passion and the courage to persevere through the obstacles, we could make a difference in the world. We felt that people with dementia should be cared for with dignity and respect. We knew that we could fulfill that need by, first and foremost, committing ourselves to enriching the human spirit. Today, 20 years after starting the company, I'm proud that our team has helped define for our industry what’s possible in memory care and make a difference.

How has the field changed since Silverado was launched?

Today we know more about what’s possible in memory care than ever before. For example, researchers now know that there are steps we can take today to help slow the progression of dementia and even delay its onset. Researchers and treating professional have much better resources to diagnose dementia than before. At Silverado, we are focused on implementing findings from this research, furthering our effort to enhance quality of life for people with dementia and their families. It is reassuring to see scientific evidence today supporting what Silverado programming was providing when we opened our first community in Escondido, California in June 1997. It is also energizing for all of us to add new components to our programming based on this information and actually measure results we are getting with our residents! Innovating memory care has always been at our core — from the programming we implemented when our very first community opened, to our new Nexus program for people in early to mid-stages of memory impairment today.

What are some of the biggest misconceptions people have about senior care?

One of the biggest misconceptions about senior care – particularly memory care — is that a dementia diagnosis is the end of a meaningful life filled with purpose. We have proven this myth to be just that, a myth, thousands of times over the past 20 years. One of the first things we do when a new resident moves into a Silverado community is to get to know them as an individual. This allows us to cater to their interests, and help them reconnect with their life’s passion. We have countless stories. From the former Spanish teacher who reconnects with teaching by leading a class for residents, to the artist who continues his craft and then hosts a public exhibit — our goal is to truly enhance quality of life for those affected by memory impairment.

You have a book coming out, how would you describe it?

The purpose of this book is to give hope to families affected by Alzheimer’s and other memory impairing conditions. It’s also to help educate the healthcare community about what’s possible in memory care and address some of the difficult problems that are often faced by people who are dealing with memory impairing disease. Families and professionals don’t know what they don’t know, but once they understand what CAN be done to serve people with dementia, they can demand better care within their own communities. This book includes a collection of resident stories — successes that have resulted from being in the Silverado environment, where a unique culture of acceptance and love exists— that exemplify what we have learned over the past 20 years and how families, and their loved one can benefit from that knowledge. The second edition further speaks to the stigma of the disease, broadening the discussion about how it affects children and families. It also addresses end of life matters.

Who is the book primarily for?

This book is for those looking for a place to turn when faced with the difficult emotional task of caring or finding care for a loved one with dementia. It’s for individuals who alongside us, would also like to see the world change the way it cares for and perceives people with cognitive decline — a world where we eliminate completely the stigma attached to memory impairing diseases. Silverado is a purpose driven company and our purpose is to change the world. This book is a tool to tell the story of what quality of life can be with a memory impairing disease. Someday there will be a cure for Alzheimer’s Disease and other memory impairing conditions, but until then we at Silverado are committed to partner with like-minded professionals and caregivers to make a difference in the lives of those people who have this affliction and their families. What we saw in the earlier days was a lack of understanding and appreciation for what someone with a memory impairment could do. People suffering from memory impairment never lose the desire to love and be loved just like you and me.

What are the main points you would like readers to come away with?

A family once shared with me that finding Silverado was like finding a lighthouse in a storm. That’s how I want people to feel after reading our story. I want them to feel hope — and to know that a dementia diagnosis is not the end. Another family member told me that, before finding Silverado, she tried to get another community to improve in how they were caring for her mother. When they were unwilling to change, she moved her mom to Silverado where she quickly became more alert and responsive! I want people to feel empowered with knowledge, and to know not to accept the status quo.

A high-level banker toured Silverado in Scottsdale and received a copy of the book. When flying back to the East Coast he started reading it and was moved to tears. Even though it was a Friday evening, he got off the plane and sat in the terminal to finish reading it. He then went into the office on Monday, insisted that each of his bankers read the book and shared with them that ‘this is the type of company we want to finance!’ A number of CEOs and senior leaders at assisted livings have read the book and then bought copies for their leaders, making it required reading and holding discussions on how to implement some of the ideas. Recently, at a national investor conference, a man stopped me in the hall to express his gratitude for the book and thank me for the Silverado model of care. He was about to open his 20th community in South America serving the memory impaired by copying what we do.

While researchers remain committed to finding a cure, we continue to provide individuals with the best quality of life possible by seeking and implementing new innovations in care and achieving an even better quality of life for both the person suffering from the disease and the their family. I hope that when families read our story, they feel empowered not only to seek the right help, but to take some of what we have learned and incorporate it into interactions with their own loved one. I hope that it serves to fan the flame of innovation in others who seek to join us in our quest to change the world in how the memory-impaired are treated.

How do you see elder care changing in the next decade?

For starters, we are in a growing industry. As baby boomers retire and the population ages, dementia is going to become one of the greatest challenges of our time. Too many people think of a bad experience they had as a child, visiting grandma in a scary, smelly nursing home of 35 years ago. As more and more people gain experience with good senior housing operators, they will begin to see the difference the right environment can make on an elderly persons quality of life. I want everyone to know that there is scientific evidence that social isolation of the person suffering from memory impairment actually exacerbates his or her cognitive decline. Add to that depression, malnutrition, lack of stimulation, and it gets even worse. This does not need to happen in 2016, but to change the trajectory we have to lose our fear of what all too many people experienced as a child.

While it’s my hope that researchers do indeed find a cure, we must address it until then. In fact, the book also touches on the importance of addressing this issue as healthcare changes. For example, rather than bill for number of days in the hospital, insurance companies are now giving healthcare providers a predetermined sum of money based on the patient's condition. This challenges the hospital to seek the right level of care for their patients to avoid constant readmission to the hospital. That’s where elder care providers will be able to help. In fact, we are currently part of a pilot program in which a hospital sends dementia patients to Silverado for care. So far, it’s resulted in not only a cost saving to the healthcare system, but a better quality of life for that individual. It’s a win-win.