Silverado Senior Living

Loren Shook, who co-founded Silverado Senior Living with Stephen Winner, has a distinct philosophical approach to providing seniors housing for the memory impaired.

Loren Shook

By Keat Foong, Executive Editor

Loren Shook’s number one advice for providers of seniors housing serving residents suffering from Alzheimers and other forms of dementia is this: Have highly trained staff who understand the relevant medical and psychiatric conditions. The personnel “should be empowered with training and knowledge so they know how to work with the population without medication and restraint as primary tools,” adds Shook, president, CEO and chairman of Silverado Senior Living.

Shook, who co-founded Silverado Senior Living with Stephen Winner, senior vice president and chief of culture, has a distinct philosophical approach to providing seniors housing for the memory impaired. The vision of the award-winning company is to re-engage its residents into life, explains Shook. Very frequently, residents to Silverado facilities come from other settings in which they have “given up on life,” says Shook, but it is important to remember that “everyone with dementia seeks meaning and purpose.” “We believe people with dementia can do anything as long as they have support.”

The Irvine, Calif.-based Silverado Senior Living operates 23 memory-impairment homes in California, Arizona, Utah, Texas, Illinois and Washington, D.C. Facilities, which contain an average of about 90 beds, have so far been mostly acquired from other owners and converted, says Shook. In addition, Silverado Senior Living operates a medical office, as well as eight offices under Silverado Hospice, and five home care offices under Silverado at Home.

Silverado Senior Living has won awards from organizations including the Texas Assisted Living Association, the Alzheimer’s Association, the Assisted Living Federation of America and the American Psychological Association, and it has been cited as “One of the Best Companies to Work for in Texas.”

At the time Silverado Senior Living was founded in 1996, there were many “misguided notions” about seniors suffering from memory impairment such as Alzheimers, says Shook. “What I saw in the marketplace is the lack of recognition of what people with memory impairment disease were capable of doing.” Units were small; it was felt residents needed to be protected from “breaking things;” and stimulation was kept at a low level because the belief was that residents “would not be able to handle anything more. It was all about what they could not do. There was all this nonsense, and it is all wrong,” says Shook.

Since its founding, Silverado Senior Living’s care has been predicated on sparking life in residents through, for example, the presence of pets and children. In each facility, there are about three to four dogs and five to six cats and three to four fish tanks, says Shook. Children visit the facility every day, and the staff are invited to bring their children to work. Residents are taken to community and volunteering events such as children’s hospital visits and beach cleanups.

Silverado Senior Living facilities also aim to minimize the need for physical and pharmaceutical restraints. Shook says residents’ drug use is reduced from an average of 10 to 12 different drugs to 5.7. With the 24-hour presence of nurses on site, the need for visits to the emergency rooms is lowered, says Shook. And the number of falls was cut, while residents who regained the ability to walk or feed themselves have been documented at the facilities.

Very often, the most difficult cases from other facilities come to Silverado Seniors Living communities, says Shook. “We do not restrain anyone.” Incoming residents are also routinely assessed for depression, and treated. “We find that 65 percent are depressed. This is an easy disease to treat. Most groups do not assess for depression.”

The high level of service comes at a cost: There is a ratio of one full time employee per resident per day at the communities, says Shook. The company has about 2,600 employees in total.

Moving forward, the company is starting to increase its level of involvement in new development. Silverado Senior Living has announced its partnership with Meridian Realty Advisors LP, a Dallas-based developer of aged care facilities, to develop memory care communities in Texas and surrounding states. Six properties are currently under development throughout the country. The company’s plan is to “grow our communities by three to four a year,” whether by new construction or the acquisition of third-party management contracts, says Shook.

Shook says when he was growing up, his aunt and uncle operated a 28-bed dementia care operation, where he saw “the best of dementia-care services delivered.” Later, when his father suffered from a cancerous brain tumour, a nursing home, with an institutional approach, was the only setting available. “I felt called to serve this population. I knew [residents] could have a much better quality of life, and the thinking about seniors suffering from memory impairment diseases needed to change.”