SCOTTSDALE, Ariz. – August 11, 2026 – In the evolving landscape of senior living, memory care operators are increasingly recognizing that superior resident outcomes extend far beyond the confines of clinical protocols and regulatory checklists. Experts convened at HEALTHTAC West 2026 underscored the critical role of comprehensive staff training, fostering staff confidence, implementing individualized responses to dementia-related expressions, and crucially, the degree of freedom residents retain in their daily lives. These multifaceted elements, they argued, collectively shape the quality of care delivered in memory care communities.
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The insightful discussion, aptly titled “Beyond the Care Plan: Training, Environment and Dignity in Memory Care,” unfolded during the second full day of the prestigious HEALTHTAC West 2026 conference, held from August 2nd to 4th at the luxurious Phoenician resort in Scottsdale, Arizona. Verna Chisman, president of Allure & Wellness Management Services, expertly guided the conversation as moderator, posing probing questions that facilitated a rich exchange of ideas among the distinguished panelists.
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The panel featured a formidable lineup of industry leaders, each bringing a wealth of experience and unique perspectives to the forefront. AJ Cipperly, vice president of memory care at The Arbor Company, shared insights from a large-scale operator; Jaime Cobb-Tinsley, vice president of family & professional education at the James L. West Center for Dementia Care, offered expertise in educational frameworks; Heidi McLester, executive director of Amber Creek Inn Memory Care, provided practical operational insights; and Marcia Miranda, executive director of Silver Creek Inn Memory Care, contributed valuable on-the-ground perspectives.
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The dialogue commenced with an in-depth examination of workforce training, specifically addressing how memory care operators can effectively measure the tangible return on investment from their training initiatives. From this foundational discussion, the conversation organically expanded to explore how staff interpret resident actions, the efficacy of non-pharmacological interventions, and the delicate balance required to ensure both resident safety and their overall quality of life and autonomy within memory care communities.
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Measuring the True Impact of Training Investments
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A significant portion of the discussion centered on the crucial question of how to ascertain whether investments in staff training are yielding measurable improvements in resident care. AJ Cipperly of The Arbor Company emphasized a multi-indicator approach to evaluating the return on investment (ROI) of training programs. She candidly acknowledged the inherent challenge in isolating training as the sole causative factor for shifts in resident retention or staff satisfaction.
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However, Cipperly highlighted a recent initiative that provided a more direct and impactful measurement. When The Arbor Company observed an uptick in workers’ compensation claims stemming from residents inadvertently injuring team members, the organization responded by developing specialized training to address this specific issue. "We developed a training to address that, and from that, we saw, you know, a decrease in our claims," Cipperly reported. This experience served as a powerful validation of the value in directly linking specific training efforts to observable, positive outcomes.
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Jaime Cobb-Tinsley echoed this sentiment, explaining that the James L. West Center also meticulously tracks incidents and satisfaction metrics. However, her organization has expanded its focus to include the crucial, albeit less tangible, indicators of caregiver confidence and trust in the organization. "When our caregivers have confidence in the skills that they have gotten through training, whether it’s on-the-job training or it’s orientation or just the ongoing training that we do, that confidence helps them respond better in all interventions," Cobb-Tinsley explained. This increased confidence, she noted, translates directly into more effective and compassionate care delivery.
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Furthermore, Cobb-Tinsley pointed to the high participation rates in her organization’s career ladder program as another key indicator of training’s success. With approximately 90% of employees voluntarily engaging in the program, she stated, "We correlate a lot of that. That’s for our ROI." This self-selection into professional development opportunities signals a strong buy-in and perceived value of the training provided.
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The conversation then broadened to encompass the critical question of who within a memory care community requires specialized dementia education. Heidi McLester articulated a progressive philosophy, asserting that dementia-specific education cannot be confined solely to direct care workers. At her communities, she explained, training extends to all employees, regardless of their role. "We do specific dementia training for all of our staff, whether they work in the kitchen, housekeeping, caregiving. It doesn’t matter," McLester stated emphatically.
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McLester described a program called "Personal Touch," which aims to reframe the approach to activities of daily living (ADLs) from mere tasks to meaningful interactions. For instance, assisting a resident with dressing can be transformed into an opportunity for reminiscence or a discussion about the resident’s personal interests. "It’s not just a task," McLester emphasized. "It’s really making that connection with that resident, which ultimately makes that experience much easier." This shift in perspective fosters deeper connections and enhances the resident’s overall experience.
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The Crucial Art of Asking "Why?"
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This emphasis on connection naturally led the panel to a discussion about resident expressions, moving beyond the simplistic label of "behaviors." Panelists asserted that when staff are trained to see the individual rather than merely the task at hand, they are far better equipped to discern what a resident might be attempting to communicate.
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Marcia Miranda highlighted the importance of empowering team members to ask "why" a resident is responding in a particular way, rather than immediately framing the response itself as the problem. "Why do you think your resident is acting that way? Is it that they are overstimulated? Is it that you triggered something that you didn’t know about, and this is how they’re reacting to you?" Miranda posed these questions as examples of the thought process staff should engage in. Understanding a resident’s personal history, she added, is instrumental in helping staff recognize potential triggers and adapt their responses accordingly.
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For Jaime Cobb-Tinsley, this paradigm shift begins with the very language caregivers employ. Her organization deliberately uses the term "expressions" instead of "behaviors." This subtle change in terminology is intended to fundamentally alter how caregivers perceive and interpret what residents are communicating. "We’re not there to correct or control. We’re there to be curious," Cobb-Tinsley stated, underscoring a philosophy of empathetic inquiry.
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This approach also underpins the organization’s trauma-informed training, which encourages staff to consider a person’s past experiences rather than simply focusing on what might be perceived as "wrong." Cobb-Tinsley shared a powerful adage frequently used within her organization as a reminder for caregivers: "A person with dementia is not giving you a hard time; they are having a hard time." This simple phrase encapsulates the core of person-centered care, fostering compassion and understanding.
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Individualizing Non-Pharmacological Approaches for Optimal Impact
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Once staff are adept at inquiring "why" a resident is expressing themselves in a certain way, the subsequent crucial step is to determine "what" to do with that information, particularly before resorting to medication. AJ Cipperly cautioned against the indiscriminate application of commonly recommended interventions, stressing that they are not universal panaceas.
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"I could sit up here and say, ‘Oh, music therapy, horticultural therapy, getting them more involved in activities.’ These are all the things we always hear when somebody has a behavioral expression," Cipperly acknowledged. "But the reality is, those things only work if they’re individualized and person-centered." This highlights the necessity of tailoring interventions to the unique needs, preferences, and history of each resident.
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Cipperly also emphasized the need for caregivers to possess practical tools that can be deployed in the moment to de-escalate situations when a resident becomes agitated or attempts to leave. Once the immediate concern is addressed, she explained, the care team can then collaboratively investigate the underlying cause. "Was there a trigger? Were they hungry, thirsty, overstimulated?" Cipperly prompted, illustrating the diagnostic approach required. She cautioned against automatically defaulting to a familiar activity without first understanding the resident’s underlying motivation for attempting to leave.
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Cipperly further warned that even well-intentioned non-pharmacological approaches can become superficial if caregivers consistently apply the same response without understanding the root cause of a resident’s actions. "But why are they trying to leave? What is it about where they are that they don’t like?" she questioned, underscoring the imperative of probing deeper.
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Heidi McLester reinforced this point, asserting that the effectiveness of any intervention is inextricably linked to the individual resident. "There’s no game plan for dementia. There’s no, you know, linear path that everybody takes," McLester stated. "You really have to get to know them individually as a person." This personalized approach is fundamental to providing truly effective care.
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Cipperly illustrated this concept with a hypothetical scenario: a resident becomes resistant during a shower because the water is too cold. If the resident is unable to articulate their discomfort, Cipperly explained, this resistance could be mistakenly attributed to dementia-related aggression rather than a direct response to an environmental factor. "We’ve got to stop blaming the dementia," Cipperly urged. She posited that assumptions caregivers make about dementia can inadvertently obscure the identification of solvable problems. "So, these behaviors that we often talk about are just normal reactions to an abnormal situation," she concluded, reframing the caregiver’s perspective.
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Transitioning from Tasks to Meaningful Experiences
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This exercise in considering situations from the resident’s perspective served as a crucial bridge between the discussion of interventions and the cultivation of caregiver empathy. Jaime Cobb-Tinsley asserted that technical skills and intervention strategies must be consistently reinforced with ongoing empathy training. "It’s the empathy. It’s, ‘How would you feel? How is your home set up?’" Cobb-Tinsley elaborated, highlighting the importance of perspective-taking.
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Heidi McLester pointed out that frontline caregivers often operate under significant pressure to complete numerous tasks within a limited timeframe. This can become problematic if personal care is reduced to a mere checklist. "When they look at caring for a resident as a task and not an experience with that resident, you know, that’s where the behaviors can come in because they don’t know how to approach," McLester observed.
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Miranda provided a compelling example of how this shift in approach can transform a caregiver’s response to what might otherwise be labeled as difficult behavior. She described a hypothetical resident, a former bus driver, who consistently attempts to leave the community around 3 p.m. each day. Understanding the resident’s background, Miranda explained, could help caregivers recognize that this timing aligns with a deeply ingrained work routine, allowing for a more informed and compassionate response. "The more you know about your resident, the better care you can provide," Miranda concluded.
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Navigating the Delicate Balance: Dignity and Risk
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The profound emphasis on understanding the individual resident naturally led to a discussion on what Verna Chisman termed "dignity with risk"—the complex challenge of preserving meaningful experiences for residents while simultaneously managing safety concerns in memory care communities.
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AJ Cipperly shared invaluable insights gleaned from a visit to dementia care farms in the Netherlands two years prior. While acknowledging that a direct replication of the care-farm model might not be feasible for all communities, Cipperly stated that the experience spurred a work group to explore ways to enhance resident freedom. She noted that some communities are now incorporating animals like chickens, rabbits, and goats, while others are re-evaluating the necessity of securing all doors and cabinets for extended periods. "The key is to take ‘incremental steps,’" Cipperly advised.
The overarching objective, she explained, is to create "a path to more freedom," drawing inspiration from the principles observed at the care farms: "freedom, independence and access to the outdoors." This philosophical shift prioritizes resident autonomy and engagement with the wider environment.
Jaime Cobb-Tinsley concurred that preserving a resident’s quality of life sometimes necessitates accepting a degree of risk, rather than imposing overly restrictive measures solely to prevent the possibility of injury. She highlighted the crucial role of family education in helping relatives understand and embrace this delicate balance. Cobb-Tinsley candidly acknowledged that maintaining such freedom can involve inherent risks, even with robust safety measures in place. "But this is about life," she stated, underscoring the fundamental human right to live fully.
Extending this perspective, Heidi McLester emphasized the paramount importance of residents’ quality of life. "We’re trying to give them the best day we can possibly give them every day, given the disease that they have," she articulated. Managing family expectations, she added, is an integral part of this process, particularly when communities strive to uphold resident dignity while navigating the realities of dementia.
Miranda offered a poignant example from her community: a resident who had been a lifelong gardener struggled with the transition into memory care. Staff ingeniously devised a solution, enabling her to continue tending to flowers in the community courtyard while remaining within close proximity for safety monitoring. "Now she has a purpose again," Miranda expressed with evident satisfaction. "She is doing something that she has always done her life, and we’ll continue to monitor until we see she’s not safe." For the present, Miranda confirmed, the resident can continue to engage in an activity she deeply loves, enhancing her sense of well-being and purpose.
Strategic Investments for the Future of Memory Care
As the session neared its conclusion, Verna Chisman posed a forward-looking question to each panelist: what single strategic investment or operational change would they prioritize in the next 12 months to advance memory care?
AJ Cipperly immediately reiterated her focus on workforce development. "I think it would be stronger workforce development strategies, both from a recruitment, retention and training perspective," she stated. Cipperly firmly believes that no system or operational process can achieve its full potential without a stable and capable workforce to execute it. Furthermore, she emphasized that training designed to bolster caregiver confidence not only benefits residents but also provides invaluable peace of mind for their families.
Jaime Cobb-Tinsley concurred on the critical importance of workforce development but also introduced another significant priority: enhancing freedom within the physical environment. She urged operators to critically examine the number of doors, cabinets, and drawers that are inaccessible to residents, posing the provocative question of whether their own homes operate in such a restrictive manner. Cobb-Tinsley noted that some of these environmental adjustments may be relatively inexpensive, requiring a reconsideration of the physical space rather than the addition of costly amenities.
Heidi McLester advocated for a dual investment in both staff and the physical environment. "We have a whole budget just for employee appreciation every month, and we spend it," she revealed. McLester explained that demonstrating to employees that leadership recognizes the inherent difficulty of their roles can cultivate a supportive culture, leading to increased caregiver retention and ensuring that residents are treated with the utmost dignity and respect.
On a similar note, Marcia Miranda called for a significant investment in organizational culture. "Build the culture. Make your team feel like they are family and they are caring for a loved one," she implored. This ethos of familial care, she believes, is foundational to exceptional memory care.
Concluding the session, AJ Cipperly broadened the perspective, suggesting that these workforce investments carry profound implications beyond current operations. "All of us in this room today, we’re creating our future care environment," she declared. "No matter if you’re a provider or a vendor." This sentiment underscores that workforce development is not merely an operational concern but a long-term responsibility for the entire senior living industry. "We’ve got to start training the people that are going to be caring for us one day," Cipperly concluded, highlighting the profound intergenerational aspect of this critical endeavor.
