HEALTHTAC West 2026: Beyond the Care Plan
From the Senior Living News newsroom | August 11, 2026
SCOTTSDALE, Ariz. — Memory care operators looking to improve resident outcomes need to examine more than clinical protocols or regulatory compliance. Training, staff confidence, individualized responses to dementia-related expressions and the degree of freedom residents retain in daily life all shape the quality of care, according to panelists at HEALTHTAC West 2026.
The discussion, “Beyond the Care Plan: Training, Environment and Dignity in Memory Care,” took place during the second full day of HEALTHTAC West 2026, held Aug. 2-4 at The Phoenician in Scottsdale, Arizona. Verna Chisman, president of Allure & Wellness Management Services, moderated the session.
Panelists were AJ Cipperly, vice president of memory care at The Arbor Company; Jaime Cobb-Tinsley, vice president of family & professional education at the James L. West Center for Dementia Care; Heidi McLester, executive director of Amber Creek Inn Memory Care; and Marcia Miranda, executive director of Silver Creek Inn Memory Care.
The conversation began with workforce training and how operators can determine whether those investments are producing measurable results. From there, panelists moved into how staff interpret residents’ actions, when nonpharmacological approaches are effective and how memory care communities can balance safety against residents’ autonomy and quality of life.
Measuring the Value of Training
Cipperly said The Arbor Company looks at multiple indicators when considering the return on investment from training, while acknowledging that it can be difficult to isolate training as the cause of changes in retention or satisfaction.
One recent initiative offered a more direct measurement. After the company saw an increase in workers’ compensation claims resulting from residents injuring team members, it developed specific training to address the issue.
“We developed a training to address that, and from that, we saw, you know, a decrease in our claims,” Cipperly said.
That experience reinforced the value of connecting specific training initiatives with specific outcomes, she added.
Cobb-Tinsley said the James L. West Center also measures incidents and satisfaction but has begun examining 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,” she said.
She also pointed to participation in the organization’s career ladder, saying about 90% of employees are self-selecting into the program. “We correlate a lot of that,” she said. “That’s for our ROI.”
The discussion then widened from measuring training outcomes to the question of who within a community needs dementia-specific education in the first place. For McLester, dementia education cannot stop with direct care workers. She explained that at her communities, training extends to employees throughout the building.
“We do specific dementia training for all of our staff, whether they work in the kitchen, housekeeping, caregiving. It doesn’t matter,” she said.
She described a program called Personal Touch that trains caregivers to approach activities of daily living as interactions rather than tasks. Helping a resident get dressed, for example, can include reminiscing or discussing something that interests the resident.
“It’s not just a task,” McLester said. “It’s really making that connection with that resident, which ultimately makes that experience much easier.”
The Importance of Asking ‘Why?’
That emphasis on connection carried directly into the panel’s discussion of resident behavior: If staff are trained to see the person rather than simply the task, panelists said, they are also better positioned to ask what a resident may be trying to communicate.
Miranda said team members are taught to ask why a resident is responding in a particular way rather than immediately treating 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?” she said.
Understanding a resident’s history can help staff recognize triggers and respond differently, she added.
For Cobb-Tinsley, that shift begins even with the language caregivers use. Her organization deliberately uses the word “expressions” rather than “behaviors,” a change in terminology intended to affect how caregivers perceive what residents are communicating.
“We’re not there to correct or control. We’re there to be curious,” she said.
That approach also informs the organization’s trauma-informed training, which encourages staff to consider what may have happened to a person rather than simply asking what is wrong.
Cobb-Tinsley pointed to a phrase used throughout the organization as a reminder for caregivers: “A person with dementia is not giving you a hard time; they are having a hard time.”
Individualizing Nonpharmacological Approaches
Once staff begin asking why a resident is responding a certain way, the next question becomes what to do with that information — particularly before turning to medication. Cipperly cautioned against treating commonly recommended interventions as universal solutions.
“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,” she said. “But the reality is, those things only work if they’re individualized and person-centered.”
Cipperly said caregivers also need practical tools they can use in the moment when a resident becomes agitated or attempts to leave. Once the immediate situation has been addressed, the team can go back and investigate what prompted it.
“Was there a trigger? Were they hungry, thirsty, overstimulated?” she said.
She cautioned against automatically assigning a familiar activity without understanding why a resident is trying to leave.
Cipperly cautioned that even nonpharmacological approaches can become rote if caregivers apply the same response each time a resident tries to leave rather than first trying to understand what is prompting the resident to do so.
“But why are they trying to leave? What is it about where they are that they don’t like?” Cipperly said.
Understanding the reason behind a resident’s response is crucial, McLester said, because none of the interventions can be separated from the individual resident.
“There’s no game plan for dementia. There’s no, you know, linear path that everybody takes,” she said. “You really have to get to know them individually as a person.”
Cipperly later illustrated the same point with a hypothetical example of a resident becoming resistant during a shower because the water is too cold. If the resident can no longer explain that the temperature is uncomfortable, she explained, that resistance can be mistaken for aggression associated with dementia rather than a response to the immediate environment.
“We’ve got to stop blaming the dementia,” Cipperly said. The assumptions caregivers make about dementia can prevent them from identifying a solvable problem, she added.
“So, these behaviors that we often talk about are just normal reactions to an abnormal situation,” she said.
Moving From Tasks to Experiences
That same exercise — considering how the situation feels from the resident’s perspective — became the bridge between the panel’s discussion of interventions and its discussion of caregiver empathy. Cobb-Tinsley said technical skills and intervention strategies must be reinforced with ongoing empathy training.
“It’s the empathy. It’s, ‘How would you feel? How is your home set up?’” she said.
McLester noted that frontline caregivers often work under pressure to complete numerous tasks within a limited period of time. That can become problematic if personal care is treated primarily as a 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,” she said.
Miranda illustrated how that approach can change a caregiver’s response to what might otherwise be treated simply as a difficult behavior. She offered a hypothetical example of a former bus driver who becomes intent on leaving every day around 3 p.m. Knowing the resident’s background could help caregivers recognize that the timing corresponds with a deeply established work routine and respond accordingly.
“The more you know about your resident, the better care you can provide,” Miranda said.
Balancing Dignity with Risk
That emphasis on knowing the resident led into what Chisman called “dignity with risk,” or the question of how memory care communities can preserve meaningful experiences while still managing safety.
Cipperly shared lessons that she brought back after visiting dementia care farms in the Netherlands two years earlier. Although The Arbor Company could not simply reproduce the care-farm model, she said the experience prompted a work group to consider how communities could create more freedom for the residents.
Some communities are exploring animals such as chickens, rabbits and goats, she said, while others are examining whether doors can remain unsecured for certain periods.
The key is to take “incremental steps,” Cipperly said.
The broader objective, she explained, is to create “a path to more freedom,” drawing on principles she observed at the care farms: “freedom, independence and access to the outdoors.”
Cobb-Tinsley said preserving quality of life sometimes requires accepting a degree of risk rather than restricting residents solely to prevent the possibility of injury. Family education, she said, is an important part of helping relatives understand that balance.
Cobb-Tinsley acknowledged that preserving that freedom can involve risk, even with safety measures in place. “But this is about life,” she said.
Extending that idea, McLester offered a perspective that considered 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 said.
Managing family expectations is part of that work, she added, particularly when communities are trying to preserve dignity while addressing the realities of dementia.
Miranda offered an example from her community of a resident who had been a lifelong gardener and struggled with the transition into memory care. Staff found a way for her to continue caring for flowers in the community courtyard while remaining nearby to monitor her safety.
“Now she has a purpose again,” Miranda said. “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 time being, Miranda said, the resident can continue doing something she loves.
Investing in the Workforce and Environment
As the session drew to a close, Chisman asked each panelist to identify one strategic memory care investment or operational change they would prioritize during the next 12 months.
Cipperly returned immediately to workforce development.
“I think it would be stronger workforce development strategies, both from a recruitment, retention and training perspective,” she said.
No system or operational process can succeed without a stable, capable workforce to carry it out, Cipperly said. Training that builds caregiver confidence can also contribute to family peace of mind and resident well-being.
Cobb-Tinsley agreed on workforce development but added another priority: freedom within the physical environment.
She encouraged operators to examine how many doors, cabinets and drawers that residents cannot access and to ask whether their own homes function that way. Some changes, she noted, may be relatively inexpensive and involve reconsidering the environment rather than adding another amenity.
McLester said operators should invest in both staff and the environment.
“We have a whole budget just for employee appreciation every month, and we spend it,” she said. Making sure employees understand that leadership recognizes the difficulty of their jobs can help create a culture in which caregivers stay and residents are treated with dignity and respect, she said.
On a similar note, Miranda called for an investment in organizational culture. “Build the culture. Make your team feel like they are family and they are caring for a loved one,” she said.
For Cipperly, those workforce investments also carry implications beyond current operations.
“All of us in this room today, we’re creating our future care environment,” she said. “No matter if you’re a provider or a vendor.”
That makes workforce development a long-term responsibility for the senior living industry, she added.
“We’ve got to start training the people that are going to be caring for us one day.”
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