Tag: Senior Living

QUOTES

“Our vision was very simple, and that was to help change the way we age. Sounds easy—lot harder, because virtually everything we do impacts the way we age.” (Colin)

“It will take you about 30 years to have an impact… and now, 25 years in, wellness is everywhere. Things take time to change.” (Colin)

“It’s about being engaged in life, in all areas of life… if you’re engaged, the ripple effect begins to happen.” (Colin)

“We are driving change as opposed to responding to it—and we’re speaking with our pocketbook.” (Colin)

“When you see aging as growth, everything changes. The world opens up to you as opposed to closing off.” (Colin)

“No one is guaranteed longevity. We need to earn it by living a better quality of life.” (Colin)

“If we don’t shrink the health span gap, all we’re doing is extending our life—and extending years of ill health.” (Colin)

“Put on your shoes and go for a walk… get out of the house and be curious about life, and a lot of other things begin to fall into place.” (Colin)

“Curiosity is the spice of life… everyone I’ve spoken with, that has been a key element in their success.” (Colin)

“Senior living communities should be centers for discovery.” (Colin)

“Two older adults have 70 to 75% of the disposable income—and yet marketers still overlook them.” (Colin)

“No two people age the same way or at the same rate… personalization enables people to embrace their potential.” (Colin) 

NOTES

Colin Milner is the founder and CEO of the International Council on Active Aging (ICAA) and a leading voice in the global longevity movement. For more than two decades, he has challenged outdated perceptions of aging and advocated for active, engaged lifestyles at every stage of life.

The International Council on Active Aging is a mission-driven organization focused on helping older adults live better, longer lives. Through research, education and tools, ICAA supports senior living communities and organizations worldwide in advancing wellness, engagement and quality of life.

Founded nearly 25 years ago, ICAA operates in more than 50 countries and works with thousands of senior living communities. The organization provides research, benchmarking tools and guidance to help operators improve outcomes, including demonstrating the ROI of wellness programs through increased resident retention and engagement.

Milner emphasized that aging is not defined by decline but by engagement, and that staying active across physical, social and mental dimensions creates a ripple effect that improves overall well-being.

He noted that shifting perceptions around aging takes time, but meaningful progress has been made as wellness has become more widely accepted and integrated into everyday life.

Milner highlighted the critical gap between lifespan and health span, stressing that without improving quality of life, longer lifespans simply extend years of poor health.

He encouraged simple behavior changes like staying active and maintaining curiosity, pointing to curiosity as a key driver of long-term fulfillment and success.

He described baby boomers as a generation driving change, with higher expectations and greater willingness to spend on experiences and products that support quality of life.

Milner pointed out that older adults control a significant share of disposable income, yet are often overlooked by marketers due to persistent ageism and outdated assumptions.

He advocated for rethinking senior living communities as centers for discovery, where residents can continue exploring interests, building connections and redefining their capabilities.

He also stressed the importance of personalization in aging, noting that no two individuals age the same way and that tailored approaches are essential to helping people reach their full potential.

Dementia care is too often framed around what’s lost—memory, independence, identity—when in reality, the opportunity lies in recognizing what remains and how people continue to adapt. Shifting that perspective doesn’t just change care outcomes, it changes how teams communicate, how organizations train staff, and how families stay connected through moments that might otherwise feel overwhelming.

That was the focus of a recent conversation on Varsity’s weekly Roundtable, where we welcomed Teepa Snow, founder of Positive Approach to Care®. Known for her practical, human-centered approach, Teepa shared how reframing dementia from decline to ability can unlock better interactions, stronger relationships and more effective support systems across senior living. Below are a few Fresh Perspectives from her discussion.

PEOPLE DON’T STOP, THEY SHIFT

Dementia doesn’t mean someone is doing less, it means they’re doing things differently. When one pathway breaks down, the brain adapts and finds another way forward.

BEHAVIOR IS COMMUNICATION, NOT DISRUPTION

What looks like repetition, frustration or withdrawal is often a person trying to communicate, stay engaged or solve a problem without the tools they once had.

DEMENTIA ISN’T JUST MEMORY

When we treat dementia as forgetfulness alone, we miss the broader signs like language loss, confusion or physical changes and delay the support that could make a difference.

HOW YOU SHOW UP CHANGES EVERYTHING

The difference between resistance and cooperation often comes down to approach. Directing and correcting creates tension, while partnering builds trust and keeps interactions human.

SUPPORT STARTS WITH CURIOSITY

The strongest care doesn’t assume it understands the situation. It asks what’s working, what’s not and meets people where they are to tailor support that actually helps.

SKILL IS THE MISSING INFRASTRUCTURE

Dementia care isn’t something people just “figure out.” Without training, coaching and real-time reinforcement, even good intentions can lead to frustration and breakdowns in care.

Varsity’s Roundtable is a weekly virtual gathering of senior living marketers and leaders from across the nation. For updates about future weekly Roundtable gatherings, submit your name and email address here. 

Well-being is often treated as a personal responsibility, but the data tells a different story. The environments we live in, the people we surround ourselves with and the systems we design play a far greater role in shaping long-term health outcomes than willpower alone. That shift in thinking is at the core of the Blue Zones approach, which focuses on creating communities where healthier choices happen naturally and consistently over time.

Dan Buettner Jr. of Blue Zones joined Varsity’s weekly Roundtable to explore what the world’s longest-living communities can teach us about building healthier, more resilient environments. Below are a few Fresh Perspectives from his discussion.

ENVIRONMENT BEATS WILL POWER EVERY TIME

Stop asking people to make better choices and start designing environments where better choices happen automatically. Behavior change isn’t about discipline, it’s about design.

LONGEVITY ISN’T SOMETHING YOU CHASE, IT’S SOMETHING YOU LIVE IN

The longest-lived people in the world aren’t pursuing health. They’re living in communities where purpose, movement and connection are built into daily life.

SMALL CHANGES, BIG SHIFT

There’s no silver bullet. Real impact comes from a “silver buckshot” of small, consistent nudges that compound into lasting lifestyle change.

COMMUNITY IS THE ORIGINAL HEALTH INTERVENTION

Where you live and who you surround yourself with matter more than any diet or fitness plan. Social connection isn’t a bonus, it’s foundational.

WELL-BEING IS A BUSINESS STRATEGY, NOT A BENEFIT

Higher well-being drives lower costs, higher productivity and even stronger financial performance. This isn’t soft, it’s measurable and material.

THE FUTURE OF HEALTH ISN’T HEALTHCARE

A multi-trillion-dollar “well-being economy” is emerging, shifting focus from treating illness to proactively helping people live better.

SIMPLICITY IS THE UNLOCK

Healthy living isn’t expensive or complicated. The fundamentals—simple food, daily movement and meaningful connection—have been hiding in plain sight all along. 

Varsity’s Roundtable is a weekly virtual gathering of senior living marketers and leaders from across the nation. For updates about future weekly Roundtable gatherings, submit your name and email address here. 

Three hundred conversations in, and the spirit of connection is stronger than ever! Varsity’s 300th weekly Roundtable featured yet another thoughtful exchange, this time with nationally recognized downsizing expert and former Hoarders host Matt Paxton. 

“Downsizing should be an opportunity to share your generational stories and move to a better life. It should not be this overwhelming daunting task,” said Paxton during his conversation with the group. 

As a guest on Varsity’s weekly Roundtable, Paxton talked about the emotional side of downsizing. Why it’s never really about the “stuff,” but about the memories and meaning behind it. He shared practical ways to help people move forward, from starting small to focusing on what truly matters, all while honoring the past. Below are a few Fresh Perspectives from his discussion.

IT’S NEVER ABOUT THE STUFF, IT’S ABOUT THE STORY

What people hold onto isn’t clutter, it’s identity, memory and meaning. Until you address the emotional connection, you can’t unlock the move.

PEOPLE ARE STUCK BETWEEN PAST AND FUTURE

Many prospects aren’t resisting the move, they’re paralyzed by memories of the past and fear of making the wrong decision, keeping them from living in the present.

START SMALL TO BUILD MOMENTUM

Downsizing doesn’t begin with big decisions. It starts with small, non-emotional wins that create progress and confidence to keep going.

DON’T RECREATE THE OLD LIFE, CREATE A NEW ONE

The goal isn’t to replicate a former home inside a community. It’s to embrace a new chapter, new space and new experiences.

MOST “VALUABLE” ITEMS AREN’T ACTUALLY VALUABLE

Families often overestimate resale value. Outside of things like gold, most furniture and household items have limited financial return.

SERVICE AND TRUST DRIVE EVERYTHING

Whether working with residents or prospects, success comes from leading with empathy, building trust and helping people move forward, not just moving their stuff.

Varsity’s Roundtable is a weekly virtual gathering of senior living marketers and leaders from across the nation. For updates about future weekly Roundtable gatherings, submit your name and email address here.

QUOTES

“Theater has the great ability to bring people together in a dark space without anything to distract them. So everyone’s there to hear the same story at the same time. And when they leave the theater, they walk away with that story.” (Jerry)

“Live theater is a very, very special and unique experience that can only happen with that particular group of people you happen to show up with for the same performance.” (Jerry)

“I looked into her eyes and I saw a 19-year-old. She was so eager to be the best that she could be, even at that age. Here’s this young choreographer, and she was willing to listen and take the notes because I was out front watching.” (Jerry)

“Making musicals is like fishing with a net. You throw it into the sea. If it comes back with a lot of fish, you’re going to have success. But if it comes back half empty, you’re not going to run very long.” (Jerry)

“There are more letters in the word business than there are in show. My mom always used to say, it’s our job to get them to come back tomorrow.” (Jerry)

“By giving to my community and creating a safe space and raising money with the help of millions of other dancers and creative artists, that philanthropic event gave me a career.” (Jerry)

“Michael Bennett used to say to me, don’t wait for the muses. Just show up and do the work. And really, that’s what it is. It’s about showing up.” (Jerry)

“The food that you eat, how you fuel your body, is as important as how you use your body to exercise and express itself. The fuel will actually help you in the longevity, without question.” (Jerry)

“When people are in physical spaces together, they are actually doing a dance not to bump into each other. And patterns start to emerge.” (Jerry)

“Finding space for those stories is important, because along with them comes a lot of young, new artists that have new voices. And we need those voices.” (Jerry)

“My relationships with my younger creative artists fuel me as much as I’m giving them advice and fueling them. It’s a give and take, there’s no question.” (Jerry)

“Patience. Patience is the one thing that so many young artists have to learn.” (Jerry)

NOTES

Jerry Mitchell is a two-time Tony Award-winning director and choreographer known for shaping iconic Broadway productions like Hairspray, Kinky Boots, and Legally Blonde. With a career spanning decades, he has built a reputation for blending storytelling, movement and emotion to create memorable theatrical experiences.

Beyond his creative work, Jerry is deeply involved in the Broadway community, contributing as a mentor, collaborator and philanthropist. His leadership and influence extend across generations of performers and creators, helping shape both the art and business of theater.

Jerry is also the creator of Broadway Bares, a long-running fundraising initiative that has generated over $30 million for Broadway Cares/Equity Fights AIDS. His philanthropic impact earned him the Isabelle Stevenson Tony Award, recognizing his commitment to community and giving back.

Live theater creates a shared experience that connects audiences in a way no other medium can.

Great performances evolve over time, with shows becoming stronger and more refined as actors fully inhabit their roles.

Different generations engage with stories in unique ways, often reflecting their own personal experiences and perspectives.

Success in creative work comes from consistently showing up and putting in the effort.

Strong collaboration is essential, requiring alignment, trust and a shared vision to bring ideas to life.

Mentorship is a two-way exchange, where experienced artists and younger talent learn from each other.

Staying relevant requires adapting to changing audiences and understanding what resonates across generations.

Patience is a critical ingredient for long-term growth, especially for those early in their careers.

The desire to age in place is changing how older adults engage with senior living—and challenging communities to rethink when and how they connect with future residents. As a result, models like continuing care at home (CCaH) are gaining attention as a way to extend care beyond the campus while building earlier relationships.

On Varsity’s weekly Roundtable, Dr. Amanda Young, CEO of M.A. Longey Consulting, shared insights from her experience launching and operating these programs, including how they’re evolving and where they fit within the broader continuum. Below are a few Fresh Perspectives from her discussion.

EARLIER ENTRY POINT, STRONGER FUTURE PIPELINE

CCaH doesn’t cannibalize independent living demand, it captures prospects earlier. By engaging individuals years before they’re ready to move, communities can build relationships, strengthen waitlists, and ultimately convert more residents over time.

EDUCATION IS THE GROWTH BOTTLENECK

Interest in the model is growing, but adoption lags due to confusion. Consumers don’t know what it is, leaders don’t fully trust it, and the lack of a physical product makes it harder to explain, turning education into the biggest growth constraint.

THIS IS A NEW BUSINESS, NOT A SIDE HUSTLE

Programs that struggle are often under-resourced. Success requires dedicated staff, marketing investment, and leadership alignment because this isn’t an add-on, it’s an entirely new line of business with its own operational and financial model.

THE MODEL EXPANDS YOUR REACH—WITHOUT BUILDING

With demand for senior living far exceeding supply, continuing care at home offers a scalable way to serve more older adults without major capital investment. It extends your mission beyond your campus and into the broader community.

FLEXIBILITY IS THE FUTURE OF THE MODEL

The traditional life care structure isn’t reaching the middle market, but innovation is underway. Hybrid models, care coordination-only options, and waitlist-based programs are reshaping the offering to be more accessible and financially realistic.

RETHINKING THE CONTINUUM AS A CONNECTED JOURNEY

The most effective organizations don’t treat at-home and community living as separate choices. They position them as connected steps, allowing individuals to enter earlier, stay longer, and move seamlessly when the time is right. 

Varsity’s Roundtable is a weekly virtual gathering of senior living marketers and leaders from across the nation. For updates about future weekly Roundtable gatherings, submit your name and email address here. 

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The following is Part 2 of a two-part series (see part one here) exploring how pharmacogenetic (PGx) testing can help senior living communities navigate medication conversations and support more personalized care. The series is written by Dr. Troy Veale, CEO of PHD Laboratory, a healthcare innovator with more than 25 years of experience in behavioral health and over a decade in laboratory science focused on advancing precision medicine and improving patient outcomes.

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In Part 1, we explored why medication conversations matter in senior living environments. In Part 2, we turn to the clinical side of pharmacogenetic (PGx) testing, what it is, what it is not, and why it holds particular relevance for aging populations.

WHAT PGx TESTING ACTUALLY EVALUATES

Pharmacogenetic testing analyzes specific genes that influence how medications are metabolized. Using a non-invasive cheek swab, laboratories evaluate genetic markers related to drug-processing enzymes, particularly those that impact common prescriptions used in aging adults.

Results may indicate whether an individual is likely to:

• Metabolize a medication too quickly (reducing effectiveness)
• Metabolize it too slowly (increasing side effect risk)
• Process it as expected
• Benefit from alternative medication classes

The goal is not to dictate therapy but to provide additional data to support provider judgment.

WHY AGING POPULATIONS BENEFIT FROM PERSONALIZATION

Older adults are more susceptible to adverse drug reactions for several reasons:

• Decreased liver and kidney function
• Changes in body composition
• Multiple coexisting health conditions
• Polypharmacy (use of multiple medications)

Research consistently shows that adverse drug events are a leading cause of emergency department visits among older adults. Even when medications are appropriately prescribed, genetic variation can influence response.

PGx testing brings that variability into clearer focus.

ADDRESSING COMMON MYTHS

Myth 1: PGx testing is only for complex cases.
In reality, many commonly prescribed medications,  including those for cardiovascular health, depression, pain, and neurology — have pharmacogenetic considerations.

Myth 2: Stable patients don’t need this information.
Even stable residents may benefit from minimizing long-term risk or identifying lower-risk alternatives.

Myth 3: It replaces physician expertise.
PGx testing enhances decision-making. Providers interpret results within the context of medical history and clinical presentation.

Myth 4: It is invasive or risky.
The test requires only a simple cheek swab.

BENEFITS ACROSS STAKEHOLDERS

For providers:

• Additional prescribing insight
• Support for medication adjustments
• Alignment with evidence-informed care

For senior living teams:

• Stronger educational positioning
• Confidence in discussing holistic care
• Alignment with preventative models

For families:

• Greater transparency
• Reduced uncertainty
• Peace of mind

Medication conversations become proactive rather than reactive.

PRIVACY, COVERAGE AND NEXT STEPS

Your DNA is used only to analyze how your body processes medications. PHD Laboratory does not sell, share, or store your DNA for any other purpose. We are CLIA and COLA certified and fully compliant with HIPAA privacy laws, ensuring your genetic information is protected and confidential at all times.

PGx testing is covered by Medicare Part B for eligible patients and may also be paid for using FSA/HSA funds, CareCredit, or private pay options.

For questions, educational information, or to order a PGx test, please visit the PHD Laboratory website or email info@phdlaboratory.com.

Aging has long been framed as a story of decline. Slowing down, scaling back, preparing for what’s next. But that narrative is starting to shift, driven by research, changing expectations and a growing recognition that later life can be defined by strength, purpose and continued growth.

That shift was at the center of a recent conversation on Varsity’s weekly Roundtable, where we were joined by Colin Milner, CEO of the International Council on Active Aging, to discuss The Wellness Revolution: From Decline to Potential. Below are a few Fresh Perspectives from his discussion.

DECLINE WAS A STORY, NOT A DESTINY

For decades, aging was framed around managing decline, largely because of the gap between lifespan and healthspan. But emerging science is rewriting that narrative, showing that decline isn’t inevitable, it’s modifiable.

MINDSET IS A HEALTH INTERVENTION

How people think about aging directly impacts outcomes. A positive outlook, paired with healthy behaviors, can improve both longevity and quality of life, making mindset a critical (and often overlooked) part of wellness strategy.

WELLNESS HAS A DEFINITION PROBLEM

Many communities claim to be “wellness-based,” but without a clear understanding of what wellness actually means, execution falls short. True wellness is active, intentional and rooted in whole-person outcomes, not just programming.

THE MODEL SHIFT IS FROM CARE TO POTENTIAL

Senior living is moving from a place that manages decline to one that unlocks potential. The communities leading the way are designing experiences around purpose, identity and continued growth, not just support.

THE FUTURE RESIDENT IS ALREADY DIFFERENT

Incoming generations are more health-focused, informed and expectation-driven. Communities waiting until residents “need” care risk missing the opportunity to engage them earlier through a wellness-first approach.

WELLNESS ISN’T A PROGRAM, IT’S A COMMITMENT

The communities doing this best aren’t looking for quick wins. They’re investing time, resources and energy into building cultures where wellness is fully integrated, measurable and continuously evolving.

Varsity’s Roundtable is a weekly virtual gathering of senior living marketers and leaders from across the nation. For updates about future weekly Roundtable gatherings, submit your name and email address here. 

 

Dementia is often defined by what people lose, but a more helpful question is what abilities remain. In a recent episode of Varsity’s Roundtable Talk, Derek sat down with Teepa Snow, occupational therapist, educator and founder of Positive Approach to Care, one of the most influential voices in dementia care.

Their conversation explored why fear still shapes public perceptions of dementia, how communication must adapt as brain changes occur and why Snow prefers the term “care partner” over caregiver. She also discusses caregiver burnout and the importance of building stronger community support around people living with dementia. The following are some fresh perspectives from their conversation. Check out the full episode here. 

WHAT DOES IT MEAN TO TAKE A POSITIVE APPROACH TO DEMENTIA CARE?

Well, in my experience, I can’t use what you can’t do. It’s not possible. What I can do is engage with you and see what you have. And that’s where we can come into a relationship and I can work with you. I need to tune in to the reality of who you are now, not just who you were and what you’re capable of, because that’s what we have to work with and come together with.

WHY IS FEAR STILL THE DOMINANT EMOTION PEOPLE ASSOCIATE WITH DEMENTIA?

I think human beings, as a rule, like the predictable. They like once they master something, they don’t have to think about it so much. And I think what dementia does is rob us of our knowingness. It forces us back into a space of paying attention, being observant. The reality is dementia is ever changing. You don’t get to relax into routine. You have to stay alert, and maybe people don’t want to be on the job so much.

WHAT MISCONCEPTIONS ABOUT DEMENTIA DO THE MOST HARM?

The idea that everybody experiences the same kind of losses and changes in the same order. Alzheimer’s tends to take the front seat, but if I’m living with Lewy body or vascular dementia, my symptoms may be very different. It pays to get a pattern established of what I’m living with and how it’s going. And people also think it only happens to older adults and that it’s all about memory. Memory is just this much. There’s a whole lot more going on.

HOW EARLY SHOULD PEOPLE START LEARNING ABOUT BRAIN HEALTH AND CHANGE?

I would like us to learn more about brain health and wellness when we’re younger. Kids know their body parts, but they don’t know the brain parts, and those are super important. If I know how my brain’s supposed to work, then I can notice when it’s doing something unusual. We tend to wait until there’s so much evidence something isn’t going well, and by then we’re past screening and dealing with significant change.

WHY DO YOU PREFER THE TERM “CARE PARTNER” OVER “CAREGIVER”

I believe there is no care about me without me. It’s time to quit treating someone living with dementia like they’re a football and we’re passing them around. It’s their life, their care. I’ve got to figure out how to work with that human being. I can’t just give care because if I give it, you have to receive it. If you don’t want it, you don’t want it. So I have to partner with you.

WHAT ARE EARLY SIGNS OF CARE PARTNER BURNOUT?

If I were to ask you to tell me three things you’ve done today for yourself and you can’t, that’s a sign. If you can’t tell me something you feel good about in your relationship or something that brings you pleasure, it’s time to have a conversation. We don’t train people for this work. We drop them into it and they keep going until they drop. We need to build community around this, not expect one person to carry it all.

Want to hear more from Teepa? Check out the full episode of Roundtable Talk for more fresh perspectives. Watch new episodes of Roundtable Talk on the Varsity website and on Apple Podcasts, Spotify, and iHeartRadio.

QUOTES

“I can’t use what you can’t do. What I can do is engage with you and see what you have. That’s where we can come into a relationship and work together.” (Teepa)

“When you’ve lost something, your brain doesn’t give up. Your brain picks something else to use.” (Teepa)

“Dementia robs us of our knowingness. It forces us back into paying attention and being observant because it’s always changing.” (Teepa)

“I need to tune in to the reality of who you are now, not just who you were and what you used to be capable of.” (Teepa)

“People think dementia is all about memory, but memory is this much. There’s all this other stuff going on.” (Teepa)

“The relationship is going to change dramatically. Living with brain change is hard whether you’re on the inside of it or the outside observing it.” (Teepa)

“My job is not to decide that someone is suffering. My job is to figure out how to support you through what you’re going through.” (Teepa)

“I believe there is no care about me without me. It’s their life and their care, and I have to figure out how to partner with them in it.” (Teepa)

“The reality is they’re not less, they’re different. Their brain works differently, but they’re still living life.” (Teepa)

“Eighty percent or more of this work is done by unpaid people like family and friends, and we don’t train them. We just drop them into it and they keep going until they drop.” (Teepa)

“We need at least three people, maybe five or more. We need to build community around this condition.” (Teepa)

NOTES

Teepa Snow is an occupational therapist, educator and one of the most recognized voices in dementia care. She is known for helping families, care partners and senior living professionals better understand brain change and build more meaningful connections with people living with dementia.

Snow is the founder of Positive Approach to Care, an organization focused on improving dementia care through training, education and practical support strategies. The organization works with families, senior living providers and healthcare professionals around the world to build skills and confidence in supporting people experiencing brain change.

Through Positive Approach to Care and the Snow Approach Foundation, Teepa and her team provide training programs, professional education and community-based demonstrations designed to improve dementia care practices. Her work emphasizes practical communication techniques, recognizing remaining abilities and building supportive communities around people living with dementia. Her programs now reach professionals and families across the United States, Canada and more than two dozen countries.

A positive approach to dementia care focuses on what abilities remain rather than what has been lost, meeting people where they are and building connection through observation, tone, body language and supportive communication.

Fear often dominates public perceptions of dementia because the condition disrupts routines and predictability, forcing family members and care partners to stay attentive and adapt constantly as abilities change.

Dementia is often misunderstood as primarily a memory problem affecting older adults, but brain change can involve many other cognitive functions and can also appear earlier in life depending on the type of dementia.

Communication challenges arise because people living with dementia may struggle to retain new information, making it important for care partners to simplify questions, provide visual cues and offer structured choices rather than open-ended requests.

Care partners often experience burnout because most dementia support is provided by unpaid family members who receive little training or preparation for the emotional and practical demands of caregiving.

Snow encourages replacing the term “caregiver” with “care partner,” emphasizing that the person living with dementia remains the central decision-maker in their own life and that support should be collaborative rather than controlling.

Effective dementia care requires broader community support systems, with multiple people sharing responsibility rather than placing the entire burden on a single family member.

Senior living organizations can improve dementia support by training staff to recognize individual histories, preferences and abilities, allowing residents to continue experiencing purpose, independence and meaningful engagement even as cognitive abilities change.