The Oregon Caregiver Fall/Winter 2016

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feature
Gateway Living
Mark Kincaid co-owns several long-
term care communities that specialize in
assisting residents with memory care and
dementia and is the administrator for the
Gateway Living campuses located in the
Eugene/Springfield area. One of these
facilities specializes in memory care and
houses 70 residents with Alzheimer’s and
dementia.
Because of their flexibility in placing
residents, Kincaid said they are able to
accept residents with dementia that other
communities have struggled to care for.
He said that these are often private pay
residents who are able to spend more
for their care, which affords Gateway
to have extra staff on hand to help care
for residents who may have challenging
behavioral issues.
Being properly staffed is critical to
identifying these behavioral triggers and
discovering how to best manage them
and support the resident.
“We need more one-on-one care
approaches, so we can better identify and
figure out the triggers, what sets them off,
and the best interventions to avoid and
calm the person down,” he said.
Kincaid said it’s important to try to
avoid the triggers after they’ve been
discovered. For example, sometimes a
trigger for a dementia resident can be
as simple as there being more than five
people in a room talking at once. “All of
the sudden [the resident] says, ‘You guys
shut up,’ or maybe he doesn’t even say
that. Maybe he just gets mad and goes
over and slaps somebody because he had
the inability, due to cognitive disability,
to actually identify what’s making him
upset. He just reacts to it,” said Kincaid.
By doing one-on-ones, Kincaid said they
can start to realize, in this example, that
it’s larger groups that upset this person.
“Maybe they need to eat in the room by
themselves. Maybe they don’t participate
in large group activities but are a part of
smaller group activities with two or three
people,” he said.
By having several buildings, Kincaid and
his staff can reposition clients to find
the best fit for their needs. Kincaid said,
“With five or six buildings on a campus,
that all provide memory care, I may
have a resident with specific issues in a
building; maybe the one resident likes
to sing church hymns and another can’t
stand to listen to church hymns. Maybe
I can move one of them to a different
building.” He also said that moves like
these are discussed with the residents’
family members before action is taken.
Their memory care community is
currently about 40 percent Medicaid
and 60 percent private pay. Kincaid said
this is a sustainable level where they
can provide the necessary care for their
residents and also provide competitive
compensation for the staff.
Even in a larger community like
Eugene/Springfield, Gateway Living is
experiencing similar challenges as those
facilities in the less populated areas of
the state: a low number of applications
and an even lower number of viable
candidates. Kincaid said that less than 10
percent of applicants will be a good fit.
“We’ve added, between McKenzie Living
and Gateway Living, about 40 positions
in 18 months. That means I need at least
500 applicants to fill those 40 spots; that’s
a lot of people,” he said.
Offering a diverse range of services helps
Kincaid attract applicants. “If you have a
cross-section of residents, then you have
a cross-section of offerings for staff. It
makes it easier to hire. I have people who
want to work in mental health care, so
if I don’t have mental health care work
opportunities then they’re never going to
be an employee,” he said.
Kincaid also recognizes there will be
new challenges on the horizon, such as
the minimum wage increase. “There’s
other things that come at you too, like
the Affordable Care Act and mandatory
paid time off. There’s nothing that’s come
across my desk in the last 20 years that’s
lowered our costs,” he said. 
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Fall/Winter 2016 The Oregon Caregiver