The real power is love. It’s love greater than fear,” Loren Shook says.
In a sector heavily defined by compliance and risk mitigation, Loren has built a business around a different premise. For three decades, he has challenged how the senior living industry approaches, delivers, and markets care for people living with memory loss. As the founder and CEO of Silverado, he has championed a model that integrates advanced clinical practice into the rhythm of daily life, allowing residents to live in home-like environments with continuous medical support.
The challenges he set out to overcome in the mid-1990s have not gone away. At the time, the senior care sector lacked alignment between what providers promised and what residents experienced. Loren saw that firsthand when he began exploring the market.
“In 1994 and 1995, I researched what providers were doing with people living with memory impairment, and I didn’t like what I saw. The gap between the brochure and the reality was glaring,” Loren recalls. A lot of marketing materials did not match what was happening behind closed doors. Silverado, he decided, would be built to close that gap.
Thirty years on, Loren’s role has evolved to focus on organizational alignment and strategic direction. “My job is to pull together the resources, the teams, and the organization so our people across the country can execute our mission. We are constantly looking beyond our own borders to help change the way the world views memory impairment.”
Early influence
Loren didn’t enter healthcare by chance; he grew up in it. His family operated a psychiatric hospital, which served as both his childhood home and his earliest classroom. “I watched my family provide care to psychiatrically ill individuals with genuine love, always accepting people exactly for who they were. They would take on any disease, no matter its severity. What struck me even then was the profound benefit that pets and children had on the quality of life for people living with mental impairments.”
His early exposure to that environment taught him that true care is built through relationships, not control. That early lesson, care through connection not control, still runs through everything Silverado does.
Loren built his early career in behavioral health, becoming a hospital administrator at just 22 years old and quickly rising through executive leadership within a healthcare system that expanded across the US and into the UK. “That experience not only brought operational discipline and scale, but showed me exactly where traditional care models were failing families. We were building a massive footprint, yet the industry as a whole were missing the mark on true relational care.”
Breaking the model
As Loren began researching the sector in the mid-1990s, he found an assisted living industry built on a well-established, real-estate-first formula. Operators competed on location, pricing, and high-end amenities. “The whole foundation of the sector was real estate. Occupancy drove the business, and actual clinical care was often treated as an afterthought.” Some providers introduced designated memory care wings, but these frequently lacked meaningful integration with medical and psychosocial support. “The result was a system that looked supportive on paper but couldn’t meet complex medical needs.”
Rather than separating residential living from healthcare, Loren combined them. He integrated skilled nursing, social work, and daily cognitive engagement into a single, cohesive hospitality model. “You can’t just walk into a residential setting with a pretty living room and expect it to work if you don’t have the back-end clinical support. At the time, that approach ran completely counter to industry wisdom.”
The sector viewed deep clinical investment as an unnecessary expense and a commercial risk. “They all told me, ‘Don’t do it,’” he recalls. “‘Don’t hire full-time nurses. Don’t bring in social workers. Don’t build a medically complex model; it’ll only increase your liability.’ I rejected the advice.” The gap between what people needed and what they were getting was simply too wide to ignore.
The first community Silverado built challenged every prevailing assumption, operating at a scale that outsiders questioned. “From the start, we served residents across every stage of disease progression, from early diagnosis through end-of-life care.” Traditional assisted living settings faced strict legal limits on the acuity of residents they could support,” Loren says. “We were going to change those laws – and we did.”
The same willingness to push boundaries extended to the company’s approach to neurology. “We’ve had neurologists tell us that once a part of the brain is gone, it’s gone forever. That’s an interesting clinical take, but we don’t let it become a barrier to care. We succeed by never giving up on people and by designing programs around the cognitive abilities they still have.”
Daily practice
As Silverado expanded, Loren’s focus shifted from proving the model to sustaining it across dozens of communities. He points to culture as the anchor. “Culture is everything. We want to create freedom to move around, freedom to enjoy life. We want to give residents as much control over their own lives as we possibly can.”
At Silverado, residents enter warm, open living spaces rather than formal, clinical reception areas, allowing their daily routines to remain recognizable. “We let residents move in with their own pets. Why should someone have to give up their last best friend just because they need care?”
The model relies on a shared cultural understanding throughout the entire team. Every staff member, regardless of role, undergoes specialized memory care training to ensure that consistency holds. “A lot of negative behaviors or outbursts actually come from a frustrating or confusing environment,” Loren notes.
The team treats behavioral changes as an expression of unmet needs rather than an isolated incident, pointing to physical pain as one of the most commonly overlooked causes. “Imagine you are older, you have dementia, you can’t verbally communicate, and you are experiencing severe joint pain. Suddenly, someone forces your arm into a coat sleeve and the pain is excruciating. You get frustrated and you hit out.” Without clinical context, that response is often mislabeled as aggression.
That’s where Silverado’s approach diverges from standard care. Rather than defaulting to sedatives or antipsychotic medications, the organization works to understand the underlying biology – including whether a resident’s body is properly metabolizing their prescriptions. “Some people are prescribed treatments without the provider knowing that the medication doesn’t actually work on that specific person’s biology.”
The goal, as Loren sees it, is precise and compassionate intervention, addressing pain at the source, adapting the environment, and using medication only when it’s clinically effective. In practice, that deeper approach creates a completely different experience for both the resident and the staff caring for them.
Programs and growth
That same individual focus extends into Silverado’s cognitive programming. “We’ve built dedicated tracks designed to actively influence brain health and track measurable outcomes.”
The company’s signature Nexus program sits at the center of this effort. It began with Loren sending Kim Butrum, MS, RN, GNP-bc to search the world for what works. “I told Kim before you become immersed in your new position as Senior Vice President, Clinical services go out and look globally and bring back what works, there are no sacred cows in our existing programs, we are willing to change whatever is needed.” The resulting program combines non-pharmacological social engagement, physical exercise, added resident support group led by a master’s level social worker, stress reduction and cognitive development strategies .
The clinical results have been striking. “A study of 733 Silverado Nexus program cases with the University of California, San Diego showed a 60% benefit in cognitive function for participants compared to standard care. It’s a non-drug program, and the only side effect is fun.”
That same logic – that targeted stimulation can positively influence brain function – now shapes how Silverado evaluates new interventions. “It builds the olfactory system and is actually growing the hippocampus. Rather than replacing existing practices, these approaches extend them, always keeping human connection at the center.”
Silverado continues to expand to meet growing demand across the US, with consistency at the core of its model. “Culture is everything.” That commitment to culture – the thing he’s returned to throughout three decades – remains the foundation as the organization scales.
A planned leadership transition is now underway as Wayne Sanner assumed the CEO role July 1 to lead the next generation of Silverado forward. Loren is moving into the role of Executive Chair, staying close to innovation, culture and strategy while handing off day-to-day operations. After thirty years in the field, his conviction hasn’t wavered.
“People living with memory-impairing diseases can absolutely live a joyful, meaningful life. They just need the right system to support them.”
