.png)
Most senior living communities are still built to react. A resident falls. A UTI lands them in the hospital. The team adds an intervention and hopes it holds. Weeks later, it happens again.
There is a better way. It starts long before the alarm sounds.
OneStep recently partnered with iAdvance Senior Care for a live webinar, From Reactive Care to Proactive Wellness: Using Technology to Support Independence in Senior Living. The conversation brought together three people who see this shift from very different seats:
Missed the live session? Watch the full recording here.
Below is a recap of the biggest ideas, the strongest moments, and answers to the questions leaders are asking most.
Proactive care means acting on the small, gradual changes that show up weeks before a crisis, instead of waiting for the fall or the hospitalization that makes the decline obvious. Mo Carr described the turning point in her communities. About a year ago, she started seeing the same pattern. The same residents. The same falls. The same UTIs. Recurring, over and over. The team was catching the events. They were missing the signals that came first.
"We were missing the whispers." — Mo Carr, MoBetter Global Care
Those whispers were subtle. A resident who is usually talkative goes quiet. Someone eats a little less. Someone sleeps a little more. Someone needs cueing where they did not need it before. None of it triggers an incident report. All of it tells a story. The fix was not a new piece of equipment. It was a shift in focus. Mo's teams moved from documenting the diagnosis to knowing the person, and from responding after the fact to intervening in real time.
Every step tells a story. Proactive care is simply learning to read it earlier.
The earliest signs of decline are rarely dramatic. They are quiet changes in daily behavior and function that build gradually over days and weeks. Watch for:
These shifts almost never happen overnight. They happen gradually, which is exactly why they get missed. As Sarah Kyle put it, decline and confidence are linked, and when one slips, the other follows.
"Function is tied to confidence. When confidence decreases, function decreases, and people's world gets smaller." — Sarah Kyle, Everwell
The practical takeaway for care teams: stop celebrating only the masses. A packed activity calendar can hide the three to five residents who quietly stopped showing up. Exception reporting, not averages, is where early intervention lives.
Gait is considered a vital sign because how a person walks reflects the health of many systems at once, and small changes in walking predict serious outcomes before other symptoms appear.
Clinicians have started calling gait speed the "sixth vital sign." A usual walking speed below 0.8 meters per second is consistently linked to higher risk of falls, hospitalization, cognitive decline, and loss of independence. When speed drops, fall risk and hospitalization risk climb, and cardiometabolic and cognitive risks rise with them.
The problem has always been visibility. Gait in a resident's natural environment has been almost impossible to measure objectively. Care teams have described it in vague terms like assistance level and distance, which misses the nuance.
That is the gap OneStep was built to close. As an AI-powered movement intelligence platform, OneStep turns everyday movement into clinically meaningful insight using only smartphone sensors. No wearables. A phone in the pocket and a walk down the hall is enough. This early signal can surface rising fall risk before a fall occurs, and OneStep reports that partner communities have reduced falls by 23 to 25 percent over multiple years. In short, OneStep is making gait a vital sign, so teams see more and act sooner.
When a resident sees their own movement data, an uncomfortable subjective conversation becomes an objective one.
"You've helped us make what was otherwise sometimes an uncomfortable subjective conversation much more objective." — Pat Tarnowski, OneStep
Wellness ROI is best measured as "return on impact," using indicators like staff turnover, family referrals, and objective function data, not just direct reimbursement. Life enrichment rarely gets reimbursed directly, so leaders need broader proof of value. Sarah Kyle pointed to three places to look:
"ROI is really return on impact." — Sarah Kyle, Everwell
The bigger point: give residents agency over their own functional health. When people can see what wellness looks like, they engage with it.
"If you want people to chase longevity and vitality, they have to be able to see what it is they're chasing." — Sarah Kyle, Everwell
You personalize at scale by grouping residents around shared personality and how they like to engage, not around identical individual interests. One attendee asked the question every wellness director feels: if 30 residents love 30 different things and there is one life enrichment coordinator, how do you hit a meaningful, personal target for each of them?
Sarah's answer was to change the intake questions. Instead of asking only about specific interests, ask how people like to interact. Do they prefer two or three close connections or a larger group? How important is routine? How open are they to trying something new?
Then build around commonality, not common interest. A single "creative space" can hold watercolor, pottery, jewelry making, and poetry at the same table. You individualize the experience without needing 30 separate programs.
Mo's small residential model makes this even more visible. But the principle scales: know the person first.
"You start from somewhere, and that somewhere is before they move in. Who is this as a person?" — Mo Carr, Mo Better Global Care
The right technology reduces work rather than adding it, solves a top-three problem, and earns a long-term commitment. Mo's biggest implementation challenge was never the software. It was caregiver buy-in. New tools can feel like just one more task. Her approach: show caregivers how a tool makes their work easier, then show them how it helps the resident.
Sarah offered a simple three-question test for evaluating any new platform:
"Don't just date technology. You've got to commit to it." — Sarah Kyle, Everwell
OneStep frames the same idea through a value lens: clinical value, economic value, and operating value. When falls come down, quality measures rise and readmissions fall. And because the data comes from a phone already in someone's pocket, it is easy for real teams to actually use.
The most powerful tool in the room was never the technology. It was a culture of care that sees the whole person and acts on the whispers early. Data, programs, and platforms only work on top of that.
Reactive care waits for the fall. Proactive wellness listens for what comes first. Because every step tells a story about a person's health, the right movement intelligence helps care teams read it sooner and deliver better care.
Want to see how OneStep helps communities catch decline before the fall?
What is proactive wellness in senior living? Proactive wellness is a care approach that identifies and acts on subtle, gradual changes in a resident's behavior, engagement, and movement before they lead to a fall, hospitalization, or functional decline. It contrasts with reactive care, which responds after an incident has already occurred.
What are the early warning signs a senior may fall? Common early signs include sleeping more, eating less, needing cueing for familiar tasks, withdrawing from favorite activities, talking less, and subtle changes in gait such as shorter steps or slower walking speed. These often appear days or weeks before a fall.
Why is gait speed called the sixth vital sign? Because walking reflects the combined health of the musculoskeletal, cardiovascular, and neurological systems, gait speed strongly predicts falls, hospitalization, cognitive decline, and mortality. A usual walking speed below 0.8 meters per second is linked to higher risk across all of these outcomes.1
How do you measure the ROI of a wellness program in senior living? Beyond direct reimbursement, measure return on impact: staff turnover and retention, family referrals, resident length of stay, and objective function data like gait speed. These indicators capture the value that traditional cost accounting misses.
How can one activities coordinator personalize care for many residents? Group residents by personality and preferred style of engagement rather than by identical interests. A shared "creative space," for example, can serve many mediums at once, letting a small team individualize the experience without running dozens of separate programs.
How should senior living communities evaluate new technology? Confirm the tool addresses a top-three organizational priority, verify it removes more work than it adds, and make sure you would still use it in three years. Prioritize tools that reduce staff burden and are easy enough for real teams to adopt.
1Gait speed is increasingly recognized as a "functional vital sign." A usual walking speed below 0.8 m/s is consistently associated with increased risk of falls, hospitalization, cognitive decline, and mortality. Sources: National Institute on Aging and peer-reviewed geriatrics literature on gait speed as the sixth vital sign; CDC data on falls (roughly 1 in 4 adults over 65 falls each year, and falls are the leading cause of injury-related death in older adults).