In early March, the Global Ageing Network’s mission of international collaboration in ageing services was on full display as leaders from St. Monica’s Trust in the United Kingdom visited senior living communities in the United States, bringing together U.S. and U.K. providers to exchange insights on financial sustainability and innovation.
David Williams, the Chief Executive Officer from St. Monica’s Trust, traveled with a small delegation to explore life plan communities in the U.S. The tour included ten member sites across two cities, Chicago and San Diego, and highlighted both the shared challenges and distinct operating environments facing providers on each side of the Atlantic.
The idea for the visit originated when Williams connected with Global Ageing Network and LeadingAge members and staff members to learn more about U.S. life plan communities and how organizations navigate financial challenges.
With senior living markets evolving rapidly, U.K. providers are increasingly interested in the U.S. model, which has experienced significant growth over the past three decades. Dee Pekruhn, Senior Director, Life Plan Communities & CCAH, connected with state partners including LeadingAge Illinois and Executive Director Angie Wiersma organized a tour of communities in the Chicago area.
Visits to Chicago and San Diego
Over three days, the delegation visited several life plan communities, including:
- GreenFields of Geneva, a Lifespace Community
- Westminster Place, a Presbyterian Living Community
- Lutheran Home of Lutheran Life Communities
- Park Place of Elmhurst
- Montgomery Place

Each day included morning and afternoon tours, as well as discussions with leadership teams and staff which provided opportunities to exchange perspectives on governance, operations, and financial sustainability. Evenings brought informal networking, including dinners where U.S. and U.K. leaders engaged in candid conversation and relationship building.
As planning for the visit to Chicago progressed, Williams expressed
interest in expanding the tour to include San Diego; Global Ageing Network and LeadingAge California members then scheduled site visits in the San Diego area.
Over two days, communities visited included:
- St. Paul’s Senior Services
- Covenant Living Communities and Services’ Mt. Miguel Community
- White Sands La Jolla, a Human Good Community
- Front Porch’s Casa de Mañana
Regarding the site visits, Pekruhn reflected, “The response from members was incredibly generous. Organizations opened their doors, shared their experiences candidly, and took time to connect with our international colleagues.”
Shared Challenges, Different Systems
Throughout the tour, participants explored both the similarities and differences between U.S. and international senior living models.

One key difference lies in regulation. In the United States, communities operate under extensive oversight from entities such as the Centers for Medicare & Medicaid Services (CMS) and various state agencies.
International providers often operate with greater flexibility. This has enabled experimentation with new community designs, service models and resident engagement across Europe.
For example, participants discussed the innovative dementia village model pioneered at The Hogeweyk Dementia Village in Denmark, where residents live in a small-scale neighborhood designed to replicate everyday life. The concept has inspired similar ideas elsewhere, including emerging memory care initiatives in the U.S. such as the innovative memory support approach being developed by EverTrue Living, (formerly Lutheran Senior Services), which is exploring neighborhood-style memory support environments designed to foster autonomy and social interaction.
However, participants noted that replicating such models in the U.S. often comes down to economics.
During the discussions, one participant asked, “Why don’t more U.S. providers build dementia villages?” The answer was simple: capital costs. Developing entirely new community designs requires significant investment, which can be difficult in an already challenging financial environment.
A Changing Market on Both Sides of the Atlantic
Despite structural differences, the tour revealed common ground between providers in the U.S. and the U.K.