Building a New Kind of Eldercare in the Bay Area: The Origins of Sage Eldercare Solutions

As Sage Eldercare Solutions approaches its 25th anniversary, our origin story continues. This is the third installment in a series of reflections on Sage’s 25-year evolution, captured in my interviews with Nina Herndon, Sage’s founder and executive director, in October 2025.

In this blog post, Sage enters its second decade and expands its service offerings. 

From the start, the goal of providing holistic care remained unchanged. However, Sage’s new approach to care required a broader range of services beyond Sage Care Management. Care management alone couldn’t deliver the desired holistic care. That is where home care and the novel The Hummingbird Project came in. 

As a result, Sage Home Care was introduced in 2011, and The Hummingbird Project began in 2012 and was then formalized in 2013. (See the Origin timeline.)

A Philosophy That Aged Well

From the very start, the vision was to solve problems, make life easier, and help people enjoy a good quality of life so families can find peace even during difficult times. In its second decade, the expansion to include Sage Home Care and The Hummingbird Project was a natural extension. These developments broadened the company’s reach without altering its core principles. 

As Nina elaborated:

The core and essence remained the same as always. What changed wasn’t the reason but the method — along with a willingness to keep listening. We can adapt only by committing to learning and listening. 

The Impetus Behind Home Care and The Hummingbird Project

During Sage’s first decade as a care management practice, the focus was on creating an experience defined by details tailored to each client. Nina reflects that during this period she discovered that, as a care manager, Sage could be more effective for the client if care were delivered by a team working in unison on the client’s behalf.

As Nina explained:

The idea behind both Sage Home Care and The Hummingbird Project was to provide advanced support, curriculum, and engagement for individuals who go beyond what a Personal Care Attendant (PCA) typically offers. Our role was to ensure that Sage professionals have the techniques and support to explore different modalities, develop diverse content, curate experiences, practice deep listening, and promote purposeful interactions.

The organization also changed with the service expansion.

The addition of Sage Home Care and The Hummingbird Project sparked greater energy and excitement across the organization. The multidimensional staff, with diverse life experiences, traditions, and educational backgrounds, brought a bounty of knowledge and ideas. A new kind of energy was created.

For the team, the sky was the limit for how Sage could support people throughout their lives and help them make the most of their years. 

As Nina described the new challenge:

Our team members now faced a thrilling—and enjoyable—challenge: how to reignite and engage our clients, given their diverse backgrounds and interests. In other words, we asked in a humanistic way, “How can I support YOU?” The answers uncovered new opportunities to do the kinds of things we had only imagined possible to support our clients. That was a major source of excitement.

Realizing the Promise of Quality of Life

By launching the two new services, Sage demonstrated its ability to deliver a new kind of eldercare focused on holistic wellness. As Nina explained in Sage’s Early Years: The Eldercare Landscape, she founded Sage with “the hope that older adults can achieve the best quality of life by applying a hospitality perspective.” 

From Day One, the mission made clear that quality care was more than three meals and a bath. Connection, meaning, and engagement must be integral to care. 

Nina explains:

It felt like a huge disconnect: people were receiving attentive support and assistance, but weren’t getting what, to me, care is all about—that integrative support that is experiential and engaging. It makes you feel alive rather than just being cared for.

Sage Home Care and the proprietary Hummingbird Project helped make Sage’s mission a reality. With the full suite of services, Sage could now elevate eldercare, transforming the quality of care well beyond three meals and a shower. With Sage Home Care and the support of Hummingbird, Sage ensures clients are engaged in a wide range of activities that foster quality of life, meaning, and purpose.

The Seven Domains of Wellness

With Hummingbird came the framework that defined Sage’s holistic wellness approach: The Seven Domains of Wellness. The 7 Domains of Wellness offers a revolutionary approach to enhancing quality of life (QOL) for older adults, going far beyond traditional medical models. Sage articulated the framework in the mid-2010s, even though the activities and services designed to foster QOL were already routinely implemented. 

The Seven Domains serve as a guide for all Sage employees and a roadmap for delivering QOL-enhancing services. When applied, an individualized care plan is developed for each client, reflecting their unique interests, passions, and life story. 

As Nina elaborates:

When you apply the lens of holistic quality of life to these seven domains of wellness, it gives you an opportunity to run a mental checklist, asking, for example, what am I doing in the environmental realm, even if it’s not the most obvious. It pushes the team to look beyond what is obvious. In any of these instances, we’re trying to support a human.

Each domain addresses distinct dimensions that together constitute well-being – the aspects that enable human flourishing. We know from experience, formalized at Sage through The Hummingbird Project and its evolution, that older adults, including those living with dementia, experience joy and purpose through meaningful activities that support all seven domains of holistic quality of life.

The diagram below depicts the seven domains. For more information, read our blog, Reimagining Wellness for Older Adults: The Seven Domains of Wellness Framework.

Helping clients live their whole lives

By its second decade, Sage had defined—and executed—its core values. In effect, the company’s DNA had fully actualized. The practice was set up to be the “place” that Nina envisioned:

I wanted to create a place where we could make magic happen in people’s later years. Life offers an incredible bounty, no matter our age. That is central to who we are as an organization and to Sage’s core value of cultivating and celebrating creativity. There was a sort of genius to our pursuit of quality of life, which we earned honestly from the start.

Nina describes the values as about nourishing not just the body but also the soul and the mind. To her surprise, Nina noted that Sage’s original descriptor, “wise decisions, extraordinary care, and joyful moments,” has held up for over 25 years. Sage began in 2001 with the same values and intention it has today – 25 years later. 

As one final note in this blog, I want to share a letter from a Sage clinical consultant that was included in a time capsule created for Sage’s 15th anniversary.  Eileen exclaims about the growth of Nina’s brainchild, which was fully formed 10 years ago, and continues to grow and thrive today.

 

A Personal Note from the Blog Author (Kari Rogenski)

The Hummingbird Project came to life through my work with Nina and the Sage team. As its co-creator, I spent over a decade shaping its curriculum, philosophy, and growth into the program it is today. Writing this series has been a meaningful way to honor that work and the mission that has always driven it.

 

We hope you enjoyed this series on Sage’s origin story. September marks our 25th anniversary. Keep an eye out for more recollections on our website and LinkedIn. (Please follow on LinkedIn: Sage Eldercare Solutions and The Hummingbird Project).

We are always ready to address any eldercare questions or issues that you or your family are facing. You can schedule a free consultation here.