Fabric........try making a braid like the braided fabric rugs only smaller. You could add ribbon and lace along with the fabric strips. To make it extra fancy you can string some large hole beads in with the braid. You could either make it long enough to tie off or sew on a closure of velcro. The velcro would make it easy to take on and off for the resident and have a neater finish. It doesn't sound like it would be too classy, however we activity people are artistic by nature and I am sure that you could design something beautiful. If the resident truly is bother by having things around her neck another suggestion would be to decorate the necks of t-shirts or collars on button up shirts with paint, beads, sequins or other items. I would stay away from pendants on chains they can be very painful if the resident is really insistant on pulling it. And stay away from fishing line, it can cut into the skin. I hope this helps.