Memory Care Innovations
The most up-to-date approaches to dementia care
“We focus on the person, not the disease,” says Maggie Beckett, Director of Memory Care for Alavida Lifestyles. It’s an attitude echoed in many care communities, one that sparks personalization and constant innovation in treatment and care available. Alzheimer’s and dementia care in Canada undergo continued improvement, seen in emerging trends like the following:
- Improved education of care staff to provide more sympathetic care
- The creation of intimate spaces that promote social familiarity and calmness
- Masking clinical aspects to create an environment free of confusing distractions
- Programs that encourage memory and social interaction
- Use of the latest technology to protect the safety and security of those with dementia
Here's a look at the way memory care communities innovate their approach in 2019:
Ongoing education of care staff
Rachelle Vroom is proud of Symphony Senior Living Orleans’ recent training in virtual dementia. “A few months ago we ran sessions at all four of our Ottawa locations, holding it open to the public, family members, anyone who wanted to take part and kind of ‘walk a mile in their shoes,’ to find out what a difference dementia makes to their loved ones' lives.” This training program for staff was also open to family members and others who wanted to get a sense of what it is like to live with dementia.
In the virtual dementia program, people were suited up with various equipment and placed into a mockup of a resident’s room. They were asked to complete five tasks, but in a VR context that simulated symptoms of someone living with dementia or Alzheimer’s.
The effect of the exercise was phenomenal. “Trying to understand and complete tasks was completely different for people. The virtual dementia program allowed them to understand how someone with dementia would go about trying to understand a task. It really helped everyone, including family members and our staff to understand the frustrations of dementia. It gave them a better understanding of the confusion the resident may face.”
“After the program,” says Vroom, “staff was better able to understand and relate to the resident. For example, they would now focus on giving visual cues to the resident, visual cues that avoided confusing the resident, instead of just a verbal cue. They might now lay clothing on the bed and give the resident a visual choice what they might wear today.”
Staff was better able to understand and relate to residents. We saw a 30 percent improvement in our DACE scores.
That wasn’t just a vague feeling but a quantifiable improvement in staff’s ability to understand care needs. “In our DACE* scoring system,” explains Vroom, “we scored all of our employees prior to the training, then after they went through the training, and we saw a 30 percent improvement in scores.”
This impacted family members who took part in the program as well. “Now family understands why they have to repeat the same thing five times. Now they understand why their loved one gets impatient or responds differently to lights and sounds. It helped them understand their loved one and how to live with the disease as well.”
Relationship-centered care, by professionally trained care staff
Other retirement communities also use the virtual dementia program, including staff at Alavida Lifestyles and elsewhere. Training and support, says Beckett, "is deeply rooted in relationship centered care and wellbeing – to ensure that our residents feel belonging." Coupled with training in Gentle Persuasion, care staff in these communities are exceptionally well-trained in patience and empathy with dementia sufferers.
Ratios of care staff to residents are also kept to a minimum at many communities, to maximize care given to each resident. For example, at Credit River in Mississauga, this ratio is kept to six to one, says Bobbie Seaton, supervisor of Memory Care. "Everything is very tailored to person-centered care here," she adds. "We take information from families and customize it for each individual. In the end, we're able to appeal to each resident's uniqueness."
"That's really what makes our community special and unique," echoes Jennifer Beninato, MemoryPlus Manager at Delmanor Elgin Mills. "Our kind, dedicated team members. Each team member was carefully chosen, and each and every one comes with a rich history in dementia care. Time and time again, our families express their gratitude and how it’s clear to them how genuinely our team cares."
Spaces that promote calmness
The centerpiece of Davenhill Senior Living’s memory care floor is the simulated beachside quiet room. The “ocean room” features Muskoka chairs, an aquarium full of fish, seaside sounds played over speakers (including waves and calling gulls) and even sand for people to sink their toes into. “It’s perfect for those times where people feel the need for a quiet spot to calm down. They come here and they hear the sounds of the ocean and you can just see them lighten up,” says Janice Pitts, the community's Executive Director.
It’s a solution that works for people experiencing the anxiety and agitation that are symptomatic of dementia, especially sundowning. No matter who you are, it’s hard not to feel calmer when you are in the beachside room at Davenhill Senior Living.
At Schlegel Villages, you’ll also find intimacy created in “neighbourhoods” following from the village concept to Schlegel, but every Schlegel community has a neighbourhood dedicated to people with Alzheimers’ and other forms of dementia. Its memory care neighbourhoods, found in its Villages across Ontario, are ideal as a stopgap for families waiting for a long term bed in that province. As Barb Sutcliffe of the Village of Winston Park in Kitchener says, “this affords people the opportunity to get the support they need as an interim step.” Emma’s Neighbourhood is the name of the memory care neighbourhood at Winston Park. Sutcliffe says, “It’s a safe, secured environment, where there are registered staff on duty 24 hours a day.”
Creation of a more homelike feel
The intimacy and peace found in these spaces is part of an effort by designers like Toronto’s Andrea vander King to "as much as possible, mirror life through the creation of familiar surroundings." Schlegel Villages remain a superior example of this, with the layout of every community mimicking a village, with a main street, town square and shops to create a pervasively familiar, small town feel.
A “homelike feel” is critical to memory care at Carp Commons, one of many Verve Senior Living properties across Canada. One of the features of this community, just outside Ottawa, is its “Household Suites.” Here, a minimum number of residents live in a quiet, comfortable environment that includes a private family style dining area. We don't take a "one-size-fits-all approach," says Sales & Marketing Manager Rebekah Gunning, but instead, "focus on reducing anxiety for residents and their families."
“At our communites," says Elaine Wood, Vice President of Delmanor, "we have a life skills area, where we have an office set up, everything is there for them to be able to go to work and for them it’s about being able to continue doing a job. But Life Skills is only one component of our MemoryCare Plus neighbourhood…Our dementia design expert has helped guide us in others. One of the important design elements seen in our communities is the indoor porch.”
Similarly, Annette Polasek is proud of “Personal Care Households” at Wintergreene Estates in Regina. 12 units are "designed in a circle" to eliminate dead ends and wrong turns that can easily cause disorientation for dementia sufferers. As she says, "The resident always end up back at their room." It’s a wonderful instance of continuous circulation paths, an important component of many of the best memory care communities.
The layout of Credit River's memory care floor is also circular, "really more like two households in a kind of figure 8," says Jill Somerville, the community's Senior Sales and Marketing Manager. "Inside, there's a very bright and happy feel. The suites, too, are very relaxing. One family member has called our suites a 'zen zone,' where it's so easy to decompress and relax."
One of the design features you’ll immediately notice on Davenhill Senior Living’s memory care floor is closets and doors wallpapered with the appearance of a bookshelf. This is also in line with a principle of minimizing seniors’ tendency to confusion, wandering or elopement. Memory care residents are discouraged from opening a door that may only confuse them.
As much as possible, we try to mirror normal life through the creation of familiar surroundings.
These design innovations are not meant to "trick" those with dementia but to guard safety and security and remove things in their environment that may make them apprehensive or disoriented. This softened feel supports better personal relationships among everyone (staff and senior residents) "and stress levels are minimized."
Encouraging memory and social interaction
Many communities offer brain games and other programs that facilitate and improve memory. One exceptional example is The Healthy Minds Program at Ravines, Promenade and Park Place in Ottawa (all owned by Alavida Lifestyles). Maggie Beckett, Alavida Lifestyles' dedicated Director of Memory Care and Clinical Services, focuses on helping all family members through their journey with Alzheimer’s. Music Therapy is a critical component of this program, also. You’ll find a certified Music Therapist regularly visiting any Alavida community, facilitating its Music & Memory Program. "The program gives our residents a renewed meaning and connection in their lives through the gift of personalized music," says Beckett. Music is demonstrated to stimulate memory and exercises specific parts of the brain.
Carp Commons ensures “research-based, professionally directed, and completely customizable activities” for those in memory care, according to Gunning. “This includes brain fitness, cueing and reminder exercises. These help bring out the best in our residents and support a positive outlook and overall mental health.”
The Music and Memory program at Schlegel supports residents living with dementia, using music that helps bring a sense of wellbeing, improves mood and soothes any negative stress they may be feeling.
The Java Music Program is another noted program found at memory care communities across the country, including McCowan Retirement Residence in Scarborough. Here, the Memory Lane (its dedicated memory care floor) activity calendar includes Java Music Club twice per month. This program encourages social interaction through music, helping to alleviate the isolation inherent to dementia while also encouraging memory retention through music.
And in a unique take on social interaction, Credit River encourages internal residents to work with those in memory care. "Residents from independent living come in for reading programs and baking programs," says Seaton. "It's really a very homey communal environment here."
Use of latest technology
Innovations in technology are at the forefront in memory care as well.
Call badges. At Symphony Senior Living communities throughout Ottawa, the security of dementia residents is safeguarded through the use of pendants equipped with GPS tracking. Under this system, used with the enthusiastic consent of family members, dementia patients who have a tendency to wander are given a Momentum Badge. The Badge is used to call for help if they need it.
Real time location systems are a simple way of tracking the whereabouts of those suffering from dementia and the tendency to wander, and inobtrusive use of GPS is found in an increasing number of memory care communities across the country.
WanderGuard is another similar technology used in communties such as Credit River (see above). "It looks like a watch," says Seaton, "but it signals to staff and beeps to staff's phones, so that staff can respond when a resident needs direction."
Snoezelen rooms create a “soothing, stimulating environment” for Alzheimer’s Disease sufferers, as noted by Kolasek. Other memory care communities including many Schlegel Villages are also equipped with Snoezelen rooms.
Circadian lighting. Harsh or overstimulating lighting is known to exacerbate the effects of sundowning, a syndrome strongly associated with Alzheimer’s Disease and dementia. Davenhill Senior Living is one of the first communities in Canada where the lighting mimics circadian rhythms. This has a calming effect on residents here.
Every room in the Davenhill is equipped with a Google Home unit, as well. Residents adapt well to this simple, unobtrusive technology, understanding they can control music and other environmental elements. One senior at the Davenhill likes to speak in the Spanish of her childhood and Google Home is an easily accessible help with this. “Sometimes she’ll go back to her Spanish and it helps us translate,” says Janice Pitts of the Davenhill.
One senior at the Davenhill likes to speak the Spanish of her childhood and Google Home helps staff easily translate.
The residents adapt easily to the availability of Google Home in every room. “They love it that they can find and play old music,” she adds, “things like Cole Porter and the old standards. They can play anything that suits them.”
“It’s really important that we look at everything through the lens of our residents,” says Elaine Wood of Delmanor. "MemoryPlus is about looking at dementia through a different lens. It’s about saying to people that, although I have dementia, I’m still here.”
It's an ideal held by many in the memory care field. And as, Bobbie Seaton of Credit River says, "just because there's memory loss, doesn't mean that we can't make life amazing and make every day enjoyable."
*Dementia Awareness Competency Evaluation
- Jim Huinink