From http://www.memorycareformom.com

How Memory Care Is Reinventing Assisted Living

November 15, 20143

by Dana Larsen

Making the decision to move a loved one to a memory care community can be heart wrenching. But knowing that your loved one has the expert care they need—that you may not be able to provide—makes a difference. And these days, memory care offers more than assisted living; it offers improved quality of life with state-of-the-art construction catered to Alzheimer’s residents, as well as, excellent amenities and a plethora of activities.

Just the thought of moving a loved one to assisted living is enough to bring tears to your eyes. It’s emotional. It symbolizes the end of independence and the beginning of the end of someone’s life. This is how the every day America thinks. In fact, to many, assisted living and nursing homes represent the institutional, white-walled environment where all the residents are medicated and not really living. It’s where you go when you have nobody else to take care of you, where you go to get old and decrepit. But the truth is; the vast majority of our fears of senior living are inaccurate. And memory carehas completely reinvented senior care.

What Does Memory Care Offer?

Many of today’s assisted living communities offer socialization, gourmet meals, planned activities and cutting-edge amenities. And memory care offers all of this, as well as, a living environment catered to those with dementia andAlzheimer’s disease. From recreational and social events to wander paths and guards to secured properties and senior clubs, memory care has reinvented assisted living. Many dementia residents have been able to also better regulate their medication/s and learn to walk again. Silverado Senior Living CEO, Loren Shook comments:

“Dementia patients are typically over-medicated. Because of Silverado’s program and their philsophy of giving freedom to live and freedom of choices, with the support of 24-7, licensed nurses and highly trained caregiving staff, we’re often able to reduce medications. And, in many instances, residents come to Silverado unable to walk. Silverado provides physical therapy, encouragement and treatments that enable more than 4,000 residents to walk again; a huge gain in quality of life freedom. In fact, some family members think loved ones have been cured.”

In addition to offering expert dementia care, many memory care facilities these days also offer resort living that caters to dementia sufferers; a sort of juxtaposition of human innovation and the mind’s deterioration to create an ambiance fit for someone living in their own hallucinations and past. De Hogeweyk in Amsterdam is one such example. The founders of this cutting-edge dementia program made the villages a place where “people want to be,” according to Eloy Van Hal, a facility manager. There are no locks and residents come and go as they please, enjoying cafes, the theater, and socialization through community events and clubs.

But what exactly is happening with memory care in the United States? Read on to learn why memory care is vastly expanding and how it offers not only skillful care, but also improved quality of life for many dementia sufferers.

Memory Care Development Booming Across America

The statistics are staggering:  There are 5.4 million Americans living with Alzheimer’s disease, including one in eight older Americans—and that statistic is expected to more than double in the next 40 years. Alzheimer’s is also the 6th leading cause of death in the U.S. and the only cause of death among the top 10 in the U.S. that cannot be prevented, cured or even slowed, according to the Alzheimer’s Association.

With this “Silver Tsunami” of aging baby boomers, the senior care industry is breaking ground on many memory care communities to support the demand. In fact, according to Senior Housing News, “Development activity for memory care is far outpacing that of other senior living sectors, but oversupply isn’t a concern considering the concentration of projects in a few hot markets and staggering upcoming demand.”

There is literally not nearly enough supply for the memory care demand. For example, the existing memory care inventory numbers are less than 75,500 in the top 100 metro areas tracked by the National Investment Center (NIC) for the Seniors Housing & Care Industry, which is why developers are gearing up for the market’s demand. In fact, there are just under 49,000 memory care units undergoing construction in 2013. Chris McGraw, a senior research analyst at NIC discusses some of this growth: “Freestanding memory care [in particular] does have quite a bit of construction and it’s grown very rapidly because one, they’re starting a fair number of units, and two, because there aren’t a lot of existing units.”

Daily Memory Care Inquiries and Demand For Care from Families

A Place for Mom saw a 35% increase in seniors moving into memory care settings over the past two years.  This is because families want to find good care for their loved ones when they no longer have the resources and expertise that is involved with dementia care.  Michelle Egerer, Regional Vice President at Silverado Senior Living, feels passionate about the services her company offers not only to seniors, but also to their families.

“What Silverado wants to do is change the world in the way in which memory care services are provided to those who suffer from various memory care impairments. We want to give life to residents—to be able to give families a peace of mind and understanding that there is a life for their loved one with the special care and special services Silverado provides.”

Michelle feels that Silverado’s 24-hour nursing care and engaging programs that promote individuality and socialization benefit dementia suffers and provide more peace of mind for their families.

But what makes memory care so unique? In addition to social activities, a pleasing ambiance and fun amenities, memory care treatment programs often feature:

• A secure environment, while allowing healthy wandering
• A low staff-to-resident ratio
• Sensory-based programming
• Color-coded hallways and design features to facilitate easy navigation and reduce anxiety for residents
• The ability to accommodate residents in the early, middle and late stages of Alzheimer’s and dementia

Beverly Sanborn, Vice President of Program Development at Belmont Village Senior Living, discusses why her company is expanding their dementia care and memory care housing and services.

“The memory care programming is moving from the leisure model to the therapeutic model. By offering more than just enjoyment and socializing—by also including goals for the wide-range of programs you offer that are both measurable and track-able, an improved level-of-care is being seen.” Beverly continues to discuss how memory care has much to offer seniors and their families as far as catered programs, specialists and even buildings designed to deal with wandering and memory care impairment. “In a full-scale memory care program, the goal is for the resident to function at the highest possible level and to maintain that level for as long as possible. If you provide mental, physical and nutritional health at optimal level, you should be able to improve mental acuity for at least a 6 month period. This is very positive for the sense of well-being for the resident, as well as, being gratifying for the family.”

Memory Care Facility Information

Every now and then I get an e-mail from Memory Care Support Facilities asking me to share their information with my BLOG readers. Usually I have avoided doing this as they are commercial ventures and I am not. But I have decided to include this type of information in a post when I receive it as it may be beneficial to you. I am not supporting or vouching for this establishment but their information looks good as does their web site. If you are in California check them out!

http://activcareliving.com

Memory Care Facilities

So it turns out that my instincts were correct in what to look for when I visited Alden Gardens and Sun Rise. This came across my e-mail today:

Tips to Choosing a Strong Memory Care Community (From https://www.emeritus.com)

Memory care for residents with Alzheimer’s or dementia conditions is usually provided in a dedicated community, or a special care section in an assisted-living or skilled-nursing community.

Because of the nature of Alzheimer’s disease and dementia, it is crucial to find a community where the staff is highly skilled and experienced in caring for this fragile population and significant safety precautions are in place.

Once you know the particular special care needs of your loved one, here are some of the things you need to look for when visiting a care community:

The Environment

• Do the residents have adequate privacy for bathing, toileting and hygiene?
• What safety measures are in place for residents with Alzheimer's and dementia?
• Are there door and window locks, motion detectors, monitoring systems, adequate lighting and no-slip flooring?
• Is there an outdoor patio or walking area that is easily accessible to residents yet enclosed to prevent wandering away from the community?

The Staff and Care Team

• How much time does the staff take to gather information about a resident in order to provide the best care for them?
• How does the staff handle challenging resident behavior?
• Do the caregivers have specialized training in effectively communicating with and caring for residents who suffer from Alzheimer’s or dementia?
• Do the caregivers interact with residents in a comforting and professional manner, maintaining their dignity and respect?
• How do the caregivers deal with the progression of the disease?

The Residents

• Are residents actively engaged in activities that are appropriate and interesting to them?
• How is their hygiene? Do they have brushed hair, are clean-shaven, are wearing matching, clean clothing, and free of incontinence odors?
• Do the residents appear to have a level of dementia that is consistent with your loved one’s current needs and behaviors? In many cases, communities specialize in a certain care level that may not be appropriate for your loved one.

For individuals living in a special Alzheimer’s or Dementia care unit in an assisted-living community, there may come a time when they need more advanced medical care, which would be skilled nursing care.

Looking for Home II

This weekend, while in Battle Creek Michigan visiting Gregory's family, niece Colleen and I checked out two more Memory Care Facilities. Same experiences more or less: Clean. Friendly. Safe. Expensive. Average age 80+. Reinforces the need to keep Gregory healthy and happy and at home for as long as possible.

Received this e-mail from Michelle who took us on a tour of "The Reflections."

Michael,

Thank you for your email. I scoped out your collection of tiny treasures and your blog. I could not stop reading it. It is very honest, raw, and full of emotion. You are doing a great job. Would you mind if I passed your blog link onto my co-workers? Please let me know if there is anything else I can help with.

 

Blessings,

Michelle Huffman

Looking for Home

What makes a home? I have been thinking about this recently especially in relation to my "research" on future possibilities for Gregory. I have visited several Memory Care Facilities so I can get an idea of what is out there. I think that Gregory is far from needing to be placed in one but it is always good to be prepared.

As long as I can physically take care of him, he will stay at home with me. As far as the emotional ride and how it affects me, that is up to me to keep in check. Also there are many options available to us before placement like home health care, a live in companion, visiting nurses, etc.

After visiting Arden Manor in Northbrook and Sunrise Manor in Wilmette it has taken a while for me to be able to put to words the image in my mind which I took away from the visits. I am sure this time lag is due to the emotional content of my processing.

Both places were clean and orderly. Neither smelled like "old people" or urine as my boyhood memory served from when I used to visit my Grandma Lindenbaum at her "old people's home." I remember my mother feeling guilty at putting Grandma in the home but mom could no longer provide for her mother's needs and it was probably a good decision. While my decision will be a hard one if I have to make it, I will not feel guilty.

In some ways, as I walked the halls of the memory care facilities, I was shocked that I was thinking in terms of Gregory. In terms of my parents, OK, makes sense. But in terms of my boyfriend, my lover, my life companion, my most important other person in the world, my peer ... FREAKY!

Luckily mom and dad were able to "find their way out" without having to go to a "home." Gregory's dad avoided the "home" and Helen did need an assisted living environment but she was alert and active and involved enough in life that the facility she was at was really more like a smaller apartment with a restaurant down the hall and help available as needed.

Both Arden and Sunrise were nicely furnished with little private areas and nooks, protected gardens and walking paths, TV's, restaurant type dining rooms, porches, sun rooms, activity rooms, and even barber shops.

Arden was set up like four neighborhoods surrounding the public spaces with each one decorated in a different theme and different color for easy recognition by the residents.

Sunrise was more "institutional" with the more alert, active people having their rooms and public spaces on the first floor and the more disabled people living on the second floor. Why in facilities of this type do the more disabled people end up being higher in the building?

Arden and Sunrise are specifically for memory care (nicely euphemistic) so some of the props placed around are stuffed animals, play areas, cribs & baby dolls, children's toys and puzzles. While seeing these things was mildly disconcerting. 

These types of items do go along with the research into what people with dementia need as they regress to child like behaviors or earlier parenting skills for their own children or realistic delusions.

Sunrise has a resident cat which is a nice touch. 

In both places, all exit doors are secured and need a code to be opened. In the event of emergency, the panic bar sounds an alarm and opens after 15 seconds, the idea being that staff can attend to the emergency (if there is one) but people could escape in case of fire within 15 seconds which wouldn't be too long a wait. 

Arden has extensive gardens all around the building and Sunrise has fewer. But all of the gardens are open to residents, secure areas, monitored every 30 minutes, and locked at night or in bad weather.

Meals are served with a choice from two or three entrees, help with eating is provided as necessary, snacks are always available including freshly baked cookies (I had one,) fruit, juices, coffee, etc. Often specific items can be requested like a peanut butter and jelly sandwich or butterscotch pudding.

Resident schedules are respected so the can get up early or sleep in. They can get dressed when ready and their breakfast is held until then. Lunch and dinner is served at the same time but if the resident isn't hungry it can be covered and refrigerated.

All resident rooms in both places are checked and each resident spotted where ever they are every hour during the day. At night rooms are checked every two hours. If necessary they are reminded every hour, "Do you need to use the bathroom?" 

Both places have daily activities which consist of exercise, arts & crafts, discussion groups (should be interesting to witness,) movies, TV, music hours, guest performances, and field trips.

A relaxed attitude towards the usual outward demonstration of dementias was comforting. When asked if people steal from each other the response was, "Oh yes, sometimes. But we know who does the stealing and we periodically check their room and return the stolen items." 

What if a meal left for someone in the refrigerator is eaten by another resident? "Oh we will just make a new one. Apparently the interloper was hungry." 

What if a person gets hostile or violent? "We try to find out what is troubling the person. Their acting out is usually part of a lack of communication or understanding and we can handle that. In extreme cases we ask the doctor what he might suggest, but that rarely happens."

Chatting with the intake person, it seems that dealing with dementia patients is so easy. Maybe it is for them because the interactions are not loaded as they are with loved ones who are witnessing the decline. Also it is what they are paid to do and they get to go home at the end of shift. For us caregivers it is a 24/7 ordeal.

The same care givers work with the same residents all of the time. Each resident has a few workers if only to cover the daily shifts and the workers days off etc but the caregivers and the residents get to know each other really well and the specific needs and schedules etc work well.

Both facilities work with their residents through death including hospice help when that time comes. If a person is in great need of medical attention then the person has to go to a different kind of care center, which makes sense. But most of their residents who die of the normal process of dementia die out of the home. Sad but also reassuring.

Arden has a fixed fee that only goes up based on cost of living, not a resident's decline. 

Sunrise has a room fee which includes cleaning, meals, and general care but as the needs increase each one has a fee attached. For example if a person needs periodic reminding about bath rooming there is a fee which further increases if the person needs "Pampers," or to be cleaned and changed, etc. Twice a week showers are included but if a person needs to shower more often there is a fee. Medication administration has a fee. 

Both places would be acceptable to me from my surface investigation. Arden seems to be the better, more active, more opportunities of the two. But Arden is a 80 minute drive round trip. Sunrise is just in the suburb next to Evanston, 30 minutes round trip. To be able to visit with Gregory often, especially as I get older, the long drive would be prohibitive.

One deal breaker is the other residents themselves. They are old. Median age is 80 and up. Gregory is 65. Of those residents who are still alert, their alertness is an old age alertness, somewhat cloudy and slow. Gregory is young and vibrant by comparison. 

The final deal breaker is the cost. All memory care facilities of this type are private pay. Medicare and Medicaid do not pay anything towards this type of care. They kick in only when the person is in such medical need that they are in a nursing type center. Would you believe approximately $6,000/month. Ouch!

I think what I was feeling most, however, in seeing these places as future homes for Gregory is that based on both quotes below, for the Alzheimer's resident they are only houses, not homes. It takes a mind and a memory and an active interaction with one's life and with other people to make it a home. 

That is what I was feeling strongly and it made me very sad. Both were lovely houses but home was nowhere in sight. Life was not being lived, only supported and made safe which may be all you can do for someone with advanced Alzheimer's. While it is said that interactions with others is important, I did not see any residents talking to or visiting with another. Hopefully the residents have loving family that visit often.

For Gregory our home is vibrant and his limited abilities do not get too much in the way of his feelings of having a good quality of life.  His life is safe and predictable. His routines are meaningful and his days full. We interact with each other often, enjoy our friends, go out to eat, and attend plays, musicals, operas, and other events. We even (although I do all of the work) entertain some 50+ people at July 4th birthday parties, Christmas parties,  BBQs, etc.

Many other options, cheaper ones, would be to continue having companions spend some time with Gregory and giving me time for errands and personal space. When the time comes; home health care, live in help, and/or visiting nurses should provide the needed services. As long as Gregory continues to be aware of himself and his environment, home matters and I will continue to provide that for him. Why? Because I love him.

•  •  •

A house is not a home unless it contains food and fire for the mind as well as the body. Benjamin Franklin


Never make your home in a place. Make a home for yourself inside your own head. You'll find what you need to furnish it - memory, friends you can trust, love of learning and other such things. That way it will go with you where ever you journey. Tad Williams.

An E-Mail to C and M, Our Niece and Nephew

C & M

How about a visit Wed August 7 through Sunday August 11? We have theater tickets the next weekend.Want to spend longer so G and I could enjoy the area, spend more time with R & L, and more being with M & D. Of course we can never get enough time with you guys but understand that you'll be working during the week. No expectations for your being available during the week.

Interesting comment on thinking about what is still to come. Do you have any idea of what you might be looking for? You certainly are a success in your personhood, your real estate career, your love relationship, etc But I guess that you are still young enough to aspire to more, bigger, better, different, etc. 

For me, I feel that I can relax on that account because I have achieved much and have what I want (given G's Alzheimer's.) I do not find the need to prove myself or to "earn my keep" in society. Been there done that. While Michael's Museum was great and continues to be a wonderful legacy I am happy it is over. I also recently quit Ragdale because my efforts and volunteerism there began to feel like a job. Feels good to say goodbye to them while I hold on to the fond memories of my residency in 2010.

One continuing desire is to be a published author. Not self-publicaiton but bigger. So I guess I think about that but not obsessively and many not strongly enough to really get it done. 

I have begun my first attempt at writing fiction. Based on my real psychic past life regression experience which I think we have talked about. I am researching the time period of each "life" and trying to flesh out a chapter for each person I have been based on the regressions: Carny, Nun, Farm Wife, Rural Child, and Renaissance Baker. 

Travel might be a possibility but only will happen if I can do it by myself, with G being taken care of, and while OK it is a little lonely to do so without him. P has said it would be fun to travel together. She spent a long weekend with G and I in Mexico and I think we would get along as travel partners. 

But for the most part I am content to be at home with Gregory. I can fantasize about big trips to Europe or Japan etc but don't really believe that I have it in me, even with help. Maybe when the ship comes in and we can take R or P along all expenses paid it would make it easier, or with you and M. Fun to think about.

I would like to have more avenues to express my creativity but that seems back door to getting through each day. Sometimes I think that I can NEVER be creative ENOUGH! 

I find that Gregory and my world continues to narrow and we pull in but that is probably a combination of old age and his illness. We keep busy, see friends, entertain, are entertained, enjoy the movies on DVD and our theater and opera adventures. I do not feel the need to accomplish anything great or volunteer and give give give anymore.

G's birthday party was best attended ever with close to 50 people attending. All had a good time. But I find myself saying I need to cut back, after all planning, executing, and cleaning up after a party like that for a man who is almost 70 years old takes its toll. I am not crying "old man" but am getting older, aren't I? Next year fully catered or just having people in for fireworks, cake, and birthday wishes.

Agreed good and bad are one and both part of being alive. One must take the one with the other.

Regarding your question, we are doing fine. I am feeling a little constricted since we have no companion and I had gotten used to have some freedom and alone time. I expect more students will respond to our notice when they begin returning to campus.

Meanwhile I have enlisted R and J to be with Greg for three times so I can investigate Memory Care Facilities in the area. We are far from that need with many options available but I want to know what is available and get a sense for how it might make me feel to think about having to place Gregory if and when it comes to that.

As far as sad, I am sad but that is part of the "life of good and bad" we spoke of. Some days seem slow and dull and others are more fun. But sadness seems to ride on my shoulders as part of who we are today. If I can get through a day evenly without not to many "confusions" with Gregory, I am content.

As far as Gregory's sad, I think he is just getting more and more tired, a little more withdrawn, and more settled into being "less." But he is happy, appreciative, enjoys his food and TV etc.

All for now.

Love you both lots.

m