As memory care providers compete to meet the needs of a growing segment of Americans with dementia, many are turning to innovative solutions that revolve around engaging the senses.
By 2050 the number of those 65 and older in the United States is expected to almost double, and those 65 and older with Alzheimer’s disease, the most common type of dementia, may nearly triple, from 5 million to as many as 16 million, according to the Alzheimer’s Association.
With the growing number of those who will need memory care services, operators are implementing unique ways to serve residents and compete among industry peers.
While Snoezelen Therapy is not new for use among those with disabilities, its emergence on the memory care scene is slowly growing.
Snoezelen, or a controlled multisensory environment (MSE), allows memory care residents to guide their own therapy. Lights, sounds, textures and aromas stimulate a variety of senses, promoting both relaxation and a sense of control in a Snoezelen Therapy room.
Costs can range from $8,000 to $40,000, depending on the scope of the therapy environment, according to an article in the National Review of Medicine.
“A starter kit with bubble tube, tactile quilts, fibre optic lights, and music costs about $7,000,” the article says, adding that the average room costs about $25,000 to set up.
In the Snoezelen rooms at Tulsa, Okla.-based Senior Star’s four memory care facilities, two to five tubes built with distilled water that bubble give residents the opportunity to control the frequency of bubbles, water color and more.
The program is designed in a moderately-sized room to create an intimate setting, and residents are always accompanied by a staff member. Only one resident uses the room at a time.
Other features include a light product that promotes eye and hand coordination. When a resident makes a noise, such as clap, he or she will see light movement on the wall.
“It can bring residents from a high level [of emotion] to a state of calm,” says Letitia Jackson, vice president of health services and programming for Senior Star. “It helps them manage those difficult emotions. It provides tactical, visual stimulation and individual control, which often people with dementia feel like they’re losing.”
Research supports the positive impact of MSE therapy among seniors with dementia.
A recent study published in the American Journal of Alzheimer’s Disease & Other Dementias found that non-pharmacological interventions, such as multisensory stimulation environments, have demonstrated the ability to reduce inappropriate behavior among individuals with Alzheimer’s disease.
“The use of these interventions, where feasible, should be considered prior to the use of pharmacological methods,” concludes one 2009 study published in the American Journal of Alzheimer’s Disease & Other Dementias, which compared incidences of problematic behavior among those with Alzheimer’s disease in long-term care facilities who were and were not exposed to MSE.
Just as MSE therapy helps residents, it helps staff as well.
“It’s difficult for our staff who get to know and care about our residents see them in a state where they are distraught or afraid,” Jackson says. “So, care staff being able to be with residents as they calm themselves by using different tools in the room has a great impact.”
The biggest challenge to rolling out the therapy rooms was helping family members and associates understand the benefit of the room, Jackson says.
“Some people are uncomfortable and don’t understand what it is and how to use it,” she says. “It’s getting people to embrace anything that is relatively new.
Once employees were educated about how the room works they promoted its use.
“We’ve seen the room do remarkable things,” she says.
At Silverado Senior Living, a memory care provider in eight states that also offers home and hospice care, the concept of a MSE is applied throughout its communities’ three neighborhoods.
Each neighborhood is created to meet a different degree of dementia needs, says Stephen F. Winner, senior vice president and chief of culture at Silverado.
“The third neighborhood is the sensory group,” Winner says, noting that the sensory-focused neighborhood houses residents at the most progressed stage of dementia. “Incorporating the senses is the best means to communicate with them.”
Contrary to Snoezelen therapy, the multi- sensory room in the highest acuity neighborhood is meant to get residents awake and engaged, rather than enhance relaxation.
The room also accommodates up to eight residents at a time, and rotates between about 20 different themes.
For example, during a themed-China event, a Chinese street scene with vendors will be played on the TV, including hanging chickens and the sights and sounds of a busy street. Local music plays, incense is burned, and Chinese food and Chinese objects are also featured.
“The purpose of our sensory room is to grab all five senses and re-engage residents with their environment,” he says. “The goal is to trigger deep-seated memory through feel, smell, taste, touch and sound.”
The Bridge: Keeping Couples Together
As couples age, it’s common for one spouse to develop needs different from those of his or her spouse — including dementia care, says Nader Kameli, CEO of Chicago, Ill.-based Bright Oaks Group, Inc. about the impetus for the company’s “The Bridge” program.
Dubbed “The Bridge,” the concept enables couples to continue to live together, even when one needs memory-related care. The program will be at the heart of all of its Illinois and Florida communities, which feature both memory care and assisted living at most locations.
Bright Oaks’ communities have slated open dates between next year and 2016.
“Right now, the industry separates [those who require memory-related care] from their loved ones,” Kameli says. “When they separate it’s difficult for both parties. And, it’s painful for dementia residents as it brings on anxiety and other behaviors that staff have to take care of. The biggest benefit of The Bridge program is that, for the dementia resident, it keeps their loved one — the one most familiar to them — with them.”
The Bridge Program comprises one wing of the building, which houses couples wherein one spouse needs dementia care and the other does not. The wing is secured like a memory care neighborhood, but is open to other residents as well. Other wings include either assisted living or memory care. The spouse of the dementia resident in The Bridge wing can receive assisted living care or live independently, depending on his or her needs.
“Couples that come to The Bridge have different needs,” he says. “So, if you have a couple in their 60s and one is completely independent and doesn’t need us, but the other spouse needs assisted living or memory care The Bridge accommodates that. The couple can be independent inside their units, but have the larger environment to provide support and care when they ask for it.”
A new approach to dining in memory care is doing away with the days of applesauce and fish sticks to give residents a contemporary dining experience: Grind Dining.
Nearly two years ago The Arbor Company decided its memory care residents, served at 18 of the company’s 21 communities, should experience the same quality food as everybody else — but they weren’t sure how to make that vision a reality.
After The Arbor Company reached out to foodservice professionals Sarah Gorham and Stone Morris in 2013 to develop a menu specialized for those with cognitive impairments, a new menu was formed — and the culinary duo soon formed Grind Dining. Grind Dining specializes in recipes for those with a cognitive, neuromuscular or chewing disorder.
Unlike other alternatives to memory care dining, which might include strapping a utensil to a resident’s wrist, spoon feeding or pureeing food, this program consists of grinding the proteins and carbohydrates to make eating possible without utensils.
This process allows the ingredients to retain their natural texture and flavor, thus presenting meals many residents are familiar with from a taste and smell perspective, just in a new form.
The equipment, which usually requires little more than a food grinder, is usually already on site with the food costs built in. Instead of purchasing a separate set of ingredients for memory care patients, such as fish sticks and apple sauce, operators use the same ingredients as those served to other residents through implementing the Grind technique.
“We see the desires and appetites of those in memory care the same as our other residents [in assisted living, or independent living],” Mary Campbell Jenkins, executive vice president with The Arbor Company, says. “What gets in the way is the cognitive and physical changes. We needed to find a way to deliver the same quality food for the resident who needed it in a different format.”
Written by Cassandra Dowell