Chocolate Mousse for four topped with whipped cream and dark chocolate shavings.

Escargot to Chair Chi: Providers Adapt for Memory Care Needs

Catering to the different stages of Alzheimer’s disease and other forms of dementia poses a series of challenges for caretakers, as loss of memory and motor skills becomes more profound with time.

In fact, Alzheimer’s is the only disease among the top 10 causes of death in the United States that cannot be prevented, cured or even slowed, according to the Alzheimer’s Association.

But memory care providers are rising to this challenge, creating innovative programs focused on food and exercise to engage residents and promote wellness at every stage of the disease.

Food: Palate Pleasers for All

One nonprofit continuing care retirement community (CCRC) in Norridge, Ill. has customized an array of dining activities for residents across the spectrum of acuity levels.

For independent living residents, Central Baptist Village (CB Village), which contracts with Morrison Community Living on its food and dining services, offers Savor the Flavor, a program in the main dining area that gives residents a chance to try new or exotic flavors not usually on the menu. Some residents who are in the early stages of memory care also partake in the program.

“This allows residents to stretch their palate and learn more about the world in a way that doesn’t impact their main meals,” says CB Village Executive Chef Davis Knight.

In addition, the once-a-month program allows culinary staff to purchase foods that might otherwise be too expensive for a daily menu.

“A lot of residents grew up during the Depression era, so there is a lack of confidence when it comes to trying anything new,” Knight says. “This allows them to try something new without committing to an entire meal with that ingredient.”

Some Savor the Flavor items have included whole monkfish, escargot, skate fish and buffalo—to name a few.

For those residents still within the independent living wing but starting to show some early signs of memory loss, CB Village developed Culinary Express.

During Culinary Express, hosted once a week, participants receive tactile stimulation by helping to prepare a variety of items. In nicer weather, Culinary Express takes place outside on CB Village’s patio.

Some activities include decorating Easter eggs, decorating cupcakes, making homemade trail mix, and sampling chocolates.

“We have staff from different departments participate,” says Marlene Wolter, culinary services director for CB Village. “We’ve even had employees play guitar and sing during the program.”

Programs like these help to remind residents with memory impairment of activities they enjoyed doing in the past, says Julie Stevens, director of sales and marketing at CB Village.

“Our Culinary Express program is comprised of all women right now,” Stevens says. “They miss that role of housekeeper—the hubbub of the kitchen. They’re not independent enough to be fixing snacks for themselves. This allows them to reminisce about what they used to serve. And, it allows them to be creative in a culinary way.”

Baking Buddies is geared toward those in the mid-stage of dementia or those with higher acuity needs. CB Village’s The Terrace, where these residents live, has a kitchen on each floor. Each floor features 15 home-like apartments.

Baking Buddies takes place once a month in these kitchens, with culinary staff demonstrating how to bake or cook an item from start to finish.

“I try to keep whatever we’re making relatively simple,” Knight says, noting this program runs about 20 to 30 minutes. “Residents are invited to participate, or many enjoy just observing. We’ve made chocolate mousse from scratch. We’ll walk them through the process, and residents can help crack the eggs, sift flour. This gets all their senses involved.”

In the special care pavilion, which houses residents with late-stage dementia and Alzheimer’s Disease, CB Village offers Food Fun. During this program, culinary staff set up shop and make simple treats, such as smoothies, for residents to enjoy.

“We do something very simple, but it’s more about giving them a snack in the middle of the day,” Wolter says. “It’s something for them to enjoy, and it’s made in front of them. Often those with late-stage dementia are challenged with weight loss. They’re not eating as much as they should be. Here they’re getting real food, versus commercially-infused substances that are typically given to this population.”

Regardless of a resident’s acuity level, food programming offers a distinct therapeutic value, Knight says.

“Food is a great vehicle for helping residents maintain that sense of independence,” he says, adding that providers must adapt to the changing tastes and diversity of their community. “Some of the things we’re doing now we wouldn’t have considered two or four years ago because of how much residents’ senses have changed. We’re always trying to innovate.”

Exercise: ‘The Chair Chi Posse’

Memory care provider Autumn Leaves recently launched a new exercise program to engage residents at its more than 40 communities nationwide.

Irving, Texas-based Autumn Leaves certified all of its engagement managers to teach chair chi, a gentle exercise program for people at all fitness levels. Chair chi is an adapted version of tai chi chuan, a slow-motion, moving meditative exercise for relaxation, health and self-defense.

The program is ideal for people living with dementia because it increases cognitive function while promoting strength, balance and flexibility, says Clair Jameson, director of life engagement at Autumn Leaves.

“It’s a very slow and fluid program that promotes hand and eye coordination,” Jameson says, noting this also provides cognitive training for participants.

Tai chi chuan instructor Patrick Griffith created the chair chi more than 14 years ago, and says it helps with cognitive training by implementing word association muscle exercises that “work the muscle and brain.”

“All the movements have names to help participants remember the exercises,” Griffith says. “So for ‘white crane spreads wings’ we tell them to stretch out their arms. This stimulates them mentally as well as physically.”

The exercise also focuses on deep breathing and good posture, which can be a challenge for those with dementia.

“This helps them have a better range of breathing,” Jameson says.

Since implementation earlier this year, the program has been a hit with residents, she says.

“Residents who typically didn’t like to participate in other activities have taken a real liking to this program,” she says. “We’re always looking for new, innovative ways to bring programs to our communities, and this is one of them.”

Many of the residents in these programs are in wheelchairs or have difficulty walking, and chair chi allows them to strengthen their muscles, Griffith says.

“We want them to keep their pride,” he says. “This helps them build their confidence. They’re in a group, and they’re having fun. They call themselves the ‘chair chi gang’ or ‘chair chi posse.’ Adrenaline is a natural pain killer, and we try to make them feel good from inside out.”

Written by Cassandra Dowell