The Rise of Dementia Villages — The Happiest Places on Earth?
WHY YOU SHOULD CARE
Because independence doesn’t need to end with the onset of dementia.
With its aging brick walls, fading paint on concrete steps and nondescript window drapes, Lakeridge Seniors Residence in Penetanguishene, Ontario, looks like many of the assisted living facilities in towns across Canada. Only inside, this one houses a memory care center that’s one of a kind in the country — designed to trigger positive recollections as well as stimulate chatter about the good ol’ days for dozens of residents living with dementia.
Some seniors shuffle by a retro barbershop, where they reminisce over what haircuts and other services once cost in bygone eras. Others push walkers through a hallway with walls meant to mimic the exteriors of their old homes — brick, pink stucco and wood shingles that conjure up nearby cottage country. There are calming rooms aplenty for moments of agitation, including one with an aquarium, sand on the floor, beach chairs and a water scene that stretches along the walls and onto cloud-covered ceiling tiles. There’s even a vintage 1947 Dodge sedan, wheeled in after a wall was broken down. “It was always my dream to change the way we care,” says Dawn Wiggins, the residence’s former director of care who helped introduce these elements a few years ago.
Some have questioned whether it’s ethical to be deliberately deceitful by creating false realities for those with dementia.
Though nestled away in a harborside town of just 8,962 people, Lakeridge Seniors Residence (formerly the Georgian Bay Retirement Home) is one of a growing number of facilities coming to life around the world with fanciful memory care amenities. Wiggins is now working on a new dementia residence set for Ottawa with similar features, while a few years ago, Baylham Care Centre in Suffolk, England, created a replica street from the 1950s to help patrons revisit happier parts of their past. Entire villages catering specifically to those with Alzheimer’s disease or other types of dementia are now in the design or construction phase in Rotorua, New Zealand, and Rome, Italy. Plans for a town square in San Diego included offices with typewriters so participants can “go to work” and an old-school diner. “I’m getting calls from all over the country saying, ‘How do we get this here?’” says Scott J. Tarde, CEO of George G. Glenner Alzheimer’s Family Centers, which is behind the town square project.
Interest in these kinds of memory care centers is on the rise as more seniors face memory-related losses. Nearly 47 million people worldwide were living with dementia in 2015, and that’s projected to top 131 million in 2050, according to London-based Alzheimer’s Disease International. Costs at one of these centers can vary widely depending on a person’s insurance coverage, how their country’s health care system is funded and the level of support they need. In U.S. currency, it’s $1,500 to $3,300 each month at Lakeridge Seniors Residence; the nonresidential daytime town square in San Diego will run $65 (half day) to $95 (full day). Another consideration among elder-care experts is borrowing best practices from other countries.
That’s how nursing professor Jenny Carryer of Massey University in New Zealand ended up in the Netherlands in 2016. She visited Hogeweyk, a sort of Disneyland for those with dementia — and the inspiration for many of Wiggins’ designs at Lakeridge Seniors Residence. Located outside Amsterdam, Hogeweyk opened in 2009 with seven “lifestyles” that seniors can choose from to enjoy the kind of food, art, music and furniture they were once accustomed to. Carryer left impressed by the amount of freedom residents had to move around and the depth of involvement they had with staff in meal preparation, laundry management and gardening, which helped them maintain what Carryer calls a “sense of purpose.” During one of her meetings in a community restaurant, a resident wandered in and took a seat. “The staff just served a drink, and she sat through our meeting,” says Carryer. “It’s so different from where people are restrained, constrained or shouted at.”
Many of the principles underlying the care at Hogeweyk and similar residences stem from reminiscence therapy, which helps people discuss past experiences and usually involves prompts through photographs, music or household items. The practice is being leveraged by the town square in San Diego, where design aesthetics will mimic the 1950s and ’60s. “For us to take average participants in their early 80s back to that time period is powerful,” says Tarde. “We’ve seen the results over and over of when participants get nostalgic.”
In recent years, virtual reality experiences have also been used to stimulate reminiscence and conversations, as has been the case at more than 20 residential homes under Mercy Health in Australia. How safe is this though? Researchers in France recently reported that VR-based training can help elderly people with cognitive impairment and dementia and noted users feel low discomfort, anxiety and fatigue. More companies are also creating VR programs that assist in treating issues related to dementia. “The whole space of using digital tools like virtual reality to help alleviate symptoms of depression, anxiety or loneliness is really exciting,” says Damian Moratti, CEO of Liminal VR, an Australia-based startup that created a VR experience to help long-stay hospital patients.
Some have questioned whether it’s ethical to be deliberately deceitful by creating false realities for those with dementia. And patient advocates recommend scrutinizing which amenities a memory center might include. Wiggins says some bigger retirement home brands prefer to keep a corporate aesthetic over offering, say, contrasting colors in the bathroom for those with poor depth perception. “They want to keep everything pretty,” says Wiggins. “Well, with dementia, it’s about the environment — it has to be what suits them and where they are in the moment.”
This feature was originally published in July 2017.