An integrated approach to memory care

Heritage Senior Living, the largest senior living provider based in Wisconsin, has built a person-centric approach to memory care called “Toddy’s Touch.” The program is named after the mother of Heritage Senior Living founder and president Milo Pinkerton, who lived with Alzheimer’s disease.

Toddy’s Touch embraces nationally-known best practices in memory care and emphasizes the value of relationships while encouraging effective and person-centered communication. When a new memory care resident joins a Heritage community, a Heritage life enrichment specialist conducts interviews with family members and the resident to put together a life story that includes details, memories and preferences about the resident that can be woven into an individualized care plan. These plans are updated twice each year with the resident’s family.

This type of individualized care is not possible without a talented and dedicated team of caregivers. Often, caregivers interact with memory care residents more than anyone else. Instead of a one-size-fits-all approach, both resident care and the community design will need to become much more personalized for each individual’s holistic needs from life enrichment activities to culinary options.

Multi-sensory activities

The “Toddy’s Touch” approach to memory care utilizes a variety of therapies, including art, music, culinary, gardening and intergenerational activities to both stimulate and calm residents. Beyond building cognitive strength, a goal of these therapies is to reduce dependence on medication.

Many memory care units also incorporate Snoezelen rooms that use light, sound and music, touch and scent to initiate sensory stimulations in the brain. For example, a Snoezelen room might have a lava lamp, scented candles, light patterns projected onto walls, music, squishy bean bags or fiber-optic lights. These rooms have been shown to promote feelings of calm, especially in residents with late-stage dementia, those who wander and individuals who experience sundowning or agitation.

Heritage Senior Living offers the music program, “A Measure in Time,” based on the well-known Music & Memory program. Each memory care resident is provided with a personalized music playlist to stimulate meaningful recall of fond memories and create opportunities for expression.

Another vital addition to today’s memory care units are dementia stations. These areas allow residents to touch familiar objects in a safe environment. For example, a desk would have drawers that open but don’t slam, a work bench might have a soft hammer but no nails and a fishing station may have a pole but no hooks. The idea is that these are part of once familiar activities for residents. By participating in them, residents use multiple senses that can stimulate the brain and cause deeper engagement with the world around them.

Technology integration

Older adults entering memory care communities today are more comfortable with personal technologies such as computers, tablets, smartphones and wearable devices than yesterday’s seniors, and that comfort level will continue to grow in the future. Some senior living providers are experimenting with providing tablets preloaded with memory games and brain twisters and can also be used to order meals or schedule life enrichment activities.

Technology integration is also vital for communicating with families. Caregivers need to have convenient access to email with families, who expect more real-time communication about their family member’s health status and activities. Video conferencing technology is also a priority, as some families may wish to see their families. This does not have to be anything fancy—many communities use FaceTime, Skype or similar consumer applications. This will become even more critical as telemedicine continues to grow and more health consults are conducted via video.

Community design

Pinkerton is an architect by trade and designs all of Heritage’s memory care units to help make residents feel as comfortable and safe as possible. An uncomplicated circular building design eliminates dead-end hallways and any anxiety they may cause while allowing residents to stroll freely through a safe, peaceful and familiar environment. This so-called “donut design” creates a never-ending corridor for residents to explore and is at its best when it surrounds an interior courtyard that allows memory care residents to safely access the outdoors.

Other best practice memory care design elements include:

• Open communal spaces on each floor offer residents an unintimidating venue to socialize.
• Resting areas throughout hallways provide residents comfortable places to sit if they get tired.
• Memory care suites feature an open concept layout: one room for the bedroom and living area plus a bathroom. This design helps residents know where they are at all times and can prevent falls stemming from confusion.
• Each Heritage memory care unit includes a memory box at the entrance to residents’ suites where residents and families can post photos and memorabilia that may spark conversation and help share each resident’s personal story.
• A neutral color palette for memory care suites soothes and calms residents and gives them the freedom to personalize their own space.
• Large windows allow for maximum natural light, which helps keep residents’ Circadian rhythms in place. Outdoor views can also prompt positive sensory stimulation.
• Some communities are experimenting with artwork that helps direct movement around the space, such as birds flying or horses running in one direction to help residents understand how to navigate through the community.

If memory care is part of a senior living community with multiple levels of care, such as independent or assisted living, it is important the entire community is as compact as possible rather than featuring long connecting hallways to reduce fatigue and anxiety. This is especially important if one spouse is residing in the assisted living portion of the community and the other is in memory care.

Until new treatments are found, it’s up to senior living providers to make memory care communities as engaging and comfortable as possible for residents.

Jaime Schwingel serves as vice president of clinical and medical operations at Heritage Senior Living, where she is responsible for overall resident care at Heritage’s 15 senior living communities. She has more than 20 years of nursing experience, including 13 years in leadership roles. She can be reached at jschwingel@heritageal.com.