Memory care is being addressed in a number of long-term living environments, from small house and neighborhood models to downtown and village-like settings. Speakers Eric McRoberts, a partner at RLPS, and Michael Smith, president and CEO of the Alzheimer’s Resource Center of Connecticut, reviewed the pros and cons of these models on Sunday during the Environments For Aging Conference in the session, "Unforgettable: Creating Communities and Environments That Move Beyond Memory Care."
Their discussion illustrated the point that there's not one solution for treating these residents, while also raising the question of whether it's time to stop segregating this population and look for more integrated living solutions.
Smith said most dementia models are fear-based and designed to the worst-case scenario. "We need to get away from that," he said.
For example, citing statistics that 3 out of 5 people with Alzheimer's disease will wander, he said the design response has been to create safer environments by "locking people in" so they can't get out.
McRoberts said another common design approach in memory care focuses on creating settings that simulate reality, such as Main Street environments or stores where residents can shop within their village setting. While we want to make these places feel authentic, there's something that's absent of reality because the only people there are people with dementia, he said.
Instead, the speakers said they'd like to see the industry adopt a more integrated approach, similar to those taken with other disabilities, and to design based on residents' abilities, not their disabilities. "How often do we design for people with dementia where they can see something but can't do it," Smith said.
Citing examples in Europe, McRoberts and Smith talked about taking a community-wide approach to supporting residents and family members with dementia. In the U.K., for example, civil servants including bus drivers have gone through training to better understand the needs of people with dementia.
In North American, Smith while operators and designers can be proactive and change the approach, but he also wouldn't be surprised to see regulations change in the next decade to move away from a focus on "control" or keeping residents segregated in one area to one that's more inclusive and community-based.
The road to a better care approach starts with listening and asking the right people the right questions. "Rarely are we looking to someone living with dementia for answers," Smith said.
For example, the current expectations when designing for dementia care include such topics as safe, respectful, secure, and nurturing. However, when dementia residents are asked to list their wants, they include things like engaging, stimulating, interdependence, personalized, connected, and meaningful.
The stigma surrounding dementia creates a sense of "otherness" that leads people to think they need to create different design solution, Smith said, but in reality, "The things they want aren't really different from what anyone wants."
