Alzheimer’s disease changes how seniors interpret their environment. Here’s how Harmony Village at CareOne Paramus is using new research to provide care for them.
Joan DiPaola has worked with senior citizens who have dementia for more than two decades, but she says she’s “never been more excited” to work in her profession. The reason: Last year DiPaola, a registered nurse and certified dementia specialist, helped CareOne open up Harmony Village at Paramus, in Paramus, NJ, a trailblazing assisted living community fully dedicated to memory-impaired individuals. Harmony Village at CareOne Paramus’ accommodations include 124 private apartments and four distinct “neighborhoods” for residents with varying stages of memory impairment, making it the only dedicated, assisted living community for the memory impaired in Bergen County, NJ. But the neighborhood concept is only one of the unique features of Harmony Village at CareOne Paramus.
“With each new building that we open, we strengthen our operational expertise and illustrate our strong commitment to seeing older adults with compassion and excellence,” said CareOne Chairman & CEO Daniel E. Straus, when the community opened.
Indeed, DiPaola says, the CareOne team has taken the latest in memory-care research and incorporated it into the brand-new facility. The result? “We’ve completely changed our approach to memory care, and our patients are thriving as a result,” she says.
Here’s what DiPaola and the CareOne team have learned about treating those with memory impairments—and how Harmony Village at CareOne Paramus’ residents are benefiting.
A Person-Centric Approach
Study after study has shown that people with dementia are more likely to thrive in a familiar environment. So residents who are suddenly thrust into a hospital-like setting and forced to follow a new schedule are more likely to become anxious and agitated, DiPaola says. To combat this, DiPaola and other caregivers at Harmony Village meet with new residents and their families to learn their life stories and routines.
“If you’re somebody who has been used to sleeping late for years and years, imagine if you suddenly were forced to be up, washed and dressed, and eating breakfast at 9:30 a.m.,” DiPaola says. “You probably wouldn’t function very well, and we recognize that here.” Instead, DiPaola says, she and her fellow caregivers create a customized schedule for each resident. For example, one woman at Harmony Village at CareOne Paramus likes to sleep until 11:30 a.m. and then have breakfast before getting ready for her day. “We honor those kinds of requests, because we realize that following a familiar routine is important to a person’s well-being,” DiPaola says.
Activities for Every Ability
Another component of Harmony Village’s program is that activities are tailored to the abilities of the residents in each neighborhood. “We’ve learned that every resident has a cognitive ceiling—a limit to how much information they can absorb at one time,” she says. “If you require a person to perform higher than their ceiling, they’ll become self-isolating and maybe even have behavior issues,” she says.
In the past, DiPaola says, health professionals would try to calm such behavioral issues by using anti-anxiety medications. Now, DiPaola and her team members try to design more appropriate activities to help relax residents. As an example, she says, Harmony Village has a cooking club that includes residents who are at both mild and moderate stages of dementia. When participating in an activity like pizza making, the cooking club residents with mild dementia might follow each step of the recipe, while the residents with moderate dementia might be given a single, sensory task, like kneading dough or putting the toppings on. “That way, everybody feels empowered to do something, but no one becomes frustrated,” she says. “Plus, this gives people from other neighborhoods a chance to interact with one another in a productive way.”
A Whole New Language
Here’s another way Harmony Village is different from traditional memory-care facilities: “We’ve completely changed our vocabulary when addressing the needs of our residents,” DiPaola says. For example, she says, “We’ve stopped using terminology that’s age-specific.”
Items that used to be referred to as “bibs” are now called “clothing protectors,” she says. “My grandchildren use bibs, not our residents,” she says. “People who used to be labeled as ‘wanderers,’ now have a more positive label: ‘able to walk.’
“We’re really taking a more positive approach and trying to take away the negative stigma of their disease.” In addition, she says, nurse aides are now referred to as “care partners” who work hand-in-hand with residents and families to provide customized care.
Engaging the Senses
Recent research shows that individuals with late-stage Alzheimer’s and other advanced memory impairments often exhibit symptoms such as challenging behavior, agitation, apathy, and depression resulting from unsatisfying interactions from the environment, limited ability to communicate, and too much or too little stimulation. “Again, the old solution was to treat people with medication,” DiPaola says. A new antidote, and one that Harmony Village uses, is to provide “sensory rooms,” where caregivers use gentle light, movement, music, and tactile objects designed to either calm or stimulate residents.
Harmony Village uses, “sensory rooms,” where caregivers use gentle light, movement, music, and tactile objects designed to either calm or stimulate residents.
“At the late stage of Alzheimer’s people still feel emotion, so it’s very critical that our staff understands that and provides them with things that are calming and pleasing to the senses,” she says. As an example, a care partner may take a resident to the sensory room and treat them to a foot bath, first placing cool cucumbers over the resident’s eyes. Often, dimmed lights and soothing music will be introduced. If someone is confined to his or her bedroom, she says, caregivers will come to the person’s room with a sound machine and photographs to help them relax or stimulate their senses, depending on their needs.
In addition, DiPaola says, residents are assigned consistent caregivers who become familiar with their needs and their likes and dislikes. “So much can be done to help people just by learning more about them,” she says. “We’re providing a whole new type of care.”
Create Your Own Sensory Room
Here are some design ideas that combine gentle light, movement, music, and tactile objects, meant to either calm or stimulate individuals with dementia.
- Find a quiet corner or room that can hold four to six people
- Display a few familiar items to help your loved one relax before engaging in activities
- Include everyday, pleasant smells like chocolate, peeled fruit, or wood; stay away from dramatic smells like perfume
- Use soft, filtered lighting, and not overhead lighting
- Play music at a moderate level to attract your loved one to the space, but not loud enough to overpower his or her thoughts
- Make sure you have something in the room that will stimulate each of the senses: flowers, musical instruments, lightly-scented cushions
- Use items like Play-Doh, sand, or water to stimulate touch
- Use items like buttons, pockets, ribbons, and zippers to stimulate hearing, memory, movement, touch, and vision. Courtesy of alzheimers.net