Answering the Call
With Alzheimer’s rates climbing, local senior care providers are adapting to meet the need.
According to the Alzheimer’s Association, an estimated 5.3 million Americans currently have Alzheimer’s. By 2025, that number is expected to grow to 7.1 million.
As the country’s population ages, the need for senior living facilities that can handle “memory care” has also increased, causing many owners of nursing homes and assisted living communities to adapt their facilities to accommodate this need. Some integrate memory care residents into their existing homes, while others have created homes dedicated solely to people with varying degrees of memory problems. The idea is to offer a variety of lifestyles, so families can find the one that best fits their loved one’s needs.
As we age, a certain amount of forgetfulness is normal, says Dr. David Houghton, chief of Ochsner Medical Center’s Division of Movement and Memory Disorders in the Department of Neurology. “Forgetting a name, misplacing your keys, repeating a story, are all relatively appropriate with aging,” he says, adding that the issue becomes more concerning when the individual begins having problems because he or she forgets so often. Mood changes, such as depression or irritability, can accompany this conditio, called mild cognitive impairment (MCI).
People experiencing serious dementia have difficulty carrying out the activities of daily living: driving, writing a check, buying groceries, etc. At this stage, people may need 24-hour care, either at home or in a facility.
“Some sort of safety net is really the key,” Dr. Houghton says. Although the care must be safe and reliable, it’s important to look for two other characteristics, he says: compassion and understanding.
Maison Grace at The Trace Senior Community
The Trace Senior Community in Covington recently opened a $3 million building called Maison Grace that is dedicated to memory care. Executive Director Richard Totorico says all 24 rooms are occupied, some with people whose family members relocated to the north shore from New Orleans and wanted their loved ones nearby. Maison Grace offers activities seven days a week and has an activity director trained to help those with dementia. Residents also interact with residents in The Trace’s independent and assisted living sections.
Most importantly, family members are welcome around the clock. “We have family members that we kind of adopt,” Totorico says. “We include them in the team.” The Trace also offers support groups: Interacting with aging parents with memory disorders “can be frustrating and overwhelming for a family member,” he says.
Some residents enjoy going out for meals or visits with family members, Totorico says. The Trace also invites nearby schoolchildren to come over in their costumes and trick-or-treat, and asks high school marching bands to entertain during Carnival.
Because memory problems can cause people to become agitated and anxious, staff at Maison Grace are taught to reorient residents with the routine as often as necessary. “Some need reorienting every day, some just certain days,” Totorico says. Each person’s plan of care is reviewed and modified as often as needed.
St. Margaret’s and St. Luke’s
Westbank nursing home St Margaret’s encourages family participation by providing access to residents 24-hours a day.
Photo Cheryl Gerber
Alec Lundberg is chief operating officer of St. Margaret’s, a faith-based nonprofit that includes memory care at its two nursing homes, St. Margaret’s at Mercy and St. Luke’s, on the Westbank. He says families often come to him after a scary episode (a stove left on, someone getting lost) forces them to face the fact that their loved one can no longer be alone at home. He can reassure them that at St. Margaret’s and St. Luke’s, people with Alzheimer’s or dementia will be treated as individuals. “You’ve got to have a staff that is very patient,” he says. “It’s a daily effort.”
Families sometimes express guilt at moving an aging parent to a home, Lundberg says. But finding and paying for in-home care can become too much for many people, and some don’t like the idea of having strangers in their homes. Both St. Margaret’s and St. Luke’s are open to family members 24/7, Lundberg says, and he encourages family members to visit as often as possible. “The best care people receive is when families are very involved,” he says. “We want people to feel cared for and not abandoned.”
There’s a lot of competition in New Orleans for staff members at care facilities, Lundberg says. He looks for people who are warm, welcoming and pleasant. The right attitude can eliminate pushback from residents who are confused or frightened.
Peristyle Residences are former single family homes that have been modified to house up to eight residents. All five residences are currently at 100 percent capacity.
Photo courtesy of Peristyle Residences
Locals Jason Hemel and Sean Arrillaga both have experience working in senior living, and both were struck by how many people who are fairly healthy physically end up in nursing homes if they have problems with dementia and Alzheimer’s. The pair decided to try a new model, creating Peristyle Residences in 2011. Peristyle has five typically one-story, one-family homes in residential neighborhoods, with a sixth under contract. Each home has been modified to include all the safety features needed for seniors, such as doorways wide enough for wheelchairs. Up to eight residents live in each home, with caregivers around the clock and supervision by a RN wellness coordinator.
The idea has proved to be popular, Arrillaga says; thanks to word of mouth, the homes reached 100 percent occupancy in one year. The two say families like the idea that their loved ones are living in a real home, with no elevator or front desk. Families are encouraged to decorate the bedrooms with familiar objects, and staff members carry out lots of small-group or one-on-one activities, such as playing cards or talking about the past. “It all keeps memories vivid,” Arrillaga says.
Hemel says the homes emphasize maintaining a calm, easygoing environment, with lots of the same activities residents enjoyed doing back home. For example, caregivers bring planter boxes on wheels into shady spots so those who enjoy gardening can still work in the dirt. Residents aren’t kept on a strict schedule; they have lots of choice in when and what they eat. Music and pet therapy are available, but Hemel says sometimes the best therapy is just conversation. “You’ll see that it brightens their day,” he says.
Beau Provence, a 46-unit memory care home in Mandeville, uses a model of care designed to help those with Alzheimer’s and Dementia make the most of their abilities as they progress through their disease.
Photo Courtesy of Beau Provence
David Schonberg has made a career of developing a variety of senior residences. Like Hemel and Arrillaga, he felt that people who needed memory care could still participate in a quality lifestyle.
Schonberg recently opened Beau Provence, a 46-unit memory care home in Mandeville. The home is divided into two communities; Schonberg believes that smaller units foster friendships and allow residents and their families to get to know each other better.
Beau Provence uses the Warchol Best-Abilities Care Model, a system of care for people with Alzheimer’s and dementia that centers on making the most of the abilities people still have as they move through the stages of the disease.
“We want people to perform at the best of their abilities,” Schonberg says. “We develop a program centered around what that person can do.” Instead of restraining those who like to wander, for example, caregivers make sure they have lots of opportunities to take walks.
If residents become angry or agitated, staff members are trained to find out the best ways to defuse the situation. Sometimes playing music or looking at family pictures can calm people down, while others find caring for a pet soothing. “It’s different for everybody,” Schonberg says. These methods are a big improvement from ones used in the past, which included housing dementia patients in lockdown units.
“Lots of times, people think there is nothing left,” he says. “We believe there’s still a lot of things left. (People with memory problems) can laugh, smile, dance, still enjoy what they can. They can still be happy.” Although Alzheimer’s and dementia are debilitating diseases, those coping with them needn’t always suffer, he says.
Major medical health insurance doesn’t cover the costs of long term care. Separate long term care insurance may be used to pay for these expenses, whether in a nursing home, skilled care facility, or in a private home. It’s a good idea to discuss coverages with an insurance professional to get a policy that addresses your needs and concerns.
Alzheimer’s Numbers On the Rise
In the U.S.:
• Currently, approximately 5.3 million people age 65 and older
have Alzheimer’s disease.
• By 2025, this number is projected to grow to 7.1 million.
• Approximately 82,000 people 65 and older have Alzheimer’s disease.
• By 2020, that number is projected to be 92,000.
• By 2050, it is expected to rise to 110,000.
Source: Alzheimer’s Association