Assisted-living communities have become the fastest growing long-term care option for seniors. These communities offer combined supportive housing and services, including assistance with meals, transportation, and activities of daily living, medication management, and a range of healthcare services. The most recent 2015 Genworth Financial Cost of Care survey revealed that the average annual cost of living for a private room in an assisted-living community in the United States is $43,200 compared to $91,250 for a private room in a nursing home.
The average age of residents living in assisted communities is 85 or older, the majority are female, and more than 40 percent require assistance with three or more of their daily care needs. In the last 10 years the incidence of dementia in these communities has shown a dramatic increase. This trend has presented new challenges for assisted communities. Specifically, the primary reason that residents are discharged from a community is related to cognitive and behavioral symptoms related to dementia.
To address this challenge, many assisted-living communities are developing memory care units to provide more intensive and specialized care to those with dementia and to retain existing residents in their communities. These units are either being retrofitted into existing structures or free-standing buildings are being created on continuum-care campuses to allow residents to remain in communities by simply being relocated to another building.
However, the creation of a good memory care unit/facility is not simply the placement of a lock on the door and increasing staffing ratios. A quality memory care unit should be designed, built, and staffed with the understanding of the progressive needs of the disease. Thus, the physical environment becomes part of the therapeutic process. A focus only on aesthetics is not a therapeutic environment. The senior care industry continues to move away from designing facilities that look institutional in nature and is steadily moving toward the development of facilities that physically appear more home like. While a familiar and welcoming environment has been found to be critical in emotional and physical healing, dementia care facilities are challenged to incorporate more than home-like amenities. Evidence-based designs and features based on the science of the many diseases that cause dementia are critical to providing state of the art person-centered dementia care.
As we continue to advance our knowledge of the progression and impact of the diseases that cause dementia, we are compelled to develop environments that address the brain changes to improve the quality of the person’s daily functioning. Research on therapeutic environments has focused on primary areas of the brain that are damaged and has examined the effects of environmental changes to improve functioning and overall well-being.
A good memory care facility should have a strategically designed environment that best meets the needs of the individual with deficits by creating a physical space that will help compensate for lost skills and to highlight remaining skill sets. It is also important to keep in mind that while the primary focus is on the needs of the individual, the family and staff/caregivers can also benefit from interacting in a therapeutic environment. An environment that supports positive interactions, ensures safety, minimizes care demands, manages behaviors, and overall provides a soothing and welcoming experience reduces caregiver stress and subsequently yields better overall care for the person.
Lori Stevic-Rust, Ph.D., is the owner of Stevic-Rust and Associates, a Willoughby-based practice that educates healthcare consumers through television, radio, print ads, books, and national speaking engagements. She is also a national consultant for Artower Advisory. CBC readers can forward questions or inquiries to her at firstname.lastname@example.org. Her website is doctorlori.net and her Twitter handle is @drlorimindbody.
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