The Kindergarten at Riverspring Residences in Bronx is a sunny, hospitable space equipped with a rattan, a crib with a musical mobile, some games, bottles, books for sleeping and rack in tiny sizes.
The next morning, Wilma Rosa was there trying to soften one of her crazy, small categories. “What is going on, baby?” He pulled, hitting the complainant’s back. “Are you okay? I want to sleep for a while. ”
Mrs Rosa, 76, a memory care that resides in assisted living, visits the Daily Kindergarten. He had enough experience with babies.
She was the oldest girlfriend of eight children, so she handled many family responsibilities, she told Catherine Dolan, director of the Inrichment of the facility, who asked questions to help the memories flow. Later in life, Ms Rosa worked in a bank and shop. The stories appeared as it hugs the doll.
No real baby live in this flagship environment, where the aroma mixture includes a talc. Just as real sales were made in the store under the corridor, another new Riverspring business.
Through the wooden shelves of clothing, accessories and tchotchkes, sales employees were, such as Ms. Dolan, the members of the staff who were trained to interact effectively with residents with dementia.
“Great choice,” said the cheerful Treasurer-Andre Ally, the coordinator of a 91-year-old who had chosen a plaid silencer. “Ideal for this time.”
The buyer handed over a plastic card issued by residents, who had no monetary value and headed with his walker, thanked for his new scarf. “It’s too hot,” he said. “And a nice size so you can wear it with any coat.”
David V. Pomeranz, president and CEO of Riverspring Living – his campus includes independent and assisted living, memory care, detoxification and nursing home – sees such efforts as ways to “restore regularity to people who have been so far.
Taking a group of residents with dementia in a real store can prove to be over -stimulated, he said, and people could not just leave when they had enough. But a single shop or kindergarten “gives them those familiar experiences that are familiar, which are comfortable, that empower and negate the feeling that they do not have control of their lives.”
It is a strategy with supporters – and some critics.
A few decades ago, those who care for people with dementia, either at home or in facilities, adopted a very different approach.
They tried “orientation of reality”, reminding patients that today is Tuesday, not Thursday. That they couldn’t “go home” because their home was sold. That their spouses did not visit because they had died years ago (causing fresh shock and sadness with every repetition).
“It didn’t work,” said Steven Zarit, a professor at Penn State and a long -term researcher on care and dementia. “It didn’t help people’s memories. It didn’t help to adapt. It wasn’t useful.”
Instead, carers have largely adopted a strategy, sometimes called “therapeutic lies”, diverting gently painful questions. Where is a (dead) loved one? “I’m sure he’ll be here soon. You know how traffic is. Let’s go for a walk while we are waiting. ”
The introduction of robotic pets cleaned and inflated, and baby dolls for care, expanded this approach. Especially when the pandemic limited other kinds of interactions, some people with dementia seemed to enjoy such lifeless comrades.
Creating whole environments, which can cause the past or may simply allow people to feel involved in the present, seems to be the next step.
In 2018, the family centers of the Glenner Alzheimer’s non -profit organization developed the city’s adult program, reproducing a small 1950s main street in a large warehouse in Chula Vista, California.
It has a retro dinner for meals, a library displaying the portrait of the IKE, a venue that mimics a vintage cinema theater and atmospheric touches like a 1959 Thunderbird and a private telephone booth. The franchisees have opened nine similar squares of the city in seven states, with more growth.
Daytime programs have shown benefits for well -known reduced participants and their carers, but “this environment allows us to go deeper into the treatment of memories,” said Lisa Tyburski, head of marketing for Glenner, referring to the use of prompts and objects to use items to We encourage memories and communication.
For participants, “it brings so much peace to be able to discuss something they remember,” Ms. Tyburski said. “We see them laughing and smiling, forming friendships.”
There is minimal evidence that such environments, including dementia villages in Europe that create entire neighborhoods (but do not mimic the past), provide clinical benefits or reliably improve quality of life.
However, “the environment is really important and can allow or turn off,” said Andrew Clark, co-author of the book “Dementia and Place” and a professor at the University of Greenwich in England.
“We need to find ways to connect people, maintain routines and daily activities,” he said. Such environments can encourage those who have dementia “to deal with people, go out and not close”.
Some experts express ambiguity and moral concerns. Dr. Clark supports the shift from the orientation of reality. “In dementia, there are all situations where they do not say that the truth could be better for people’s well -being,” he said.
But ethics gets “dark”, he added, if well -intentioned carers face people with dementia like children. For Dr. Zarit, for example, the distribution of baby dolls “feels childish”.
The main roads of the Rostback “Try the boundaries of how much this creativity is over deceit,” said Dr. Jason Karlawish, an old-fashioned and co-director of Penn Memory Center. “It begins to become problematic if ‘other’ people,” he said, creating a distance between those with cognitive impairment and everyone else.
“I think we could find more creative ways to deal with important activities,” he added.
Indeed, dementia programs across the country have more and more offers such as interactive theatrical experiences, opportunities to make art and explore music, efforts to connect through ecclesiastical churches, assembly between generations with real children and the treatment of pets with live animals. Hundreds of memory cafes meet regularly.
Nancy Berlinger, actress and researcher at Hastings Center, shows another concern about dementia -focused environments: “So much of it come to what you can afford.”
At Franchized Town Squares, participants pay an average of $ 150 a day. (Medicaid, Veterans Affairs and State and Local Services sometimes subsidize daily care costs.) In Riverspring, which already offers a full interactive program, memory care costs $ 15,000 a month.
(In New York, for a comparison, assisted living on average $ 6,500 per month and the nursing home takes about twice in this 2023, according to Genworth’s annual survey.)
With villages and dementia environments, “the concern is that they are pockets for the rich,” Dr. Clark said.
Or that there are substitutes for adequate staffing. The creation of the Kindergarten and the Riverspring store was cheap, Mr Pomeranz said. But staffing is not and operating as foreseen, the environments require employees to deal with extensive conversations.
Many nursing facilities and aid living facilities, multilevel executives, are struggling to meet basic needs, such as accompanied by residents in the bathroom, let alone facilitate markets in a store twice a week. Instead of hiring and training several people, administrators can be tempted to simply pass around dolls and robo-pets.
Nevertheless, the continuing search for ways to make life more stimulating and maintaining the elders with dementia, a growing percentage of the population, gains applause everywhere.
“The choice to restore their brain in an intact situation does not exist,” Dr. Berlinger said.
But carers can “try to meet people wherever they are and say,” What gives comfort? What reduces stress? What brings pleasure? “He said.” We need to think this time all the time. “
