Memory Care: Designing for Success

In 2009, I wrote a book entitled The Person-Centered Way: Revolutionizing Quality of Life in Long-Term Care. Chapter 6, “From an Institution to a Home: Environmental Changes”, outlined some ideas about deinstitutionalizing a senior care facility and making it more like a home or personal residence. Many years later, experts in senior care are still working on improving not only senior care communities as a whole, but much is being done to enhance memory care units within such communities.

Importance of the Memory Care Environment

Accomplished violinist from Japan, Shinichi Suzuki, once said “Man is a child of his environment”. He was incredibly right concerning how seniors with Alzheimer’s and other dementias are influenced by the design of the memory care environment. In my book, I stressed the importance of warm social and private spaces, not only for residents, but for their family members as well. I called them “Family-Friendly Environments” and believe that if family and friends feel welcomed they will visit more often and possibly for longer periods of time. I then focus on the simplicity of using our 5 senses to guide in the design of the environment. Visual cues to guide seniors from one place to another, soothing and pleasant music, natural wood and fabrics for tactile stimulation, and the aromas and flavors of home can lead to so many positive experiences and reduce negative behavioral and emotional reactions.

Many experts are still talking about and trying to improve the “Neighborhood” concept, which I am a big fan of and wrote about in my book many years ago. More recently, there is another focus on the “Household” model, which is also a great idea. The bottom-line idea with both concepts is to reduce the size of the typical institutionalized space to a smaller, homelike living area. Ideally, 10 to 14 resident rooms should be cozy and decorated with as many personal belongings as possible. A smaller dining room, living room, kitchen area and spa-like bathrooms complete the shared living space. Importantly, the design in physical space brings caregivers and seniors together in very natural ways. While quality of care is provided, quality of living is enhanced.

Benefits of a Well-Designed Memory Care Space

As the “Grey Wave”, “Silver Tsunami”, or “Elderly Eclipse” continue to build momentum in the United States, we must continue to design, re-design and improve living spaces for elderly individuals, especially those diagnosed with neurocognitive disorders. Right now, 1 in 9 or 5.7% of adults over the age of 65 has Alzheimer’s and by 2050 that number will more than double to 14 million. These numbers do not include other forms of neurocognitive disorders like frontotemporal or vascular dementia. As the numbers of older adults with neurocognitive disorders increase, the demand for well-designed living spaces becomes critical. If they are done right, the physical, mental, emotional and spiritual benefits are endless.

Memory care living spaces can reduce overstimulation brought on by larger living environments, filled with larger groups of residents. Such an environment can increase agitation, anxiety and confusion. It has been found that smaller and more soothing environments are associated with better outcomes. I saw this with my mother who first lived in an assisted living community, then moved to a skilled nursing facility in the large, open area. It wasn’t until she moved to the memory care unit, that she became more relaxed and settled. There are no benefits to noisy and visually overstimulating living spaces.

Smaller and more comfortable memory care spaces bring the familiar to the resident. Beyond their cozy and private room, the living room, kitchen and dining room are meant to remind them of their own home. They are meant to be relaxed settings. Having more natural lighting and a view to wooded areas can bring a sense of seasons and time to the confused mind. It has been shown that natural light can reduce anxiety and depressive symptoms, regulate circadian rhythms, improve sleep and sundowning.

Final Words on Memory Care: Designing for Success

Our nation is aging rapidly and the tidal wave of seniors with neurocognitive disorders create an urgency to maximize designs of memory care living spaces that will bring positive health benefits. Much work has been done in the past and more is required for the future to ensure better quality outcomes. What types of senior care communities and memory care living environments will be available for us in the not too distant future?

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