If you talk to someone whose parent suffers from Alzheimer’s, they will tell you the disease changes life for everyone in the family. Alzheimer’s can create changes in a person’s independence and personality that are emotionally and financially devastating to loved ones.

Alzheimer’s is a progressive, degenerative disease that attacks the brain and results in increasingly impaired memory, thinking, reasoning, and behavior. It is the most common form of dementia, an umbrella term used to describe the loss of cognitive or intellectual function.

The single greatest risk factor for Alzheimer’s is age. Although the disease can occur in younger people, even in their 30s and 40s, the risk significantly grows after age 65. It is estimated that 50% of those who pass their 80^th birthday will be stricken. There are other risk factors besides age: family history of Alzheimer’s, stress, serious illness or injury, inadequate physical and social activity, poor diet, and perhaps even race.

Taking care of someone with Alzheimer’s can be overwhelming. Many people turn to assisted living or a nursing home as their best solution. Innovative design features are transforming dementia care. Outlined below are design items to consider when searching for a memory support community. In addition to asking about staffing, meals, and other operation issues, take a look at the building’s design and amenities.

Glare, bright light, noise, clutter, and interactions between other people are some of the factors that need to be controlled.

Contrasting colors between floors, walls, and ceilings to help discern where each starts and ends. Painted walls behind a toilet and/or a colored toilet seat help people find their target.

Indoor and outdoor furniture should not tip over or have sharp edges.

Doors equipped with two-way locks that cannot trap residents in a room.

Visual cues like pictures on drawers and closets to remind residents of the contents. Or a toilet on the door to a public restroom.

Lever handles for door and faucets so they are easier to operate.

Walking and sitting areas with ample room to protect a person’s “private space” and prevent tripping.

Decals on large glassed areas, such as doors or windows.

Level floor surfaces. Flooring should have a pattern free of design, avoiding large dark areas that can appear to an Alzheimer’s resident as a hole they might fall into. Floor surfaces should have a dull finish, not a wet look that can be interpreted as dangerous to walk on.

Interior designs need to be simple rather than busy. Some paisley designs might be interpreted as snakes. Busy patterns can cause confusion or anxiety.

Courtyard landscaping that is free of thorny or poisonous items.

Security measures to prevent a wanderer from exiting unnoticed thru a door, window, or fence.

Life skills stations that contain familiar things for the residents to touch and do.

Walls with tactile, three-dimensional artwork that can be touched.

A snuggling room that provides a calm, soothing environment to reduces tension, anxiety, and hostility.

Nightlights or motion sensitive lights that turn on if a resident gets up from bed during the night. A 24-hour low level light over the toilet.

Open shelving and removable bathroom and closet doors in resident apartments to increase visual cueing. Conversely, some people do better with limited access and may require lockable closet doors.

Inside and outside wandering paths with built-in areas of interest to occupy and entertain residents along the way. Comfortable places to sit and rest should be included along the pathway.

Joyce Clark is the CEO of Achievis Senior Living Associates. Achievis is a development and consultant company to a variety of long-term care providers. www.achievisseniorliving.com

Email: achievis@cox.net

Senior Living Development Makes Me Happy Because…

After 16 years of working in senior living, I am still refreshed to see the positive impact long-term care has on the lives of so many people. From staffs who genuinely enjoy the people they serve to exhausted families that can now focus on quality time with mom, senior living is a benefit to many.

Assisted living is a long-term care option preferred by individuals and their families because of its emphasis on resident choice, dignity, and privacy. There are 35 licensed assisted living communities in Oklahoma County. They provide apartment style housing with services, including assistance with bathing, dressing, and medication administration. Some provide specialized care for people with Alzheimer’s disease or dementia.

I long ago lost count of assisted living residents I saw blossom with renewed vigor after moving to their new home. The four things I feel most improve seniors’ wellbeing are nutritious meals, socialization, medication administration, and exercise.

The majority of assisted living residents are women age 80 or better. Before moving, they tended to eat easy-to-prepare meals such as frozen dinners or cheese and crackers. Sometimes medications were skipped, dropped, accidently doubled, or taken inappropriately. The loss of a beloved spouse had them reeling with insecurity and grief. Social circles and close friendships were fading away. Family struggled to make time to visit, go on outings, or help with chores.
Muscle tone and balance had deteriorated.

It is amazing to see how a person’s outlook and health improves after a few months of eating balanced meals, accurately taking medications, and participating in stretching and toning exercises. But the biggest reward of all is seeing the smile of someone who is surrounded with peers and new friends as they share a joke or life experience. Widows serve as natural support groups for each other. Church services and hymn singing is available for those who want to participate. Meals and snacks are prepared for a variety of diets. Most assisted living communities offer fun and educational things to do such as shopping excursions, entertainers, speakers, crafts, games, and parties.

Each month I will discuss assisted living or other senior care topics in this column. Topics will range from local costs and new laws to fall prevention and caregiving tips. Email me at achievis@cox.net if there is a particular subject you would like covered.

Joyce Clark is the CEO of Achievis Senior Living Associates. Achievis is a development and consultant company to a variety of long-term care providers. www.achievisseniorliving.com Email: achievis@cox.net

Hospital Readmission Reduction Program’s Impact On Assisted Living

Under the Hospital Readmission Reduction Program, Medicare will withhold 1% of a hospital’s reimbursement rate for readmissions that take place within 30 days of a discharge and are deemed to be excessive. The initiative takes effect October 1st and will initially focus on 3 conditions: congestive heart failure, heart attack, and pneumonia.

This may be a game-changer for assisted living and nursing facility providers who will increasingly have to demonstrate their ability to safely prevent hospital readmissions. Those who do will become preferred partners for Medicare discharges and gain a competitive edge in markets where Accountable Care Organizations (ACOs) are active (not Oklahoma). As subcontractors to ACOs, assisted living providers may, for the first time, become part of the Medicare revenue stream.

Assisted living communities are responding to the policy change with tools and methods to better manage conditions associated with hospital readmissions. Strategies include installing an electronic medical records system, enhancing staff levels and clinical capabilities, and making renovations to accommodate new services and levels of care.

Some assisted living providers are remodeling to offer short-stay units and 24-hour nursing services in states with regulations allowing high levels of medical care. They are partnering with therapy and home health care companies to provide more medical components. Health care systems are transforming as more people are served in long-term and post-acute care settings instead of a hospital. This pushing of acuity down the continuum of care is likely to become even more pronounced as the government looks for ways to further reduce costs. Home-based services will likely be more used as an alternative to long-term care.