Treating dementia with high- and low-tech therapies

When you move a loved one into a memory care community, your family is entering a whole new world. Modern memory care is highly individualized, respectful, and involves high-tech and low-tech therapies to make life better for those with dementia.

Memory care has changed with new research and theories about dementia, says Anna Walters, RN, health services director of Senior Star at Weber Place in Romeoville. Senior Star has independent living, assisted living and memory care residences.

"Twenty years ago when I went to nursing school it was all about reorientation, trying to make residents see what the reality is. Now it's the exact opposite. It's about meeting them where they're at," she says.

That includes working to maintain the abilities residents have, rather than trying to "improve" them; redirecting rather than restricting; and encouraging them to do as much for themselves as possible, with assistance.

For example, Senior Star staff members often eat their lunch with residents, while helping them eat too.

"It's a moment of engagement, not a task to be done," Walters says.

Staff training on dementia care across all living units creates a culture of caring at Senior Star, Walters says. "Even though residents might not have memory issues coming in, our average age is 83, so this is where it starts."

Good memory care begins with a good diagnosis involving neuropsychological testing, says Sara Sanderman, administrator of Silverado, a memory care community in Highland Park.

Silverado, which is new to the Chicago area, specializes exclusively in memory care. Each Silverado community has three neighborhoods — social, supportive and sensory — that tailor care and activities to residents' abilities.

"People assume that everyone in memory care has Alzheimer's disease," Sanderman says, "but that is not the case."

Dementia is actually a complex set of symptoms and not a disease.

Alzheimer's disease accounts for 60 to 80 percent of dementia cases, according to the Alzheimer's Association.

Silverado fosters a family-friendly environment, complete with a playground for the grandchildren and a pet-friendly policy for residents.

"We utilize the families as part of the care team," Sanderman says.

Memory care communities use high-tech and low-tech therapies to enhance residents' lives, and reduce reliance on medication.

One example is a Snoezelen room, a multisensory stimulation and relaxation environment developed in the Netherlands. Senior Star at Weber Place has one.

Residents sit back in a recliner, and can enjoy a chair massage under a warm blanket, listen to music, get aroma therapy, or watch videos projected on the ceiling.

"It is a roomful of opportunities to engage them on a sensory level," Walters says. "For some people it works very well."

Equine therapy is one of the oldest and most powerful therapies to effect change in people, says Colette Collins, clinical psychologist and therapeutic riding instructor at Equestrian Connection in Lake Forest.

"Clients are much more engaged and having fun when they are here at the barn because it engages all their senses. If they can lead a 1,000-pound horse, they feel power and meaning again," she says

After a year of working with seniors from local communities that offer memory care, such as Balmoral Care Center, a part of Lake Forest Place, Collins says success stories abound.

"There was a woman who hadn't spoken in a couple of months, and someone asked if she wanted to come back. She looked right at us and said, 'Yes!'" Collins says.

"Sometimes with dementia, people's bodies are very anxious, but they quiet their body and mind in order to work with the horse," she continues. "Sometimes their bodies are constricted. We put a pony right next to their wheelchair, and they will extend their arm farther to brush the horse."

Horses at Equestrian Connection are specially selected and trained to work with individuals with memory and mobility issues. Clients from memory care communities generally do not ride, but they pet, groom, lead, feed and talk to the horses, or put on riding tack.

Another animal proven to work well with those who have dementia is a baby harp seal — specifically a robotic one called PARO.

Developed in Japan a decade ago, PARO looks and responds like a live pet. The seal simultaneously calms and stimulates people in a positive way, similar to a dog or cat. It has soft fur, cuddles, blinks and makes cooing sounds when a person strokes it and talks to it. It cuddles and warms up when held. It even remembers and responds to its name.

This year a California retirement community in Cupertino called Front Porch did a six-month trial with PARO and its memory care residents. PARO was a huge success, according to Davis Park, director of the Front Porch Center for Innovation and Wellbeing.

"The device improved stress and anxiety levels, decreased wandering, dramatically improved social engagement, and reduced the use of psychotropic medication. It actually improved the overall quality of care," he says. "There is this fear that robots will replace caregivers, but it actually made them more effective."

Why a seal?

"Some people may have negative memories with dogs or cats," Park says, "but they don't have any preconceived notions about a seal."

Any community can purchase a PARO for $6,000, or rent one for $200 a month, Park says.

Originally published in Chicago Tribune Prime Time senior living section on November 6, 2014.