3 Must-Haves in Designing for Dementia Care
A surge in memory care construction is bringing more competition into the space, dragging senior living designers back to the drawing board to create stand-out communities.
In the past year and a half, the supply of memory care units has increased by 3.1%, far outpacing growth rates in other senior housing property types. Because of this influx, overall occupancy has dropped across memory care facilities, bringing vacancy levels up to 9.3%.
So with increased competition and more choices for prospective residents, memory care providers are finding that to carve out their niche, they must implement top-notch design techniques specifically catered to those with Alzheimer’s or other forms of dementia.
Two providers are ahead of the curve, showcasing three emerging design trends and must-haves in their communities. The LaSalle Group’s nationwide Autumn Leaves properties and Capri Communities’ Mätterhaus Memory Care Community provide a blueprint for design innovation in the space.
Autumn Leaves — designed, developed, built, managed and owned by The LaSalle Group — operates 36 communities in four states, serving more than 1,800 residents.
Mätterhaus Memory Care Community — operated by Capri Communities, developed by Tarantino & Company LLC and designed by PDC Midwest — is a new 24-unit, 26-bed memory care community in Germantown, Wis. It is located at The Gables of Germantown’s existing campus and opened for occupancy in April.
For those providers whose memory care properties are still in the making or have yet to break ground, implementing these three techniques may push the community from average to occupied, their creators say.
1. Wandering Encouragement
Six in 10 people with dementia will wander, according to the Alzheimer’s Association. With a majority of memory care residents likely to roam about the property, designing buildings for the population is a unique task.
Many communities have incorporated built-in sensors throughout the buildings and apartment units to track resident movement and ensure safety, but Autumn Leaves and Mätterhaus have taken wandering design to a new level.
Dead ends have been shown to frustrate or confuse those with dementia, which can lead to agitation among those who are wandering. To prevent this agitation, Autumn Leaves has implemented strategic interior decor, as well as structural design elements.
At the dead ends of its communities’ hallways, Autumn Leaves has placed off-center photos to encourage residents to keep walking. When looking down the hallway, only a portion of the photo is visible, which signals to the residents that there is more to see and that they can continue down the next hallway.
Although wandering has been discouraged in years past, providers like Autumn Leaves are seeing the benefits of implementing safe design techniques that encourage the activity.
“Walking exercises help stimulate [residents] so they have more energy, but also when they have more energy they become more hungry,” says Nicole Gray, director of design at Winfield Design, LLC, LaSalle Group’s design division. “That’s a huge factor for us — to encourage eating.”
Water and snacks are stationed throughout the community so wandering residents can eat when they are hungry.
The hallways also have sitting areas in alcoves, which serve two purposes: They allow wandering residents to take breaks when they are tired, but they also create the illusion that the hallway is a winding corridor, not a straight path, decreasing the tunnelvision commonly experienced by those with dementia.
Mätterhaus Memory Care Community
Capri Communities has also addressed the dead-end challenge at its Mätterhaus Memory Care Community to promote wandering and reduce agitation.
PDC Midwest designed the community in the shape of a figure-eight or double racetrack with the kitchen, dining area and living room at the intersection of the two loops. In the center of one loop is a common room focused on music; in the other loop’s center is a multisensory area incorporating elements of Snoezelen therapy. And along the perimeter are resident rooms.
Located throughout the community are “memory stations” designed to spark memory and activity among residents. These themed stations engage wandering residents and also help with cognitive functions.
“It’s not just the ability to wander, it’s about the ability to find something that you’re interested in while you are wandering,” says Aaron Matter, real estate development manager at Tarantino & Company LLC, the developer of the property. “You’re not just walking to the end of a hallway; there are different elements along the way that help to attract [residents’] attention to avoid [them] having to experience agitation.”
The stations’ themes include gardening, nuts and bolts, sports memorabilia, ironing/laundry and child care, among others. They are designed so that residents can stop and interact with the stations while they are wandering, and potentially feel a connection with the items.
“Generally people [with dementia] place themselves somewhere in their mind in the past — whether they were a teacher, took care of children in a household, or had building in their background or gardening,” Matter says. “We went back to antique stores and found elements that people could place themselves into. It allows them somewhat of a release because it places them where they feel comfortable.”
2. Themed Wings
Another must-have design element in memory care communities are themed wings, which help trigger residents’ memory. Though becoming more commonplace in memory care design, Autumn Leaves and Mätterhaus have incorporated unique elements that make their communities’ wings rise above the rest.
At most Autumn Leaves properties, the four themed wings are Music, Harbors, Cities and Gardens, which all have a designated color and design scheme.
The Music hall is a wheat color, Gardens is green, Harbors is blue and Cities is brown.
“What that does is as the mind progresses and deteriorates, if they have a hard time understanding a photograph of our themes — if they’re looking at pictures of flowers, for example, and don’t understand what they’re looking at — they at least have the back-up reinforcer that they’re in a green hall,” Gray says.
What sets apart Autumn Leaves’ wings, though, isn’t the colors or the themes. Unlike other memory care communities, Autumn Leaves encourages residents’ families to decorate their rooms according to their themed wing. So the decor continues from the hallways into the residents’ rooms, adding another component that will help residents remember where they live.
As an added touch, special flooring has also been designed into the space, allowing for a safe wandering environment. Transitioning between wings is seamless (literally), as the flooring has a secure heat-weld transition seam so there are no thresholds or trip hazards in the buildings.
Like Autumn Leaves, Mätterhaus also has themed wings, City Side and Country Side, which are indicated by their decor.
There are different gates on the feature walls for each wing: a metal gate for City Side and a picket fence for Country Side.
But it’s the artwork that sets apart Mätterhaus’ wings from others. The community chose local art to trigger memories and foster a connection with residents.
For example, on Country Side, there are photos of the state bird of Wisconsin and a picture of the state of Wisconsin with different flowers found in different areas.
“We really tried to focus in on local art as much as we possibly could,” Matter says, “and things that could mean something to a particular resident.”
Along with hallway and unit decor, both communities have also installed shadowboxes outside residents’ rooms — the background of which also reflects the color of the themed hallway at both communities — where family members can display photos of their loved ones and their cherished items. This acts as yet another reinforcer meant to remind residents where they live.
3. Sensory Stimulation
This technique has been proven to reduce behavioral and psychological symptoms of dementia among individuals with Alzheimer’s disease, according to the Alzheimer’s Association. So implementing design elements that increase sensory stimulation has become an important part of memory care construction.
Autumn Leaves and Mätterhaus have taken cues from this research and have developed their own approaches to addressing this challenge.
Several years ago, research found that displaying tanks of brightly colored fish may curtail disruptive behaviors and improve eating habits of people with dementia.
In fact, the study showed that patients who were exposed to the fish tanks appeared to be more relaxed and alert, and they ate up to 21% more food than they had before the introduction of the fish tanks. The average increase in food consumption was 17.2%.
In hopes of replicating this success, Autumn Leaves designed fish tanks into the space outside of the dining room areas.
“It allows more natural light in, which is better for the eating experience, and the movement of the fish and the sound of the water helps them relax during eating,” Gray says. “Plus, visually seeing the fish actually helps increase appetite.”
To ensure that the fish tanks are working as the research suggested, Autumn Leaves has conducted in-house polls, which have shown an increase in the percentage of residents who are eating.
“When you gather 30-plus properties with the fish tanks, it weighed more on the ‘yes’ percentage. We feel that the study was truthful,” she says.
In the center of one of the community’s figure-eight loops is a multisensory room that incorporates elements of Snoezelen therapy, as well as other stimulating activities.
Snoezelen, or a controlled multisensory environment (MSE), allows memory care residents to guide their own therapy using lights, sounds, textures and aromas to stimulate their senses and promote relaxation.
Inside Mätterhaus’ multisensory room, one side is devoted to traditional Snoezelen elements, including a bubble tube with a remote control to change the colors of the tube, a spotlight and a disco ball. But this design element is becoming increasingly more common among memory care communities.
So what sets apart Mätterhaus’ multisensory environment is the other half of the room, which addresses what’s called “sunsets” in dementia care.
“[Those with dementia] tend to get agitated as the sun goes down,” Matter says. “We find that by giving them something to do during that period of time that relates to a place they were at in their past helps manage that agitation.”
On this half of the room, there are bookshelves with 28 baskets, one for each resident. Inside each basket are different items that the resident can interact with, which are meant to improve cognitive functions and dexterity.
For example, a retired teacher would have a basket of papers with a red pen to grade papers.
“We did some research and figured we would want to be a forerunner in different types of Alzheimer’s care,” Matter says. “We’re planning to get a feel for how people respond to it and have some discussions with people in the memory care/Alzheimer’s community.”
These sensory stimulation techniques, along with the themed wings and wandering encouragement design elements at both Mätterhaus and Autumn Leaves, have come a long way from memory care design just a decade ago. And these must-haves will no doubt shape memory care design in the future as construction in the senior housing segment continues to increase.