Assisted living increasingly includes ‘memory care’

02/28/2013 11:26 AM

08/14/2014 3:20 PM

Tim Buchanan and Jerry Carley have spent most of their professional lives caring for seniors. From differing jobs, and different perspectives, they’ve seen suffering and tried to relieve it.

Both can quote statistics that foreshadow the challenges of age that many of us will face either as seniors or caregivers.

Over the next 20 years, Carley said, 90 million people in this country will suffer from some form of dementia.

By 2030, Buchanan said, quoting from U.S. Census projections, 2.5 million people will have Alzheimer’s disease.

About 10 years ago, Buchanan, a Wichitan and a pioneer in the business of assisted living nationally, and Carley, now president and CEO of Via Christi Villages Inc., began to study and use “memory care,” an additional innovation.

Carley says he started his business life determined to help people.

Buchanan, the owner and CEO of Legend Senior Living, was a Wichita home developer in the late 1980s when he went on First Church of the Nazarene mission trips, helping build schools and churches in places like Haiti and Honduras. The suffering he saw in those countries, and the spiritual urges he felt all his life, became a constant thread in his thoughts as he pioneered ways to build assisted-living facilities in several states. He founded and ran Sterling House Corp. from 1991 to 1997, and saw it become a nationwide corporation.

The business he entered two decades ago was just beginning to try to improve the lot of seniors in need of aid.

But before that, he said, there were nursing homes. He saw them up close, researching them personally in the late 1980s. “They were all built as a clinical setting them,” he said. “Tile, hard floors, fluorescent lights.”

Assisted living came along, he said, because people realized they could do better in caring for fragile seniors. In the old days, he said, they housed mentally alert elderly people whose bodies were failing alongside mentally declining people whose bodies might not be failing yet at all. In the old days, some of the memory-impaired seniors would upset other residents, wandering into their rooms.

Assisted living, he and Carley said, began when complaints from nursing home residents made everyone realize that they needed to segregate the confused from those who were alert.

“And at first, all they did was wall off one wing of a nursing home,” Carley said.

Some of the treatment of the dementia sufferers in those nursing homes decades ago would not be allowed today, Carley said. They relied on drugs to subdue people. “And years ago they just tried to tie those people down,” Carley said.

Buchanan wasn’t the only innovator of assisted living who gave people “a home-like atmosphere” with drapes, carpeting and other amenities. But in his units he placed a strong emphasis on customer service and personal choice. When memory care came along as another innovation, he embraced and refined it. In his facilities now, staff works to try to customize each resident’s care as carefully as possible to that person’s needs – and past memories. The result, he said, is often that people become less stressed, happier, and mentally and physically healthier.

Nursing homes are better now, having adopted many of the aesthetic and more humane practices of assisted living, Buchanan said. And nursing homes are still needed, for people who have serious medical issues that require supervision by nurses and other medical staff.

But memory care is now a growing and separate segment of assisted living.

As Buchanan defines it, in his Legend units in Oklahoma, Kansas and Florida, memory care is designed as much as possible around each individual resident.

“Our goal is to have them on as few medications as possible, coupled with some group activities – but also with an individual atmosphere centered, as much as possible, around what a resident has done in the history of their life,” he said.

He helped develop “reminisce kits,” tailored to each client, kits built around former hobbies, former jobs and memories.

“We had a resident in Oklahoma who would not eat,” Buchanan said. “From his family, we learned that when he worked, he ate lunch at his desk every day. I do that a lot too, by the way.”

His staff for that client put together a desk, complete with a typewriter and catalogs to thumb through. The client, less agitated, began eating and putting on weight.

They tailored mini-lives for many other clients, he said. For a retired car salesman, they rounded up car catalogs from the 1960s. “He’d page through those catalogs for hours,” Buchanan said.

A retired dressmaker was given dress molds and fabrics to work with. (“We gave her Velcro instead of pins and needles,” he added.)

In his residences, they try to keep people busy with things they used to do: folding clothes and towels, for example. They even try to stimulate the senses, putting aromas in the air to stimulate appetite and make the place seem homey.

In the 40-unit Catholic Care Center, on North Woodlawn, the staff does what Carley calls “person-respected care,” in which “all that should really change when a client comes in is their address.” There are not just apartments, but apartment “neighborhoods,” with distinct names, decoration, picture windows, he said.

One of the tougher parts of Carley’s job, he said, is listening to people talk about trying to care for a loved one who is agitated, confused, sometimes even aggressive. Spouses come in tired, even exhausted. Wanderers at night keep them up and try to go outside, even in the freezing cold.

At the Catholic Care Center, the building architecture is designed specifically to help confused wanderers, Carley said. The neighborhoods of apartments are all in a circle, so if a person does wander, they encounter no confusing barriers. And if they keep walking, they follow the circular architecture … and come home anyway.

Memory care is not for everyone. “It’s intensive labor,” Carley said.

The cost at Via Christi: $4,000 to $7,000 per month. Buchanan’s facilities range from the high $4,000s to low $5,000s per month in Wichita. On the coasts, it can cost much more.

Medicare will cover the cost if the client is in a nursing home. But most assisted living is private pay, Buchanan said.

“One of these days, as this becomes a growing problem in the population, at some point we’ll have to see if there is a way to help reimburse individuals who need this care,” Carley said. “For people without means, it is very challenging to find placement.”

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