Memory Care: The Intersection of Aging and Mental Health
By 2031, the largest segment of the U.S. population—the Baby Boom generation—will reach the age of 85 (Alzheimer’s Association, 2018; Crimmins, 2015). At this age, people experience the greatest number and most extreme effects of the normal changes associated with aging. It is also the age associated with the highest risk of developing dementia, particularly Alzheimer’s disease and LATE (limbic-predominant age-related TDP-43 encephalopathy) (Alzheimer’s Association, 2018; Crimmins, 2015; Nelson et al., 2019).
PROGRAMMING CONSIDERATIONS FOR MEMORY CARE DESIGN:
- Integrated care
- Interconnections with the surrounding community
- Small building scale with fewer occupants
- Intuitive layout of rooms, adjacencies, and affordances
- Destination-based amenities and services
- Access to nature
- Residential ambiance, character, and décor
- Access to familiar items, equipment, and tools
- Regulation of contextual sensory stimulation
- Involvement in meal planning and preparation
- Spa-like bathing atmosphere
- Single bedrooms for comfort, privacy, and personalization
Currently, there is no prevention, cure, or therapy for Alzheimer’s or LATE (Alzheimer’s Association, 2018; Nelson et al., 2019; World Health Organization [WHO], 2018). People with dementia frequently experience an alternate reality and exhibit maladaptive behavioral responses; the use of physical and chemical restraints to control many of the most problematic and pervasive symptoms is restricted by regulating agencies. (See Appendix B for more detail.
) Accordingly, the development of truly effective interventions required designers and care givers to “go into the world” of those with dementia to try to understand the nature of the messages that they express and effectively address the source of their behavior. To this end, environmental design can have a profound effect on the quality of life and care for older adults (Scales, Zimmerman, & Miller, 2018). The built environment can reduce the stresses associated with declining physical abilities, memory loss, and care provision.
It is important to understand the changes associated with normal aging, as well as the changes common to dementia. Understanding the unique abilities and challenges of these populations better equips teams to design supportive living spaces that can serve as therapeutic resources for both individuals aging normally and those living with Alzheimer’s and other dementias. The literature suggests 12 programming considerations for design to support these populations and demonstrates how these design principles, while particularly relevant for people with impairments, can benefit everyone (Nahemow & Lawton, 1973).
Alzheimer’s Association. (2018). 2018 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 14(3), 367–429. https://doi.org/10.1016/j.jalz.2018.02.001
Crimmins, E. M. (2015). Lifespan and Healthspan: Past, Present, and Promise. The Gerontologist, 55(6), 901–911. https://doi.org/10.1093/geront/gnv130
Nahemow, L., & Lawton, M. P. (1973). Ecology and the aging process. In C. Eisdorfer & M. P. Lawton (Eds.), The psychology of adult development and aging (pp. 619–674). Washington, D.C., U.S.: American Psychological Association.
Nelson, P. T., Dickson, D. W., Trojanowski, J. Q., Jack, C. R., Boyle, P. A., Arfanakis, K., … Schneider, J. A. (2019). Limbic-predominant age-related TDP-43 encephalopathy (LATE): Consensus working group report. Brain. https://doi.org/10.1093/brain/awz099
Scales, K., Zimmerman, S., & Miller, S. J. (2018). Evidence-Based Nonpharmacological Practices to Address Behavioral and Psychological Symptoms of Dementia. The Gerontologist, 58(suppl_1), S88–S102. https://doi.org/10.1093/geront/gnx167
World Health Organization (WHO). (2018). Ageing and Health. Retrieved from Fact Sheets website: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health