August 16, 2018

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New approach at Alzheimer centre

Updates meant to make facility feel more like home

When Riverview Health Centre built its first unit for residents with Alzheimer’s disease and dementia nearly 20 years ago, it was considered “state of the art,” says president and chief executive officer Norm Kasian.

Today, the notion of a locked, 60-bed unit with nowhere to go and not much to do seems almost jail-like.

“It was really an incarceration model,” Kasian said. “The residents were in units that they never left.”

Riverview is transforming how it houses and cares for such residents with its Alzheimer Centre of Excellence (ACE). On Monday, the first of four groups of 15 residents moved into a redeveloped section of the Alzheimer’s wing. It has smaller, more family-like groupings of five residents, with more room to safely wander, activities, cues to help them find their own rooms and more natural lighting.

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When Riverview Health Centre built its first unit for residents with Alzheimer’s disease and dementia nearly 20 years ago, it was considered "state of the art," says president and chief executive officer Norm Kasian.

Today, the notion of a locked, 60-bed unit with nowhere to go and not much to do seems almost jail-like.

PHIL HOSSACK / WINNIPEG FREE PRESS</p><p>Cindy Roger shows off Circadian lighting panels in the ceiling of the Alzheimer Centre of Excellence project at the Riverview Health Centre.</p>

PHIL HOSSACK / WINNIPEG FREE PRESS

Cindy Roger shows off Circadian lighting panels in the ceiling of the Alzheimer Centre of Excellence project at the Riverview Health Centre.

"It was really an incarceration model," Kasian said. "The residents were in units that they never left."

Riverview is transforming how it houses and cares for such residents with its Alzheimer Centre of Excellence (ACE). On Monday, the first of four groups of 15 residents moved into a redeveloped section of the Alzheimer’s wing. It has smaller, more family-like groupings of five residents, with more room to safely wander, activities, cues to help them find their own rooms and more natural lighting.

"We’re hoping this will go a long way to making this a more domestic situation," Kasian said.

The entire 60-bed Alzheimer’s unit and addition will be completed by February, and the goal is for it to be "world class," Kasian said. The aim is to provide exemplary patient care, with staff members getting extra and ongoing training in practical strategies for working with Alzheimer’s residents, and to conduct research using technology that tracks patients’ movements and responses to their new home.

"This is really going to be a living, evolving, clinical laboratory," Kasian said during a recent tour of the first redeveloped unit. "We’re introducing a dozen modes of innovation that we’re going to evaluate with the University of Manitoba."

Researchers will interview staff, professionals and families, "to find out which features were a success and which did not contribute to their quality of life."

Improving Alzheimer’s care is an urgent matter for Manitoba, community health researchers say.

An estimated 22,500 Manitobans have been diagnosed with Alzheimer’s disease or another type of dementia — and that number is expected to hit 40,000 in the next 20 years. It’s expected the dementia boom will be a soaring cost to the province.

"Alzheimer’s is like a tsunami coming down the tracks," Kasian said.

Riverview looked to the Netherlands for some of its best practices in caring for people with dementia — such as giving them room to move, said ACE interior designer Cindy Rodych. "It’s about freeing up the residents and moving them from a locked-down facility to a more protected one with a larger geographical footprint so they can move throughout it."

The 6,000-square-foot pavilion still under construction will have a recreational and therapeutic area, including a kitchen, dining area and a sensory experience room. The pavilion will have access to an outdoor courtyard residents can freely move through.

PHIL HOSSACK / WINNIPEG FREE PRESS</p><p>Cindy Roger shows off Circadian lighting panels in the ceiling of the Alzheimer Centre of Excellence project at the Riverview Health Centre.</p>

PHIL HOSSACK / WINNIPEG FREE PRESS

Cindy Roger shows off Circadian lighting panels in the ceiling of the Alzheimer Centre of Excellence project at the Riverview Health Centre.

Each redeveloped unit will have a theme to help residents recognize home. The first unit opened this week has a sunflower theme, but each resident’s door is different: Riverview hired a photographer take pictures of different colours and designs of doors in the area; the images were enlarged and affixed to each resident’s door, helping them to recognize their room.

"No two doors are the same," Rodych said.

Next to each unique door is a digital picture frame — a "memory box" — displaying photos of the resident and family members. When the door is opened, a curio cabinet containing a few familiar keepsakes is visible (ensuring residents they are in the right room); inside the room, there are no obvious handles or pulls on cupboard doors or drawers, preventing residents from rummaging through a neighbour’s belongings, said Rodych.

Exits for staff will be disguised, to reduce the agitation of exit-seeking behaviour common among residents with Alzheimer’s disease. Rodych said the goal is make the place seem like home.

A real-looking cat that appears to be breathing as it naps in a wicker basket is in the family room. There’s a life-like baby doll in a carriage waiting to go for a walk or to be picked up and cradled. Familiar household activities such as folding and cleaning will be available at times throughout the day. The hallways have activity boards available.

Instead of fluorescent lights — which have been connected with "sundowning," a term describing dementia patients who wander after dark — each family-room area will have a circadian lighting system: faint blue during the day and a reddish hue towards sundown. With the help of U of M researchers, Riverview will be tracking whether or not the costly lighting system helps, and if it is worth expanding throughout the pods.

"The strength of the research component — that’s a really important addition that we haven’t see in Manitoba," said Wendy Schettler, chief executive officer of the Alzheimer Society of Manitoba, who toured the first ACE pod last week. "I think they really have moved the bar forward, and that’s an important thing."

carol.sanders@freepress.mb.ca

Carol Sanders

Carol Sanders
Reporter

Carol Sanders’ reporting on newcomers to Canada has made international headlines, earned national recognition but most importantly it’s shared the local stories of the growing diversity of people calling Manitoba home.

Read full biography

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