A new approach

Exploring Alzheimer's

The Alzheimer's Association Southern Nevada Chapter will present its first Symposium on Alzheimer's Disease: "Exploring Advances in Care" from 8 a.m. to 1 p.m. Feb. 12 at the Riviera hotel-casino. Medical and health care professionals will discuss the basics of Alzheimer's disease, treatment options and care giving. For cost and information, call 248-2770.

The first thing a visitor notices after passing through the locked doors of Sara's Garden are the memory boxes mounted next to each apartment door in the long hallway.

Filled with old photos, needlework and other souvenirs from a long life, the boxes help jog memories for the 16 Alzheimer's patients at the facility.

The framed pictures of loved ones locked in glass cabinets also help the residents locate their own apartments.

But at 3 p.m. on a recent day the hallway and the apartments were empty. Everyone was in the recreation area where a game of tossing a bean bag was in full swing.

As one group aimed for a target's bull's-eye with the small bean bags, another group worked collectively on a woodworking project at a large table.

Near the entrance, a silver-haired woman entering the room temporarily left her walker to lean back, strike a pose and, with a laugh, show off her new haircut done by the on-site stylist.

Hardly a scene one might expect to see at an Alzheimer's care center, where patients who suffer from the irreversible, progressive brain deterioration usually experience delusional or combative behavior, loss of interest in life, frustration and sadness.

At Sara's Garden, the residents appear happy -- very happy.

"It's because they're busy," says Shannon Brophy, director of the locked wing inside Chancellor Gardens, an assisted-living center at 2620 Lake Sahara Drive that opened six months ago.

Sara's Garden, with 34 apartments, is one of a handful of assisted-living centers in the valley that focuses on residents with memory impairment.

Activities begin each morning with a reminiscence period. As the residents sip coffee with staff members, they might talk about a movie from the 1950s or about a popular dance.

Afterward, everyone goes to the country kitchen where they begin making the day's bread and help with preparing meals. After breakfast, they might wander into the gated courtyard to do some gardening.

There are usually two activities at once, Brophy said. "It's a whole different approach to Alzheimer's."

The tightly planned daily activities and a four-to-one ratio of residents to staff members help keep the residents' minds active and redirect possible confrontational behavior.

More than anything, Brophy said, it offers residents a more dignified way to live. "They need their sense of pride. They need to know they're still a person."

Sara's Garden was named after Sara Gosinan, mother of the founder of CareMatrix Corp., which operates Chancellor Gardens. She lived with the disease for more than 15 years.

The first Sara's Garden was dedicated in June 1998 in Connecticut; there are now 17 facilities nationwide.

Aside from Sara's Garden, there are only about five or six assisted-living centers in the valley that specialize in Alzheimer's care, according to Phyllis Montavon, executive director of Alzheimer's Association Southern Nevada Chapter.

"But there are other facilities in our area that are starting to gear up and focus on memory impairment," she added. "Caring for someone with Alzheimer's is a 24-hour, seven-day-a-week task."

Ten years ago the disease was handled more like a mental illness, Montavon said. Some patients were placed in state mental institutions.

Nationally about 4 million people live with Alzheimer's. The disease affects one in 10 people over the age of 65 and nearly 50 percent of those over age 85. There are about 400,000 new cases each year in the United States.

As society ages, there is a growing concern about the care of Alzheimer's patients.

"Until the last few years there weren't many options for the family," Sharon Ball, spokeswoman for Aegis of Las Vegas, said. Aegis is an assisted-living center for Alzheimer's and dementia patients that opened this week.

Prior to that Alzheimer's patients wound up in a skilled-care nursing home for several medical conditions, Ball said. "Yet many of the residents are pretty healthy individuals."

Assisted-living centers are too expensive for some. About 75 percent of Alzheimer's patients are living with family members and five adult day care centers in Southern Nevada offer relief for those families.

"The home isn't always set up for the needs of Alzheimer's patients," Ball said. "There may be safety concerns, behavioral changes."

The type of approach is key in dealing with Alzheimer's patients, Montavon said.

Brophy, who has worked with a variety of disabled children and adults, says that when working with Alzheimer's patients "you definitely need to be a part of their world,"

And Sara's Garden is their world.

Brophy points out a '50s style telephone inside an open office area. Although it no longer works, its used every day, she says. The office was designed for the residents to use.

Many of the residents who believe they still hold a job spend their time typing, filing or making calls in the office.

"Some of the residents are completely capable of being in this world, but can't function in society," Carol Errisson, director of business development at Chancellor Gardens, said.

A '40s Corona typewriter is also used often. An antique fan and RCA Victor radio -- other objects that most of the residents can identify with -- sit on a shelf. In a nearby hallway, a World War II Army coat and sailor's jacket hang on the wall.

"Anything an individual can connect with, they'll feel safer," Montavon said.

Robert (no last names are used for this story) is one such resident. He likes to follow the stock market and is one of four residents who arrive at the central office each morning to pick up a copy of the daily newspaper.

Another resident, who was once a letter carrier for the U.S. Postal Service helps Brophy pick up the mail each day.

Joe, a resident who was once a baker, helps bake the center's bread. This helps his mind simulate the past by replaying a day at work. At the residents' office, many who were businessmen or clerical workers go through the motions of a workday.

"We try to encourage them to do things on their own as much as possible," Brophy said.

Not every activity is meant to jog a memory, Brophy said. Some are simply leisure activities. And if they feel like being with others, there's always an activity available, whether it's bowling, dance or crafts.

Just before dinner Pedro, a staff member, folds up the vinyl mat for the bean bag game and puts it away. He returns with two entree plates that he shows to the residents so they may select their dinner.

White-linen tablecloths and dinner ware have replaced the woodworking project at the large table. The lights are dimmed and background music plays. At the end of the day, residents gather quietly around the table in a family-like atmosphere.

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