By Matt Perry
California Health Report
Sister Roseanne Murphy basks in the sun of the peaceful courtyard of the Mercy Retirement & Care Centeer, content after finishing off a lunch of barbecued chicken alongside 100 fellow residents.
“You can tell the spirit of a place, can’t you?” smiles Murphy, a former college department chair. “You can tell whether it’s dead, or whether it’s welcoming and alive.”
Although Murphy is at the Oakland facility only temporarily for rehabilitation after a knee replacement, she’s visited many senior care facilities, and contrasts this one with others where the favored activities are often sleeping and watching television with “no real sense of joy and peace.”
Over a decade ago, Mercy adopted principles of the Eden Alternative, an international organization based in Rochester, NY, committed to humanizing the aging process. It’s one of many progressive new alternatives for engaging older adults inside long-term care facilities using various pathways: art, nature, music, animals, dance, literature and friendship.
Adopted in California – and around the country – this groundswell of adventurous programming is riding the wave of America’s “silver tsunami,” changing the way older adults are perceived and cared for.
“The old model was doing things ‘for’ the patient who is inert,” says Anne Davis Basting, one of the nation’s leaders in older adult care and the developer of a unique storytelling forum for seniors with dementia. “The shift here is from entertainment to engagement. (Today) you’re doing ‘with’ them. Co-creating and co-learning.”
Sister Mary Creedon admits that 20 years ago Mercy was more concerned with operational efficiency than people: if you slept through breakfast, you missed a meal.
“Oh, we were very good at it,” cringes Creedon, Mercy’s enthusisastic executive director, who has worked at the facility since 1979.
By adopting the ten guiding Eden principles – intended to eliminate “the plagues of loneliness, helplessness and bordedom that make life intolerable in most of today’s long-term care facilities,” according to the Eden Alternative – a new patient-centered approach brought meaningful care for mind, body and spirit.
First, Mercy introduced the canine companion Captain, a dog so intuitive he would visit the rooms of sick residents and sleep under their beds. Mercy’s Eden program expanded with the addition of birds, cats, even lizards.
“Some (residents) who can’t relate to people can relate to animals,” says Creedon.
Life Enrichment Director Jana Gesinger then started a gardening program, which produced tomatoes, onions, garlic, strawberries, bell peppers and herbs. Gesinger says the gardening makes closer friendships.
“It’s a good reminiscing time,” she says.
Mercy has also added cooking classes, drum circles, and a daily exercise program with curriculum provided by the Arthritis Foundation. Gesinger will be trained in Tai Chi this summer, and she’s also exploring “Conductorcise” – “a sound workout for body and soul” – which blends exercise with orchestral conducting.
“We moved from an institutional environment to a home,” says Creedon.
She cites writer Maya Angelou in her facility’s evolution: “When you know better, you do better.”
Mercy is one of ten California facilities to adopt the Eden Alternative – the second of six Elder Care Alliance members in the Bay Area to do so.
Basting, as director of the Center on Age & Community at the University of Wisconsin-Milwaukee, has pioneered the popular TimeSlips Creative Storytelling to engage patients with dementia in an artistic process without the burdens of technique or memory.
During her research, Basting found that the ancient art of storytelling helped residents at long-term care facilities become more alert and engaged. Caregivers also reported happier staff.
TimeSlips facilitators use photographs or other prompts to start the group storytelling process.
“It’s an invitation to expression and an affirmation of whatever omes out,” says Basting. “These tools are what enable you to bridge and reach each other again.”
Although centered at two Milwaukee-area facilities, last year teachers nationwide started becoming certified in the TimeSlips technique.
Basting is also one of many collaborators with Wisdem – wordplay combining “wisdom” and “dementia” – an international organization of eductors, neurologists and artists dedicated to changing society’s perception of dementia.
Basting says she no longer separates the aging process from a clinical diagnosis of dementia.
“When I talk about aging, I talk about people with dementia,” says Basting. “I don’t separate them out in a special category anymore.”
Older adults with dementia – Alzheimer’s Disease being just one form – often spiral into a cocoon of loneliness and despair as their cognitive functions and verbal skills decline.
While working together at a Kentucky Alzheimer’s research center, David Troxel and Virginia Bell in the early 1990’s watched families and friends abandon these patients, and came to a simple yet powerful conclusion: the best therapy for patients with dementia is a best friend.
The duo pioneered the “Best Friends” approach to treating dementia patients, and now train national organizations and local caregivers how to engage with dementia patients by learning everything possible about them – and sharing their interests.
“If you do repetitive work, if you study Emily Dickinson’s poetry, or read from an upbeat publication like USA today, you can get to them,” says Troxel, a Sacramento resident. (Bell, who is 90, still lives in Lexington, Kentucky.)
Sacramento is just the second city in the nation to introduce the arts appreciation program “ARTZ: Artists for Alzheimer’s.” Coordinator Tiffany Paige has made alliances with several local museums to offer tours for Alzheimer’s sufferers in an effort to connect with them outside the traditional – and limiting – world of conversation.
Paige recounts a moving story from the daughter of an Alzheimer’s mother after a recent museum visit.
“She was almost in tears. She hadn’t seen her mother so engaged in months,” says Paige. “There was so much happening inside, but she just wasn’t able to articulate it.”
On a June day at the Crocker Art Museum in Sacramento, six older adult women wander the halls in walkers and wheelchairs, perusing works from the museum’s permanent collection. Paige peppers them with quertions about the art, color choices, subject matter, characters, even theme.
The women comment and joke, clearly more engaged in the museum’s larger paintings, like the western-themed “The Patriotic Race.”
Paige asks them if the painting was made at sunset.
“Looks like a bonfire,” says one woman.
“Will you bring the smores?” asks another, evoking laughs.
For children of Alzheimer’s patients, ARTZ is a welcome antidote to the frustrations of cognitive and verbal decline.
“I see hope in the families,” says Paige. “They’re learning this communication technique they may not have known before.”
Across the nation, there are dozens of other new programs, conferences, and workshops transforming the aging process: Songwriting Works in Washington state; the Alzheimer’s Poetry Project in Brooklyn; Opening Minds Through Art from Ohio’s Miami University; and San Francisco’s annual “Poetics of Aging” conference.
In Oakland, Creedon is thrilled that Mercy adopted the Eden principles to help ride the crest of the silver tsunami.
“We liked it beause we are part of something larger,” says Creedon. “It’s not just us doing this, but it’s part of a whole movement dedicated to moving patient-centered care forward.”
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