Sage Spotlight: “The Longest Day” and Abe's Garden's Role in Advancing Memory Care Innovation

June 21 is a very important date for all of us at Sage Age Strategies and our many memory care client-partners nationwide.  The date marks the Summer Solstice, the celestial event that the Alzheimer’s Association® has chosen to recognize The Longest Day® and an opportunity to show our love and support for all those affected by Alzheimer’s disease and other forms of dementia.

The Longest Day® is also the perfect time for us to recognize and honor the senior living communities throughout the country that serve individuals with memory loss and provide Alzheimer’s care, or what researcher, author and innovator Dr. John Zeisel calls, “a life worth living.”

“One of the more innovative memory care communities found today is our client-partner Abe’s Garden® Alzheimer’s and Memory Care Center of Excellence located in Nashville, Tennessee,” says Faith Ott, Founder, President and Executive Consultant for Sage Age Strategies.

“Their story is an interesting and highly instructive one that offers useful insights and lessons for other senior living providers seeking to make the lives of memory care residents more pleasant and meaningful.”

Abe’s Garden®: A Mission to Research, Implement and Share Best Practices for the Common Good

Faith adds, “At the heart of Abe’s Garden’s unique mission is the goal to create innovative programming and environments of care that significantly enhance the well-being of residents, which can then be shared with other memory care providers nationwide for the greater good. In doing so, they have assembled and organized resources and information from academia, clinical research, facility design and social engagement therapy to create groundbreaking approaches that measurably improve the lives of those with cognitive decline.

“In many ways, Abe’s Garden® functions as a national laboratory for Alzheimer’s care innovation that constantly seeks to study, improve and share knowledge on the most effective Alzheimer’s care initiatives.”

Combining Science, Innovation and Social Engagement to Advance the Cause of Alzheimer’s Care

Abe’s Garden® is the first memory care campus that offers a totally evidence-based lifestyle focused on elevating the quality of life for those with Alzheimer’s disease. While any day can seem like the longest day for a loved one living with Alzheimer’s, the unique programming at Abe’s Garden® helps residents live a lifestyle that is rich, purposeful and fulfilling.

The unique environment of care found at Abe’s Garden® is the result of several underlying program components that combine to form a special place for residents. A place where the days don’t seem so long and each is filled with a sense of enrichment and purpose.

Six Program Pillars Create a Hopeful Place Filled with Meaning and Purpose

These key foundational components include:

Instead, they enjoy a wide variety of personalized programs that cater to their individual preferences to keep them interested, fully engaged and connected throughout the day. In the daily lives of memory care residents, there is a significant difference between being busy and being engaged.

Commenting on the power of Engagement Replacement Therapy (ERT), Zeisel says, “The Summer Solstice is the actual longest day of the year – the longest day with sunshine – and a reminder for all of us how long a day can feel when caring for people living with Alzheimer’s – so much to do! The I’m Still Here® approach focuses on what people can do, not what they can’t. It focuses on engaging people with Alzheimer’s in what they enjoy, can do and thrive by doing.

“The flow of an I’m Still Here® day is much like a normal day in each of our lives – with routines from morning until night that make the day feel shorter, not longer, for all involved – persons living with Alzheimer’s and their care partners. If we all engage each other with interest and joy, we can, together, make the longest day – shorter.”

Even before moving to the Abe’s Garden® campus, their care team meets with the resident and their family to gain an in-depth understanding of the most important things in their life. From there, the team develops clubs, classes and committees that reflect the person’s interests.  

For example, residents may choose to participate in a weekly cooking class; join the book club; visit the hair salon; or take on a leadership role in the decorating committee. In addition, there are fitness classes, spiritual opportunities, outings and games such as Lingo Bingo that provide mental stimulation.

In total, Abe’s Garden® offers three neighborhoods with 46 residents that integrate personalized programs that include music and nature all designed to provide enjoyable days filled with meaning and purpose.

  • A Strategic Alliance with Vanderbilt University One of the distinguishing features of memory care at Abe’s Garden® is the collaboration with the distinguished Vanderbilt University and the Vanderbilt Center for Quality Aging (VCQA) to develop best practices for Alzheimer’s care. The Abe's Garden® community itself was developed by noted academic specialists in the fields of geriatrics, aging design and lighting.

    The relationship with Vanderbilt highlights Abe’s Garden’s commitment to research, teaching and knowledge sharing and most importantly, identifying new, highly effective dementia care models that can be implemented immediately for the benefit of residents.

    They Abe’s Garden® staff are closely connected with the Vanderbilt Geriatric School of Medicine and are currently working with the leadership there to develop a diagnostic treatment center that applies newly developed best practices in memory care. Their ultimate goal is to share their knowledge with other memory care providers to enable their own residents to benefit from effective new methods.

  • Purpose-Built Facility Design – Evidence-based facility design is an emerging science that was used extensively in the construction of Abe’s Garden® to create a living environment that optimally supports, comforts, engages and inspires loved ones living with Alzheimer’s disease.

    Specifically, the most current research on natural and artificial lighting, human functionality, security, appropriate furnishings, wayfinding and technological resources for individuals with Alzheimer's was incorporated in the architectural, interior and landscape design at Abe’s Garden®. The end result is innovative memory care households that are conducive to family visits and merge beautifully with numerous themed gardens where residents can safely enjoy the outdoors.

  • Resident Assessment and Family Education – Unlike traditional resident assessment programs that are highly subjective and not based on scientifically valid measurement principles to ensure accuracy, Abe’s Garden® uses assessment tools that are based on standardized performance tests determined to be scientifically valid.

    What this means for the incoming resident and their family is that Abe’s Garden® caregivers are able to make accurate, informed decisions about their care needs. Of equal importance, informed decisions can also be made about whether or not programs are effective for individual residents as defined by maintenance or improvement in health, functioning and/or quality of life. This information system can be used to generate summary reports and other documents, so caregivers can easily determine if a resident’s care needs are changing over time.

    In addition, all assessments are reported to Vanderbilt researchers and Abe’s Garden® staff to continuously assess the effectiveness of programs.

  • Workforce Training and Support Everyone living and working at Abe’s Garden® benefits from favorable staffing ratios, evidence-based training, a proprietary workweek/compensation model, and a competency-based career ladder. Care partners are continually trained to assist people with Alzheimer’s disease and empowered to make caregiving decisions.

    Adult learning is conducted using  specificity and job relevance, which are incorporated into a staff training and management model developed by the Hearthstone Institute and Vanderbilt and evaluated by Vanderbilt Center for Quality Aging researchers. This model is further evaluated and refined at Abe’s Garden® under the supervision of Vanderbilt faculty.

    In addition, Corvirtus is used to assess care partner and nurse applicants in order to help identify quality candidates and reduce turnover and cost.

With support from Vanderbilt University, the Abe’s Garden® team continuously monitors programming effectiveness, resident well-being, staffing, care and environment. Systems are continuously identified, assessed, improved as needed and shared as part of the mission to establish best practices and elevate the quality of memory care throughout the nation.

A Continuous Education and Quality Improvement Coordinator conducts daily observations of staff/resident interactions during activities of daily living (ADL), meals and invitations to engagement opportunities based on 14 different care criteria. Levels of resident “engagement and affect” observed during programming are also used for program evaluation, using measurement techniques created by the Hearthstone Institute.

Weekly huddles are held with the clinical team to identify and correct any items not consistently performed to the desired standard (i.e. person-centered care, engagement, meal assistance and proper transferring).

Says Faith, “Abe’s Garden® is more than a memory care community. It is a leading-edge developer of optimal environments for residents designed to turn their “longest days” into meaningful, rewarding and life-enriching days. And beyond providing top-quality memory care, the Abe’s Garden® team is deeply committed to sharing their knowledge so that other providers and residents around the country can make their own longest days more productive and purposeful.

“As Abe’s Garden® nears its third full year of operation in September, it has been gratifying for me to witness and to share in their success as a model for innovative Alzheimer’s care. Upon opening, the entire campus was filled within three months. And while Abe’s Garden® is currently at capacity with a waitlist, they are now in the process of developing another wing, so they can expand their mission to help families touched by memory loss.”

If you would like more information about Abe’s Garden®, their research alliance with Vanderbilt University or any of their clinical or operational best practices, you are invited to contact Judy Shmerling Given at jgiven@abesgarden.org.

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