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Home Has Care in Mind

Aging: New center for Alzheimer's patients incorporates the latest science in its design.


Recent discoveries about Alzheimer's disease inform every inch of the newest building at Los Angeles Jewish Home for the Aging in Reseda. But there is nothing sterile about the Paul Goldenberg and Daphna and Richard Ziman Special Care Center.

As Molly Forrest, the home's chief executive, pointed out during a tour, 96 people will live at the center, each in a room with a large window. Natural light seems to lessen the anxiety of those with dementia and to help them sleep.

Designers of the $13-million building referred to a thick stack of current Alzheimer's research to make their decisions, Forrest said.

The nearly 50,000-square-foot building is divided into sections, or clusters. In each cluster, the walls and furnishings are done in a given shade of noninstitutional peach, gray-blue or green, making it easier for residents with tattered memories to find their "neighborhood" by its distinctive color.

There are no dark colors on the rugs or floors because Alzheimer's patients often interpret these as holes. They will painstakingly avoid them, putting themselves at greater risk of falling, Forrest said.

A glass-fronted "memory box" hangs on the wall outside each resident's room. Family members may fill the box with mementos of the resident's life. The memory boxes acknowledge the things that have been important to the individual and help them stay oriented.

"As I'm walking down the hall, I see my wedding picture, my children's pictures, my military papers," Forrest said.

The need for specialized facilities to care for people with dementia is only going to increase, said Peter Braun, executive director of the Alzheimer's Assn. in Los Angeles.

"Alzheimer's disease is affecting more and more people in our society, as our society ages," Braun said. "In L.A. County alone, there are more than 150,000 people with Alzheimer's disease. Alzheimer's and related dementias affect one in 10 of those over 65, but almost half of those over 85."

Braun said he was impressed with the capability of the new facility to meet the needs of individuals at different stages of the disease. Currently, more than 70% of people with dementia are cared for at home, he said.

"When you walk in, you feel like you're walking into a fine hotel," Forrest said of the lobby, with its grand piano. Such touches contribute to "resident dignity," something easily lost in the dehumanizing course of Alzheimer's disease.

Forrest refers to the lobby area as "town central." The intent, she said, is to recreate, inside the building, the atmosphere of a small, friendly town. Residents may be easily confused, but they still need an environment complex enough to pique their interest.

"There are things to do, to see and experience that will stimulate your senses," Forrest said.

Off the lobby is an area, reached by a door marked "cafe," where residents will be able to get a bagel or other nosh. Another door leads to the facility's gift shop. A feature of the shop will be a rack where lost items of clothing will be hung.

It is one of the features added after planners canvassed nursing homes throughout the country asking, Forrest said: "What did you do that worked and what did you do that you would have done differently?"

Alzheimer's patients seem to cope with their agitation by wandering, so the building has a system of curving paths that allow the residents to keep moving safely without coming to a sudden, disorienting stop. There are also places to stop and rest along the way. Without them, Forrest said, Alzheimer's patients will sometimes walk until they are exhausted.

The center has private areas where families may celebrate Shabbat with a resident and where disruptive residents can be cared for without upsetting others.

Phyllis Newstat of West Los Angeles said she is happy that her 90-year-old mother, Tillie Kaiser, will soon be moving into the center. Newstat said her mother was always an active person, who drove until she was 85. Newstat said she is glad the center incorporates strategies for stimulating the residents.

"They're trying to make them aspire to the best possible place they can be," she said.

The Jewish Home for the Aging was founded 90 years ago to provide a Passover seder to five homeless men, Forrest said. It has a special commitment to the Jewish poor. Seventy-five percent of the residents are financially needy.

There are almost 300 names on the waiting list for the new center, which includes 12 beds for end-of-life or hospice care. The home gives priority to Holocaust survivors (20 are currently on the list) and Righteous Gentiles, non-Jews who risked their lives to save Jews during the Holocaust, Forrest said. Next in line are observant Jews.

The cost for those paying privately will be $210 a day for a semiprivate room.

The rituals of Jewish life will be observed throughout the center, to be dedicated today. When a resident dies, the family will be able to sit shiva in his or her room, and the empty bed will not be filled until the traditional seven days of mourning is completed, said Forrest.

Jules Fogel, chairman of the building committee, said his group hammered out every detail of the new center, from the style of the armoires in the rooms to the chairs in the hospice wing that fold out for sleeping.

"We're building a home for 96 very worthy residents," Fogel said. "It's a tremendous privilege for us to be involved in a project like this."

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