A New Approach To Care
By Cara Tanamachi(from the Austin American-Statesman)

When Vincent Hollister discovered that his 79-year-old father had advanced Alzheimer's disease, he was determined to find him the best care available.

To his shock and dismay, the Austin communications consultant found few nursing homes capable of caring for patients suffering from Alzheimer's a terminal disease that causes loss of memory and reasoning skills and afflicts one in 10 Americans over the age of 65.

Many nursing homes, which tend to cater to the physical frailness of the elderly, simply aren't prepared to handle the special mental care for Alzheimer's patients. Bill Keane, board member of the National Alzheimer's Association, said Alzheimer's patients sometimes lose themselves to bouts of aggression, confused wanderings or long periods without the ability to make rational decisions.

After visiting more than 20 institutions between Austin and San Antonio, Hollister found a home for his dad at Barton House, a new facility in Northwest Austin designed exclusively for Alzheimer's patients. The first of its kind in Texas, the facility discards old institutional approaches and promises to revolutionize how caregivers approach Alzheimer's patients.

Keane said care facilities like Barton House are on the rise across the country as the need for specialized care grows among a population that's living longer. As people become older, their chances of developing Alzheimer's increases. One in four Americans over the age of 85 has Alzheimer's a disease that does not yet have a cure.

"The nursing home industry grew out of a hospital model, with an intensive medical model of care," Keane said. "But a person with dementia doesn't need the medical model of care. They aren't physically needy until the last stages of the disease."

For many of these new specialized assisted living homes, atmosphere takes precedence. Barton House looks more like a family home than a traditional nursing facility or hospital. Tasteful, upscale furniture fills the sitting room. The floors are covered in soft carpet and the walls in oak paneling.

Designed to accommodate 20 patients, the cozy residence has vaulted ceilings and is bathed in bright sunlight.

But what makes Barton House unique is the attention to detail in anticipating the needs of Alzheimer's patients. Co-owners Bob Bouchard and John Trevey toured the country and found that most institutions didn't understand the needs of Alzheimer's patients."

Instead of stifling the behavior of patients, Barton House works to accommodate them.

Exploring not discouraged

One symptom of the disease for some patients is a tendency to wander. At traditional nursing homes, wandering is strictly discouraged because of doors set with alarms. When Hollister's father stayed at a San Antonio facility, he was fitted with an alarm band around his leg so he could not go far. That experience was humiliating for both father and son, Hollister said.

But at Barton House, a spacious back yard is accessible for residents with an itch to explore. The patio opens into a lush yard, complete with a raised vegetable garden, wooden porch chairs and a small trail of circular gravel paths. Patients are free to walk through the yard, which is enclosed on two sides by an 8-foot wooden fence. At the end the the yard, a green chain-link fence gives residents a view of more trees and green space, gaining them the feeling of roominess.

"The Whole building is designed to let them wander freely just as they did at their homes," Bouchard said. "The freedom really gives quality of life back to them."

Retaining the dignity of patients at Barton House is a top priority. Helpful details throughout the building encourage residents to remember day-to-day things. Each door has a different panel designed to help them recognize their own rooms. Outside each door hangs a small display cabinet filled with common trinkets and pictures of relatives and loved ones to give them added familiarity.

Inside the rooms, dressers are fitted with two compartments: a locked on end an open one. Each morning, a staff member comes through and opens up the locked compartment to place one set of the resident's clothes in the open compartment. This eliminates a common embarrassment for Alzheimer's patients: a tendency to layer clothing or wear two or three outfits at once.

Historical pictures, of Austin buildings in the '20s and sports heroes of the era, such as Babe Ruth, line the walls to lend a feeling of more familiarity.

"It's amazing what they do recognize and remember," Trevey said. "Even if they can't remember their wife's name, they might still recognize the state Capitol building. That memory gives them a feeling of security and confidence."

Hoping to start a trend.

This sort of care is not inexpensive. The cost to live at Barton House is $3,200 a month - less expensive than full, 24-hour nursing care, which can run about $4,000 a month, but still not affordable for all elderly. Medicare does not cover assisted living, so all patients at Barton House pay with private insurance or savings.

Other facilities like Barton House may become more common soon, which could lower the price, Keane said.

Already, Trevey and Bouchard are planning a second home, next door to their first, which still has room for more residents.

For Hollister and his father, the home has been a godsend. His father, a successful engineer before he retired, now can live out his life peacefully.

"I found a place that's full of love, and when I walk out the door, I know my dad is being looked after," he said. "He has his independence and dignity, and someone is giving him the care he needs. I don't have to worry about leaving him there."