It’s lunchtime at Cristwood, a sprawling senior living community just north of Seattle, but one memory care resident named Midge has her mind on other things. She sits upright, squints, and gingerly waves her right hand between three 18-inch-tall sensors lined in front of her.
Midge, a lifelong teacher, is witty but frail. Her motion is tentative and gentle as if petting a skittish cat. Depending on where she edges her hand within the sensors, her movements produce the sounds of a strumming guitar, a slide whistle, and rattling maracas. She strains to hear, but a smile washes over her face when she realizes she is making music to accompany the old song, Hail, Hail the Gang’s All Here, as it blares from a computer console.
“You’re doing that, Midge,” says Aloma Jackson, memory care activities coordinator at Cristwood. “Good job! Sounds great!”
The achievement may strike some as a trifle, but technology-fueled moments like this are playing a growing role in long-term memory care facilities. The goal is to reach and touch residents and bridge the gap between them, especially those with dementia, and the world that often swirls about or speeds past them.
The need to get creative is great. The World Health Organization says more than 47 million people live with dementia and nearly 10 million new cases arise each year.
Dementia harms memory, motor skills, sensory abilities, and often visual perception. As it progresses, the condition also diminishes communication. And as isolation intensifies, so do agitation and confusion.
In March, Cristwood began employing a computer system known as iN2L (It’s Never 2 Late). The center incorporates it in group and individual sessions to engage residents in both its assisted and unassisted units. The system is mounted on wheels so it can go into individual rooms and help residents who may be too sick or shy to join the common areas.
Oversized, easy-to-read icons on a touch screen lead users to a wide range of applications. Residents can explore foreign lands or reminisce about hometowns. They can sit in a virtual cockpit or use a wand to paint or doodle. They can compete in trivia games, sing songs, or Skype with family members.
“We believed then, and we believe now, that older adults living in senior living communities, particularly people living with dementia, have the desire and the right to stay connected and engaged with the outside world,” says Jack York, president and co-founder of Colorado-based iN2L.
“It’s a simple concept, but it has met a lot of resistance along the way,” York adds, noting that both staff and families sometimes dwell more on what people with disabilities cannot do rather than what they can do.
York was working as vice president of a Southern California technology company in the late 1990s when he learned from a friend about the loneliness that pervaded a local assisted living community. Near the same time, he was moved by his dying mother who told him that he was meant to “do more than make money.”
He donated computers to the facility and saw their value to residents. That planted the seed that led him to found iN2L, now 18 years old and with systems in about 2,500 communities, from rural nursing homes to high-end memory care communities, across the U.S. and Canada.
The goal is to engage minds and spark social integration, which may in turn help reduce the use of psychotropic drugs, improve speech, incorporate occupational and physical therapy, destigmatize the experience of moving to a care facility, and help with staff efficiency and turnover.
The effects and potential of iN2L and other systems are still being studied. While several studies have shown positive results, more research is needed to determine the long-range benefits and best practices.
York acknowledges that some facilities have balked at using the tool because it dramatically changes the way activity of therapy programming is delivered. Still, the systems were used several million hours last year, he says.
“The market is starting to demand engagement,” he adds. “Families are insisting their loved ones have access to technology.”
Cristwood saw enough promise to jump aboard. The Shoreline facility raised enough money through donations to purchase four iN2L systems, and the community will also test the application on iPads. The center also recently got two donated big screen televisions that can furnish programs to large groups. Staff reports that residents who otherwise are withdrawn and unresponsive have shown emotional and physical connections while using these programs.
The icons present options with labels like “Therapy,” “Lifelong Learning,” and “Travel” and options continue to be added. The evolving applications allow staff to tailor to a resident’s interests.
Aloma Jackson, the Cristwood staff member, recently used the system to search for California missions that a resident had painted long ago. Not only did the resident recall powerful memories by “touring” the missions on the system, but her daughter passed along an image of the actual paintings, spurring interest from other residents.
The iN2L is meant to spur human engagement. The Cristwood staff acknowledges it is still learning how to maximize the system’s potential, but the center’s administrator, Debra Hawkins, has ambitious plans including group activities, such as a cycling club, in which assisted living and independent residents use the system together.
“We are seeing residents engage who otherwise did not,” she says. “And they in turn are not self-isolating as they have been in the past and are making friendships and relationships throughout the neighborhoods.”
While engagement with others is an overarching goal, so is finding that one thing that can reach each single person.
“I came in on a Sunday and one of the residents, said, ‘I’m bored!’ so I got her on Google Earth and we ended up in her hometown of New Orleans,” says Jackson. “We got onto her street. She talked about the corner store she used to go to. She was in tears by the end. She was so moved by the experience.”
It was one moment with one resident, but it was success.
Richard Seven has lived and worked as a journalist in Seattle for more than three decades. He spent most of that time as a feature writer and editor for The Seattle Times.