Forget everything you know about nursing homes: residents thrive at One Kenton, a spanking new, design-for-modern-living facility, for Alzheimer’s patients only.
Marilyn Kogon had started the paperwork to move her parents into One Kenton, an Alzheimer’s residence in North York, Ont., when her father was hospitalized. Worried about her high-needs mother’s ability to live at home with only a caregiver’s help, she picked up the phone on a Friday to ask to move her mother in that Sunday.
“I called Esther [Grinsaft, director of care], and she said no problem, we’ll find a way.” By Sunday, her father wasn’t doing well, and Kogon called again to ask if her mother, who’s nearly 90, could move into a single room, instead of the couple’s suite. No problem. Grinsaft sat with the family as Kogon and her sister broke the news of their father’s subsequent passing to her mother, ready in case she had heart problems or a medical emergency. “They got us through the most difficult time,” the 63-year-old social worker says.
That flexibility to accommodate people sets One Kenton apart from more institutional residences. Kogon’s mother is among the first people in the facility, an Alzheimer’s home that’s been designated as a Centre of Excellence because of a unique partnership with its backers: the Jewish philanthropic organization B’nai B’rith, and the government of Canada, through a one-time $5.4 million grant. It’s also partnering with a research team connected to the University of Western Ontario.
A Groundbreaking Facility
The facility, which opened Dec. 9, 2013, follows in the spirit of groundbreaking organizations like The Green House Project in the U.S. that offers homelike settings with fewer than 12 residents in each place, and the “Dementia village,” in Hogeway in The Netherlands, which includes an enclosed courtyard, and caregiver-staffed grocery store and restaurant. One Kenton has been painstakingly designed to make everyday life easier, using tools from flexible routines to digital trackers. Its goal is to feel as homey as possible, with most of the administrative offices hidden away. Thanks to the partnership with Western University’s Ivey International Centre for Health Innovation, residents get to test the latest technology through pilot projects.
One Kenton Alzheimer’s Centre of Excellence opened on December, 2013. It specializes in patient-centered care. (Climans Green Liang Architects Inc.)
The four-story residence sits nestled among other residentical houses. Its modern, squared-off lines are reminiscent of the new condos popping up downtown, and the feeling continues inside, with dark wood floors and modern kitchens. It will eventually house 45 to 47 people in 44 rooms, including the couple’s suite that can accommodate partners with or without Alzheimer’s. While the facility is open to anyone, all current residents are Jewish, and kosher food and Jewish customs are part of the package. (When I arrived for a tour, traditional challah bread, made by Kogon’s mother, was braided and on the counter in the kitchen, ready for the oven.) The non-profit residence, conceived when B’nai B’rith discovered Alzheimer’s patients didn’t have many options that fully met their needs, has a 3:1 ratio of caregivers to residents, and prides itself on patient-centered care. It’s $6,750 to $8,000 a month per person, though a fund will eventually help offset the costs for those who can’t afford it. One Kenton’s motto is: “We’re not taking a family member with Alzheimer’s off your hands. We’re taking them into our arms.”
We’re not taking a family member with Alzheimer’s off your hands. We’re taking them into our arms.
Since the home shelters only people with Azheimer’s, the building and routines are created with their needs in mind. The rooms – about 200 square feet, including a private bathroom – are intentionally small, to encourage socialization. There’s another benefit: “People will literally get lost in large spaces, not remember how they got from the bedroom to the den,” says Isaac Weinroth, the executive director. The communal spaces are easy to navigate: Hallways have handrails, and most have an armchair at the end – Alzheimer’s patients have trouble gauging distance, and an object helps them. The ground-floor courtyards are surrounded by pleasant but high fences, so in the summer, the residents can go outside.
The One Kenton bistro. When one resident moved in, the chef came to ask her what she thought of the food, and tweaked it after he got her feedback: too salty.
Staff monitor residents’ whereabouts, but One Kenton plans to implement digital badges, about the size of a pager, to track residents’ and workers’ locations. The standard nursing station is noticeably absent – the kitchen and staff rooms are all downstairs; it’s less institutional and encourages caretakers to interact more with the residents.
Ivey has an office on site from which to run pilot projects, such as a camera system that recognizes body language. For example, if someone hesitates in front of a sink, a computer might tell them how to brush their teeth. Residents are encouraged to bring memory aids, photos and mementos from home, and the furniture is easy to clean and homey – wooden beds instead of hospital beds, for example. But the real difference goes well beyond the bricks and mortar, says Weinroth.
“We look for the person behind the disease, and we also look for the potential.” Personalized care plans are created with input from the resident and the family, with a focus on maximizing independence. Families are encouraged to stop by – there are no visiting hours, and guests are welcome to eat with residents, or sleep over.
We look for the person behind the disease, and we also look for the potential.
When Kogon ‘s mom first moved in, the chef came to ask her what she thought of the food, and tweaked it after he got her feedback: too salty. Kogon calls regularly, and staff will put her mother on, often relating an anecdote about the day. “When I call she says, ‘I’m doing my exercises. I’m doing bingo,’” Kogon says, adding that her mother’s diabetes and her mood has improved.
The center doesn’t use physical or medical restraints.
“People will become anxious or get frustrated, and not be able to verbalize that fully,” says Weinroth. “Then they communicate with behavior. We find out what is causing those signs, and we look for solutions.”
They discovered music helped one resident, so he carried around an iPod, and listened to the music when he got anxious. Other success stories include a woman – who had declined in a retirement home – and came to One Kenton confined to a wheelchair. “Within a week and a half, she was up and walking,” says Weinroth. “Just the other day, we were literally dancing with her.”
One Kenton is located in North York, a region of Toronto, Ont., Canada. For more information, call 647-932-7913 or visit onekenton.ca.
Vanessa Milne is a health writer based in Toronto, Canada