New approaches to early-stage dementia introduced at Stein Assisted Living Somerset

New approaches to early-stage dementia introduced at Stein Assisted Living Somerset

A resident colors at the new transitional care unit at Stein Assisted Living.
A resident colors at the new transitional care unit at Stein Assisted Living.

Over the last year, a resident of the Wilf Campus for Senior Living’s Stein Assisted Living in Somerset was starting to experience early signs of dementia.

Increasingly uncomfortable around her friends at meals and at mahjong, a result of her growing forgetfulness and other cognitive difficulties, she began to self-isolate and miss out on the social activities she had enjoyed.

Stein Assisted Living’s administrator, Jean Leone, who also is the Wilf Campus’ vice president of operations and clinical compliance officer, noted the change with concern.

“She is an incredibly strong woman, but she saw that while her friends still loved her, she was unable to engage with them as the person they once knew,” Ms. Leone said.

While the Wilf Campus has a newly expanded secure memory care unit with 24-hour supervision by specially trained staff, as do most facilities of its type, it did not have a unit catering to residents with mild or early signs of dementia.

Now such a unit has opened, and it’s quite revolutionary in the eldercare universe, according to Ms. Leone, an ordained minister who came to the Wilf Campus in 2019 after working as a registered nurse for decades.

The Transitional Care Neighborhood at Stein Assisted Living is designed for residents such as the woman with early-stage dementia.

In fact, the 15-room unit, which has its own garden and common space, was created in the wing where she already lived. She and other residents with symptoms of early or mild dementia can age in place in dignity, without a disorienting move out of the area that has become their home, Ms. Leone said. Rooms also are available for newcomers assessed as likely to benefit from it, she added.

The vision for this unit is not merely as a place for residents to stay as their dementia progresses. Not only does it provide a safe space to allow residents to leave their rooms for activities and meals without fear of judgment, it also is meant to be actively therapeutic.

A partnership with Robert Wood Johnson Medical School’s divisions of geriatrics and general internal medicine brings in “focused and individualized medical consultative oversight and expertise in evidence-based care for our Transitional Care Neighborhood residents,” Ms. Leone said.

A resident colors at the new transitional care unit at Stein Assisted Living.

“Evidence-based care” refers to research showing that targeted early interventions — such as certain word games and even evocative scents and colors — can be used in a consistent way to strengthen the memory pathways of people with early dementia, and it can increase their engagement with their peers and surroundings.

“For example, I’m Italian, and in my household, we sauté onions in olive oil and add basil and oregano to make gravy,” Ms. Leone said. “This smell strongly triggers memory. We can use triggers like this to help the memory come back in the early stages of many types of dementia.”

Dr. Karthik Kota, an assistant professor at the medical school, is coordinating the program with the Wilf Campus clinical team.

“The collaboration between the medical school and Wilf will ensure care for the older adults in an evidence-based manner with opportunities for research in the management of complex geriatric syndromes,” Dr. Kota said.

The medical school faculty provides each Transition Care Neighborhood resident with an individualized plan to be implemented by the facility’s specially trained staff in collaboration with the primary physician. The plan will be evaluated regularly to adapt to the residents’ changing needs.

Ms. Leone said although “there are programs across the world that put interventions in place from a dementia standpoint, this model is being built with the assistance of Robert Wood Johnson Medical School specialists.

“We hope it will lead to a different care model than is out there currently.”

She explained that typically when people in assisted living facilities get to a point when their behavior becomes agitated or they experience difficulties with their personal care, they are transferred to nursing homes.

“I just can’t do that,” she said. “This is the home some have lived in for 10 or 12 years.”

Families will be included in ongoing dementia wellness assessments. Medical school and Stein Assisted Living personnel work together on staff training and education, policy reviews, quality assurance, and performance improvement.

Additionally, through the partnership with Rutgers, Stein Assisted Living will offer presentations to the general community on cognitive impairment topics and plans to develop onsite support groups for loved ones.

Ms. Leone envisions the Transitional Care Neighborhood as an ideal setting for clinical trials of pharmaceutical and dietary interventions for dementia. “My hope is that six months or nine months from now we will be able to bring in an integrative nutritionist,” she said.

Stein Assisted Living accommodates 90 people in a building that opened in 2003 as part of the Wilf Campus for Senior Living, which was established in 1975 as a Jewish nursing home.

The campus also encompasses the HUD-subsidized independent-living Wilentz Senior Residence, which opened in 1985, and Stein Hospice, established in 2005. Wilf Transport, a senior transportation service, started operations in 2014, and Wilf At Home, a homecare agency, opened in 2020.

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