Faces look up as you enter the Corinne Dolan Alzheimer Center, and immediately you notice their expressions: some of suspicion, more of curiosity, a few of bemusement, mild surprise. No confusion, none of the distress or
disorientation so common in Alzheimer`s patients. At mid-morning, the Dolan Center has the lazy, intimate atmosphere of a small dormitory: There`s a clink of plates and silverware, the opening and closing of bedroom doors, the low buzz of conversation.
In a dining area two gray-haired women are trading theories on Saddam Hussein over lukewarm coffee, while a few other breakfast stragglers are hidden behind Wednesday`s Cleveland Plain Dealer. A man in a baseball cap shuffles around the eating area, but somehow it`s not an aimless shuffle.
”People are very comfortable here, you can see that,” says Paulletta Gwinnup, the center`s program supervisor. ”I think a lot of them feel like they`re staying at some kind of resort.”
In fact, the Dolan Center is more of an ongoing experiment. Opened in 1989, it was built expressly to study how architecture could be used to make the effects of Alzheimer`s disease less confounding, less disruptive. The center`s layout, its decor-even its windows and doors-are designed to jog the fragile memories of its 23 residents, reminding them where they are, for instance, and helping them decide whether it`s time to eat lunch or go to the bathroom. These everyday routines confuse many of the 4 million retirement-age people with Alzheimer`s, an affliction that saps the short-term memory and leads to paralyzing dementia.
The building`s exterior resembles the Stealth bomber in shape-flat and angular, with two wings, a Frank Lloyd Wright-inspired design whose sloping geometry blends into the woodlands east of Cleveland. ”The idea is to let the residents know they are not at home, they`re someplace else,” says Maggie Calkins, an architectural consultant who helped design the project. ”There`d be something contradictory in building, say, a rambling farmhouse for a group of strangers and staff; some patients might actually think they were back with their families-which would cause all sorts of problems.”
Not that getting lost would be easy. The building`s airy design keeps everything in plain view-not only to reduce the wandering and disorientation common in Alzheimer`s facilities but also to visually prod weak memories. In both wings of the center, a dozen bedrooms encircle a large open area containing a small lounge, kitchen and dining area. Just a glimpse of the dining area around noon might tip off some residents that it`s lunchtime.
Each resident also has his or her own bedroom, something researchers say provides a constructive sense of independence, dignity, personal turf. Compact and simply furnished, the rooms all have Dutch doors. Leaving the top half open when they go out, residents can catch sight of the familiar surroundings inside to help them find their way back.
”These items reach into their long-term memories, which are still intact,” says Namazi. To test the strength of memorabilia, Namazi and Calkins had staffers ask residents to find their rooms several times a day over a period of six weeks last year. Each patient was tested under two conditions:
with his or her display case full of significant mementos, and with the case full of meaningless odds and ends. Among most residents who needed help finding their way, the genuine keepsakes sharpened room-finding abilities by up to 50 percent.
Already, several of the center`s design features have found their way into blueprints for future Alzheimer`s care facilities. ”We just had some people in here planning a clinic in Michigan,” says Robert Harr, president of Heather Hill, the Chardon, Ohio, health-care complex that operates the center. ”And their architect was with them-taking notes.”
Namazi and Calkins also plan to experiment with closet layout-lining up clothes to help patients dress, for example-and with design ideas to cut down on distracting sights and sounds. Distractions are especially difficult for Alzheimer`s patients because the disease dissipates their ability to concentrate, making reading, writing and even fixing the TV antenna endlessly frustrating. To measure auditory distraction, the researchers have rigged a tentlike enclosure next to one of the dining areas; there patients take written tests while a tape recorder plays various sounds.
In the meantime, on this morning, the experiment itself is a little distracting. Every now and again the tent emits a sharp click or pop-causing several residents to look up in surprise and curiosity. But the interruptions hang in the air only for a beat or two before the buzz of the morning resumes, and people return to the small routines of the day.
