Alzheimer’s Health Clubs vs. Day Care: re-thinking dementia care

It’s the first time one of my work trips makes the news, but here it is, I have the honour of being the UK academic mentioned in this news report about the opening of Memory and Company, an “Alzheimer’s Health Club” in Toronto. I came across it by chance on Twitter (thank you @DiverseAlz), while catching up on discussions about day care on #Diversealz and #demphd. The concept is simple: a high-end health club that caters for people with dementia. There is all that you’d expect in a health club: a spa, a fitness suite… and also a cinema room, a huge open kitchen, and a garden. It looks beautiful, I can’t wait to see it in action in early May.

the kitchen at the Memory and Company Alzheimer's Health Club, TorontoTraditional day care services, at least in the UK, are not seen as a very attractive care option, and the numbers of people using them are declining, but in principle day care has the potential to be play a much larger and fundamental role in the care of people with dementia, particularly for people in the moderate to severe stages who are not in care homes. While there has been little research about the role of day care for people with dementia, the evidence that there is shows that it is cost-effective, partly because day care can delay admission to care homes, and because it reduces stress and burden on unpaid carers.

From a theoretical point of view, and given that we know that the numbers of people with dementia will be rising faster than the numbers of potential carers, and expected increases in the retirement age, there is a very strong case for good quality day group care.

In practice, day care can enable working age family carers to continue to work, as was the case with my grandfather, who lived with my parents in the last years of his life. He was picked up every morning and driven to a wonderful day care centre in Catalonia, where he spent the day while my parents worked. He was initially reluctant to go, but was quickly persuaded by the fact that the day care programme included exercise classes and singing, and by the warmth with which he was welcomed and cared for. It also meant that, like the rest of the family, he had been out for the day and had had experiences that, when his condition allowed it, he was able to share.

A specially interesting aspect of group care is that offers a great opportunity, not just to keep the person with dementia safe and meet their care needs, but also to deliver many of the therapies that have been shown to improve the quality of life of people with dementia, or that are simply enjoyed: from cognitive stimulation, exercise, falls prevention, to music, arts, films, reminiscence, gardening… even hen keeping!

Perhaps, as we re-think how, as a society, we can provide good care to increasing numbers of people with dementia, we need to think more creatively about group care that is appealing to people with dementia, their families and to health and social care commissioners. Words matter, and a “health club” may already have greater appeal than “day care” for many people.

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