MONDAY, November 3, 1997                          E'LOUISE ONDASH - Staff Writer

Silverado Senior Living Specializes
in caring for patients with dementia

Five weeks ago, Bill moved into the assisted-living community, which specializes in caring for those with dementia. According to Stephen Winner, vice president of operations, it is the first to provide an environment totally designed to conform to the latest philosophy in Alzheimer's care: to return the control and responsibility for the environment and their health to the patients. By doing so, "we can take care of the residents nobody else wants- those with dementia who wander or are combative and disoriented - without restraints and little or no medication."

And because Silverado is an assisted living community and not a traditional nursing home, it is not required to spend money on burdensome paperwork required by the state.

"We can spend that money on direct patient care," said Winner, a veteran of the long-term care industry who has won awards for Alzheimer's facility design.

Formerly the Seven Oaks Care Center, the center was bought by Orange County-based Silverado Senior Living Inc. and transformed into a more homelike setting. For instance, 10 of the 90 beds were eliminated to make room for a music room, a "Saturday-morning garage" and a kitchen. Residents also have easy access to several enclosed outdoor areas, a "wandering path," and a garden, tiered to accommodate the ambulatory and those in wheelchairs.

"These activities give the residents purpose," Winner said. "They must take responsibility rather than just be entertained."

Silverado also comes complete with family dogs (Cassie the black Lab, Charlie the cocker spaniel, and Jasper the terrier), four cats and about 30 birds. Residents care for the pets, who easily wander inside and out.

Other ingenious tools used by the staff are aroma machines that emit grapefruit smells to stimulate appetites, "redirection" devices on the wall to distract from worrisome thoughts or bothersome behavior, piped-in music, and a large-screen television.

"Everything is geared to stimulate the senses." Winner said.

And for the families and caregivers, there are free meals when visiting, laundry service, a room for birthday parties or other celebrations, and weekly psychiatrist-led support groups.

"Families get help with their grief," said Loren Shook, chief executive officer of Silverado Senior Living. "They are experiencing the dying process, but the patient hasn't died yet, and that's even harder."

Placing a loved one in institutional long-term care is "very frightening for families," Winner added. "It's one of the toughest decisions in their lives. By the time they are ready, caregivers have become isolated, they've locked away everything in their house, they can't sleep and they have no friends."

That's where Ruth Caspari found herself some months ago. "Bill would fall and I couldn’t get him up by myself," she said through tears. "I couldn’t take him with me anywhere, and I just about quit entertaining."

Watching the deterioration of her formerly take-charge husband, once the youngest naval officer in command of a destroyer is painful, she said. "He was a very proud man, so it’s terrible," she said.

With Bill’s placement, though, life has improved for both. Ruth visits everyday and still greatly misses him at home, but she is comforted knowing that he is no longer combative, walks more steadily, and participates in all the activities.

Silverado also is prepared to keep patients until the end of life, Winner said. It employs registered nurses to assess medical problems. This decreases the likelihood that noncommunicative patients will receive drugs for behavior problems when the real problem is medical. And when death is imminent, home health care agencies and hospices can be used, just as if the resident were home. Care at Silverado costs about the same as some other area dementia-care units.

The need for "communities" such as Silverado is great, Winner said, and will only become greater with time. About 4 million people in the United States suffer from Alzheimer’s disease, and that number is projected to become 15 million by the year 2020.