Lydia Cordero had been living at Crimson Ridge Meadows, an assisted living facility, for three years when the 82-year-old started needing more support than the facility could provide.
But with widespread nursing shortages made worse by the COVID pandemic, the number of skilled nursing beds — including those for memory-care patients — has declined across the region and nationally. Her family’s top choices for local memory-care units had waitlists of up to 2 1⁄2 years, according to Lydia's daughter-in-law, Nancy Cordero.
That's when Crimson Ridge suggested the family check out Friendship Place at Monroe Community Hospital.
“When we walked in there, we fell in love with the place,” said Nancy, who toured the recently renovated facility with her husband, Miguel A. Cordero Jr.
“The courtyard was amazing,” she said. “And that's why we picked the room that we did for Mom. Mom is a people watcher, and her room looks right into the courtyard."
Friendship Place is a 25-bed secure unit for residents who may wander, including those with dementia and Alzheimer’s disease. Planning for the redesign began in 2019 — although it stalled when the pandemic hit — with the help of dementia-care expert consultants from around the world. Construction began last year, and the first residents moved in earlier this fall.
It had been decades since its last refresh, and Alyssa Tallo, executive health director at the hospital, said it was time to make some changes.
“We wanted to ... bring it up to a more home-like environment,” she said. “I think someone referred to the (previous) color scheme as ‘Pepto pink.’ It really was outdated. It was not dementia-friendly (based on) what we know now.”
New York state awarded a $500,000 grant to the project, and the Mother Cabrini Health Foundation provided a $400,000 grant. The remainder of the $2.86 million budget came from Monroe County.
The unit’s design focuses heavily on maintaining a balance between safety and independence for the residents.
Though residents cannot leave the facility on their own, they can access the outdoors by entering a fenced-in courtyard.
To promote independence and what Tallo refers to as “safe wandering,” the design encourages safe paths of travel. The flooring pattern almost “points” in certain directions, and it’s a light color where residents are encouraged to walk and dark where they shouldn’t go, like supply or other staff areas. Matte flooring was chosen, as shiny flooring is often interpreted as wet or slippery by those with dementia.
The walls are painted with soft shades of blue and green to differentiate between certain areas of Friendship Place. Doors that should only be accessed by staff are almost hidden within the color scheme and wainscoting.
Trash and dirty laundry bins are similarly hidden, with walls built out around them, with the goal of providing a more home-like experience, with less clutter.
One of Tallo’s favorite design features is the use of biodynamic lighting, meaning the lights inside change color temperature — its visual warmth or coolness — and brightness to mimic what’s happening outside.
“That was probably one of the more meaningful cost investments on the unit. ... The lights have been shown to help regulate circadian rhythms, sleep cycle, improve mood, and improve behaviors,” she explained.
Shadow boxes in front of each room are filled with items that speak to the residents’ individual interests and help them identify their rooms. Bathrooms feature walk-in showers, sinks with motion-activated faucets and no stoppers to avoid flooding risks, and more.
Considering the physical environment of a person with dementia or Alzheimer’s is incredibly important, according to Arlene Wilson, senior director of programs for the Alzheimer's Association of Rochester and the Finger Lakes.
“You want a person to feel safe, for the environment to feel familiar, and, as memory loss progresses, to feel comfortable. If you think about your home ... there are certain things that make you feel comfortable,” Wilson said. “Those are things that impact people, and you want to make sure that a person with dementia has a setting that is as close to the quality of life as they're familiar with and they're comfortable with.”
Lydia Cordero and the seven other current residents of Friendship Place — the hospital is keeping enrollment numbers low to ensure the goals of the unit are being met — are settling into their new home.
Nancy Cordero said that while she expected there'd be an adjustment period, her mother-in-law felt at home right away. Staff provided Lydia with a vintage stroller to keep her beloved dolls or “babies” in, so she could walk the unit with them in tow.
And although the renovation is complete, Tallo said the work is not over, and the learning continues.
“I think what's important to remember for all of us is that we serve people,” she said. “The people that are on that unit are our customers. The ribbon cutting has come and gone ... (but) it's going to be an evolving process that we can look at and improve upon."
