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MCDM AG.COM | M AY/ J U N E 2016 | Medical Construction & Design 53 patients with the need to meet regulations. At Abe's Garden, the team ultimately succeeded in delivering a home-like envi- ronment with few visual cues to remind residents they are in a state-regulated health- care building, other than exit signs and fi re extinguishers. To enhance the residential environment, it's important to design the interior to feel home-like and comfortable. As individuals with dementia frequently become upset in unfamiliar places, incorpo- rating design elements from the past that residents might recognize from their youth can help them feel relaxed and stimulate conversation. Additionally, incorporating elements like fi replaces and designing kitchens and din- ing areas that resemble the family home can also help put patients at ease. It is also benefi cial to design hallways and communal spaces with a more open concept — which also allows more natural light to fl ow in — rather than de- faulting to the expected long, straight hallways that are com- mon in healthcare facilities. Building a facility con- ducive to family gatherings, private conversations and physical and cognitive engage- ment can also make residents feel more comfortable. For example, Abe's Garden de- veloped themed households based on interests: music and movement, connection to nature and arts and lifelong learning. These include yoga classes, cooking, travel and book clubs, specially designed computer programs and pet care areas that are available in the various households. These designated spaces and opportunities, as well as encouragement to assist with setting the dinner table, preparing afternoon snacks and inviting new or shy residents to socialize or dine with staf or fellow residents, are coupled with residen- tially scaled and appointed household kitchens and dining areas. Built environ- ments that support engage- ment and hobbies, whether through themed households or design elements like the use of lighting, have a benefi cial impact on cognitive function and can help reduce patients' need for antipsychotic drugs. Wayfi nding cues As individuals with Alzheimer's have the tendency to wander, it's important to create a safe and enclosed area for residents to do so. For example, a well-scaled and landscaped courtyard can create an environment to hold classes and spend contained time outside. In order to pre- vent residents from leaving the campus unsupervised, but still providing ample opportunities for daily walks, Abe's Garden's interior courtyard includes a walking path with closed loops and directional choice. The design also took wander prevention one step further by building all three of its households to surround the courtyard, allowing resi- dents to enter their "homes" by walking through a front door, rather than a traditional healthcare facility entrance. Despite the prevalence of Alzheimer's, there have been few studies on how design impacts individuals with the disease. By designing and building with the unique needs of these patients in mind, new memory care communities will serve as incubators of research and training that will benefi t the nation's existing and future Alzheimer's residential and day/evening care centers. Jef Elpers is senior project manager at Skanska USA.