Honoring Abe

Alzheimer's treatment community Abe's Garden to provide cutting-edge model

Nashville will soon have what might be the most innovative Alzheimer’s treatment community in the nation.

Interestingly, that facility — to be called Abe’s Garden and to open in late summer of 2015 on the lush Park Manor campus in West Nashville — will have been designed with its officials having taken cues from various dementia treatment communities throughout the country. Similarly, the Abe’s Garden team has worked with national entities to create a cutting-edge buildings and grounds that might serve as a model of sorts.

For example, Abe’s Garden Executive Director Dr. Andrew B. Sandler says the Manuel Zeitlin Architects design team took a look at the Alzheimer’s Resource Center of Connecticut.

“We brought [Executive Director Michael J. Smith] here and we are incorporating their dining model,” Sandler says.

Likewise, the team is using the Chicago office of Perkins Eastman, a New York-based interior design firm.

“A lot of the research we’ve done was taken from their designs,” Zeitlin says.

As to the Abe’s team both soliciting information from and sharing info with, officials with Maryland-based Copper Ridge visited the Park Manor campus last August. Of note, Copper Ridge has a relationship with Johns Hopkins University and its world-class medical center.

Sandler describes Abe’s Garden as using elements of an assisted living model while avoiding replicating a conventional nursing home approach.

“It will feel like a home as much as possible,” he says.

Similarly — and differentiating itself from other dementia care communities — Abe’s Garden residents will have as much interaction as possible with the residents at Park Manor, Sandler adds.

Abe’s Garden, on-site work for which recently started, will be an aging-in-place facility spanning about 50,000 square feet with residences for 42 individuals and a series of exterior gardens. The campus will be arranged in “households,” each with its own distinctive characteristics designed to provide various environments for residents and their families.

Each household will feature between 12 and 16 single bedrooms (with two dual-occupancy suites) with a common kitchen, a dining room and living areas. The households will be connected by spaces that provide a  series of options and services for socializing, creative activity and connection to the exterior gardens.

Zeitlin says his design team has focused on the concept of “living in the moment.” As such, the facility will incorporate natural materials, filtered light, stone, wood and multiple windows.

In a move unusual for the designing of a facility of this type, the Abe’s Garden team is working closely with the Center for Quality Aging at Vanderbilt University Medical Center. Zeitlin says the team has with VUMC a research relationship that will soon appoint an endowed chair, courtesy of the Shmerling family and an anonymous donor, in Alzheimer’s and geriatric care to be involved in the process. On this theme, some Vanderbilt faculty have served as consultants to the team.

This is the first time that benefactors of an Alzheimer’s care community have endowed a chair at a major medical university. The faculty member will provide opportunities for Vanderbilt to lead applied research on dementia.

“We’ve included Vanderbilt representatives in the design process,” Zeitlin says.

As part of that process, the team two years ago conducted a one-day charrette with Alzheimer’s experts. The charrette results “significantly altered the design,” Sandler says.

“It was refreshing to get that input,” he notes.

The idea of Abe’s Garden was born when Dr. Abram “Abe” C. Shmerling, the father of Nashville entrepreneur Michael Shmerling, was diagnosed with Alzheimer’s  in 1995. Dealing with the disease firsthand, Michael found what he felt was limited availability of quality services and care dedicated to elderly adults with Alzheimer’s and related dementias.

Michael Shmerling’s desire to establish an Alzheimer’s “center of excellence” grew as he and his family watched their relative suffer for more than 11 years. Abe Shmerling died in November 2006.

The specific elements and characteristics of Abe’s Garden are worth noting. For example, an outdoor fireplace will help residents better orient themselves with their surroundings.

Sandler and Zeitlin attended a conference related to lighting, and their findings will be incorporated as related to circadian rhythms to allow residents to enjoy maximum quality sleep. The facility will be centered around a courtyard that will allow for lots of natural light. The team has worked with Nashville-based Hawkins Partners Inc. on this feature.

“Unless the weather is bad, every Abe’s Garden resident will go outside at least once every day,” Sandler says. “And every household will have a dog, a cat or an aviary.”

Sadler says the goal is to create a connection between the indoor spaces and the outdoor courtyard, which will provide the residents a certain freedom much like they would have were they living in their own homes.

“We are seeking a manageable model from design through programming, through family interaction and through end-of-life,” Sandler says. “Our overriding goal is to implement evidence-based best practices.”

On that theme, some elements commonly found in conventional senior-care facilities will not be evident at Abe’s Garden. Other characteristics perhaps not as common — including art, music and dance programs — will be emphasized.

“It will be a bingo-free zone,” Zeitlin says with a chuckle.

Zeitlin stresses that residents of Abe’s Garden will be able to “age in place.”

“The idea that people can age in place is a pretty revolutionary concept,” he says. “Families can maintain relationships with care partners.”

A key goal is to offer salaries attractive enough so as to lure and keep top-notch professionals — in the process minimizing turnover and reducing the need for traditional nursing care. 

“We are looking at financial viability,” Sandler says, acknowledging some practical realities that accompanying such undertakings.

Zeitlin and Sandler say the nation offers  some quality and respected facilities dedicated to the care of those with dementia. However, many use a for-profit model that, potentially, can limit their scope and effectiveness.

Similarly, they note, various Alzheimer’s facilities offer some strong programs and designs, but few offer all those programs and design features under one roof.

Abe’s Garden should forever change the dynamic.

“It’s not so much about replicating a style [of dementia treatment community] as it is creating a place where the residences can feel connected and engaged,” Zeitlin says. “People with Alzheimer’s can still have meaningful days and experiences.”