Sometimes the findings reach a dead end. For instance, aromatherapy was considered by many in the field to help calm agitation in people with dementia. The staff at Copper Ridge worked with the Johns Hopkins team to develop a study to determine the effects of aromatherapy on residents with problem behaviors. Then they used aromatherapy with a select group of residents over a period of several weeks. End result: zilch. It didn't help at all.
Another key to the Copper Ridge approach is steady staffing. The facility claims an overall nursing staff turnover of around 25 percent annually, compared with more than 100 percent for nurse aides at many nursing homes and 50 percent for nurses. Remarkably, many staffers, including Koenig, have been at Copper Ridge from its inception in 1994. That's a good sign, says Katharine Bau Hsiao, coauthor of The Baby Boomer's Guide to Nursing Home Care. "If the staff wants to be there, they tend to pay more attention to patient care."
The Hopkins collaboration ensures that staff training is continuous and well above par. Maryland state law calls for 12 hours of ongoing education each year for certified nursing assistants, for example, and Copper Ridge more than doubles that quota. Nurse specialists, neuropsychologists, and neuropsychiatrists from Johns Hopkins teach and brainstorm with staff to assess the right solution for every challenge. "For this population, you need to have a training program that is ongoing and very topic specific to what they are dealing with," Koenig says. "Our staff tells us what most of our training topics should be based on what they are dealing with on a daily basis."
While there are other facilities around the country aiming to provide top-level dementia care similar to Copper Ridge's, they are far from the norm. The most obvious similarity, though, is found in the living quarters and resident-centered care. A growing number of assisted living and nursing homes are offering a homelike environment and are stressing activities and physical stimulation. Few, however, have the extra benefit of working in tandem with a world-class medical team each day.
Not surprisingly, the educated care doesn't come cheap. Copper Ridge costs as much as $113,515 a year for assisted living (from $205 to $311 per day, depending on the level of care) and up to $140,525 a year for nursing home care ($385 a day). Although the facility's nursing home unit accepts people on Medicaid, the assisted living component is strictly private pay. (Some residents have long-term care policies that help foot the bill.) Even at this price, at times there's a waiting period of a few weeks for a bed. In the nation's 100 largest metropolitan areas, dementia care in assisted living averages $56,316 a year for a private bedroom, or about $154 a day, according to the Annapolis-based National Investment Center for the Seniors Housing and Care Industry.