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Let me live out my confused days in dignity...

There is no doubt that a supportive environment is essential for the person with Alzheimer's disease. Lately, much has been written and spoken of Alzheimer's and the "special care" implications it carries. The most frequently asked question is, "just how special is 'special care'?" Special care for AD seems reasonable, and on the surface, appears to be a good solution for the care that people with Alzheimer's require. Yet, think about some factors that affect special care. From the corporate angle, special care units are being developed in both new and existing spaces. The label 'special care unit' however, does not necessarily mean anything different or special is happening in those spaces. In fact, some spaces are merely as they were before, yet with a new label. Design purists claim that in order to insure a different or special kind of care, the space itself must be re-designed and re-thought. Those lucky enough to consider an empty slate of space (as opposed to existing spaces), can consider some of the newer innovations with regard to the needs of the AD patient and the best environment to meet those needs. The care of Alzheimer's must address issues of privacy and socialization as well as ease of the activities of daily living. All the 'special' characteristics of a person with Alzheimer's must be taken into consideration. For instance, do rooms off a long corridor, (in a typical old fashioned hospital design) help the AD person remember his room, or be able to find a nurse, a bathroom, or anything he may need? Confusion, wandering, incontinence, restlessness are just a few important considerations. Design innovators are looking at hallways and corridors with a new eye. Patterns and color are considered important cueing devices. Confused persons are dependent upon the environment to provide them with clues that allow independent functioning. Orientation is space organized in such a manner that it has a singular, unambiguous definition and use. How can we orient a confused person? Designers suggest color, architectural differentiation, signs, the establishment of landmarks or structures used as points of orientation, visual distinctiveness and visual access (the ability to see one' s goal before actually arriving there). Safety must also fit into the design considerations for the AD environment. Wandering and confusion are real problems that have resulted in real tragedies for institutional and home care providers. With innovation, thoughtfulness and care of design, can we insure safety and perhaps dispose of chemical and physical restraints? A second related question must be, at what cost? A look at The John Douglas French Center for Alzheimer's Disease in Los Alamitos, California reveals an ex-