Remember When

A Colorado nursing home explores new territory for treating Alzheimer's patients: the past.

But going to Main Street is no trip to Disneyland. At times residents lose the ability to speak, or they greet visitors--even their own family members--with vacant stares. One woman, dressed in sweatpants and a prim blouse, spits out a string of obscenities until a staffer hugs and calms her. "It's interesting to see how the parts of the mind work," says Shirley Parmele, a social worker and program coordinator for the unit. "They can't tell you they want a drink of water, but they can spell 'locomotive.'"

Alzheimer's is only one of several diseases causing dementia, defined as the loss of intellectual functions such as thinking, remembering and reasoning. Huntington's disease, Pick's disease, Creutzfeldt-Jakob disease, Parkinson's disease and multi-infarct dementia, caused by multiple strokes in the brain, can also produce dementia.

Once a general community hospital, Family Health West realized in the 1980s that the advent of high-tech medicine and less-indulgent insurance companies was cutting into its patient base, so it started converting more beds to long-term care for the elderly. Today the 47 residents of Main Street range in age from 65 to 102, with most in their 70s and 80s. Many come from western Colorado and eastern Utah or have grown children in the area who moved their parents here from other states so they can check in more often.

The upbeat atmosphere of Main Street has made it easier for children and grandchildren to drop by. "Some families never miss a day," Snider says. "Other families can't emotionally deal with it. In general, it can be a pretty depressing situation." But now visitors don't have to sit in a dreary bedroom; they can stroll to the ice cream parlor, play with the dog or sit together on a park bench. "All the Alzheimer's patient has is now," Snider explains. "Sometimes when you get a smile from an Alzheimer's resident, that's as good as it gets."

In its eighteen-month life span, Main Street has been honored by the El Pomar Foundation and the Colorado Department of Public Health and now fields three to four inquiries a week from other nursing homes wanting details. The unit plans to more than double its beds with a 10,000-square-foot addition opening in spring 2000. The $1.8 million project will include a secure courtyard so residents can spend time outdoors or work on waist-high gardening plots. In the meantime, social worker Parmele is planning another revolutionary touch on Main Street: busy holiday decorations, complete with colored lights.

According to the Rocky Mountain chapter of the Alzheimer's Association, an estimated 50,000 Coloradans have Alzheimer's --enough to fill Coors Field. Despite rapid advances in understanding the disease, scientists don't expect any immediate cure.

But the Main Street concept could help. "Of course, there are some patients who won't recognize Main Street," says CSU's Bell. The big-band tunes won't evoke long-term memories in everyone; the next round of Alzheimer's patients will have grown up with shopping malls and rock music. "For the next generation," he says, "you'd have to pipe in the Beatles or Simon and Garfunkel."

To view a promotional video clip for the Main Street Experience, visit

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