Nursing Home Recreates Communist East Germany For Dementia Patients
Monday, January 22, 2018
It's said that time heals all wounds. But not for people afflicted with dementia like Gerda Noack. The 93-year-old German woman's memory is fading, as is her eyesight.
The losses scare her. On a recent morning at the AlexA Residence for Senior Citizens in Dresden, where she lives, Noack sounded anxious as she asked, over and over: "Where am I supposed to go?"
Director Gunter Wolfram gently took her arm and suggested they visit a government-run store from the former communist East Germany called Intershop. The once popular chain no longer exists — but a mockup of the store is only a few steps away.
For the many East Germans who spent decades trying to free themselves from communism's regimented lifestyle, it might seem like a return to captivity. But for Noack, it's an escape from a mental jail that today's reunified Germany can't unlock.
With the director's help, she searches one of the shelves featuring the Intershop logo for items produced in the former East.
The sight soothes Noack, and her face lights up each time she recognizes something. Like a shopping bag made out of a polyester fabric called Dederon — a name based on DDR, the German initials for the German Democratic Republic. Or a laundry detergent called Spee.
She and Wolfram share a giggle over the alupfennige — a nickname for the lightweight East German pennies made of aluminum that, like the rest of East German currency, were worth very little on the open market.
Ten minutes later, Noack declared: "That's enough for today." She shuffled back to her chair with a smile and a faded copy of a former East German television guide called FF Dabei to page through.
Such trips down memory lane to a place that no longer exists are the hallmark of the Dresden nursing home. Wolfram says most of the 130 residents at AlexA suffer some level of dementia. For the two dozen who are the worst off, he says, spending a few hours each day in two "memory rooms" that recreate the East Germany of the 1960s and 1970s is both soothing and therapeutic.
The rooms are filled with furniture, wallpaper, appliances and other mementos from the communist era and have helped AlexA clients with some of the worst cases of dementia become communicative and enthusiastic about daily tasks, like eating, Wolfram said. "It's really fascinating to see how people who basically lay in bed and lacked any motivation to do anything suddenly flourish."
He said it feels strange to hunt for memorabilia from the former East Germany, considering that he has few fond memories of growing up there. Wolfram and his family were among the few East Germans who received permission from the communist government to emigrate to West Germany. He recalled how they had to leave in a matter of hours once the permission arrived, and were forced to leave most of their belongings behind.
Tens of thousands of other East Germans who couldn't get permission tried to flee to West Germany before the Berlin Wall came down in late 1989. Most of the 327 who died in the attempt were civilians.
But Wolfram says there are no political statements in AlexA's historical recreations of daily life, except a famous protest mural that shows then-East German leader Erick Honecker kissing Soviet leader Leonid Brezhnev.
Caregivers in the memory rooms try to coax memories out of the residents in group exercises that include singing popular songs from that era — including ones the communists forbade, like Schwarzbraun ist die Haselnuss, or "Black-brown is the Hazelnut." It is an old folk tune that was used as a German marching song during both World Wars.
Wolfram says his is the only facility he knows of that conjures up the former East Gemany for its residents. But providing safe, inviting and historically familiar places for dementia patients is gaining traction worldwide. One "dementia village," Glenner Town Square, is due to open in San Diego this year and will feature a 1950s-'60s American "Main Street" experience for its residents.
Such settings expand on a widely accepted treatment known as memory therapy. Patients are shown or handed items from their past that help them retrieve older memories, which remain even after short-term memory fails.
Experts say memory therapy doesn't cure dementia, but it can improve brain function and increase the independence of patients in performing daily tasks like eating or going to the bathroom — which are results Wolfram has observed at his nursing home.
"All elements that are always used in the treatment of people with dementia are there" at the Dresden nursing home, said Dr. Vjera Holthoff-Detto, who heads the psychiatry department at Alexianer Hospital in Berlin. "They used the opportunity to really remodel their setting and make everything look [like] 50 years earlier."
Wolfram said another common therapy for dementia patients is to trigger memories by showing them personal mementos or tools from their former jobs.
But he said the individual approach doesn't always work well with people who lived in societies like East Germany, where the state heavily controlled its citizens' lives, including what line of work they went into.
"What has worked better here is this return to a culture as a whole," Wolfram explained. "People feel safe again and end up remembering how they were part of that scene."
He first experienced that phenomenon at AlexA in July 2015, when Wolfram set up a movie theater for residents. He says he went all out, and even commissioned black-and-white murals of film stars for the walls. But it was an East German, 1960s motor scooter he bought for $732 on eBay as a prop for the makeshift cinema that stole the show.
"It proved more interesting that the actual film, which was River of No Return, featuring Marilyn Monroe," Wolfram said.
He said residents flocked around the Tourenroller scooter, working its brakes and ignition. "Suddenly people with the worst cases of dementia, who had barely spoken before, started talking about their own experiences with the scooter, like how the seat was quite thin and would get hot after about 50 or 60 kilometers and how they had to stand to keep driving," he said.
That spark, he says, prompted him and his fellow caregivers to create the two memory rooms at AlexA. Many of them play roles for the residents in a simulated trip back through time, pretending, for example, to be clerks at the Intershop.
A few staffers are old enough to remember living in the former German Democratic Republic themselves. Urusula Beer, 64, says it wasn't always so happy, nor were the shelves stocked as they are in the memory rooms.
"Nowadays we think, 'My God, these are the kind of circumstances we lived under?' We had nothing, yet we had everything. As they say, necessity is the mother of invention," she said.
There are 1.8 million Germans who suffer from dementia, in a country that is rapidly aging. A quarter of Germany's population is 60 and over.
She and Wolfram say that as the number of German seniors grows, they would like to see more nursing homes adopt their approach, although some dementia experts like Holthoff-Detto expressed concern.
She said while she lauds what the Dresden nursing home is doing, she opposes segregating dementia patients. She prefers expanding mixed-model retirement communities that keep people with early and middle-stage dementia together with seniors who are healthier.
For example, Holthoff-Detto said: "A lot of people with dementia are very good in singing and remembering the lines and having a wonderful voice. and in everyday life they're not even able to really prepare breakfast for themselves, and when they are seen by people without dementia in their capacities in music, they get a very different relationship to those people."
She added that symbiosis benefits not only the seniors with dementia, but those who are healthy.
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