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How Throwback Model Towns Could Help Alzheimer's Patients

One 1950s-themed town will have a city hall, a movie theater, and a park to help bring back memories for dementia patients.

San Diego Opera

There’s going to be a new town square in Chula Vista, a suburb near San Diego County, California. But while most cities try to update their town squares to be trendy and modern, this one takes inspiration from the 1950s.

On Wednesday night at University of California, San Diego, the centerpiece of the town was unveiled: A one-story, scaled-down replica of what used to be San Diego’s city hall. (The full-size, working building is currently used as the county administration center). Like the real thing, you can walk inside through a set of doors under an intricate blue-and-white tile mural, along with two plaques bearing the city’s logo. Above those is a large sign that reads “City Hall” in elegant, printed letters.

Come 2018, when Glenner Town Square is schedule to open, that city hall will be surrounded by a park, a movie theater, a hospital, a diner, and more than a dozen other functioning buildings typically found in any city. Like the city hall, these will also be scaled-down versions—so that they all fit inside a roughly 15,000-square-foot industrial building with a 24-foot-high ceiling.

Its primary visitors will be Alzheimer’s patients at the San Diego-based nonprofit George G. Glenner Alzheimer’s Family Centers. For them, the town square will be a literal walk down memory lane—and that’s exactly what Scott Tarde, the CEO of the Glenner Center, wants.

The Glenner City Hall on display at the University of California, San Diego. (San Diego Opera)
The interior features two offices that patients can walk through. (San Diego Opera)

“The town was built to trigger memories,” he says. The Glenner Center has three other adult day-care centers in San Diego, but this is the first time they’ve built an entire town. It will be one of the first “immersive facilities” in the U.S. “Research has shown that memories are the strongest between the ages of 15 to 25, and most of our individuals in our centers are in their early eighties.” If you do that math, that means their best memories were formed in ‘50s and ‘60s.

The fake city is part of “reminiscence therapy,” an increasingly popular alternative to nursing homes and drug treatments for Alzheimer’s patients. It uses sounds, visual cues, and tangible objects to bring back memories of personal experiences. The therapy goes back to the 1960s, but was made popular again in the early 2000s, in part by the launch of Hogewey, the world’s first “dementia village” in Amsterdam. The isolated village houses some 150 Alzheimer’s patients who live among caretakers stealthily disguised as neighbors and gardeners. It’s filled with old-style homes, gardens, and even has its own little town square. This year, according to their website, the architects behind Hogewey hope to bring a version of it to Rome.

In Cleveland, Ohio, three facilities by the assisted-living center Lantern have been designed to look like towns from the  1930s and 1940s. They feature rooms built to imitate charming single-family homes. Ceilings with LEDs simulate outside light, and the sounds of songbirds and the soothing scent of peppermint are piped throughout to give the patients a sense that they are still living their “normal” lives.

In these three “towns,” Jean Makesh, an occupational therapist and the CEO of Lantern, ultimately aims to see his residents not only function at a high level, but be able to live on their own again. “We have been wrongly focused on the idea that if someone has dementia, there is nothing we can do for them,” Makesh says.

Meanwhile, the Glenner Center’s Tarde says that his project was inspired by his 11-year-old daughter’s field trip to an indoor day camp, where students practiced for job interviews and for holding jobs in faux shops and offices. He says he chose a urban setting for dementia patients, so that they could re-experience a typical day around town. When the center is fully built, caretakers will guide small groups of patients through the city. They can play with animals at a pet shop, shop at a grocery store, and even sit down with their families at a ‘50s-style diner.

“Structure is very important for individuals” with dementia, Tarde says. “If you do not engage them, behaviors can start to escalate in the evening because there wasn't a lot of mental stimulation during the day.”

The floor plan of Glenner Town Square features more than 20 buildings and attractions for Alzheimer’s patients. (San Diego Opera)

In the weeks leading up to the city hall unveiling, nearly 20 craftsmen and artists were busy painting, carving, and putting the final touches inside the San Diego Opera’s scene studio, which was contracted to make Tarde’s city a reality.

It’s a fitting task, says the San Diego Opera’s general manager, David Bennett. “We build and replicate real spaces for the stage in a very artistic and realistic way,” he tells CityLab. “And we are in the business of building things that elicit emotion, along with memory.” He adds that the San Diego Opera has long been trying to branch out and involve the community in their work.

One major difference between building for the stage versus for life is that everything in this city hall building has to be functional, while the crew is often making 2D replicas for theater productions. That means they had to make the interior just as believable as the facade. And no detail was spared.

“If you go inside, there are two offices that are big enough to have a couple desks and bookshelves,” Bennett says. “There are windows that are operational, and two fully scaled glass doors of the era that you walk through. And there's tile work that exists in the building, and we've replicated it.”

So far, the city hall is the first and only building completed. But Tarde has big plans for the rest of the city, which the Glenner Center is currently raising $3 million from private and public donors to construct. He hopes to make it as realistic as possible, with road signs, street lamps, vintage fuel pumps, and even payphones scattered throughout. "We've already purchased a 1959 Ford Thunderbird that will be housed in the garage," he adds.

While being careful about over-stimulating the patients, the team also envisions working with the San Diego Opera to re-create a cloudscape on the ceiling, with the amount of light adjusting according to the time of day. Recorded city sounds could also be played.

All of this is perhaps most beneficial to patients in the early to moderate stages of Alzheimer’s, and different patients might react differently. For some who grew up in San Diego, it could put them back in the 1950s. For others, the act of going through the motions of a typical day can help symptoms. But Tarde says that no one will know the full effects until the facility is operational.

Tarde is careful to explain that the intent is not to deceive anyone. The town will adapt and change as they learn what is and isn’t effective. Tarde hopes to open up the town square to other local care centers, eventually bringing the concept to cities across the U.S.

And it won’t just benefit the estimated 5.4 million Americans with some form of Alzheimer’s, but also their families, who Tarde calls the “silent victims” of the disease. “We have so many family caregivers who cannot take their loved ones to the movie theater or to a restaurant because they don't know what those interactions are going to be like,” he says. “So we wanted to be able to provide these experiences in a safe environment.”

Mimi Kirk contributed to the reporting of this story.

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