NICHOLASVILLE — Best Friends Day Center serves individuals with dementia, but a first-time visitor braced for a depressing environment is in for a cheerful surprise.
One afternoon recently, the large gathering room was filled with laughter, singing, people chatting pleasantly. Two men worked a puzzle. Some did craft projects.
Best Friends is an internationally recognized model of care for those with memory challenges; it was developed in Lexington in 1984. The approach is now used in 31 countries including China, Japan, Argentina, Australia, India, Switzerland, France and Germany.
"Regardless of the country or the culture, the Best Friends philosophy works," said Dr. Nori Graham, an Alzheimer's disease expert in England.
On Monday, Graham, who was chairwoman of the Alzheimer's Society of England, will be keynote speaker at a dinner to celebrate the 30th anniversary of the Best Friends program.
From 2001 to 2010, Graham was mental health adviser to Nightingale House, a residential and nursing home in London. She was national chairman of England's Alzheimer's Society from 1987 to 1994 and chairman of Alzheimer's Disease International from 1996 to 2002. She is currently vice president of both organizations.
Graham is a member of the executive committee of the faculty of old age psychiatry at the Royal College of Psychiatrists, of which she is an honorary fellow. Graham will speak on the global impact of the Best Friends method.
Best Friends pairs an individual with dementia with a trained volunteer who becomes a "best friend" for a specific time. A key to the program is the volunteer knowing the other person's life story by reading his or her biography, which is on file wherever the philosophy is employed. The volunteer then uses that information as a basis of communication, Graham said.
Another essential element is the weekly discussion topic using items to see, hear, touch, smell and taste.
"People are asked to give an opinion, or an idea, and they respond in amazing ways," said Tanya Byrne, assistant director of the Best Friends Day Center in Jessamine County. Recently, the group talked about visiting Italy, and many people could remember experiences there, regardless of how many years ago they'd visited, Byrne said.
After 20 years at Second Presbyterian Church, the Lexington Best Friends Day Center moved in 2013 to Bridgepointe at Ashgrove Woods, an assisted living facility. About 22 people come to the center each day; it is open from 7:30 a.m. to 5:30 p.m. Monday through Friday. The cost is a sliding scale based on income.
Linda Rector has volunteered at Best Friends for 29 years.
"We are totally in the present with the participant while they are here," she said. "We don't stop. We walk, dance, sing, do crafts, talk. It takes a lot of energy."
For that reason, volunteers work only four-hour shifts.
The enriched environment pays off, Byrne said.
"We see people able to function longer who are in the program," she said. "They smile more, talk more, have better self-esteem, are more upbeat. It lifts depression."
And long-term memory stays intact longer, Byrne added.
In her travels throughout the world as chairwoman for two terms of Alzheimer's Disease International, Graham has seen similar results.
"From my perspective, it is the most effective approach in caring for people with dementia," she said.
Thirty years ago, the prevailing attitude was that people with dementia couldn't be engaged mentally, said Virginia Bell, founder of Best Friends.
"The focus was all on how to help the family caregiver cope," Bell said.
As for the patient, "The goal was just to keep the person warm, safe and dry," she said, adding, "Now we know so much remains. They can still tell a joke, g arden, engage with children."
Once families see how loved ones thrive in a Best Friends setting, "It's almost like magic. It works. People see that, and they never go back to any other kind of care," said Bell, the author with David Troxel of seven books on the Best Friends approach.
Bell conceived the idea for Best Friends while working on a master's degree at the University of Kentucky's Multidisciplinary Center of Gerontology, now the Sanders-Brown Center on Aging.
She recalled a participant in the first Best Friends Day Center who wrote in her journal that her greatest fear, now that she had Alzheimer's, was that she no longer would be treated as a real person.
"That became one of Best Friends' guidelines," Bell said. "To treat people with respect and dignity, even though they may not know what day it is."