Abe's Garden Holds Memory Dear on Nashville Medical News

Abe's Garden Holds Memory Dear

By: CINDY SANDERS

Dr. Abe Shmerling

Facility Seeks to Establish National Alzheimer's & Dementia Model

For 45 years, Abram C. Shmerling, MD, practiced medicine in the Nashville community. In 1952, the respected internist established the Woodbine Clinic, one of Nashville's first fully integrated medical clinics. In the late 1970s, he became a founding member of the medical staff and the first board chairman at Southern Hills Hospital.

Six months after Abe retired, he was diagnosed with early-onset Alzheimer's. For the next 11 years, his family watched as this cruel disease robbed the husband, father, grandfather, friend and physician of his memory. By the time of his death in November 2006, Abe might not have been able to remember much, but his middle son Michael was determined his father would not be forgotten.

In honoring his father's passion for helping others, Michael Shmerling sought to take his family's experiences seeking residential and respite care and use that knowledge to create a solution for other families that his own family never enjoyed.

The first four-and-a-half years after diagnosis, Abe was able to live at home with wife, Francis, and attend a day program at the Rochelle Center. Unfortunately, said Shmerling, the program no longer exists. When it became necessary to move his father to a residential facility, the inherent issues of safely housing an ambulatory patient with advanced dementia became quickly apparent.

Shmerling said his family found most Alzheimer's facilities are units within assisted living or skilled nursing facilities. "It's a segregation unit," he said. "It's not a programmatic unit for people with this disease."

As his father's condition worsened, it became necessary to relocate Abe. "We had to move him six times during the progression of the disease," said Shmerling. "With this disease, moving is a train wreck. They go downhill every time they have to move."

It became the family's dream to create Abe's Garden — a safe, engaging, happy facility with "aging in place" capabilities so that residents could establish a routine in familiar surroundings, which is so important to Alzheimer's and other dementia patients.

Although crucial, simply creating a safe environment wasn't enough for the Shmerling family. Instead, they also envisioned a campus that would become synonymous with cutting-edge research and treatment protocols for dementia. Michael Shmerling, who serves as board chair for the non-profit Abe's Garden, pointed to the instant recognition and success of programming in other fields such as the Betty Ford Center to treat addiction or MD Anderson for the treatment of cancer. Shmerling added the common link between such programs is a robust academic affiliation.

"No one can name any place in the United States with that kind of branding with Alzheimer's disease … because there's not one," he stated.

To change that, the leadership of Abe's Garden approached Vanderbilt to discuss the possibilities of working together. Vanderbilt University Medical Center has committed to collaborate with Abe's Garden to expand Alzheimer's and dementia-related clinical research aimed at helping people maintain their cognitive health and quality of life. Going forward, there may also be a clinical component, but those details have not yet been worked out.

Although the original plan was to purchase land and start from scratch, an unexpected opportunity came up when Park Manor went on the market. Built in 1962 as Nashville's first independent living community for seniors, Park Manor will continue serving its original purpose.

"Park Manor had its own history and legacy, and we agreed to honor that," Shmerling stated. With all the activities … Rook tournaments, field trips to the Tennessee Performing Arts Center, Tai Chi and fine dining service, Shmerling said, "It's like living on a cruise ship!"

In fact, he noted, having the independent living facility on site is a true win/win. It adds another dimension to the available services, saves money on infrastructure costs and offers the possibility of keeping spouses — one with dementia and one without — close to each other on the eight-acre campus.

Currently, Shmerling said close to $3.5 million has been raised, which is a little more than one-third the total goal of the capital campaign. As the economy and bond markets improve, Shmerling said the plan is to break ground in 2010 on Phase I of the project, which would include a day program facility, infrastructure improvements, some renovations on Park Manor and the creation of a park.

"We're going to have a three-and-a-half acre park with water features, a small fishing pond, day activities, walking trails and gardens," said Shmerling. He added that safety and beauty would work together. The pond design, for example, calls for beautiful wrought iron with slots wide enough for fishing poles to go through but protective of the lake.

Alzheimer's in America

Every 70 seconds someone in America will develop Alzheimer's.

As many as 5.3 million people in the United States are living with Alzheimer's. There are more than 100,000 in Tennessee and more than 35,000 in Nashville.
Alzheimer's is the seventh leading cause of death in America.
Alzheimer's and dementia triple healthcare costs for Americans 65 & over. The direct and indirect costs of Alzheimer's and other dementias to Medicare, Medicaid and businesses is more than $148 billion annually.

Source: 2009 Alzheimer's Disease Facts & Figures, Alzheimer's Association, www.alz.org.

The second phase includes construction of the residential facility for Alzheimer's and dementia patients. To ensure seamless "aging in place," the residential facility will have assisted living, skilled care and hospice care. Shmerling said Abe's Garden would work with Alive Hospice to provide end-of-life care.

Although Abe Shmerling's experiences with Alzheimer's disease were on par with the national norm, the Shmerling family is committed to creating a new standard of care with Abe's Garden in Nashville serving as a national model. To find out more, visit online at www.abesgarden.org.