HJNO Mar/Apr 2025

52 MAR / APR 2025 I  HEALTHCARE JOURNAL OF NEW ORLEANS COLUMN  SENIOR HEALTH FOR DECADES, memory care units have relied on locked doors to protect individu- als living with dementia. But what if, in- stead of confining people for their safety, we created environments so engaging and supportive that they simply didn’t want to leave? Emerging research and evolv- ing care philosophies suggest that non- restrictive, inclusive environments can enhance well-being, dignity, and social en- gagement without compromising security. Historically, locked memory care units have been designed to prevent elope- ment, reduce injury risk, and main- tain staff control over residents’ move- ments. While these measures address im mediate safety concerns, they can also contribute to increased agitation, depres- sion, and a diminished sense of autonomy among residents. The reality is that indi- viduals with dementia often experience People Living with Dementia?” from Lead- ingAge raises a crucial question: Why are individuals with cognitive impairments of- ten placed in settings that limit their ability to engage with the broader community? 2 Instead of focusing on locked units, new innovative and inclusionary memory care models should emphasize: • Unrestricted movement: secure, but non-locking environments that allow residents to explore designated areas freely, reducing agitation and pro- moting independence. • Intergenerational and community in- tegration: programs that incorporate participation from schools and the broader community to foster mean- ingful connections between residents and people of all ages. • Engagement through activities: keep- ing residents engaged throughout the heightened stress in confined environ- ments, leading to behaviors that facilities seek to mitigate in the first place. A report by the Schlegel-UW Research Institute for Aging (RIA) underscores the psychological toll of locked units. It high- lights how these spaces can foster feelings of isolation, confusion, and institutional- ization rather than comfort and belonging. 1 Consequently, many experts are advocat- ing for a fundamental shift in dementia care — one that prioritizes inclusivity and freedom over confinement. The case for inclusive dementia care A growing body of evidence supports the idea that individuals with dementia thrive in environments that feel familiar, engaging, and integrated rather than iso- lated. The article “Why Do We Segregate Rethinking Memory Care: Moving Beyond Locked Units to Inclusive Environments