History of the Tapestry Program

The Tapestry Program was created in the early 1990s at Beaumont Rehabilitation and Skilled Nursing Center in Westborough and has continued to grow and mature on that campus and well beyond – to almost all SALMON campuses and service levels.

Initially, one of the primary objectives of the Program was to minimize unwanted weight loss in folks with Alzheimer’s, dementia and other forms of memory loss. Working together with a gifted team of staff from all departments, former Director of Nursing Karen Brennan and then-Administrator of Beaumont at Westborough Kate Salmon-Robinson, MHSA started by spending time carefully observing Resident behavior.

Kate recalls one particular aha moment…

I was outside the main dining room (which had a true restaurant-feel) as dinner time was drawing near, trying to observe and absorb all I could about the Resident dining experience. During this time, a Resident named Millie stopped just short of the entrance, looked in for a moment and turned around to leave. Knowing Millie had memory loss, I approached her in an attempt to escort her inside for dinner. But Millie, with fidgeting hands in her pockets, quietly said “No, no, no.” Unphased, I tried again but Millie resisted. When I asked her why, she looked down at her pockets, up at me and stated that she didn’t have any money. I thought: Wow! Of course; I’d never go into a restaurant without the ability to pay, either!

That was the jumping-off place for me, personally. Millie became the inspiration for our Tapestry Program. Shortly after this epiphany, Karen and I worked with the team to convert a modest “day room” into a quiet and intimate dining space for long-term Residents with Alzheimer’s.

Further changes to dining based on Resident behavior were made when:

  • Karen, along with nurses and certified nursing assistants, noticed that these folks often ate very slowly and consequently, their food would get cold before they could eat it. Now we serve meals in a sequenced fashion, allowing them to enjoy their meal and not be overwhelmed by it.
  • They noticed cold drinks, fruit and chilled deserts would get warm, so a home-like refrigerator was added.
  • They noticed that some folks needed to be up and moving as they ate and others struggled with utensils, so we offer more nutrient-dense finger foods that are easy to eat while sitting or standing.
  • They noticed that many people were eager to help set and later clear the tables, so we made that age- appropriate and failure-free activity a part of the daily routine, and many Residents felt better.
  • They noticed that mealtimes were a positive experience for Residents, so we created a 5-meals-a-day program instead of the typical 3.

As a result of these changes we’d incorporated in our new Tapestry Program, Residents were maintaining or gaining weight.

To say The Tapestry Program was innovative at its inception is an understatement. In the 1980s and 1990s, the world was still in its infancy of understanding what Alzheimer’s was and figuring out how best to serve those individuals. We still have a long way to go, but, relatively speaking, we have already come so far.

When Whitney Place at Westborough was built in 1995, it was designed to offer the best environment for people with Alzheimer’s or other forms of memory loss. No detail was too small.

  • We painted activity rooms for Tapestry Residents solid colors, as opposed to distracting, busy wallpaper.
  • We tried to design apartments so you could see the bathroom clearly from the bed.
  • We built Country Kitchens as gathering places that felt familiar…like home.
  • We tried to place common spaces at the ends of neighborhoods so that people who paced or wandered could have an interesting destination.
  • In an effort to minimize Resident neighborhood exit doors (a focal point for people to try to leave), we tried to make all doors (Resident rooms and exits) look the same via color, trim, etc.
  • We designed ‘cluster lounges’ with a path around their perimeters so those who paced and wandered could walk, observe activity and keep walking if they desired.

A decade earlier, Danny and Dottie Salmon had created a glorious dining space with polished brass railings to guide you as you entered, a vaulted two-story ceiling with hanging ferns and richly patterned wallpaper; it looked just like a restaurant! It was only later we learned the sights, sounds and activity associated with a restaurant can easily overwhelm people struggling with memory loss.

As we learn more about all aspects of Alzheimer’s, dementia and related memory disorders, The Tapestry Program continues to evolve and innovate in a careful, thoughtful and clearly defined way. Having a full-time, organization-wide Tapestry Program Director since 2008 has helped to maintain the philosophy and core principles of the Program as it matures through the years.

“We continue to be at the forefront in memory care with a unique approach and innovative practices provided in a specialized setting by our consistent expert staff- all inspired from Kate’s innovation so many years ago” notes our current Clinical Director of Tapestry Program, Diane C Tonelli OTR/L, MHA CDP CADDCT.

Why “Tapestry” ?

We chose the concept of a “Tapestry” because it illustrates the weaving together of many different threads in a person’s life for a rich, diverse and fascinatingly complicated representation of them. We’re taking each person’s unique life experiences and interweaving them with family, caregiver and peer relationships to create a more complete picture of a person living as successfully as possible with Alzheimer’s or dementia.

*Karen Brennan, RN, BSN was with SALMON since 1983-2013 and was SALMON Health and Retirement’s Clinical Services Director
**Kate Salmon-Robinson has been with SALMON since 1993 and is now SALMON Health and Retirement’s Marketing Communications Director.