Inside a small, plain-looking room at the Northglenn Heights memory care facility, volunteer Dale Jones walks slowly around a circle of older adults. Some have walkers or wheelchairs, some are just seated quietly. Jones is handing out small, colorful plush birds that fit neatly in their hands. As he gives out the toy birds, he shows each resident how to make them sing a birdsong.
"You can just hold on to it and if you want to listen to it sing, press right here in the middle," Jones instructs.
Giving singing bird toys to adults with dementia may seem kind of odd. But it's actually part of a regular biweekly educational therapy program. This program, called Bird Tales, uses toy birds to bring a little bit of nature into long term care facilities.
By 2020, 92,000 Coloradans over 65 will have Alzheimer's disease. As the state's population continues to age, the swelling numbers of dementia patients mean memory care facilities and others are looking for innovative therapies and ways to soothe residents, who often struggle with anxiety and irritability.
That's where the birds come in. The Bird Conservancy of the Rockies uses those plush, singing toy birds, along with a variety of feathers and other bird props from the natural world, to deliver educational therapy in two long-term care facilities in the state. They hope to expand the program to more in 2016.
For Tyler Edmonson, an energetic, bearded educational director with the Conservatory who runs the Bird Tales program, it's about bringing nature into the nursing home.
"It's seeing nature as an opportunity to provide healing and something that really does calm people down," he said.
On the day of this lesson, which is about feathers, the residents eagerly receive the toy birds.
"It squeaks, it squeaks, it squeaks!" repeats one, repeatedly pressing hers to hear the sound of a mourning dove. As toy birds fill pale, soft hands, the room, which before felt a little institutional, starts to sound like a forest -- that is, if every type of bird started to sing at once. Cardinals chirp, finches squeak, there's even the pound of a woodpecker.
During the lesson, Edmonson passes around feathers and props. He holds up a long peacock plume and asks residents what they see, entering into a discussion on the uses of bright male plumage. He also walks around to every single resident and touches the feather to their hands - even the ones who seem asleep. Later, he explains, "we want to make sure they have a chance to have a response even if we can't discern it or see it."
Bird Tales originated in Connecticut, when Ken Elkins, an educator with the Audubon Society there, teamed up with a Randy Griffin, a memory care specialist who worked in a care facility, to develop the curriculum in 2011. It's now spread to Colorado and Texas. Audubon's Elkins said while activities directors and facility higher-ups are often skeptical of the program at first, they come around when they see results.
That was true for Gabriella Dimotsantos, the activities director at Northglenn Heights. New to the facility, when she learned about Bird Tales, Dimotsantos had no idea what to expect.
Then she saw how the residents reacted. For hours or even the whole day following the program, they are calm, even if they don't remember the program itself. Dimotsantos likes the way the program engages various senses.
"You have visual, you have the physical touch, you hear the sound of the birds," she said.
Residents who may be impaired in one of their senses - perhaps they are blind - can still experience the program with another sense, through touch or hearing.
Even those who can't find the words to react still benefit. The Bird Conservancy's Edmonson started a conversation with one resident, Chuck, who had dropped his toy, and asked him about his bird.
"Chuck, we have your house finch on the ground with really amazing feathers. What feathers do you see on your bird?"
Chuck hesitates. "Uh, bird."
"It's a pretty great bird," said Edmonson.
"It's, it's, it's real flat," said Chuck.
His response doesn't make a lot of sense, but Edmonson continues to chat with Chuck. Later, Northglenn Heights' Dimotsantos mentions that Chuck can be one of the more difficult residents. There are only two things that calm him, she said: "Krispy Kremes and Bird Tales!"
Although Edmonson and others suspect that it's the connection with nature that helps soothe Alzheimer's and dementia patients, there hasn't been much research on the effects that exposure to nature can have on people with dementia, said Jennifer Dibert, a gerontologist who studied Bird Tales for her masters research at Miami (Ohio) University.
"It's something we're just now starting to look at," said Dibert.
One thing past studies have shown? That nature can improve many aspects of health.
"It really reduces stress, improves your mood, reduces depression, anger, anxiety. It enhances your feelings of pleasure," she said.
These are all things that could also help people struggling with dementia and Alzheimer's. Even though she's not totally sure why the program works so well for adults with dementia, Dibert said part of it just might be that hearing birds can trigger positive memories.
"I mean even if you really weren't much of an outdoorsy person, everyone can relate to hearing the birds, or hearing the robin in the spring."