The NY Times Magazine (7 July 2024) included a long essay by a daughter about her father who had developed dementia. One relatively brief section of the essay included a description of a human service day program model called Town Square, which seems to be essentially another version of Easy Street. Town Square is a day program for people described as having dementia, memory problems, Alzheimer’s, and so on.
In essence, Town Square and Easy Street, and other similar programs, build fake façades of community settings inside of a building. Many of these programs for instance build parts of fake grocery stores, fake homes with fake porches, fake barber shops, fake restaurants, fake gas stations, fake community theaters, fake parks, etc., often all from a particular era. Again, it may be hard to picture this (see links to images and videos below), but these façades are built inside of a building. Picture a movie set which looks real but is not.
Examine and compare the idea of such programs with the framework of wounding and societal devaluation, negative stereotypes, the client role, image and competency, relevance and potency, and so on. The various elements of such program models as Town Square or Easy Street are more likely to communicate the devalued role of client rather than to preserve, restore or create valued roles.
From the Town Square website:
Ostensibly, the idea is to provide cues for elders with memory problems. How might we examine the validity of this claim with the tools of Social Role Valorization, the developmental model, PASSING, and Model Coherency? For someone who may be growing (more) mentally confused, how coherent is it to have that person spend time every day on essentially a fake set, rather than in actual everyday settings? And with paid staff? And on top of this, add in the practices of congregation with other people who are similarly confused, and of segregation from valued places, settings, activities and people.
From the Town Square website:
Note that the ‘lively conversation’ is with staff, not with real neighbors, customers, theater ushers, barbers, wait staff, and so on.
Keep in mind that these settings are located inside buildings, and are fake, rather than, for instance, actually helping recipients to go to real groceries, restaurants, movie theaters, etc., presumably many of which are located not far away outside the door to such buildings which house Town Square and Easy Street programs. These programs are quite expensive to build and maintain, and often depend on significant grants from partner organizations, fundraising, etc. The Town Square model offers franchising options. These last points around funding raise non-programmatic issues.
Town Square has locations across at least seven states within the US and has announced plans to open more locations.
A video ‘welcome’ to Town Square:
An interesting note: the San Diego Opera was involved in designing and building one version of Town Square. (NOTE This one aspect might rate well in PASSING in terms of a positive image, insofar as the San Diego Opera presumably is a societally-valued cultural institution being juxtaposed to devalued elders; perhaps relevant to R1152 Image Projection of Setting–History or perhaps to R145 Image Projection of Miscellaneous Aspects of a Service. Other aspects of this partnership are likely not role-valorizing.)
Note the reference to Junior Achievement’s BizTown, which is an educational program for typical elementary school children. Consider that common negative stereotypes about elders, including elders with some form of dementia, include that they are child-like, have regressed to childhood and are in their ‘second childhood.’ Such negative stereotypes limit the expectations held by others as well as influence what is offered, and what is not offered, to such elders.
Consider the SRV and PASSING considerations around grouping, activities and time use associated with the Town Square program:
Again, note the reference to teen and young adult age groups, as well as the misleading language of ‘storefronts.’ These are not storefronts but façades inside of a human service building, even if some programs include some real aspects (such as some real food in a Town Square or Easy Street ‘restaurant’ façade). Consider also the grouping of ten elders with presumably varying levels of memory problems. What negative stereotypes, and what negative impacts on competency, might this service practice reinforce?
While such programs often make claims of being highly effective, an SRV framework and the developmental model would note that personal social integration and valued social participation in real sites where everyday life is conducted is much more likely to foster developmental growth and protect, restore and/or create valued roles.
In Model Coherency terms, some or all of the processes (setting, grouping, servers, language, methods and technologies) used by such models are likely to be ineffective in comparison with actual banks, restaurants, etc. The opportunities for growth and development in the messy complexity of “the sites of conduct of everyday life,” plus the dignity of risk, are likely to far outweigh any benefits of so-called ‘reminiscence therapy.’ [See for instance Wolfensberger, W,. Thomas, S. & Caruso, G. (1996). Some of the Universal “Good Things of Life” Which the Implementation of Social Role Valorization Can be Expected to Make More Accessible to Devalued People. The International Social Role Valorization Journal. 2 (2), 12-14.]
Another interesting SRV-relevant exercise would be to discern the real even if unstated assumptions which drive Town Square or Easy Street and then to compare these assumptions with the stated assumptions of the developmental model as laid out in SRV. What is likely to be believed about the elders to create such settings? About how to address memory loss in elders? And so on.