By Anne Ellett / Posted on February 9th, 2019
I was deeply distressed to learn that the National Institute on Aging (NIA) is sponsoring a trial for the use of electroconvulsive therapy (ECT) for people living with dementia (PLWD) who exhibit severe aggression and agitation. Not only that, according to a press release on the website of one of the participating organizations, the study is touted as the “first randomized, double-blind, controlled study of ECT for agitation and aggression in Alzheimer’s dementia,” which means that it will compare ECT against other “standard therapies” such as antipsychotic medications and behavioral therapies.
This is inhumane and unacceptable, and I join many other professionals in our field who are also appalled by this study, which is funded by an $11.8 million grant.
I believe there are several factors behind the approval of this “treatment” by NIA. Let’s start with the term “behavioral and psychological symptoms of dementia,” or BPSD. BPSD refers to the actions of PLWD, such as confusion, aggression, anxiety, refusal of care, etc., as “symptoms” due to their diagnosis of dementia. And if actions are considered symptoms, then this provides validation for medically treating these symptoms, because it allows for symptoms to be considered hallmarks of a disease state.
I’ve been a nurse for many years, long enough to remember when we responded to actions of PLWD such as confusion or aggression by tying them to their bed or chair. That was acceptable nursing practice! I can be grateful that we’ve moved beyond that…or have we?
The first-line medical treatment for “behaviors” has been the prescribing of strong antipsychotic medications. Unfortunately, even when the FDA came out in 2005 with a “Black Box” warning about the risks of prescribing these medications for PLWD, their usage has increased. In an attempt to decrease the use of these risky medications, the Centers for Medicare & Medicaid Services (CMS) now requires documentation of non-pharmaceutical interventions prior to prescribing antipsychotics, in addition to informed consent.
Even though CMS has established a goal of continued reduction of the usage of these prescription medications in nursing homes it is still common for PLWD to receive these medications.
PLWD are often devalued and stigmatized by both the public and professionals. Once diagnosed, they are perceived as unable to participate in decision making, expressing their needs, and often are considered child-like.
Therefore, when PLWD express their preferences by trying to leave where they have been assigned (known as eloping), or resist care by someone they don’t know, or cry because of loss of meaningful and significant relationships, their actions are seen as symptoms of a disease, rather than communications.
What if we considered their actions as personal expressions, or as unmet needs instead of symptoms to be diminished by medications or other treatments? What if we looked at what is going on in their environment and also at their personal histories and put together a plan for interactions that could be meaningful for them?
Strong antipsychotic medications that were never meant for use among older adults, and now ECT therapy? Let’s stop the use of the term BPSD and instead start discussing what are the unmet needs and challenges of the PLWD.
Kate Swaffer, a well-known dementia advocate, and a PLWD, expressed her fears about this study and said, “ECT is surely just another form of RESTRAINT?????” (emphasis is hers.)
As professionals and family members, if we continue to dismiss normal human actions (Wouldn’t most of us resist intimate care if we didn’t know the person? Wouldn’t most of us be looking for a door to exit if we didn’t know where we were?) as symptoms to be medically treated, we are denying PLWD their ability to communicate and express their needs.
If actions are labeled as “out of control” or aggressive, without determining what someone with PLWD is attempting to communicate, we have pathologized normal human actions.
Anne Ellett is a dementia specialist for The Green House Project (GHP), an organization that seeks to radically transform nursing homes by partnering with aging services providers to reinvent care and empower the lives of people who live and work there. Anne created GHP’s Best Life dementia care initiative, which builds on the organization’s core values of meaningful life, empowered staff, and real home.
By Claire Lucas / Posted on August 31st, 2018
The Green House Project showed up in a big way this year at the Pioneer Network annual conference in Denver, Colo., where senior leaders presented three breakout sessions and a tour of the local Green House homes was sold out.
Green House Senior Director Susan Ryan teamed up with Lisa Czolowski, CEO at Hover Community (which recently broke ground in Longmont, Colo.), and Jennifer Vecchi, principal at Vecchi & Associates, to present on transforming the looming workforce crisis into an opportunity for career enhancement. This subject was especially relevant in light of the shrinking number of qualified workers to fill healthcare positions.
Green House Project Guide, Claire Lucas shared her knowledge on The Green House Project’s success in utilizing Sages—volunteers who act as coaches and advisors for Shahbazim. As leaders across the country grapple with staff retention, Lucas suggested that this model of using volunteers to support staff transcends the Green House model and can be utilized successfully in any healthcare organization.
Debbie Wiegand and Rob Simonetti, design director at SWBR, a design and architecture firm, spoke about the benefits of small-house architecture and design, sharing 15 years of experience.
In addition, Pioneer Network attendees participated in an onsite visit to the Green House Homes at Mirasol in Loveland, Colo. The sold-out tour gave attendees the opportunity to gain firsthand experience in how Green House homes can make a difference in the lives of its elders and staff.
By Admin / Posted on August 30th, 2018
Being seen goes deeper than recognizing the visible attributes of a person. When a person is truly seen their inner complexities shine and all labels associated with them (such as Alzheimer’s disease) are shed. Their preferences in everyday life are understood and their uniqueness is honored.
This was the message that Susan Ryan, The Green House Project senior director, brought to the stage at the 33rd International Conference of Alzheimer’s Disease International (ADI), held July 26-29th in Chicago, Ill. Ryan delivered a keynote presentation and participated in a panel discussion with the goal of ‘power washing’ conventional thinking in today’s dementia care.
The Alzheimer’s Disease International Conference is the the longest running and one of the largest international conferences on dementia, attracting delegates from around the world. Ryan was among a range of international expert speakers, making up a unique program that enables participants to learn about the latest advances in the prevention, diagnosis, treatment, care and management of dementia.
The concept of being seen (#SeeMe) applies especially to a large percentage of people living in long-term care settings, who are defined by their diagnosis of dementia. Their diagnosis assigns them a label that emphasizes what they can’t do and what’s been lost. Ryan’s message was a call to destigmatize and humanize those living with dementia, in order to see the whole person first.
To see this in action, Ryan encouraged the audience to take a deeper look at how the symptoms of dementia are presented to the outside world. She noted that the Behavioral and Psychological Symptoms of Dementia (BPSD) is a term used to describe the following “symptoms” that occur in people with dementia: agitation, aberrant motor behavior, anxiety, elation, irritability, depression, apathy, disinhibition, delusions, hallucinations, and sleep or appetite changes. According to a 2012 study in the Frontiers of Neurology, about 90 percent of people with dementia have BPSD. Ryan noted that while this finding is not surprising, it is presented in a way that categorizes people with dementia even further.
Instead of following common thinking, Ryan said, what if instead the finding was that 90 percent of people living with dementia will find themselves in a situation where their well-being is not adequately supported? Attendees were encouraged to take it a step further and think through how this revolutionary way of thinking would change the way that providers and other stakeholders “#SeeMe.”
The good news is that this is already happening, Ryan noted. The Green House Project has developed Best Life, a memory care program that is built on the initiative’s core values of Meaningful Life, Empowered staff, and Real Home. Best Life is a process to transform the paradigm and defy the stigmas associated with dementia, she explained.
Ryan concluded by imploring her international audience to “lead the way, address the stigma surrounding dementia, and support caregivers with the skills to see each elder as a unique individual, and to connect them to a meaningful life.”
By Admin / Posted on August 23rd, 2018
The Green House Project Team congratulates Nate Sweeney on his new position with St. John’s!
Rochester, NY via The Post Aug 22, 2018
St. John’s recently announced that Nate Sweeney joined its team as vice president of skilled services.
Sweeney is bringing 17 years of experience in the health care industry, with nearly a decade spent in long-term care.
Sweeney will lead St. John’s skilled nursing operations and focus on developing a nonmedical model of long-term care through advancement of organization directors, processes and culture. He will be responsible for supervising and developing the clinical and administrative businesses of skilled services including Penfield’s Green House Homes, St. John’s main campus of 400 residents and its medical-day program.
“We’re confident Nate’s track record for strong leadership, experience, innovation and passion is a great match for our organization and team,” St. John’s President and CEO Charlie Runyon said. “Under Nate’s leadership, St. John’s will continue to advance its mission and evolve our services to provide the highest quality of care for our residents.“
Sweeney has extensive experience in the health care industry, specifically with exploring and operationalizing new models of care. Most recently, he served as executive director of the LGBT Health Resource Center of Chase Brexton Health Care in Baltimore. There he spearheaded the development of a new division in the organization that focused on resource development for the community, training and education for medical and social service providers and direct community programming.
Prior, Sweeney spent five years with the Catholic Charities of Baltimore where he drove two major changes for the organization. First, he worked with its nursing home, The Neighborhoods at St. Elizabeth, to change the culture of long-term care from pure medical to one focused on its residents. Next, he led the effort for the licensing and opening of The Harry and Jeanette Weinberg Green House Residence at Stadium Place, a program of Catholic Charities and a Green House Home.
Sweeney earned his master’s degree in management of aging services from the University of Maryland Baltimore Country and his Bachelor of Arts in education from University of Illinois. Outside of the office, he serves on the LGBT Aging Issues Network Council for the American Society on Aging. Sweeney resides in Rochester.
Loveland Housing Authority Fundraising Gala Kick-off Event Has A Surprise Ending from Mother Nature!
By Claire Lucas / Posted on July 15th, 2018
I had the pleasure of attending Mirasol’s Gala fund raising kick-off event in late June. The Loveland Housing Authority has decided to build two additional Green House homes by raising money through an aggressive capital campaign. Invitees included influential members of the Loveland community. They had already received a generous contribution of $100K from one person!
The event was beautiful. They had set up the courtyard in front of their event center with brunch stations – one served omelets to order another a waffle bar. They even had a bartender to provide you with a Mimosa or a Bloody Mary. Dr. Bill Thomas and Nancy Fox were on the program as guest speakers.
What could go wrong?
It quickly became evident that the party as planned would not be possible. However, that didn’t stop this incredible team. They quickly pulled out umbrellas’ and helped all the guests get inside. Food was moved into the event center and the program continued. Despite the rain, the event went off beautifully. Guests learned about the Green House Project, toured the Green House homes and learned about the Loveland’s Housing Authority’s vision for Loveland. Dr. Bill Thomas encouraged people to dig deep when giving donations, so they might provide “shelter from the storm.”
When the party broke up and everyone went out to retrieve their cars, many people, including me, discovered that the dirt lot where we had parked our cars had become a soggy, muddy field. They had to call three tow trucks to pull about 20 cars out of the field! It was quite a show watching the cars being pulled out of the mud.
Between the beautiful setting, the rain, the memorable speakers and the muddy field this is an event that no one will forget soon!
By Admin / Posted on July 2nd, 2018
LITTLE ROCK, ARK. (PRWEB) JUNE 28, 2018
The Green House® Cottages of Poplar Grove (https://poplargrove.care/) announced today the planned Fall 2018 opening of the their long term and rehabilitative care facility in Little Rock, Arkansas. Poplar Grove is the first facility in Central Arkansas based on the Green House® model of care. (thegreenhouseproject.org)
“Poplar Grove is what the future of care can and should be for our elders,” said John Montgomery, Executive Director of Poplar Grove. “We’ve adopted this new model of care so that we can serve our community better than ever before, providing a higher quality of life for residents, as well as peace of mind for their families.”
The Green House® Cottages of Poplar Grove is creating over one hundred and forty new jobs in Central Arkansas. Commenting on the healthcare jobs being created Montgomery said: “We are looking for people who are passionate about the care and service they provide to others. You don’t necessarily need a background in healthcare to join our team. Do you love to cook for others? Do you love to plan and coordinate activities? Are you a registered nurse who has been anxiously waiting to transition into the new model of healthcare? We are looking for people who recognize the autonomy and dignity of care recipients and are passionate about creating a fantastic long term and rehabilitative care environment.”
Poplar Grove is built on the Green House® model of care, a revolutionary movement transforming skilled rehabilitation and nursing home care nationwide. The Green House® model has been highly acclaimed by many national experts and leading publications because it has been shown to deliver better health and satisfaction outcomes than traditional nursing homes (for more, see: (Green House Model Articles).
Here are five ways the Green House® Cottages of Poplar Grove is different from a traditional nursing home:
- A 1:4 direct care staff ratio, substantially more than the State/Federal average
- A small cottage environment with a maximum of 12 residents, living life to its fullest in their own home with private rooms, private bathroom and showers, made to order, “family-style” meals based on elder’s choice… and so much more
- A philosophy of care rooted in meaningful relationships, holistic care and a deep knowledge of each elder and their specific needs, produces a better quality of life and care
- Superior equipment and technology
- Each staff member undergoes a minimum of 120 hours of additional education and training in areas such as nutritional services; senior care techniques and dementia to become geriatric care specialists.
The Green House® Cottages of Poplar Grove in Little Rock will join the Green House® Cottages of Belle Meade in Paragould, AR, The Green House® of Southern Hills in Rison, AR and the Green House Cottages of Wentworth Place in Magnolia, AR as the fourth Green House® model facility developed by Southern Administrative Services, LLC in Arkansas.
“We are proud to bring this transformative new model of long term care to Central Arkansas,” said John Ponthie, Founding Member and Managing Director of Southern Administrative Services LLC. “By delivering outstanding care and creating a real home environment and providing elders with dignity, autonomy and choice, Poplar Grove will provide our Elders with the best quality of life possible.”
About The Green House® Cottages of Poplar Grove
The Green House® Cottages of Poplar Grove (https://poplargrove.care/) create loving homes where Elders are supported by quality care, choice, and positive relationships. In our homes, the Elder, not a calendar on the wall, decides the schedule of each Elder. Our caregivers are dedicated to the homes, helping to create meaningful relationships with our Elders. While Poplar Grove is licensed and skilled nursing community, the cottages are designed to look like the homes in the surrounding neighborhood. Homes feature high ceilings in the hearth rooms of each cottage, large windows throughout for natural light, and private bedrooms, each with a private en-suite full bathroom.
Executive Director – The Green House® Cottages of Poplar Grove
501- 454 – 5604
CEO- Bespoke Health Media
By Mary Hopfner-Thomas / Posted on June 28th, 2018
“The Green House helps give us tangible ways to live out our mission in the way we give care” – Deedre Vriesman, Resthaven CEO.
On June 25, Resthaven team members celebrated the groundbreaking of their second Green House home, officially kicking off development of the Janssen Cottage. In 2007 the Boersma Cottage opened at Resthaven for 10 elders.
The ceremony included a special thank you to the Resthaven Board of Directors, the Janssen family, all the donors, GMB Architecture & Engineering, CL Construction and the Holland community who are making this home a reality.
Congratulations to all!
By Mary Hopfner-Thomas / Posted on June 22nd, 2018
Hover Senior Living Community will soon be the site of Green House homes for 48 elders. In late May, the weather cooperated in providing a beautiful backdrop for the groundbreaking ceremony.
The planning for these homes began five years ago and Hover President, Lisa Czolowski credited the community‘s volunteer board of directors for their dedication, saying, “This project couldn’t have happened without them — it‘s really a labor of love.”
The homes will officially be called The Katherine and Charles Hover Green House Neighborhood Homes.
The first elders are expected to move in by early Spring 2019 and all four homes should be completed by the end of Summer 2019. With the addition of the Green House homes, Hover will be considered a Continuing Care Retirement Community (CCRC) or Life Planned Community. The Hover campus includes nearly 119 apartments and 51 assisted living suites
Once complete, the new portion of the Hover Senior Living Facility would be the third Colorado Green House partner to adopt the model. The first two locations are in Mirasol Green House Homes in Loveland and Washington County Nursing Homes in Akron.
We wish the Hover team much success in the development of their homes!
By Rachel Scher McLean / Posted on May 14th, 2018
“For thousands of years, elders have been held in high esteem and involved in the community,” says Steve McAlilly, CEO of Mississippi Methodist Senior Services. As the world shifted and the role of elders changed, Steve sought a way to bring them back to a place of reverence and respect. 15 years ago, Steve courageously opened the first Green House home in Tupelo, MS, effectively building a home where elders could live full and meaningful lives, “Within hours of moving in, a peace came over the home,” Steve remarks.
Not only do these homes positively effect the elders who live in them, but also the direct care staff who take on expanded roles to become the managers of the home. The skills that they learn in The Green House homes affect every area of their lives, “I’ve watched team members grow and thrive in the Green House” says Michele Daniel, VP of Philanthropy & Strategic Implementation. Mississippi Methodist Senior Services currently has 19 Green House homes on four separate campuses.
Returning the elders to a place of esteem, honor and respect is an investment in the quality of life of the entire community.
This 15 year milestone began with the vision of Dr. Bill Thomas and was embraced by Steve McAlilly’s leadership. Thanks to the support of The Robert Wood Johnson Foundation, this radically simple innovation has become a proven movement that continues to grow with integrity and sustainability. Now with Green House homes open and operating in 33 states, small house nursing homes are a trend addressing many of the challenges in healthcare. The Green House model is demonstrating that the status quo is not good enough and that there is a better way. Thank you to Mississippi Methodist Senior Services, and all of The Green House partners who have opened their doors in the past 15 years. Together we are fostering environments of empowerment, dignity and respect, and a world where every individual can anticipate a hopeful future
By Rachel Scher McLean / Posted on May 8th, 2018
Update, 05/18: The Green House Senior Director, Susan Ryan was honored to join Leslie G. Moldow, FAIA, LEED of Perkins Eastman and Mary Muñoz of Ziegler at the LeadingAge California conference to speak about The Small House Pilot, and how providers can seize this moment to enhance the way elders in California age. Collaborating with strong leaders in our field makes our collective voice louder and our impact greater.
Originally Published 01/18
It is a pivotal moment in California’s history. The Small House Pilot Program is now live, and it has the potential to clearly demonstrate that there is a better way to deliver skilled nursing care. This profound opportunity requires that nursing home providers across the state, take a stand, and say, NOW IS THE TIME!
The wait has been long, making this moment all the more powerful. In 2013, through a tenacious journey, Mt. San Antonio Gardens became the first Green House Project in California. The work that they did to make regulatory gains with stakeholders across the state blazed a trail and were codified in late 2012, as Governor Brown signed into law Senate Bill 1228 (introduced by Sen. Elaine Alquist). The bill created The Small House Skilled Nursing Facilities Pilot Program, which authorized the development and operation of 10 pilot projects to deliver skilled nursing care in smaller, residential settings, “It puts the ‘home’ back into nursing home”, said Senator Alquist (D-San Jose). However, it wasn’t until early 2018, that the regulations to support this bill were released, and the request for applications is now open to the public. As a perennial advocate for elder directed, relationship rich living, The Green House Project is eager to support every effort to ensure the success of this opportunity.
The Green House Project has come to be recognized as the leader of the small house movement to create a high-quality, cost-effective, human-scale alternative to the traditional nursing home. Studies of the Green House model have found that:
• Residents have a better quality of life and receive higher-quality care than residents in traditional nursing homes.
• Staff report higher job satisfaction and increased likelihood of remaining in their jobs.
• Family members are willing to drive farther and pay more to have access to a Green House home for a loved one.
Real Home, Meaningful Life, and Empowered Staff: these core values align well with the regulations of the Small House Pilot in California, and they drive change in Green House homes, creating quality outcomes, consumer demand and preferred partnerships in the healthcare system.
With 15 years of expertise in design, education and evaluation, The Green House Project is a strong partner to support the expedited timeline and in-depth requirements of this pilot. The first deadline for submission is June, 2018. Design tools, like The Green House Prototype, along with educational protocols and policy and procedure expertise, will ensure an organization is able to successfully navigate this application. Susan Ryan, Senior Director of The Green House Project says, “The Green House Project specializes in a comprehensive cultural transformation that shifts the beliefs, behaviors, and systems to ensure a lasting investment across an organizational system. It is more than simply a process from ‘this’ to ‘that’; a real transformation unleashes the best of what can be by accessing collective wisdom.” The national initiative stands ready to support nursing home innovators in California, to ensure better lives for elders and those who work closest to them.
With California’s number of individuals 85 and older expected to triple by 2030, the market for Green House homes and others like them is rapidly growing. Consumer demand for the kind and quality of care that The Green House model provides has long existed, but until recently, California’s regulatory and approval process had been unable to accommodate non-traditional models of care. In fact, it took almost seven years for Mt. San Antonio Gardens to gain the approval it needed from multiple local and state agencies. Inspired by their lessons learned, Senate Bill 1228, and the newly released regulations, will enable innovation without obstacle. The Green House Project calls every organization interested in creating a real home, meaningful life and empowered work opportunities for the citizens of California to contact us, and together we will forge a trail to a brighter future.
By Laurie Mante / Posted on May 8th, 2018
Joe moved into to Eddy Village Green (EVG) in early December 2017. His wife had been caring for him at home with great devotion for several years but was completely exhausted. They had four children who were all very involved and supportive of their parents. Joe moved in with the diagnoses of Parkinson’s disease, dysphagia, delusions, adjustment disorder, anxiety, dementia and hallucinations.
Joe was came to EVG after a fall at home where he lost consciousness and spent several days in the hospital. Joe’s biggest stressor in life was his retirement. Joe had a long career in law enforcement. His life was his career, and he was forced to retire due to his Parkinson’s disease. His wife reported that he never made peace with his retirement. Two of Joe’s sons were also in law enforcement.
Upon move in, Joe was very outgoing and friendly, and had a great sense of humor. But the first day Joe was in the home, he had two falls! We knew right away that this was going to be a difficult journey. Joe also became very anxious as soon as his family left and was wandering around the house asking repeatedly where he was. Staff reassured Joe that he was safe and tried to engage him in some reminiscing. Joe had huge swings in his cognition throughout the day, so staff really had to adjust their approaches to meet him where he was. Sometimes he was very alert and lucid and could speak very well, and other times he was very confused and could not string together cohesive words. This was extremely frustrating and anxiety-producing for him.
We learned a LOT about Joe in the first few days from both him and his family. We learned that his routine used to be to work all day, come home and have a cocktail and some cheese and crackers with his wife, and then go back out on patrol with his son at night. This explained a lot of Joe’s roaming around the house in the evening hours – he would get restless after dinner and often be found rummaging in drawers of other Elder’s rooms looking for “contraband”. Joe would eat very well at breakfast and lunch but by dinner he was “on the go”. Shabazim brainstormed with Joe’s wife and began leaving out a plate of cheese and crackers and fruit at dinner time so that Joe could walk around and be “busy” but still get some calories in him. He had good and bad times of the day due to the Parkinsons, but when his meds were on board, he wanted to be moving, not sitting – so “snacking” for dinner was much better for him than sitting at the table.
A couple of weeks after moving to EVG, Joe was very agitated and walked out of the front door of the house. He was wearing a wander tag, so the door alarmed, alerting the shahbaz. The shahbaz followed Joe out of the house, but he was jogging through the parking lot, dodging among cars, as though he was engaged in a “chase”! Luckily, a staff person driving on campus saw the situation and offered Joe a ride, so he hopped in her car and she drove him around for a bit before returning him to the house. The team was wondering if getting him out more often would help, but the family was very against this as he had tried to jump out of the car with their mother driving during a hallucination.
Again, our partnership with the family was valuable in learning key information. We think Jim was hallucinating when he left the house and was running through the parking lot.. We were concerned about his speed when he exited the house, the winter weather, and the wooded areas on the campus, so we were able to place a gps-tracking devise on Joe’s ankle in case he exited the house like that again. I want to emphasize he was not exiting the house to get some fresh air or take a stroll, he was having a delusion that he was chasing bad guys and we were quite afraid he would get lost in the woods. We also instructed staff to call 911 immediately as Joe would not be threatened by a police response – these were his friends. There were other times, when Joe was calm and curious about the weather, when he would exit the house and come right back in when he was satisfied that it was cold, snowing, etc.
We also set up the den of the house with a desk for Joe, bringing case files and official forms, so Joe could do some work. Shahbazim also created a clipboard and would have Joe accompany them on rounds to inspect things. This helped to engage him, give him purposeful work – and seemed to keep the delusions away during the late afternoon and evening, which were very challenging for him.
We tried yellow signs on other Elder’s doors who did not welcome Joe’s visits, but this didn’t work at all – Joe had spent his whole career walking through crime scene tape! So we put up a big “DO NOT ENTER – KEEP OUT!” sign, and this, interestingly enough, worked most of the time!
The Shabazim and nurses were so creative in their approaches to engage Joe and honor his law enforcement background. We ran ideas by his family regularly, and they were wonderful. Shahbazim also figured out that every time the weather got bad Joe would get particularly anxious. They figured out that Joe was worried about his family – especially his son who was out patrolling the road in the snow. So whenever there was ice or snow, the Shahbazim would call Joe’s sons and let him talk to them. They would assure him they were home and safe and Joe could settle down for the night. They also asked his wife to call whenever she left after visiting to let Joe know she arrived home safely. Joe had always been the “protector” of his family and it was important for him to continue to play this role.
Joe also enriched the lives of staff and the other Elders in the house in countless ways. His smile and laugh were infectious. He greeted visitors, and many people coming to the house called him “Sheriff”. He watched over everyone in the house. There was another Elder who sometimes was very sad and Joe would sit next to her and quietly hold her hand. This was a poignant reminder of the gifts people have to offer even when they are struggling so much themselves.
These are just a few examples of how deep knowing, listening to Joe, paying attention to his behavior when he couldn’t use words to express his needs, and partnering with his family, helped us to help Joe live his Best Life.
Joe’s life was very hard – he fell a LOT – but what to do? Restrain him? Absolutely not. We managed the environment as much as we could to prevent injury. His family was adamant that Joe be allowed to be as mobile as his disease would allow him to be. Sometimes he was so jerky from the Parkinson’s that he couldn’t have purposeful movement OR rest. This was very hard on Joe, his family, and the staff. In early March Joe experienced a very rapid decline – he couldn’t ambulate independently at all and was very lethargic most of the time. We suggested to the family that it might be time for hospice – and that their expertise could support Joe, the family and the house. The family agreed and hospice was added as another layer of support. Joe came down with a respiratory infection in mid-March. He was running a temperature and was very weak. He was having a lot of shortness of breath. He had lost weight. Three weeks after his admission to hospice, Joe died, in the house, with his family and Shahbazim surrounding him with love. Family was there 24/7 for the last week of his life, and the whole house grieved when he died.
Joe was not with us long – just a little less than four months. But in that short time, he taught us a lot about living his Best Life, and caring for others, right up until the end.
By Gina LaGuardia / Posted on April 30th, 2018
The GREEN HOUSE Project was pleased to join the April 25 #ElderCareChat, with Director of Operations Debbie Wiegand serving as an expert panelist. Wiegand engaged participants in an informative Twitter conversation about innovations in senior care while also describing how The GREEN HOUSE Project has come to be recognized as the leader in creating high-quality, cost-effective, and sustainable, human-scale alternatives to the traditional nursing home.
The hour-long #ElderCareChat put the need for innovative solutions in context, with Wiegand explaining how an aging population is driving the need for more senior care options. The topic was inspired by a recent blog post that discussed how the Green House model has become a catalyst for change in the field of long-term care. The model’s emphasis on creating a “real home” environment, with a look and feel that is residential rather than institutional, has gained considerable attention in the skilled nursing care space.
The Twitter session, which generated more than 3.4 million impressions and nearly 400 tweets, gave the 25 participants the opportunity to share their thoughts on a variety of topics, including what they perceived to be the major trends in senior care. One participant identified a movement toward more person-centered care. Another mentioned the need for a social/cultural change with regard to how we look at aging. In addition, several participants cited technology as having an increasing impact on senior care solutions.
In conjunction with an aging population, Wiegand sees an increasing demand for more innovative memory care solutions. “Correlated with the increasing number of elders is the prevalence of Alzheimer’s disease, and the need for high-quality models that focus on the whole person, rather than the traditional biomedical model that focuses primarily on decline and disease,” Wiegand tweeted, adding that a Green House program called “Best Life” was created to equipment caregivers with the knowledge and skills needed to help elders living with dementia thrive.
Wiegand also stressed the importance of frontline professionals building meaningful relationships with elders and their families. “Changing demographics exacerbate staffing challenges in nursing homes,” she observed. “Without the availability of quality jobs that offer expanded roles and opportunities for growth, the long-term care industry is at great risk for worker shortages.”
The chat also included a discussion of the advantages of smaller, more residential living spaces for elders. Wiegand explained that Green House homes are designed to create warmth and foster “intentional community.” “Smaller is better,” she tweeted, “meaning less square footage, which helps to support elder mobility, familiarity and access to all spaces of home, and reduce costs of construction.”
A chat participant observed that smaller, more intimate environments allow for better relationships with caregivers, tweeting, “The social, family atmosphere of residential living spaces eliminates the institutional stigma that is often associated with eldercare.”
Participants were highly receptive to innovative solutions being introduced to the long-term care space. As one senior care professional tweeted, “The day we stop innovating is the day we need to find a new job!”
“The GREEN HOUSE Project is all about relationships and deep knowing,” Wiegand concluded. “We embrace technology, but never at the expense of the human touch and connection.”
For those wanting to learn more, the GREEN HOUSE Project will host a webinar on workforce issues at 1 p.m. ET May 3. Register now.
In addition, The GREEN HOUSE Project is presenting opportunities to visit Green House homes and take a deep dive into the model at the following locations:
Feel free to peruse the transcript of the 4/25/18 #ElderCareChat session.
#ElderCareChat is presented by A Place for Mom‘s OurParents.com in conjunction with sister sites SeniorAdvisor.com and VeteranAid.org as a forum to share resources, experiences, and expertise in eldercare. Stay tuned to @OurParents Twitter handle for information regarding the next #ElderCareChat.