Reclaiming Elderhood

By / Posted on February 25th, 2016

Andrea Tyck is the Wellness Director at Mt San Antonio Gardens, a Life Care Community in Pomona, California.  She is also a Green House Educator and helped to open the first Green House homes in California.

Andrea Tyck, Green House Educator, Mt. San Antonio Gardens, Pomona, CA

Andrea Tyck, Green House Educator, Mt. San Antonio Gardens, Pomona, CA

In Jerry Spinelli’s book Hokey Pokey, Hokey Pokey is a place where there are no adults. Kids are in charge and free to roam.  The main character, Jack, is the de facto leader and is loving his life until things start to change.  A tattoo, present on the bellies of all the inhabitants of Hokey Pokey, begins to fade.  When his bike, the symbol of his power and influence is stolen, he oddly begins to adjust to its absence. And what’s worse is that his enduring disdain for girls and a girl named Jubilee, in particular, is beginning to lose its grip.  She might even become a friend.   In addition Jack begins to sense that he is going to be leaving Hokey Pokey although he doesn’t  know why or how.  Jack tells Jubilee he thinks he is leaving that night.  When she asks “How do you know?” he replies “I don’t. It’s like” – he stares up into her eyes – “I’m on a bike I can’t steer, can’t stop.”  “So….,” she says, “Where to?”  He hangs full weight from her eyes.  “Beats me.”

The book cover explains that it is “a timeless tale of growing up and letting go, of reverence and remembrance of that moment in childhood when the world opens up to possibilities never before imagined.”   Ever since I read it I have been thinking of how the process of children becoming adults might be similar to the process of adults becoming elders.

Dr. Bill Thomas makes a case that elderhood is a distinct part of human development and that part of the process of that development is leaving adulthood. In very broad terms that means moving from a primary focus on doing and generating to embracing the “being-rich responsibilities of making peace, giving wisdom, and creating a legacy.”  In the land of Hokey Pokey, Jack’s transition out of childhood is perceptible but vague.  The reader has a sense of what might be happening to Jack (he is growing up) but the steps are still somewhat confounding.  Might that be similarly true of one’s growth out of adulthood and development into elderhood?  Are there signs that the purposes in your life and the mechanisms by which you enjoy, ponder and resolve things have been transformed?    Are there treasured parts of you or your life that you no longer have (like Jack’s bike) that you realize you are ok without?

The book ends with Jack back in the “real world” preparing to redo his bedroom with his dad to make it less childish.  There is a sense of hope, that all is right.  That the magical world he left behind wistfully has been left for “possibilities never imagined.”  Perhaps the journey into elderhood can also be hopeful, that leaving adulthood is as it should be, and that it is , per Dr. Thomas, a “complex ripening, a richness that is unavailable to those who remain in the fevered grip of adulthood.”

 


The Heart of The Home: Elders and Staff

By / Posted on August 28th, 2015

Last year, when Claremont, CA resident Bill Andrus began to need 24-hour care in their home, he and his wife, Georgeann, chose Mt. San Antonio Gardens’ Evergreen Villas for his new home. The Villas are trademarked  GREEN HOUSE homes, which provides a real home for people needing skilled nursing care. In each of the two villas, the residents are supported by a small, self-managed team of care partners, known as shahbazim, and nurses. Mt. San Antonio Gardens pioneered what are California’s first and only small homes licensed for skilled nursing.

“We wanted Bill to live in a stimulating environment while receiving the care he needs,” says Georgeann. Acknowledging the difficulty of making that decision, the couple feels fortunate that the Villas were an option for them. Georgeann, who served on the Gardens board of directors for six years when The Green House homes were being considered, says, “We are so grateful for Bill to be part of it. It has been particularly heartwarming to see this from the initial concept and then to participate in the reality of seeing it work very well.”

Bill and Georgeann Anrus

Bill and Georgeann Anrus

While Bill was settling in, Georgeann applied to live at the Gardens as an active, healthy independent resident. She moved into an apartment on campus where she takes a quick walk to the Evergreen Villas. Living on the same campus means easy and frequent visits each day. The couple goes together to lectures and performances held at the Gardens or at the nearby Claremont Colleges. “Our neurologist had said to me, ‘Now you can just be a spouse, not the caregiver’, and he was so right!”

“Bill has become physically stronger since his move here,” marvels Georgeann. The special design of the great room has inspired Bill to use his walker, unassisted. The couple also credits the home-like atmosphere and the personalized attention of the shahbazim and nurses to his continued well-being. Because this team works so closely with such a small group of elders, the care partners get to know their personalities and individual needs and preferences intimately. While the shahbazim are also responsible for cooking and maintaining the house, their first priority, Georgeann notes, is always the care of the elders.

“The people are the best thing,” says Bill, who especially enjoys sharing common interests with Registered Nurse (RN) Michael Sansosti. Both are avid readers and love fishing.

Michael and Bill Reading for screen only 100 dpi

Bill and Michael reading

“It’s great,” says Michael. “We trade books and when I have some extra time in my schedule, we’ll spend time talking about them.” The ability to give everyone a little extra attention is very gratifying. Michael, who previously worked in structured hospital environments, enjoys the opportunity he now has to cultivate more personal friendships with the residents he cares for. “Certain people, like Bill, do very well in this kind of setting. It is especially well suited to those who prefer to take the initiative for their daily activities” and who enjoy the interaction and activity that is such an important part of the daily experience in the Evergreen Villas, according to Michael.

Working with the caregivers is also a new experience for Michael. “We work side by side with the shahbazim. While the RNs are in charge of everything clinical, the care partners spend all of their time interacting with the residents, so they can give us feedback on their behavior and needs, enabling us to intervene early.”

 

Amanda, shahbaz, and Michael, nurse, work together

Amanda, shahbaz, and Michael, nurse, work together

“Communication is a big thing here,” acknowledges shahbaz Amanda Phos, who began her training for her role long before the Evergreen Villas opened. With just 10 elders in each of the two Evergreen Villas, the care partners get to know each person personally, from their life stories to their health needs and abilities, their food preferences, and their hobbies and interests. “If you know the elders well, taking care of them is very easy,” says Amanda. “I think that’s the beauty of this place. We base each day’s activities on what they individually want to do. And every day is different. When we all come together around the dinner table, we like to talk about the day’s activities. It feels like a family.

 

“It’s hard work, and it takes a team to make it work so well,” says Amanda. “We’re the heart of the home, and that makes it very gratifying to be here.”

 


California Health Report: “This Green House Grows Humans”

By / Posted on January 13th, 2014

Via: California Health Report

When the Green House homes opened in California last fall, there were a number of people who were very happy to see that day come to fruition.  One person who was very pleased to see those doors open was Yolie Zepeda.

Yolie vividly recalls the words of her uncle after he was placed in a state funded nursing home after suffering from a number of health issues.  Her uncle told her that he felt so worthless at the facility, explaining that he could be sitting alone for endless hours in a soiled diaper.  He told her “they actually treat you worse than I’d ever treat a dog.”

Today Yolie is a Shahbaz in the Green House homes, and is happy she can tell a different story.    

Click here to read more about Yolie and her dedication to the Elders in her home…a home that the California Health Report says is “a welcoming vibe that gushes home.”

 

 

Read the story behind the man who led the effort to bring those Green House homes to California, President and CEO of Mt. San Antonio Gardens, Randy Stoll.  Some people come up through academic programs, which Randy would eventually do, but first he ventured in another direction.  Click here to read about his journey in aging services.


Learning From David Pearce

By / Posted on June 28th, 2013

Eleven years ago, I came to work at the Gardens. At that time David Pearce had already been here 17 years. I knew from my first interview with him that he would make a great boss. During the interview he suddenly remembered something and with my permission, he called the Grounds Dept. to alert them to some leaves that needed removing outside a resident’s window. I was astonished. Here was the Administrator who knew of a particular concern of a resident, cared enough to call about it and reported it using the resident’s name. He knew these residents.

Within a week or so of my first day on the job, David was leaving for a 3 week vacation. When I asked him what he wanted me to focus on while he was away, he said: “I think you should just take time to get to know the residents.” I secretly thought, great, what will I do in the remaining 2 and ½ weeks once I’ve done that? After my arrogance wore off I did exactly as he suggested and it turned out to be a great directive that helped me learn about life at the Gardens and see many things I would’ve missed had I been given a long task list.

Shortly after the return from his vacation, David and I met to talk more about the Wellness Program and he confessed to me that he had a reputation as a micromanager but that he was aware of it and was reforming his ways. Furthermore, he told me I was welcome any time to tell him if he was interfering too much with my work. It was a great equalizing gesture that he repeated many times over the years by giving me permission to disagree with and correct him. He has taken this to the nines when we began working on Green House development and it became clear that his role is to make sure we satisfy regulations that often reinforce institutional practices and my role is to make sure we are true to the model, which often challenges those practices. Instead of letting this create conflict he routinely calls upon the Green House metaphor of the Dragon (institutional practices that put task before person) and, with no ego and much humor, has invited me to be a bold Dragon slayer. Since David announced his retirement I have been reflecting on these and many other interactions with him. The following are highlights of what I have learned from David Pearce:

  • Be Proactive. David is almost famous for this phrase. He encourages staff to call people when answers are needed instead of stewing over the next step.
  • Updating and informing people helps things run smoothly.
  • Build relationships – whether it’s state regulators, residents or fellow staff, taking the time for relationships is always a wise investment.
  • Take Vacation when you can – don’t stockpile it, it’s meant to refresh you.
  • Invite the opinions of others. I used to call David often about Wellness Program development and his almost inevitable response? Why don’t you call this resident or that staff member and see what they can tell you about this. Eventually I cut out the middle man and went directly to the sources.
  • Model what you expect.
  • Invite people to partner with you in your self-improvement – It’s easier to refine yourself if you have helpers.
  • Tell people you trust them David said. He trusted me so often when I didn’t trust myself that I actually started trusting myself.

It has been my privilege to report to such a fine leader. He has reflected back my strengths when I had self-doubt, given wise council judiciously, and challenged me to grow by reminding me over and over again that mistakes are part of the journey.

Thank you David, I will miss you.

The Green House Project would like to thank David Pearce for being a champion of bringing this model of Long Term Care to California, and wishes him luck in his retirement.  We are looking forward to seeing “what’s next”! 


Mt. San Antonio Garden’s Approved in California

By / Posted on June 14th, 2012

Passion and tenacity are two words that can be used to describe Mt. San Antonio Gardens, in their pursuit to bring The Green House Project to California.  Spurred on by the belief that there has to be a better way to support to our elders, in a real home environment, where all people are treated with dignity, this organization has blazed a trail.  After many years of discussion, education, and planning with stakeholders across the state, Mt. San Antonio Gardens will become the first Green House Project to break ground in the state of California! 

Mt. San Antonio Gardens is an organization with a long, 50 year history of pursuing excellence, and living values that align with those of The Green House Project.  Since its founding, residents have participated in leadership and decision making of the organization.  While it may seem obvious to involve the people impacted in the decision making process, in traditional long term care, this is revolutionary!  This sense of empowerment is reflected not only in the residents, but also in the long tenure and enthusiasm of the staff.  Their motto, “Service Beyond Expectations”, is reflected in many years of a pioneering spirit—The Green House Project is a wonderful next step of this legacy. 

Wise leadership is the lifeblood of any organization.  To successfully bring The Green House Project to fruition, strong leaders with a powerful vision for change must be at the helm.  Randy Stoll, CEO of Mt. San Antonio Gardens, has a passion for excellence that impacts all those around him,

“We have always had a goal of creating an environment of support where elders can live with dignity.  But when my dad was a resident in our nursing home, and as good as our care was, I recognized that this was not home, and I promised him that I would work to make it better.  The Green House model is the answer to create home and skilled nursing care in a meaningful and dignified way.  While a Green House home was not available for my dad, I am proud that soon, we will be able to provide a better option for loved ones who need nursing care.”   

The Green House Project is grateful for the vision and passion that has enabled Mt. San Antonio Gardens to persevere through the journey that has led to this notable moment.  We are one state closer to making this model an option in every community!


Mt. San Antonio Garden's Approved in California

By / Posted on June 14th, 2012

Passion and tenacity are two words that can be used to describe Mt. San Antonio Gardens, in their pursuit to bring The Green House Project to California.  Spurred on by the belief that there has to be a better way to support to our elders, in a real home environment, where all people are treated with dignity, this organization has blazed a trail.  After many years of discussion, education, and planning with stakeholders across the state, Mt. San Antonio Gardens will become the first Green House Project to break ground in the state of California! 

Mt. San Antonio Gardens is an organization with a long, 50 year history of pursuing excellence, and living values that align with those of The Green House Project.  Since its founding, residents have participated in leadership and decision making of the organization.  While it may seem obvious to involve the people impacted in the decision making process, in traditional long term care, this is revolutionary!  This sense of empowerment is reflected not only in the residents, but also in the long tenure and enthusiasm of the staff.  Their motto, “Service Beyond Expectations”, is reflected in many years of a pioneering spirit—The Green House Project is a wonderful next step of this legacy. 

Wise leadership is the lifeblood of any organization.  To successfully bring The Green House Project to fruition, strong leaders with a powerful vision for change must be at the helm.  Randy Stoll, CEO of Mt. San Antonio Gardens, has a passion for excellence that impacts all those around him,

“We have always had a goal of creating an environment of support where elders can live with dignity.  But when my dad was a resident in our nursing home, and as good as our care was, I recognized that this was not home, and I promised him that I would work to make it better.  The Green House model is the answer to create home and skilled nursing care in a meaningful and dignified way.  While a Green House home was not available for my dad, I am proud that soon, we will be able to provide a better option for loved ones who need nursing care.”   

The Green House Project is grateful for the vision and passion that has enabled Mt. San Antonio Gardens to persevere through the journey that has led to this notable moment.  We are one state closer to making this model an option in every community!


SB 1228 could allow for more "kinder, gentler" person-centered care facilities to be built in California

By / Posted on May 9th, 2012

via 89.3FM KPCC

“[Green House Homes offer] an individually tailored environment and experience so someone doesn’t feel as if they’re trapped in a long, pale green hallway of an institution” says Gary Passmore, Vice President and Director of the Congress of California Seniors, which supports a bill being introduced in California by Democratic Senator Elaine Alquist.  The bill, SB 1228, would provide a new licensing category so more person-centered care facilities can operate in the state of California.

To read more about the positive impact the SB 1228 bill will make in the state of California and for additional commentary from Gary Passmore, click here.

Tell us what you think about this exciting new development in California Legislature!


SB 1228 could allow for more “kinder, gentler” person-centered care facilities to be built in California

By / Posted on May 9th, 2012

via 89.3FM KPCC

“[Green House Homes offer] an individually tailored environment and experience so someone doesn’t feel as if they’re trapped in a long, pale green hallway of an institution” says Gary Passmore, Vice President and Director of the Congress of California Seniors, which supports a bill being introduced in California by Democratic Senator Elaine Alquist.  The bill, SB 1228, would provide a new licensing category so more person-centered care facilities can operate in the state of California.

To read more about the positive impact the SB 1228 bill will make in the state of California and for additional commentary from Gary Passmore, click here.

Tell us what you think about this exciting new development in California Legislature!


California Senate Committee approves a new nursing home licensing category that would allow Green House homes in the state

By / Posted on April 27th, 2012

via CaliforniaHealthline.org 

“It puts the ‘home’ back into nursing home.”  That’s how California Senator Elaine Alquist (D-San Jose) described SB 1228 when addressing the Senate Committee on Health this week.

The bill would create a new health facility licensing category for a small house skilled nursing facility that is either a standalone home or consists of more than one home providing skilled nursing care in a noninstitutional setting.

David Pierce of Mt. San Antonio Gardens, a continuing care center in Pomona, explained that his organization has been pursing approval to build a Green House home for years.

Find out what needs to happen next for full approval in California and let us know what you think!


Conference in California Today, Changing the Physical Environment of Nursing Homes: Addressing State Regulatory Hurdles

By / Posted on December 6th, 2011

Partnership is key to any innovation. Robert Wood Johnson Foundation’s CEO and President – Risa Lavizzo-Mourey recently expressed why Green House homes are crucial to California’s aging services in an opinion piece for The Sacramento Bee. Today, regulators, legislators, advocates, providers and other leaders in the field come together for a day-long conference by Chi Partners and The California Health Care Foundation to discuss the changing landscape of long term care in California.

Much has changed this year to encourage providers to implement upgrades to their physical environment, and culture change practices:

• OSHPD’s new “Household” regulatory model for nursing homes allows providers to create a more home-like environment for their residents.
• Two small home (The Green House® Project) projects are working their way through the regulatory process, creating a blueprint for addressing key regulatory challenges to this type of model.
• Important Life Safety Code changes for nursing homes have been made by NFPA with the assistance of Pioneer Network that support the implementation of culture change.
• Some states (like Michigan and Arkansas) are successfully overcoming regulatory challenges and are now instituting legislation that supports providers in building new small home and culture-change models providing lessons learned for future changes to California’s regulations.

Leaders such as Pioneer Network CEO, Peter Reed, Director of Arkansas’ Office of Long-Term Care, Carol Shockley, The Green House Project, COO, Susan Frazier, join California regulators to discuss the value of partnering to change the physical environment of skilled nursing homes to support the quality of life and quality of care for the elders and staff in California.


Thank You CA State Sen. Alquist

By / Posted on December 5th, 2011

A long life ought to entitle one to a dignified old age. We may not be able to cure diseases such as Alzheimer’s but we can offer our elders a life that is rich with kindness, patience, encouragement and appreciation. The creation of such a life is just what Green House homes were designed to do.

Dr. Risa Lavizzo-Mourey, who serves as the leader of the Robert Wood Johnson Foundation, recently examined this challenge in an op-ed that ran in the Sacramento Bee.

In Pomona, construction is starting on two modest homes that could revolutionize the way California cares for seniors who can no longer live independently. Residents will not experience the long sterile hallways, hospital-style rooms or the boredom and loneliness too often found in traditional nursing homes. Instead, these “Green House” homes – the first of their kind in California – will provide seniors with quality care and something just as important to their well-being: the feeling of being in a real home.

There is a world of difference between places that aspire to be “home-like” and those that attempt to make a real home for real flesh and blood, living and breathing human beings.

Much has been written about the “silver tsunami” of boomers now entering their retirement years and expected to live longer than previous generations. No state has as much at stake as California, which will see its number of seniors 85 and older triple in the next 30 years.

These trends are daunting, but the good news is that we know more than ever before about what it takes to provide the most vulnerable seniors with the care they need and the dignity they deserve.

Although conventional wisdom tells us that aging is a bad thing, the truth is that aging is a very good thing which, if approached correctly, will enrich the lives of people of all ages.

A decade ago, an idea like this would have been unimaginable on the basis of cost alone. But more than 100 Green House homes in 19 states have now proven otherwise. In fact, a major study published in the Seniors Housing and Care Journal concludes that Green House homes cost the same as traditional nursing homes to operate but deliver vastly better care and quality of life.

Thanks to leadership from state Sen. Elaine Alquist, D-Santa Clara, California recently took an important step by clarifying its regulatory requirements to ensure that rules designed for bigger institutions 30 years ago were not inadvertently preventing smaller Green House homes from being built. The project under way in Pomona is a direct result of the updated policy.

“Senator Elaine Alquist”— this is a name that will go down in California legislative history. While it is true that it took the energies and drive of many people to bring California’s first Green House homes into being, without Senator Alquist—- it never would have happened. With skill and tenacity she built support for this innovation and then translated that support into action. This work is the very essence of “good government.”

These first Green House homes will, indeed, change the world of long-term care in California. Elders living in California Green House homes may never know her name but they will all owe her a debt of gratitude. On behalf of those elders, I say, “Thank you Senator Alquist.”

Read More Here


Green House homes are crucial to California's Aging Services

By / Posted on December 5th, 2011

The Green House Project has been working hard to support Mount San Antonio Gardens (MSAG) open the first Green House homes in California. As part of our work to be sure that MSAG’s and Green House adopter’s enjoy broad support in the state, the GHP team worked with The Robert Wood Johnson Foundation (RWJF) and their skilled communication team to get the word out about why Green House homes are crucial to California’s aging services in an opinion piece written by RWJF’s CEO and President – Risa Lavizzo-Mourey:

http://www.sacbee.com/2011/12/03/4096447/a-chance-to-revolutionize-long.html#disqus_thread

Add a comment if you have time!