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.
September is World Alzheimer’s Month…Every 67 Seconds Someone In The United States Develops Alzheimer’s Disease
By Mary Hopfner-Thomas / Posted on September 17th, 2015
It’s an amazing statistic and there are many more that accompany it:
- It is the 6th leading cause of death in our country
- It is the only cause of death in the top 10 in America that cannot be prevented, cured or slowed
- One in three Elders die with Alzheimer’s or another dementia
- Almost two thirds of Americans with Alzheimer’s disease are women
The World Month was established to raise awareness and to increase education about the disease. It is designed to encourage people all around the world to spot the signs of dementia, but also not to forget about loved ones who are living with dementia, or those who may have passed away.
The 2015 report titled “The Global Impact of Dementia” was included in a recent article by Long-Term Living. It commented on five statistics that we should all know.
Dr. Al Power, who has been named to the Scientific Program Committee for Alzheimer’s Disease International 2015, has provided much insight on this topic to Green House adopters. His blogs, webinars and presentations have resulted in rich conversation about the disease. Dr. Power will be conducting an all day preconference session along with a plenary and education session at The Eighth Annual Green House Meeting & Celebration in Broomfield, CO from November 16-18th. The annual meeting is for Green House members only and this year’s theme is Better Together. The title of Dr. Power’s preconference session is “Reframing Dementia.” His plenary session is entitled “Living Better Together with Dementia: Taking it Further” and his education session is “Real Life Without Antipsychotic Drugs.”
To learn more about Alzheimer’s click here for information and research from the Alzheimer’s Association.
So, what will you do this month to raise awareness about Alzheimer’s Disease?
By Al Power / Posted on September 10th, 2015
Dr. Al Power will be conducting an all day preconference session along with a plenary and education session at The Eighth Annual Green House Meeting & Celebration in Broomfield, CO from November 16-18th. The annual meeting is for Green House members only and this year’s theme is Better Together. The title of Dr. Power’s preconference session is “Reframing Dementia.” His plenary session is entitled “Living Better Together with Dementia: Taking it Further” and his education session is “Real Life Without Antipsychotic Drugs.” Log-in to the Peer Network website today to register for the meeting so you can hear from Dr. Power first hand!
Like most people, I am subject to a regular barrage of media reports, coming from radio, television, internet news outlets, social media and daily RSS feeds. And here is what this information stream has taught me:
If I eat blueberries, I’ll lower my risk of Alzheimer’s. Or was that tomatoes? It now appears that yogurt lowers the risk as well—does that mean blueberry yogurt, or will any old flavor do? Maybe I should have coconut flavored yogurt, because apparently, if all that coconut oil doesn’t kill me with a heart attack, it may make my brain healthier.
And now it appears I may have to replace my plumbing, because a new study suggests that too much copper causes Alzheimer’s; though other medical studies have shown that a high copper intake actually lowers the risk. So which is it? And is lead involved? (I need to know because I tend to chew on my pencils when I do my daily Sudoku puzzles.)
And then there’s the glucose connection, the blood pressure connection, the inflammatory connection, the brain reserve connection, the mood disorder connection, the social connections connection.
And what kind of a teenager was I? Apparently, certain adolescent behaviors raise your risk. One of them is getting drunk; well, thank God, none of us ever did that! Also, it’s a risk if you have a history of adolescent antipsychotic use. (Tell that to the psychiatrists who are finding all kinds of new reasons to prescribe these drugs to young people, from depression to “oppositional disorders”.)
Another risk factor (cue Randy Newman) is being too short. Time to get out the gravity boots? And if that weren’t bad enough, now the folks in Manhattan say dementia can come from exposure to bacterial and viral infections. (Someone sneezed on me just the other day, and I swear my ADAS-Cog score dropped two points!)
Okay everyone, are you listening to me?? STOP! Just…stop. If there were a “Hitchhiker’s Guide to Dementia”, the first words would still be: “Don’t panic.”
What we have here is a collection of illnesses closely tied to the aging process, and a sequence of changes that may begin decades before we show any outward signs. And we are dissecting all the minutiae of the millions of things we do, eat, drink or experience in our lives—trying to find connections, however tenuous, that we can shoot to the media outlets to fuel the frenzy.
There are a lot of people making money off of our hysteria and paranoia. But it’s much worse than that.
You see, the more we fuel this kind of panic, the more we demonize the condition; and consequently, the more we demonize and dehumanize people who live with cognitive disability. Folks like Dr. Bill Thomas have long warned us that those people who do less or produce less are devalued in our society. It is also now clear that a similar fate befalls those who remember less in our hyper-cognitive, technology-obsessed world.
Here are a couple of known facts to keep in mind: We all die. Many of us who live to a ripe old age will experience changes in various organ functions and capabilities. Many of us will become forgetful as we reach our later years. Those who do are not bad people.
There is so much emphasis on “successful aging” these days—what does that mean? Are you successful if you run marathons until you are 96 and then die in your sleep, or at the completion of some incredible sexual escapade? That’s romantic, but highly subjective and unlikely. More important, this fixation on how we end our lives not only threatens to devalue who we are in our last years, but also how we have lived all of the earlier days of our lives.
And if you don’t make it to the grave with all of your organ functions intact (an oxymoron in itself), what is that called? “Failed aging”? What about people born with developmental disabilities or congenital illness? They would be “failed agers” from the very start. No need to even give them blueberries and yogurt, I guess.
You and I will always be more than the sum of what we can do and what we can remember. So here’s the advice I would put in my “Hitchhiker’s Guide”:
No matter who you are or how you live your life, you have a chance of becoming forgetful as you age. Your risk is never zero, but no one knows your exact “number”. You can almost certainly lower that risk somewhat if you eat well, exercise and do things that are good for your body, mind, and spirit; your risk will probably go up if you abuse any of those. But being obsessive about every little thing you do will likely not improve your odds to a greater extent than healthy moderation.
Find that “sweet spot” that gives you a life worth living. When we stop indulging the fear mongers, we can see the value in people of all abilities. This will help us to visualize a true path to well-being for all.
By Admin / Posted on July 16th, 2015
Ceder Sinai Park (CSP) is happy to announce it will be breaking ground on a $33 million construction project focused on renovation of the Robison Jewish Health Center and its transformation into a 44-bed post-acute rehabilitation center. The project will also include the construction of two additional buildings with four homes in THE GREEN HOUSE® model – providing 12 beds each (48 total) for an improved model of long-term care.
“We commend Cedar Sinai Park for their vision to further their mission by implementing The Green House model, and their commitment to transform long term care in Oregon” said Susan Frazier, Senior Director, The Green House Project.
CSP is committed to helping people stay at home as long as possible or maintain lower levels of care and is moving forward with this project in response to community needs for post-hospital sub-acute care rehabilitation services to facilitate returning home after a medical event such as a hip replacement or surgery.
Four new homes will be part of the Harold Schnitzer Health & Rehabilitation Care Center, focused on providing state-of-the-art long-term care in the model of Green House homes across the country. These homes will emphasize quality-of-life; person-directed care which results in improved healthcare outcomes for residents who can no longer remain at home due to conditions such as Parkinson’s, Alzheimer’s and Multiple Sclerosis.
On Wednesday, July 15th, we will officially break ground on the new center. The groundbreaking will take place at 4:00 p.m. on the corner of SW 62nd Avenue and Boundary Street, and will include remarks from CSP and community leaders.
“We are pleased to see this dynamic construction project begin. It is important to Cedar Sinai Park and the entire community that we develop a 21st century service capacity that is both beautiful and able to meet changing healthcare demands,” said Jim Winkler, Capital Campaign Chair.
“Cedar Sinai Park is proud to be working with LRS Architects and R&H Construction on this project” according to David Fuks, CSP Chief Executive Officer. “These two firms represent the highest quality teams and we are glad to be teaming with them on this very important work.”
The Green House Project is a radically new, national model for skilled-nursing care that returns control, dignity and a sense of well-being to elders, their families and direct care staff. In the Green House model, residents receive care in small, self-contained homes organized to deliver individualized care, meaningful relationships and better direct care jobs through a self-managed team of direct care staff working in cross-trained roles. Green House homes meet all state and federal regulatory and reimbursement criteria for skilled-nursing facilities.
About Cedar Sinai Park: Cedar Sinai Park provides residential and community-based care to elders and adults with special needs, allowing them to live with comfort, independence, and dignity in a manner and in an environment based on Jewish values. A nonprofit organization, we are committed to delivering a broad-based continuum of care that can be tailored to individuals’ unique needs. Our services include independent and assisted living (Rose Schnitzer Manor), nursing home care (Robison Jewish Health Center), daily respite care (Adult Day Services), affordable housing for seniors and people with disabilities (Rose Schnitzer Tower, Lexington Apartments, Park Tower Apartments, The 1200 Building), in-home care (Sinai In-Home Care), a collaboration with Jewish Family & Child Service), and affordable housing for developmentally disabled adults (Kehillah).
By Admin / Posted on June 17th, 2015
A son’s personal experience shapes his support for bringing The Green House model to Maplewood Nursing home, in Cheshire County, NH.
As someone whose father greatly benefited from living in a Green House cottage, I feel compelled to lend my voice in support of the concept as the proposed alternative to the deteriorating Maplewood nursing facility which now serves many needy elders of Cheshire County.
My father was a well-educated, highly respected writer and clergyman who, in his final years of life, had the misfortune to develop Lewy Body Dementia, a disease that resembles a devastating combination of Alzheimer’s disease and Parkinson’s disease. It was one of the most difficult experiences of my life to watch this highly articulate man robbed of his joy, his speech, and, eventually, his mind.
When it became evident to our family that my mother could no longer care for my father in their home, we were blessed with the opportunity to be part of a Green House community in Holland, Michigan. The Green House concept is light years ahead of the type of care that has typically been given in places such as Maplewood Center. Maplewood has been a valued and effective facility for many years, but it simply cannot compare to a Green House setting. Green House residents live in private rooms with private baths. They are always treated with respect and dignity. They are referred to as “elders” rather than “patients.” Living, recreating and dining among a small community affords them with companionship that is so vital to their continued health. Family members are always welcomed at meals and other activities.
Before my father entered the Boersma Cottage, he was sinking deeper and deeper into depression, withdrawing from life, and was rapidly losing his desire to live. What struck me as miraculous is that, within a few weeks of his arrival, he started to regain his sense of humor and even had a playful quality about him that had been lacking in recent months. It is true that, because of his dementia, he was no longer fully the man I had known and loved. But the person that he became in his final months was well cared for and enjoyed a quality of life that, in my experience of such care – which is quite extensive – is unparalleled. My only regret is that he didn’t come to a Green House home earlier so that he might have enjoyed even more of its benefits. In the end, his death was a good one and for that I will always be grateful.
The Green House concept is, I believe, at this time the best way to provide quality of life for those in need of long-term care. It respects the dignity of the person and values the gifts that they still bring to the lives of others.
It’s time for Cheshire County to embrace this truly remarkable approach.
The Rev. Mark A. Jenkins
Rector, St. James Episcopal Church, Keene
By Heather Sawitsky / Posted on March 6th, 2015
Heather Sawitsky, of White Oak Cottages, writes a moving piece about the movie, Still Alice. White Oak Cottages are Assisted Living Green House homes where people living with dementia are creative, resourceful and whole. By creating an environment that is small and warm, and where people are deeply known, The Green House model is a best practice.
Still Alice, a movie based on Lisa Genova’s novel about a linguistics professor who develops early onset Alzheimer’s, is now in wide release. For those who love people with the disease, and for those who are hoping to avoid this disease (which by my count includes everyone) the question is, “Why would anyone want to see this movie?”
The answer might be because the film adaptation is a poignant and dignified presentation of a disease that is usually described in ways that exaggerate its symptoms and stigmatize its victims. Or it may be because Still Alice presents the experience of the degenerative disease through the eyes of Alice, reminding us that a person with Alzheimer’s still strives for normalcy, involvement, and emotional connection. Or it may be because the wide-angle view of the film speaks to how all of us will need to learn to master loss: of physical abilities, loved ones, and sometimes, memory.
Julianne Moore, who plays the professor Alice Howland, turns in a masterful performance. Determined not to “make it up”, Ms. Moore spent months researching Alzheimer’s disease, speaking with clinicians, women with early onset Alzheimer’s, and family members. She also underwent the same battery of cognitive tests given to those with suspected Alzheimer’s. Her performance carries the film and has earned her an Oscar® nomination.
There is one other element that sets this film apart. One of its directors, Richard Glatzer, was diagnosed with ALS in 2011. There are many parallels between ALS and Alzheimer’s. Both are neurodegenerative diseases that slowly, incrementally rob a person of their abilities. With ALS, patients lose their ability to use their muscles, thus depriving them of their ability to walk, stand, use their hands, speak, and ultimately, breathe. With Alzheimer’s, people are slowly robbed of their ability to find words, remain oriented, practice their professions, and recognize their loved ones.
Still Alice is a powerful, but restrained look at one woman who is trying to hold onto her identity and her place in the world, knowing that each week she will be able to do something less well, but not knowing what the next loss will be. Richard Glatzer’s keen understanding of this terror and his determination to live a full life notwithstanding, help make this a film that will inform and inspire.
By Brittany Swanson / Posted on February 12th, 2014
For the past 3 years Brittany Swanson has been a Social Worker for four Green House homes – Providence Seward Mountain Haven, in Alaska. Brittany began her journey in Social Work in 2003 at the University of Hawaii, but returned to her home state of Alaska to complete her Bachelors in Social Work. She has been a licensed Social Worker since 2010, and began working with the Providence Seward Mountain Haven Green House homes in January 2011. Brittany is quick to express how grateful she is for the opportunity to work in the homes, and believes it has pushed her further in her career than she ever expected!
My first experience with TimeSlips® was during a training provided by the Alzheimer’s Resource of Alaska at our Green House home. My co-workers and I were abuzz with excitement as we all met in Raven Lodge to assist the facilitator with the session. Our staff and Elders gathered around the dining table and were warmly welcomed to the storytelling session. We were handed the same black and white image; a bald, chubby baby sitting in an empty brief case. What ensued was pure magic. The smiles and laughter began immediately as our Elders shared their thoughts and ideas composing their very own story. Every idea was included and there were absolutely no wrong answers. Even a dispute among the Elders was incorporated into the story when asked “What do we want to call him?”
“His name is Harry.” “No, it’s Bill.” “He looks like a Frank to me!”
Approximately 2 hours later I was begging my supervisor to fund my training to become a certified facilitator so I could bring these storytelling sessions to Seward Mountain Haven on a regular basis. She kindly obliged and I celebrated.
As Green House staff, we are well versed in meaningful life engagement, but the benefits I saw in using TimeSlips were unlike any other activity I have experienced. As a Green House Social Worker I often find we welcome new Elders to Seward Mountain Haven and discover they feel a lack in their ability to contribute anything of “value” to society. It is not uncommon as we age to sense we have lost our social roles as a lifelong teacher, parent or fisherman for example. TimeSlips can fill that social role by allowing the Elder to become the storyteller in a safe environment and provide that sense of contribution and value once again. Our Elders are proud of their TimeSlips stories and revel in pride as we read them in their entirety.
Anyone can become a certified facilitator for the TimeSlips method by completing an online course which teaches the history and development of the program, as well as how to implement it with Elders in varying stages of dementia. Once you complete your course, you can practice TimeSlips with your Elders and submit your completed stories to a Certified Master Trainer for review. A time is then set to complete an assessment interview to verify you understand the method and are confident in its implementation. Then you are good to go! TimeSlips works best with Elders who are in the mid to late stages of dementia, as these stages allow for the creation of an environment of open creativity. Elders who are in the early stages of dementia may become hung up on the “facts” and feel silly about making up a story they don’t know.
One of our goals at Seward Mountain Haven is to educate our community on dementia and continue to break down stereotypes and stigmas associated with nursing homes. In effort to do so, we created beautiful poster-size TimeSlips to display at the annual Seward Music and Arts Festival. The community was able to enjoy reading our Elder’s stories which sparked interest in other organizations to learn about the method and the benefits of the program’s implementation. In the near future, we hope to begin intergenerational projects between our Elders and local elementary school students using the TimeSlips method. We intend to make TimeSlips a regularly scheduled event at Seward Mountain Haven, so come join us anytime!
By Baura Zia / Posted on October 14th, 2013
When Claire Lucas entered a nursing home for the first time, she was anticipating walking into a room filled with smiling faces with laughter echoing throughout the halls. She expected to see nurses walking alongside Elders as they’d wave hello to her, their faces gleaming with happiness and joy. She thought she’d see something resembling a real home. Instead, she was greeted by unpleasant fumes and the sound of someone calling numbers for bingo. A group of Elders were huddled around the nursing station and the atmosphere was unsettling. Almost instantly, Claire felt like leaving – but thankfully, she stayed.
Although gerontology was never a field Claire thought to consider, the need to bring cultural change to the field was something Claire knew she had to help to achieve. Growing up listening to her grandparents stories and witnessing their love and affection, Claire knew the current way in which traditional nursing homes were run was not acceptable. To Claire, Elders held a certain value for which they needed to be appreciated. Thus, she decided to dedicate her efforts to helping reshape Elder care by working toward empowering and helping them at a time in their life when they needed it most.
Throughout her years Claire has worked in various capacities to assist people in Elderhood and at the end of life. As Director of Facility Based Hospice & Bereavement for The Denver Hospice in Colorado, Claire oversaw hospice services including opening a new patient care center and helping The Denver Hospice apply for The Eden Registry. Prior to her work with The Denver Hospice, Claire served as the Vice President of Operations for Vivage Quality Health Partners. Today, Claire serves as a Project Guide at the Green House Project and continues to contribute her skills and experience to help establish Green House homes across the nation.
- 19 years of experience as a Licensed Nursing Home Administrator, opening new facilities and assisting in specialty program development
- Masters of Science in Gerontology, emphasis in Direct Service
- Regional Vice President for nine skilled nursing facilities in Colorado
- Eden Educator and LEAP Educator
- Presenter at numerous national conferences, including her special interest in Alzheimer’s Disease and culture change
- Board Member Colorado Culture Change Coalition
Claire has been incredibly active in her passion toward assisting those with Alzheimer’s. She has worked on developing some of the earliest Special Care Units and continues to remain active with those projects.
Claire enjoys international travel and visiting new places. She also enjoys theater, the arts along with the outdoors and hiking.
By Karen Love / Posted on June 4th, 2013
In 2001, the Institute on Medicine released a seminal report titled “Crossing the Quality Chasm” that called for a redesign of the nation’s healthcare system and described healthcare in America as impersonal and fragmented (IOM, 2001). The report noted that a critical element needed in redesigning the healthcare system was a shift to person-centered practices. These practices are rooted in humanistic psychology and the work of Carl Rogers and Abraham Maslow among others. Unfortunately, little progress has been made in the past dozen years to transform systems and practices to support person-centered outcomes. Recently, a group of concerned national dementia care experts decided to focus on advancing person-centered values and practices for dementia care.
Several significant events occurred in 2011 that catalyzed the gathering of this group of diverse dementia care experts representing the practice, policy, and research sectors to form consensus on a definition and conceptual framework for person-centered dementia care. This initiative is known as the Dementia Initiative. In early 2011, President Obama signed the National Alzheimer’s Project Act (NAPA) into law. Part of the law mandated the formation of an advisory council to make recommendations to the Secretary of the Department of Health and Human Services on actions to expand and coordinate programs to improve the health outcomes of people who have dementia. NAPA was viewed by many dementia care experts as an opportunity to spotlight and advance the implementation of person-centered dementia care practices. Sadly, NAPA’s primary focus has been on the ‘cure’ aspects of Alzheimer’s disease. The little focus given to dementia ‘care’ has been silent on person-centeredness.
In late 2011, the U.S. Senate Subcommittee on Aging held a hearing focused on the overutilization of antipsychotic medications for nursing home residents with dementia and the need for alternative care strategies other than automatically giving antipsychotic medications for what are perceived as behavioral challenges exhibited by people who have dementia. These behaviors are often expressions of unmet needs such as pain, hunger, thirst, boredom, loneliness, or an underlying medical condition that a person who has dementia is challenged to verbally communicate to a care partner or to address him or herself. Person-centered practices, considered the gold standard by the IOM and the World Health Organization (WHO, 2012), are oriented to the person and thus understanding and addressing the cause of the behavior being expressed.
A person-centered model of care reorients the medical-disease model of care that can be experienced as impersonal and fragmented to one oriented to holistic well-being that encompasses all four human dimensions – bio-psycho-social-spiritual. Person-centered care recognizes this multi-dimensionality dynamic and reorients practices to be delivered in a manner that is positively experienced which, in turn, helps promote holistic well-being.
A recently published article in Health Affairs describes person-centered care from one individual’s experience. While the example describes the experience of someone with a mental illness and not dementia, if a person who has dementia could publish an article in a national publication, they would likely echo this person’s sentiment. Ashley Clayton, a Yale University researcher, suffered for many years in her teens with mental illness. In the article, she describes the care she experienced when hospitalized and how receiving care in a person-centered manner helped her immeasurably. “The nurses got to know me and could support me in ways that were personally meaningful…These might sound like little things – a soda, an art project, a few minutes spent talking…Nothing they did cost extra money or required intensive training, but the fact that they saw me as a person – and treated me like one – helped restore my dignity and sense of personhood” (Clayton, 2013).
The diverse Dementia Initiative experts gathered for a one-day meeting in Washington, DC in June 2012 to form consensus about the definition and conceptual framework of person-centered dementia care. Discussions and email exchanges continued over the course of the next six months. In January 2013 a white paper titled “Dementia Care: The Quality Chasm” that provides the consensus definition and framework for person-centered dementia care was published. The white paper can be accessed online at http://www.ccal.org/national-dementia-initiative/white-paper.
There is no better time for our nation to “cross the quality chasm” for dementia care as NAPA and other national dementia initiatives provide timely pathways to spotlight and transform systems and practices of care to person-centered ones. Successfully evolving to person-centered dementia care practices will require the efforts of all stakeholders including individuals living with early stage dementia, family members and other care partners, healthcare practitioners, long-term care service and support providers, consumer advocates, policy-makers, researchers, funders, regulators, academicians, and scholars among others. The Dementia Initiative white paper provides the blueprint to transform dementia care values, systems and practices in this country to person-centered ones. With 5.4 million Americans living with dementia today and the number projected to increase three-fold by 2050, there is not a moment to lose.
Karen Love is a former speech therapist and long-term care administrator with more than 25 years of experience operationalizing and advancing person-centered practices in all long-term service and support settings. Ms. Love has been co-investigator of numerous research projects to study the effects of and advance knowledge and evidence about person-centered values and practices. Karenlove4@verizon.net
Clayton, A. (2013). How ‘person-centered’ care helped guide me toward recovery from mental illness. Health Affairs, 32(2): 622-626.
Institute on Medicine. (2001). Crossing the quality chasm. Washington, DC: Institute on Medicine.
World Health Organization & Alzheimer’s Disease International. (2012). Dementia: A public health priority. United Kingdom: World Health Organization.
By Heather Sawitsky / Posted on May 14th, 2013
Susan could no longer deny she had a problem when her mother started to call her at 2:00 in the morning, asking her when she was coming to see her.
Her mother, Molly, is a vibrant, outgoing woman who raised three children and worked as a legal secretary, fully enjoying the job. She loves her family and being with people. Molly also has an impressive command of trivia questions.
Of the siblings, Susan lived nearest to her parents, and so she saw them the most often. Several years ago, she noticed that her mother seemed unfocused. Short, routine errands to nearby stores took hours. But her dad assured her that all was well.
Then Susan’s dad passed away, and Molly lived alone.
Susan assumed more responsibility for helping her mother, a role she termed as “Boss of the Bills and the Pills”. She continued to worry that her mother was “off” and she shared her concerns with her siblings, a difficult and emotional task. They were not convinced that Molly’s problems warranted taking her out of the home that she loved.
Susan increasingly worried about her mother’s confusion about time and space. She started getting calls from her mother in the middle of the night, asking her when she would come to visit. Neighbors called her to report that Molly was having difficulty driving. As Susan reports it, “I had a sick feeling in the pit of my stomach 24 hours a day.” The final straw was when Molly fell in her home and ended up in the hospital.
After the fall, the family moved Molly to an assisted living residence. Molly seemed to adjust to her new living situation, but Susan saw that her mother had lost the sparkle in her eyes. For a woman who was always busy and with friends, Molly now did not have much to do. She spent a lot of time alone in her room.
The staff at the assisted living residence reported that Molly wandered and had great difficulty finding her apartment. She left her stove on so frequently that the residence disabled it. Then Molly fell in her unit, fracturing her neck and nose. Molly did not use her emergency wrist pendant, so an aide found her long after the fact.
Molly was treated in a hospital, transferred to a rehab facility, and then she went back to her assisted living unit. Given her mental confusion, the residence required the family to hire 24 -hour care, at $600 per day. The family quickly decided they needed another solution.
Susan looked at memory care units near her home in Needham. When she walked into White Oak Cottages, she was surprised that it felt like a real home. Residents were coming and going through the living room, the smell of fresh laundry came from the dryer, and the staff was preparing dinner in the kitchen. Susan knew how much her mother wanted to be around other people, and she thought, “This is perfect!”
In September 2012 Molly moved into White Oak Cottages. Daily life is now much closer to what it was like when she was living in her family home. She has her own room to decorate and she can watch her television whenever she wants. Her children visit her, some having dinner with her, others watching movies with her in her room. They all appreciate the ability to focus on Molly, rather than on her care.
When Molly’s family is not visiting, she likes being in the action in the living room and playing word games. Molly is the recognized champ of the trivia contests. And she has made new friends. Susan enjoys the way the residents care for each other. “The residents ….are like family. They look out for each other.”
Since Molly has moved to White Oak, her medical condition has stabilized. According to Susan, “the spark is back in her eye”. Her favorite day is Saturday, when families visit with children and dogs. Susan says that the high level of activity is just what her mother needs. “She is thriving. I have nothing but positive things to say about White Oak. For me, it is peace of mind. When you walk out of White Oak and feel that all is well for your mother, it is worth everything.”
To learn more about White Oaks Cottages, of Fox Hill Villages in Westwood, MA, visit: http://whiteoakcottages.com/
By Rachel Scher McLean / Posted on May 2nd, 2013
It has been 10 years since Mississippi Methodist Senior Services in Tupelo, MS opened the first Green House project in the country. Throughout May, The Green House Project will celebrate this pioneering organization, and the revolution that they sparked. On Sunday, May 5, there was a block party to celebrate this milestone, with Green House team members and Dr. Bill Thomas in attendance. Check out the photos here and Follow us on twitter at #Tupelo10.
Steve McAlilly, the visionary leader who believed in The Green House model and brought it to his organization tells a story about its impact:
There was a retired methodist preacher who had Alzheimer’s. He lived in our Alzheimer’s unit in the old ward. He had an eight-year-old grandson who refused to come see him in that environment. His parents couldn’t get him to go see his grandaddy. His disease was so advanced he wasn’t awake but 4 hours a day. But he was one of the first people in the world to move into green house. People would ask what is he going to get out of it? He’s barely awake, has to be fed. But we believed that bringing him to the hearth, to the supper table, something would get through and it would make a difference.
So every day the Shahbazim would get him dressed and bring him to the table. Before too long he was awake again, and his grandson would come back to see him. He came to see his grandaddy so much he knew the name of every elder and every Shahbaz in the house. If that’s the only thing we did we can say it’s worth it. Whatever sweat and tears we had it was worth it.
By Rachel Scher McLean / Posted on March 11th, 2013
Maria Shriver is a national voice for Alzheimer’s Disease. Through her blog, she is able to reach people around the world to give this disease a human face. Recently a blog about The Green House model, shared how the small environment and deep-knowing relationships, helped to create a meaningful life for one family:
For the last six months, from the day [Joan] moved in [to White Oaks Cottages] on July 4th, Joan has gotten a letter from her kids. Each letter starts out, “Please print and three whole punch for Joan Hogan” followed by “Today is…”
The letters were signed at the end but Joan kept asking, “but who is writing these?” so a third line was added, “This letter is from your daughter, Kathleen.”
Then, in three to four paragraphs, Kathy and her siblings would write what was going on with the family. “We realized we could have sent her the same letter every day, but because we shared it with our extended family, we enjoyed keeping it up to date.”
Joan holds each day’s letter in her hand all day; the news fresh every time she reads it. She shares it with her friends and even reads the letter to Kathy when she calls. It gives them something to talk about.
“What she’s saying is accurate and interesting, it removes some of the frustration.” Kathy jokes, “I wouldn’t need to speak to siblings for a week because she would fill me in on everything!”
For five to six months, Joan was able to put the letters in order in the binder. She can no longer do that, so a bit of organization and assistance is required when they visit.
Kathy says having her mother at a Green House home has been a great change and a big relief.
Green House homes around the country provide a sense of peace to family members, that their loved ones are being treated with value and as an individual regardless of their cognitive or physical abilities. To read the entire blog and more on Maria Shriver’s site, click here