Green House Team Presents to Osher Lifelong Learning Institute (OLLI) at California State University Long Beach

By / Posted on May 14th, 2016

IMG_1646Green House team members were honored to share their wisdom and insight about the Green House model on the evening of May 11th— the presentation was part of the Successful Aging Lecture Series, a program made possible through the generous donation by Lori and Don Brault.

CU Claire

Green House Project Guide, Claire Lucas moderated the panel of staff from Mt. San Antonio Gardens in Pomona, California.  A large group of interested community members were eager to learn about the model and to hear the special stories from the team members.

Andrea Tyck, Diana Marohn, Amanda Phos & Mary Jean Neault shared personal experiences working in the Green House homes.  Mary Jean was able to share her insight both as a staff member and former family member.  The audience was touched by their stories and eager to learn more about Green House homes, as evidenced by the swarm of people who stood in line to talk to staff from Mt. San Antonio Gardens after the program!

Osher Lifelong Learning Institute is a national organization that offers widely varied courses of interest to persons 50 years of age or older.  There is no academic prerequisite for admission or to participate in the classes, just a desire to learn.

California currently has two Green House Project homes in the state.  We are hopeful with California’s plans to release new “Small House Regulations” that many more will be built in the future!


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.


The Green House Project: From Tupelo to California, Oh How Far We've Come…

By / Posted on June 7th, 2013


On the Frontline: Randy Stoll and Mt. San Antonio Gardens

By / Posted on May 21st, 2013

Randy Stoll once watched a woman on staff wash a wall in the skilled nursing facility where he’s the president and CEO. He noticed how she washed—from the bottom up. Smart, he thought, that way there are no drip marks. But what he really noticed was that she was wearing high heels. She wasn’t a housekeeper—she was a director—but she knew how to do every job.

Randy knows about this. Not the drip marks maybe, but the idea of a versatile worker—everybody being able to do everything, everyone being responsible. While he’s currently the president and CEO of Mt. San Antonio Gardens, a Life Care senior community in Southern California, he started off in a completely different place and got there via a different route. Some people come up through academic programs in administration, which Randy would eventually do, but first, he worked at a hospital.

“My dad was a stickler,” he said. “When I quit college he told me to go get a job, so I did—first as an orderly—and I loved it. I was serving the patients—they were my customers, not the hospital.” Eventually he became a housekeeper, a supervisor, and then a director. And after doing almost all the jobs that he could within the hospital, only then did he go back to school in administration—another versatile worker.

Today Randy oversees an entire team of versatile workers at Mt. San Antonio Gardens, a senior community in Pomona, CA. This summer, the Gardens will open the Evergreen Villas—the first Green House retirement homes ever built in California.

“The Gardens has always been a ‘resident-driven’ community,” he said. “I inherited that when I came on board in 1995. There have been six residents on the board for years.”

And over time, the Gardens did everything they could to keep up with that ethos—remodeling social spaces and common areas, putting in flat screen TV, hiring skilled nurses and training the staff thoroughly and ethically—but the traditional medical-model skilled nursing facility just doesn’t lend itself to providing person-centered care that would be attractive to elders. Randy knew there had to be a better way.

Having tried all they knew, some key stakeholders visited the first-ever Green House home in Tupelo, MS. Intrigued by the model’s promise, they then sent five residents with a board member to visit The Green House homes in Lincoln, NE to gather information and stories about the concept. Everyone came back wanting to bring this model home to California.

“Green House homes gave us the best chance of surviving without creeping back to the old way of doing things,” Randy said. “The Green House Project provided the philosophical framework and the extensive training and support we needed.”

Green House consultants also shepherded Mt. San Antonio Gardens through regulatory and legislative processes by calling state senators and seeing it through to approval.

Randy knew that The Green House model would help the Gardens improve upon the delivery of their core set of values which are built on the principles of person-driven care. He knew it could be a complete culture change. They all knew. But Randy also understood that while the residents would approve it, and that eventually he would get the state to approve it, he also wanted something else.

“The CNAs, the front-line caregivers,” said Randy. “They’re the ones who are really there at the end of life. They’re the ones who should be enabled to be advocates for the residents.”

It took over two years to get it pushed through the state, and during that time, five housekeepers went back to school to become CNAs at the new Green House home. Instead of the director of housekeeping being upset that 25% of his housekeeping workforce were transitioning to the new homes, he knew that if the employees wanted to be there, that it would make a difference to the residents. In fact, he threw a party for them and invited the residents.

“ Isn’t it nice that my favorite friend will be there to care for me?” Randy heard one resident say.

Continuity of care is part of the culture. Everyone on staff at the Evergreen Villas were employees at Mt. San Antonio Gardens. And that’s just one of the reasons Randy says that from an operational standpoint, The Green House approach costs the same to operate as the model it is replacing, not including depreciation. “But we didn’t do it for the money,” he emphasizes. “We did it for the residents and staff.”

It goes both ways, as the residents have pitched in, privately donating over $1.3 million to the Gardens—not a couple lump sums, but a bit from each of the 400 residents currently living there. They knew they were all working towards something good. Something that should be universal: Real care.


Visiting Mt. San Antonio Gardens, A Reflection on The First Green House Project in California

By / Posted on March 28th, 2013

Visionary leader Randy Stoll, CEO of Mt. San Antonio Gardens, and his dedicated team have been toiling away for years to navigate California’s complex regulations in order to introduce the very first Green Houses to the state. As we toured the construction site, you could see the home taking shape – the fireplace, the kitchen, plenty of windows and the 10 bright, private bedrooms with private baths and showers. At the end of the tour I thought – the day the elders move in, these two homes will immediately become the top two places to receive skilled care in the state.

I felt a great sense of relief to see Green House homes under construction on the campus of Mt. San Antonio Gardens. After all, I have been a licensed Administrator in the state of California since 1989. We have over 1,150 licensed Skilled Nursing Facilities here – more than any other state. In California, many well-intentioned providers are struggling to deliver high quality care and service to over 100,000 people each day. The typical setting is an old institution with 2, 3 or 4 beds per room with an adjoining single bathroom (one sink and one toilet for 4 – 8 people to share). Speaking from experience – we paint the walls, we buy new beds, we add flat screen TVs, but…at the end of the day, it’s still not the place we would want for our loved ones or ourselves.

 

I am grateful for the leadership team at Mt. San Antonio for making this happen. California needs to see this. When The Green House homes open this spring, California’s providers, regulators and policy makers will see the future of skilled nursing care. It represents a radical change from what we are all used to, because, these Green House homes are the places that we would want for our loved ones or ourselves.


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!


Clinical Support Spotlight: April is Occupational Therapy Month

By / Posted on March 28th, 2012

What do National Peach Cobbler Day, Thomas Jefferson’s birthday, and Occupational Therapy (OT) Month have in common? If you guessed that they’re all celebrated in April- you’ve got it! While delicious cobbler and our former president are by no means insignificant, The Green House® Project is particularly eager to acknowledge the OT profession and the dozens of clinical support team members that support growth and meaningful lives for Green House elders each day of the year.

In What Are Old People For?, Dr. Bill Thomas identifies habilitation as “the effort to bring forth existing but latent potential within a person or group of people. It is distinguished from rehabilitation– a term that presumes a defect to be rectified or a brokenness that must be prepared.” Similarly, the American Occupational Therapy Association (AOTA) defines the OT profession as one which “helps people engage in living life to its fullest.”  With parallel efforts to reframe society’s declinist perspective on aging, it isn’t surprising that many Occupational Therapy practitioners are drawn to the holistic, person-centered approach supported by the Green House model.

Andrea Tyck began her career as an OT Assistant and is currently the Wellness Director and future Green House Guide at Mt. San Antonio Gardens in Pomona, CA. “Amidst the loss that elders face, our role is to help people move forward- to see beyond loss and support continued growth,” says Andrea.

Andrea Tyck began her career as an OT Assistant and will be the future Green House Guide at Mt. San Antonio Gardens

 

Just as Eden Principle #6 recognizes that “meaningless activity corrodes the human spirit”, Occupational Therapy is designed to support activities that are meaningful and purposeful for each individual. “Occupational Therapy is not just about enhancing function,” explains Andrea, “but it is supporting development for a larger purpose. In deeply knowing individual interests and rhythms of the day, OT interventions are more effective at meeting personal goals.”

While long corridors, tight schedules, and departmental silos can serve as barriers in traditional long-term care “facilities”, the Green House model is designed to support individual growth in an environment that is more than homelike– it is home. Opportunities for purposeful activities abound in a small environment that supports intentional community and meaningful engagement. What better reason to maintain or regain abilities at mealtime than the smell of a home-cooked meal and an opportunity to share convivium with your friends and family? This month, be sure to set an extra place at the table and show appreciation for the role of Occupational Therapy practitioners as care partners, mentors, and cheerleaders for elders, staff, and families. (You might as well celebrate with peach cobbler for dessert, while you’re at it!)

For more information, visit the American Occupational Therapy Association