Green House Blog

Workshop Logistics: The Eddy Village Green, September 11-12, 2012

Greetings!

Thank you for your interest in THE GREEN HOUSE® Project.  This will confirm that you are registered for The Green House Project’s orientation workshop on September 11-12, in Cohoes, NY.  Please share this information with your colleagues.

Location – The Eddy Village Green

421 Columbia Street

Cohoes, NY 12047-2222

(518) 237-5630

General information and a list of hotels are included in the attached document.  Parking is free.

Hotels & Transportation

General Workshop Description:  This session will describe the key components of the model, including the foundational philosophy, the architectural characteristics of Green House homes, and the organizational redesign.  The presentation will include an update on the progress of The Green House Project, including tools for adopters and Green House research outcomes.  The workshop includes a visit to The Green House homes and discussions with the host team.  A preliminary agenda and The Green House Project Guide Book are attached.

Preliminary Agenda

THE GREEN HOUSE PROJECT Guide Book

Workshop Format – Two half-days

Day One:  12:30 p.m. – 5:00 p.m. (Lunch at noon)

Day Two:  8:30 a.m. – 12:00 p.m. (Breakfast at 8:00 a.m.)

Thank you for your credit card payment.

Please notify us in advance of any dietary requirements or accessibility needs.

The dress is business casual.

Please contact Aja Lawson or Maura Porcelli if you have questions.  Thank you.

Best regards,

The Green House Project Team

Aja Lawson
alawson@ncbcapitalimpact.org
703.647.2366
 
Maura Porcelli
mporcelli@ncbcapitalimpact.org
703.647.2311

Rhythms of the Day, Evening Time

Sometimes it’s not as complicated as it seems.  Sometimes it just takes a closer look at a situation and the solution might not be as challenging or impossible as we may believe.  “Sundowning” has long been a complicated issue for those who care for the elderly.  It is the term used to describe agitation, irritability, disorientation that some people with dementia experience during the late afternoon or evening.  But is it the dementia that causes the “sundowning”?  Eden Mentor, Dr. G. Allen Power, from St. John’s Home in Rochester, New York says “No” and offers a different perspective on the issue:

“Dementia simply “fans the flames” by making people (1) more sensitive to their environment, (2) more easily fatigued, and (3) less able to cope with having their biorhythms shifted into artificial schedules that better suit our nursing home operations.

This is a small distinction, but a very important one. Here’s why: We cannot cure dementia, but we can cure almost all cases of “sundowning” without medication, by shifting operational patterns and staff behavior.”

You may wonder if it could be that simple.  Dr. Power suggests that we take a look at the latest issue of the NYC Alzheimer’s Association newsletter which tells a compelling story about how a care home in Phoenix made just those changes and have been virtually “sundown-free” for over a decade.  Jane Verity, Founder and CEO for Dementia Care Australia, fully agrees with Dr. Power.  

“Sundowning is not a symptom of dementia. To me it is a symptom of an environment that does not feel like home. Our job is to make the place where people with dementia live – one of genuine kindness, love and compassion, where each and everyone has opportunity and is encouraged to contribute, feel needed and useful, have opportunity to care, self esteem boosted and the power to choose (which is different from having the ability to choose). As you write, the challenge for us is to shift focus from our routines and hurry to their emotional and spiritual needs. However the end result is so rewarding for everyone.”

Judy Berry, Founder of the Lakeview Ranch specializing in dementia care in Minnesota echoes the same message. 

Many times, in an effort to change a specific behavior, care partners try to distract or redirect the person without first validating the feeling or emotion they are trying to communicate. This devalues their feelings and often they become more agitated.  By making the effort to learn each individual’s lifestyle, developing a trusting relationship, respecting and validating their feelings and meeting their needs, most so called behavior is eliminated.”

Dr. Power encourages all of us to take a look at our teams and challenges us to create a more natural experience that honors the individual rhythms of our elders.  A great way to show that culture change not only improves the quality of life, but clinical care as well.  What better way for all of us to start out 2012!

Moving Day for St. John's in Rochester!!

REPOSTED

Visit the original post at ChangingAge.org

“But let there be spaces in your togetherness and let the winds of the heavens dance between you. Love one another but make not a bond of love: let it rather be a moving sea between the shores of your souls.”

Khalil Gibran

The above quote was posted today by Susan Thomas for St. John’s “Eden Quote of the Day”, in honor of the first three Elders moving into our community Green Houses in Penfield, New York. This is the culimination of an incredible journey for St. John’s Home.

It has been exactly a decade since I went to hear Bill Thomas give a talk in Utica about his latest thoughts about Elderhood. At that talk, Bill described his concept of “doing vs. being”, and his visions for “Eldertopia”.

In 2003, the first Green Houses opened in Tupelo, Mississippi. Our CAO, Veronica Barber went to visit them, and on her return she told our CEO, Charlie Runyon, “We have to do this.”

Then about four years ago, with the encouragement of former DOH Dormitory Authority Director Tom Jung and Assistant Health Commissioner Mark Kissinger, we decided to take one more very big step: we decided to bring Elders back to true community engagement, by moving off campus and integrating our Green Houses into residential communities.

This set off a series of twists, turns and setbacks that pushed us back a few years in our timeline, but what we leanred in that process about our vsision, our strengths and challenges, and about our Eden journey was priceless.

And today is the payoff as, for the first time in our nation, the first pioneering Elders move to a pair of small houses 11 miles away from the main campus, nestled in the multigenerational Arbor Ridge community. Guide Rebecca Priest has been the lighthouse for this journey and her group of shahbazim, nurses and other supportive care partners is truly incredible. Very soon after, the remaining 17 Elders, people with diverse needs and abilities, will follow.

So many people have put their hearts and souls into this journey that it is impossible to mention them all. In addition to the visionary leaders mentioned above, I must make a special note of Joanne Braunle, our Project Manager, who formerly worked on NASA contracts and showed us that culture change really is rocket science! The builders at Pridemark, architects at SWBR, and our pre-design work with Emi Kiyota all made incredible contributions to the beautiful, warm and functionally versatile houses we open today.

And of course, a huge thank you to The Green House Project, especially Robert Jenkens and Susan Frazier for their guidance and tireless advocacy, and to Bill and Jude Thomas and the Eden Alternative, who have helped shape our new vision of Elderhood that will truly be a game-changer in providing living options for Elders with skilled needs across the nation and beyond.

Way to go, St. John’s; my hat is off to you!!

Moving Day for St. John’s in Rochester!!

REPOSTED

Visit the original post at ChangingAge.org

“But let there be spaces in your togetherness and let the winds of the heavens dance between you. Love one another but make not a bond of love: let it rather be a moving sea between the shores of your souls.”

Khalil Gibran

The above quote was posted today by Susan Thomas for St. John’s “Eden Quote of the Day”, in honor of the first three Elders moving into our community Green Houses in Penfield, New York. This is the culimination of an incredible journey for St. John’s Home.

It has been exactly a decade since I went to hear Bill Thomas give a talk in Utica about his latest thoughts about Elderhood. At that talk, Bill described his concept of “doing vs. being”, and his visions for “Eldertopia”.

In 2003, the first Green Houses opened in Tupelo, Mississippi. Our CAO, Veronica Barber went to visit them, and on her return she told our CEO, Charlie Runyon, “We have to do this.”

Then about four years ago, with the encouragement of former DOH Dormitory Authority Director Tom Jung and Assistant Health Commissioner Mark Kissinger, we decided to take one more very big step: we decided to bring Elders back to true community engagement, by moving off campus and integrating our Green Houses into residential communities.

This set off a series of twists, turns and setbacks that pushed us back a few years in our timeline, but what we leanred in that process about our vsision, our strengths and challenges, and about our Eden journey was priceless.

And today is the payoff as, for the first time in our nation, the first pioneering Elders move to a pair of small houses 11 miles away from the main campus, nestled in the multigenerational Arbor Ridge community. Guide Rebecca Priest has been the lighthouse for this journey and her group of shahbazim, nurses and other supportive care partners is truly incredible. Very soon after, the remaining 17 Elders, people with diverse needs and abilities, will follow.

So many people have put their hearts and souls into this journey that it is impossible to mention them all. In addition to the visionary leaders mentioned above, I must make a special note of Joanne Braunle, our Project Manager, who formerly worked on NASA contracts and showed us that culture change really is rocket science! The builders at Pridemark, architects at SWBR, and our pre-design work with Emi Kiyota all made incredible contributions to the beautiful, warm and functionally versatile houses we open today.

And of course, a huge thank you to The Green House Project, especially Robert Jenkens and Susan Frazier for their guidance and tireless advocacy, and to Bill and Jude Thomas and the Eden Alternative, who have helped shape our new vision of Elderhood that will truly be a game-changer in providing living options for Elders with skilled needs across the nation and beyond.

Way to go, St. John’s; my hat is off to you!!

Green House Living for Sheridan Opening Celebration

Remarks of Robert Jenkens, Director, The Green House Project at The Green House Living for Sheridan opening celebration on 2/27:

It is a real pleasure to be here today to offer congratulations to The Green House Living for Sheridan team and board, from The Green House Project, NCB Capital Impact, and The Robert Wood Johnson Foundation.

The Sheridan Green House project is the 29th to open in the United States. This is a significant accomplishment for any organization and it puts Sheridan’s efforts squarely in the pioneering group of Green House adopters.

It takes skill, hard work, and courage to be among the first of a radically new approach. But it takes audacity and vision to take on a transformative innovation as a start-up community led organization. The Green House team has talked to many citizen groups interested in bringing the Green House model of skilled nursing home care to their community. All of these groups have the passion for change, but very few are able to bring this model to fruition.

When I first met Doug, Carmen, and Keith at the Green House workshop in Tupelo, MS in 2006, I knew they represented a group who could succeed. The first sign I had was that they walked right up to the front of the room and took up positions directly across from the podium. Nobody has done this before or after.

The second sign was the questions they asked. Despite being surrounded by experienced nursing home CEOs, CFO’s, and DONs, they were not intimidated. Their questions were intense and smart.

The third sign was the emotion in their eyes. Their commitment to bringing a new long-term care choice to the people they cared passionately about, their friends and neighbors in Sheridan, was clear. It was obvious to me that very little was going to stand in their way. I assume that audacity is a Wyoming trait?

And so it is with the deepest gratitude that I thank The Green House Living for Sheridan Board, Team, and community for a culture of audacity that has made you such good partners to The Green House team, NCB capital Impact, and the Robert Wood Johnson Foundation. Congratulations again for the skill, perseverance, and sacrifice that were necessary to convert your passion into the first community-led skilled nursing Green House homes to open in the country.

Free McKnight's Long-Term Care News Webinar: Reducing Avoidable Hospital Readmissions: An Opportunity for SNFs

Sign up for this free webinar on Thursday, March 15th at 1 p.m. EST/10 a.m. PST, to learn:

  • Why readmissions are a pressing issue for all healthcare providers
  • What critical role SNFs play in preventing hospital readmissions
  • What SNFs can do to reduce hospital readmissions

Register now or visit www.mcknights.com for more information.

Free McKnight’s Long-Term Care News Webinar: Reducing Avoidable Hospital Readmissions: An Opportunity for SNFs

Sign up for this free webinar on Thursday, March 15th at 1 p.m. EST/10 a.m. PST, to learn:

  • Why readmissions are a pressing issue for all healthcare providers
  • What critical role SNFs play in preventing hospital readmissions
  • What SNFs can do to reduce hospital readmissions

Register now or visit www.mcknights.com for more information.

Thrive Research: Guidelines for Reducing Risk Levels

There are different types of research, and some are riskier than others.  Take the study of new medications, for example.  While a medication is tested for safety before people are asked to participate in a study to see how well it works, there might still be unknown risks to taking it and it’s not certain that the medication will be effective.  Some other types of research are very low risk, including studies that learn new things by watching people and asking them about care practices – both of which describe the THRIVE study that is learning about Green House homes and different models of nursing home care. 

To keep risks as small as possible, all research studies must follow guidelines.  Even low risk studies where researchers are simply watching people and asking questions must follow guidelines.  To make sure that researchers follow the guidelines, every study must first be reviewed and approved by an Institutional Review Board (or IRB), sometimes referred to as an ethics committee. 

A few of the rules that must be followed include:

 

  • Respect for people participating in studies.  This means that people must be volunteers and not feel coerced, and must consent (often in writing) to participating.  There are special rules to protect people who have trouble making their own decisions (such as children or people with advanced dementia).  Respect for people participating in studies also includes protecting confidentiality.  For example, researchers aren’t allowed to tell anyone the identity of who participated in a study. 
  • Beneficence.  This fancy word means that there must be a possibility that the research will benefit society, and that it will not harm society or the people participating.  When there are risks to taking part in research, the potential benefits must outweigh the risks.  A good example of beneficence is when a new drug might have some risks and side effects, but might also have the potential to cure cancer, so might be worth the risk.
  • Justice.  Research should benefit as many people as possible.  This means that unless there is a good reason why some people can’t or shouldn’t be in a research study (such as a study about pregnancy which might justifiably exclude men), everyone should have the right to participate in, and possibly benefit from, research.

All research conducted by the THRIVE collaborative has been reviewed and approved by an IRB.  Approval for THRIVE has been pretty easy, as THRIVE is a low risk study. THRIVE is collecting information to learn about existing components of care and resident status, to understand specifically which types of care are better care. We expect to learn ways to improve care, which will benefit all of us.

Questions about THRIVE can be directed to Lauren Cohen (lauren_cohen@unc.edu or 919-843-8874).

The THRIVE research studies are funded by the Robert Wood Johnson Foundation.

Partnering with Regulators for a Better Future in Long Term Care

Is there a time where you found institutional rules and practices getting in the way of an Elder’s quality of life? Have you ever wished you could ask CMS a question to gain clarity on how to best serve an Elder while meeting the regulations? If so, stop rubbing that genie bottle because your wish has been granted!

Earlier this morning, deputy division director for the Nursing Homes Division at the Centers for Medicare & Medicaid Services (CMS), Karen Schoeneman ,challenged us all to brainstorm questions we have around culture change.  In her role with CMS, Karen and her team administer the long-term care survey process, the interpretive guidelines and the Quality Indicators Survey process. In addition, Karen and her colleagues commit to publishing a Q&A letter that tackles hot topics in culture change.

As champions of The Green House model and the appreciative inquiry approach, what would you like to see addressed in their next publication? (Don’t worry about Life Safety Code, as that issue is being addressed in a separate response.) We’ll collect all of your thoughts and send them to Karen ASAP!

Coaching Supervision: Introductory Skills for Guides and Directors of Nursing Services in THE GREEN HOUSE® Project; October 16-18, 2012

Coaching Supervision: Introductory Skills for Guides and Directors of Nursing Services in THE GREEN HOUSE® Project is a centralized, multi-site program (Guides from multiple organizations will attend together at The Green House central office in Arlington, Virginia.)  This training prepares Guides for their role as the supervisor and coach of the SMWT and prepares DONs for their role as the supervisor and coach of the nurses.  The major areas of content are:

  • Working with team members to identify strengths and concerns
  • Reaching mutual agreement solutions
  • Engaging the team in identifying solutions
  • Applying the key skills of coaching: self-awareness, self-management, active listening and presenting the problem
  • Offering support, while holding the team and its members accountable for agreed-upon actions
Fill out my online form.

Logistics: October Guide Training October 16-18, 2012

Hello Colleagues!

THE GREEN HOUSE® Project is pleased that we will have such a wonderful group participating in our Coaching for Supervision training on October 16-18, 2012.  See below for updates in the logistical planning for our three intensive days together:                        

1.    Hotel Information:

We requested a group rate for a block of rooms at Hampton Inn & Suites Reagan National Airport.  There is no obligation to stay here, but in order to receive the discounted rate, you are responsible for making your own reservation with the hotel by March 9, 2012.

Hotel Address:

Hampton Inn & Suites Reagan National Airport
2000 Jefferson Davis Highway • Arlington, Virginia 22202
Phone: (703) 418-8181 • Fax: (703) 418-4666                                   

Contact Info: Robin Highfield

Room Block Name:  The Green House Project (be sure mention when making reservation)

Rate: $149/Night (Breakfast buffet is included daily)

2.   Flight Times: Please take into consideration your flight times.  If you are going to try to fly home on Thursday night, let’s work together so that we can plan our training schedule accordingly.  We strongly recommend that you fly in on Monday evening before training April 10, 2012 and leave on Friday morning April 12,2012, so as not to impede on the intensive training schedule. Please provide us with your flight and hotel information when your arrangements have been made.

  **Also, note that Reagan National Airport (DCA) is the most convenient airport to The Green House office.  From Dulles (IAD), or Baltimore-Washington International (BWI) you will have to either rent a car, or plan extensive time for public transportation.

Highlighting The Green House Project Team: Melissa Honig

Melissa Honig, Project Guide with The Green House Project since 2007

It was the simple act of delivering a cup of water to an elder in a nursing home when Melissa was 12 years old that launched her life’s journey to make the world a better place for elders. 

Melissa and her sister were visiting their Great Grandmother at the nursing home, running around trying to be helpful, when Melissa came upon an elder that wanted “just a cup of water”.  The elder was so extremely grateful when she returned with the water, that it left a significant impression on her—Melissa felt more could be done to make life enjoyable for those in nursing homes.  Thus, began her career to transform long-term institutional care and challenge conventional attitudes towards aging.  Melissa joined the Green House team in 2007 as a Project Guide, and possesses talent and expertise in a variety of areas.

  • Master’s degree in Health Services Administration, with an undergraduate degree in Health Services Administration with a concentration in Gerontology
  • Licensed Nursing Home Administrator
  • Eden Alternative Associate & Mentor
  • Six years of experience in a variety of positions at CCRC’s
  • Culture Change keynote speaker/presenter
  • Laughter Yoga Leader – teaching therapeutic coping skills

Today Melissa imparts her knowledge and guidance to 13 different long term care organizations building or developing Green House homes.  She likes to surround her office area with quotes and messages about making the world a better place, like this one from Eleanor Roosevelt:

When will our consciences grow so tender that we will act to prevent human misery rather than avenge it?

Melissa also loves hiking in national parks, running on the national mall, and traveling the globe with her family!