Anne Ellett is a certified Nurse Practitioner (NP) with more than 20 years of experience in elder living and memory care, and served as Sr. Vice President with Silverado Senior Living, an award-winning Assisted Living company specializing in dementia care. Currently, Anne is owner/CEO of Memory Care Support, LLC, a consulting agency working with senior housing professionals as they develop state-of-the-art health and wellness and memory care programs.
The Green House Project recognizes that providing a life affirming, dignified environment for elders living with dementia (ELWD) is imperative, especially given that over 80% of people living in long term care have some form of cognitive change. Supporting these elders to thrive is a multifaceted process, and involves culture change. Best Life is a new initiative, designed to support Green House teams, by building on the core values of Real Home, Meaningful Life and Empowered Staff, and providing enhanced education that focus on principles such as:
- Power of Normal – normalizing programs and environments
- Integration with greater community
- Celebrating retained abilities
- Dignity of Risk
- Age-appropriate interactions
- Elder-directed, relationship-rich living
I had the pleasure of delivering this guided process of implementation at The Woodlands at John Knox Village (JKV) in Pompano Beach, Fl. JKV is a wonderful location incorporating independent living, assisted living, a nursing community and 12 Green House homes onto one campus! Their 12 homes have barely been open a few months but the leadership at JKV has the desire to strive for excellence in helping those with dementia thrive. Educator, Dolores Hughes said, “We feel equipped with tools to implement immediately, and also challenged to see people living with dementia in a new way. Best Life is an eye-opening experience.”
BEST LIFE supports elders living with dementia (ELWD) to have choice and dignity, while living in the least restrictive environment possible. Often, restrictions are due to our own perceptions of the capabilities and interests of ELWD. Typically, we are trained to see the diagnosis first rather than the whole person, which can limit the experiences and choices we offer to the ELWD. For example, as a nurse, I was trained to label “patients” by their diagnosis, i.e., the hip fracture in Room ###, or the patient with Alzheimer’s in Room ##.
When we use labels to identify someone, that prevents us from seeing the whole person and instead we focus on their loss of abilities, “they’re not able to ______ (fill in the blank) because they are living with dementia, they would not be interested in doing ______ (fill in the blank) because they are living with dementia.” In BEST LIFE, we learn to look beyond losses and inabilities toward retained capabilities and emerging talents.
As professionals, it’s important to examine our own training in the traditional model which emphasizes the diagnosis rather than the person. Are we limiting the experiences we offer to ELWD? For example, are we restricting them, perhaps from our own bias and belief that we need to segregate ELWD for their own safety? New research shows that there is value in offering ELWD frequent experiences with the larger community and with younger generations.
BEST LIFE has three areas of focus: Culture, Meaningful Engagements, and Health and Well-being. An entire day is devoted to each of these topics, looking both at our own biases and misperceptions of ELWD, and also examining new research from around the globe on new techniques that are beneficial and increase choice and dignity for ELWD.
During the BEST LIFE workshop at JKV, one of the most poignant experiences was when the participants shared what they would want the shahbazim to know about them if they were living with dementia. Aside from details such as their favorite foods or activities, the participants overwhelmingly requested that they be enabled to continue to have fun and laughter, and opportunities to try new things, and also to continue to contribute and “give back”.
There are already stories of elders connecting with life in new ways, as a result of this new focus on retained abilities and strengths. There is an elder in The Woodlands who plays dominoes every day after lunch and loves to teach anyone else, and an individual who recovering in short term rehab and plays his harmonica. Knowing him is a priority, and his full personality shines! There is a new garden growing in another one of the homes—it is amazing how nature, growth and learning enhances well-being for everyone.