Green House Blog

End of Life Experience in Long Term Care

Providing pain and symptom management along with religious, spiritual and emotional support can create the conditions for a good death.  In order to do this, a deep knowing of the individual is paramount.  But too often in skilled nursing settings, this is not the case.

In fact, a recent survey by Centers for Medicare and Medicaid (CMS) has found that traditional nursing homes were lowest ranked for end of life care experience when compared with home care and hospital settings.  The survey is a pilot right now but it will be officially launched by CMS in 2015 in an effort to provide better information to elders and their family members about hospice programs in their area.

The Green House model creates environments that support a meaningful end of life experience.  The Green House “home for life” philosophy, combined with the small number of elders in a home, and consistent staffing, leads to deep relationships.  In this setting, as an elder nears the end of their life, their desires and preferences are clear and respected.  End of life care is a time of honor and reverence in The Green House model.  Read this granddaughter’s experience at Tabitha Health Care in Lincoln, NE.   The Green House Project has placed an emphasis on end of life care, and has worked with adopters of the model to develop resources and guidance for the end of life that respect the needs of the individual, other elders in the home, support staff and families.

 

 

7th Eden Alternative International Conference: Green House Staffers Present on a Wide Variety of Culture Change Issues

The Eden Alternative is celebrating 20 years in 2014!  So, the conference last week was time for a celebration and a chance for thought leaders and partners from across the country to share their knowledge and experience with conference participants.  Below are highlights from just a few of the sessions led by Green House team members.

Bringing Eden Alternative Principles to Hospice: Treading New Ground

Person-centered care can be a powerful differentiator in competitive hospice markets.  The Eden Alternative Philosophy can help hospices deal with financial realities like the increased focus on efficiency dictated by Medicare reimbursement cuts, as well as the employee stress and dissatisfaction caused by these changes.   It’s also an important way for hospice organizations to demonstrate to staff that they remain focused on their clients and mission, despite the economic challenges.

That was the message from the session entitled: “Bringing Eden Alternative Principles to Hospice: Treading New Ground” presented by Project Guide, Claire Lucas, of The Green House Project.  While the basic concepts remain consistent across the care continuum, there are unique challenges incorporating person-centered care in the surprisingly medically focused hospice environment.  One challenge is that Elders are located remotely.  Another is the short duration of typical hospice care, with most ranging from just a few days to two weeks.

The Eden Alternative philosophy encourages hospice providers to enrich their visits, and add more value.  Focusing on simple pleasures, activities and hobbies, and reminiscing are a few ways to keep the focus on the person.  Other ways to enhance home hospice visits include aromatherapy, comfort touch and music.

Well-being and the Empowered Workforce: Respect, Relationships, and Growth

The key to empowered staff is coaching leadership according to Project Guide, Marla DeVries and Director, Susan Frazier of the Green House Project staff.
Empowered Staff is the “human architecture” of the Green House home explained Frazier.

In the Green House model, the CNA role is replaced by a versatile worker, called a Shahbaz .  They are part of a self-managed work team – a team that is respected for its proximity and deep knowing of Elders.  A central component of an empowered workforce is coaching leadership, creating empowerment conditions and always “educating, educating, educating.”  “While traditionally a leader is focused on managing people,” said DeVries, “coaching leaders must embrace people.”

With an empowered workforce, the focus is no longer about care-giving, but about care partnership – how staff works together.  Clinical support team staff members do not come in to deliver a solution, but to support staff and to work as a coaching partner.  While working as a mentor and an educator, a coaching leader must balance support and accountability with team members.

A Community-based Green House Approach: Development Goals, Opportunities and Outcomes

There are unique benefits available to providers and developers teaming up to provide healthcare via decentralized community-based approach.

Using the nation’s first community-based Green House project as a case study, Susan Frazier and SWBR Architect, Rob Simonetti, expressed that incorporating senior living options like Green House homes into residential developments is a win-win.  Elders benefit because they’re not segregated from the community, living in a real home, with a normalized environment and routine, and being part of a real community.

Incorporating Green House homes into developments also benefits the developer.   It enhances community support and helps them achieve construction efficiencies.  It’s also a significant market differentiator – the Green House model is very attractive and seen as a positive addition to a development.  “Green House homes make it easier for developers to sell market rate housing,” according to Simonetti.  Part of the attraction is buyers who are anticipating a future need, either for themselves or a loved one.