Green House Blog

Green House homes in Florida are Supporting Elders to Live their Best Life

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
  • Advocacy

 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.

 

 

 

A Memorable Welcoming Ritual Creates Warm Feelings for Elders and Staff

 

Jemi Mansfield is the Guide for The Green House homes at Cedar Sinai Park, and the Director of Spiritual Life for the organization. Cedar Sinai Park opened their first Green House home in July 2016, and the self managed work team created a beautiful welcoming ritual to make sure that the elders felt special and loved as they moved into their new home.  The below story is an account of what can happen when a team is empowered to make decisions that bring value to their role, their home and those whose lives they touch.  

Right from the start, the self managed work team (called shahbazim) in our Green House home knew they wanted to have a small gift waiting in the bedrooms as the elders moved in – something special and personalized to really make it feel like home. Jane, a shahbaz,  recalled that when she and her husband went away for their 40th anniversary the hotel surprised them not only with champagne and

The Infamous Dollar Tree shopping trip

chocolates in their room but also a banner hanging in the lobby. “It was unexpected and so touching,” she said. That and similar experiences shared by others laid the foundation for a gift bag filled with goodies awaiting residents. A list of personal care items was compiled: shampoo, lotion, toothbrush and paste, shaving gear for the gents, etc. – and the Shahbazim took off on an impromptu shopping trip to Dollar Tree, which was a highlight for Carol during the practicum weeks. “I liked that we worked together to plan the list and then shop,” she said. “Nothing went into the basket that we didn’t all agree upon – a real team effort.” They also bought welcome cards, which were personalized for each resident and signed by the entire team. On July 25th, move-in day, each gift bag was festooned with a cheery balloon and placed in a prominent spot alongside an African Violet plant for each resident: a reminder of the roots of the Eden Alternative to bring living things into each home.

Everyone knew that the goodie bags were going to be a hit, but the star of the welcome gifts is really the blanket. Jane had hit upon the idea during a brainstorming session – that each resident should be given something uniquely theirs to keep and enjoy in the house. She suggested a crocheted lap blanket, made by volunteers. The group jumped on the notion immediately but acknowledged that, at less than two weeks to opening, they faced a lack of time to pull together a project of this size. Nicole, a member of the self managed team,  mentioned that her son, who has autism and touch sensitivity, has a favorite type of blanket that she buys at Costco. “It’s beyond soft,” she explained. “It offers him comfort and warmth, and that’s what we want our residents to experience.” She brought in a sample the next day, and the group of Shahbazim were sold: it truly was the softest blanket in the world.

Edith with her personalized blanket The finishing touch was to personalize the gift. Each resident’s blanket was embroidered with his or her first name and the date of move in: July 25, 2016. The blankets were presented to the elders by the Shahbazim at the first dinner, as they enjoyed “convivium” (good food with good company) around the big table where meals are served together. Tony, a shahbaz,  created a lively atmosphere as he led all in a boisterous round of the “Name Game”, welcoming each elder to their new home.

lively atmosphere at the dinner tableAs new residents eventually move in, they will receive their own blanket, emblazoned with their name and move-in date to denote their place in the household. As Alisa, another shahbaz, pointed out, “This is a fresh start for our residents. A new setting, a new chapter, a new home. It’s right that they should start this chapter with something new and truly theirs.”

In the days that followed, we received a sweet note from Maureen, whose sister is among the first residents (the Alpha House Twelve, we lovingly call them). The note reads, “To all you dear people who gave Pam such a wonderful welcome to her new home. Last Monday, July 25, was a red letter day which we will always remember when we look at her beautiful new blanket and all the lovely bag of presents, card, balloon and flowers. Thank you from the bottom of my heart for all you do for Pam. You are truly wonderful!”

Learn more about Cedar Sinai Park>>

 

Pioneer Network Highlights The Green House Project as Thought Leader

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Rhonda Wolpert, Rob Simonetti and Debbie Wiegand share Design Lessons Learned

The Green House Project was highlighted as an innovator and thought leader during the 2015 Pioneer Network Conference.  The Pioneer Network is a convener of organizations who are moving away from institutional models of long term care to more consumer-driven models that embrace flexibility, self-determination and a belief that elders are meant to thrive.  During the stimulating days of educational sessions, representatives from the national Green House initiative, and Green House organizations from around the country spoke on various topics to help move the field forward.

Debbie Wiegand, Rhonda Wolpert and Rob Simonetti shared design lessons learned in their session, “Build This, Not That, Lessons Learned from a Decade of Green House Experience.”   Since the first home opened in 2003, there have been variations in layout and design. Through a formal Design Survey, The Green House Project asked every Green House adopter what works and what doesn’t for building design and regulatory challenges, and what strategies worked to overcome perceived regulatory code barriers. Also, insights from newly completed THRIVE research help us understand how the design contributes to sustainability, from operating cost and quality of care perspectives. Listen to this webinar that Debbie and Rob did to help those interested in changing the paradigm of long term care, build environments that support a new way of life.

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Cheryl VanBemden, Marla DeVries, and Susan Frazier take us into the “black box” or Green House

Susan Frazier, Marla DeVries and Cheryl Van Bemden took audience members “Into The Black Box of Green House homes”.  Here they talked about the impact of decision making to reinforce or erode culture change. Utilizing new insights from The Research Initiative Valuing Eldercare (THRIVE), a collaborative of top researchers created to learn more about what contributes to higher quality in nursing homes, this session explored the factors impacting problem-solving in long-term care organizations that lead to reinforcement or erosion of an empowered workforce, and person-centered models. Participants explored the four factors that the research determined to most greatly impact sustainability, while discovering organizational strengths and growth opportunities to create a slip-resistant change.

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Tammy Marshall, Mirian Levi and Lori Grossman from Jewish Home Lifecare

Tammy Marshall, Lori Grossman and Miriam Levi shared their experience of implementing person-centered care principles across Jewish Home Lifecare, a large organization with multiple sites.  Tammy Marshall facilitated a second session with Sonya Barsness.  They spoke about the importance of research to support “culture change” and “person-centered care.” They shared research that is being done at Jewish Home Lifecare, and how others can access research, translate it to those who need it most, and identify opportunities for additional research.

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Marla DeVries speaking about Research and Sustainability

Finally, the team from Lutheran Homes of Oshkosh shared a special session called, “Honoring the Spirit Within Through Namaste Care: An End-of-Life Program for Persons with Dementia”.  Namaste Care takes its name from the Hindu word meaning “to honor the spirit within.” The program was developed for elders with advanced dementia and strives to maintain their highest quality of life. It includes simple and practical ways for care partners to create opportunities for connection, meaning, and joy.

This conference is always an energy boost, knowing that the movement to transform long term care, and what it means to age, is growing, evolving and gaining momentum.  The Green House Project is honored to be a leader of culture change and will continue to pursue evidence based excellence, that is based in deep knowing relationships, meaningful life and empowerment for all.