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“I keep telling people, medicine & nursing are how we keep people alive, life enrichment is WHY we keep them alive.”
That’s what Pamela Atwood, M.A., CDP, of Hebrew Health Care in West Hartford, Conn., said about their Life Enrichment Program recently.
What exactly is Life Enrichment? Well I think it’s best to let Pam explain it herself:
When our Director of Recreation left this year, our CEO, Bonnie Gauthier, decided to restructure the departments. This would enable us to improve the quality of our programming, innovate our approach to recreation on many levels, and integrate some of the expressed wishes of the residents and families. From this restructuring Life Enrichment was born.
You’re probably wondering why change the name of the program from “Recreation” to “Life Enrichment.” Well, recreation can sometimes seem like it’s simply playing games or busy work.
Life Enrichment takes us beyond games, focusing on the LIVING that our residents are still doing. It allows for all of the things that encompass culture change and is centered around what our residents are interested in, such as plant care (our tomatoes stretch to the ceiling of our greenhouse!); pet care (ask us about our unannounced donation of fighting betas); events from a high school reunion to computer classes; and opportunities for those who prefer solitude, or to party, or anything in between!
It’s utilizing our youth volunteers to enrich the lives of our older adults, creating opportunities for generativity, to learn about the “world wide web” or just enjoying a visit while strolling the grounds. It’s laughing at the pet therapy Golden Doodle named Cooper while he tries to get the tennis balls on the bottom of the walker (of a resident with the same name!). It’s a cup of tea and a hug when someone feels she has no place to go on her nursing unit that is “her space” (even though we might disagree…). It’s completely spoiling every resident every day! Mostly, it’s creating opportunities for our residents, families, and staff to connect in a non-clinical way. It’s not about what’s killing us, it’s why we’re alive!
To find out more about the Life Enhancement program at Hebrew Health Care, click here. To find more examples of the good work AAHSA members are doing, click here.
What stories do you have about your innovative care and services?
Nursing homes made the front page of today’s Wall Street Journal, but the story wasn’t a scathing expose or a blurb on a new regulation. Rather, this article took an honest look at the possibilities, as well as the challenges, that face nursing homes as they strive to put the “home” in nursing home.
The story’s protagonist was a man named Bill Thomas. Thomas is a 48-year old physician who is known for developing the Green House care model. Unlike other nursing homes, elders in Green Houses live among 10 to 12 of their peers in small, homelike accommodations. The first Green House was built seven year ago in Tupelo, Miss. Today, there are currently 41 houses in 10 states.
Thanks to the Robert Wood Johnson Foundation, that number may soon be going up. The Foundation recently pledged $15 million dollars over five years to NCB Capital Impact, a not-for-profit organization that is offering technical assistance help to any party interested in operating a Green House.
Money aside, building a Green House isn’t without its challenges. Take regulatory issues. Nursing homes are some of the most highly-regulated institutions around. There are “life safety” rules intended to keep residents safe, “physical plant” standards that deal with building codes along with health-care rules, food preparation guidelines and general quality of life standards. Some nursing-home executives argue such rules can make it difficult, if not impossible, to establish a Green House’s homelike environment.
Plus, the concept often faces resistance from nursing home administrators and staff who’ve grown accustomed to the traditional model. I saw this resistance first hand during a screening of Almost Home, a documentary about culture change. In it, a head nurse complained that these kinds of models make it “so much harder” to do everyday tasks like distribute medications or serve meals.
So what is AAHSA’s take? We support the organizations that are implementing Green House model, but we don’t think there’s a “one size” fits all approach to transforming America’s nursing homes. Eliminating designated meal times, having consistent staffing and making minor modifications to a home’s physical structure can all promote better nursing home care. In fact, our web site features whole section devoted to tips and tools that can help our members offer nursing home residents the services they need in a place they can truly call home.
I’ve been watching with interest TIAA-CREF’s new advertising campaign, the powerof.org. TIAA-CREF is leveraging its status as a not-for-profit provider of financial services to draw a distinction for customers. Their point is that because they are a .org, people should trust their motives and mission. I think this is an excellent model for aging services providers to embrace. Over the last couple of months, I have asked several AAHSA members how they use their not-for-profit status in their marketing, and the answer often comes back that they just haven’t figured out how to do so. Some who have done market research find that potential residents and clients like the values that being not-for-profit convey, like being focused on people over profits, dedicated to staff, and stable for the long-term. Do you accentuate your not-for-profit status in your marketing materials? If so, I’d love to hear about it. I’m leading a session at our Annual Meeting on this topic and would be delighted to feature your efforts.
Check out TIAA-CREF’s Web site at www.powerof.org.
Congratulations to Morningside Ministries of San Antonio, for some wonderful media coverage in the San Antonio Express-News about their advances in design for the aging. Though senior-friendly design and home-like environments are old news to most people working in aging services, we have a ways to go before the media and the public understand that living in a senior housing community doesn’t mean living in a hospital. Every story like this one helps break down old stereotypes of what growing old means for where you live and how you think. We like to see all the coverage like this that’s out there.
What are you doing to tell your story through the media?
In my letters to you, I usually tell the stories of how AAHSA members are working hard to create the future of aging services. Today is different. This letter is about how AAHSA member organizations are showing, and telling, their story in a new way.
Eliza Bryant Village began in 1896 as the first nursing home for Cleveland’s African-American seniors. Today, the organizations continueto live that mission under the leadership of their CEO Harvey Shankman. He and his dedicated staff work hard to ensure that residents like Mary Lou Williams can enjoy her daily walk and the “good food” in the dining room. But there I go storytelling again. Watch and hear from Mary Lou herself.
Take seven minutes out of your day and YouTube with Harvey (http://www.youtube.com/watch?v=OJ5CQiUOzns).
In our increasingly complex media world, YouTube is a fantastic way for non-profit providers of aging services to tell how you live your story. Let me know if you already have a “YouTube story” of your own to share.
Larry
We had better know how to connect with consumers. Our scenario planning document, “The Long and Winding Road,” shows that consumer behavior is one of the two biggest uncertainties for the next decade. (The other is talent availability, which will be addressed in another letter.) What will consumers need? Want? Expect? Will the people be available to provide the services the market needs?
I’d like to comment on consumer connections in two dimensions: the science and the art of understanding and responding to basic human needs in our work. I’ll spend more time on the art because there is an abundance of resources on the science.
Of course, market studies are now an essential part of strategic planning and day-to-day management of current and future service. Regular, daily consumer feedback and response are rapidly becoming the norm, and the ability to analyze that information to generate effective and satisfying consumer service may be the most important management work we can do. There are numerous tools and business friends that can help with the most important driver of our work: understanding perceptions of the people we serve and those who serve them. The science of marketing is complex, but we must master it.
While the razzle-dazzle of marketing science is increasingly critical in our increasingly sophisticated work, I hope we can remember the fundamentals of the art because the fundamentals continue throughout our ongoing service relationship with the people who call on us to help them. This hit home to me recently through a colleague with a mother in crisis. Demented, frail, combative, falling apart, this elder went through a saga that began in an assisted living facility and continued through hospitals, nursing homes, a mental health unit, a rehab facility and a home health agency. My friend and her sister went with her. You know from your own experience that this typical family predicament is difficult in the best of conditions.
As my friend reflected on the situation, she said, “Maybe I’m expecting too much…” I picked up on that statement, perhaps thinking she and her sister were unrealistic—wanting cure where there could be none, wanting an idealistic relationship with their mother that will never exist again, wanting restoration to health where irreversible damage has taken its toll. So I asked her, “What did you expect?” She had no trouble in responding — these are mostly her words—so listen carefully—it is the market speaking through this daughter, who is YOUR colleague—and they apply regardless of the types of service you offer.
- I expected my mother to be offered a good quality of life for the condition she was in. I expected that she not be avoided because she is unpleasant.
- I expected her to be clean, well-fed, have interaction and receive the attention the facilities said she would be given and that we paid for.
- I expected her to be treated with dignity even if she is beyond understanding her condition.
- I expected staff to let me and my sister take the time to tell them what a wonderful person my mother used to be because all they see now is a crotchety, difficult demented woman.
- I expected them to believe us when my sister and I said something was wrong.
- I expected the long-term care facility to know my mother’s medical problems well enough to know that there was a developing crisis.
- I expected the hospitals where she was transferred to diagnose and fix what they could—not discharge her with an infection she didn’t enter with.
- I expected my mother to be released from the hospital when her medical problems were resolved, not when she ran out of coverage.
- I expected professional guidance from professional staff, with a doctor who takes leadership responsibility for coordinating medical care and nurse leaders who would advise me and my sister on what we should do.
- I expected nursing staff to recognize that cleaning my mother or giving her a treatment and putting her back into a soiled bed isn’t good. Simply saying another department didn’t do its job is not acceptable.
- I expected on-site advocates—not 1-800 numbers.
- I expected someone to empathize with me when I sobbed about my mother’s obvious state of affairs—not ask me what’s wrong.
- I expected to be able to trust the people and institutions to provide good professional care and support my sister and me through all of this.
Too much to expect? Maybe all of our marketing, hospitality, sales and consumer relations programs should begin and end with asking people like my colleague and her sister what they expect throughout the service delivery process… Is that too much?
The great organizations stay closely connected to expectations and needs of the people we serve—connected most closely and intimately in the midst of crisis, not just through the perspective and distance of sophisticated science, though both are essential. No, that’s not too much to expect of us, is it?
Larry
William L. Minnix, Jr., D.Min.
AAHSA
President and CEO
March 20, 2007
About 900 AAHSA members are gathered in Washington, D.C. this week to explore where “innovation meets action.” Did you know that you are an innovator?
When it comes to human services, innovation is the mandate of the not-for-profit sector. For generations, our organizations worked hard to satisfy the unmet needs of America’s older adults. From the first continuing care retirement communities and Program for All-inclusive Care for the Elderly, to Green Houses and culture transformation approaches like the Pioneer Network and Wellspring, our sector is responsible for transforming the way we care and serve our elders.
Yes, you are innovators. And your hard work is making a difference for the people you serve. Just ask John Robbins. He is a 106-year-old resident at Westminster Village in Dover, Del. This organization recently established a Dream Catcher program. Based on an American Indian custom of constructing ornaments to filter out bad dreams and allow only good thoughts to enter the mind, staff members are encouraged to listen to residents carefully and discover any unfulfilled dreams that they can help them to realize.
For John, that unfulfilled dream was receiving a high school diploma. His parents died when he was in 8th grade, and he had to quit school to take care of his younger brothers and sisters. That’s when Westminster Village arranged for the Delaware Department of Education to present him with an honorary diploma. John’s next dream is to be reunited with his 105-year-old brother in New York and Westminster Village is working on that too. That’s innovation and action.
Or, there’s Darline Schoeberl, who participated in the Evangelical Lutheran Good Samaritan Society’s technology pilot project with the University of Virginia. Darline received a system of sensors in her bed to track her sleeping patterns and monitors in her hallways to analyze her activity levels. The data those technologies collected helped Darline decide to move into an apartment at Mikkelson Manor, a Good Samaritan Community in her hometown, where she could receive a higher level or care and still stay close to her loved ones. That’s innovation and action.
Betty Standafer wanted to be able to fix her own oatmeal and allow her cat to roam in her room. The staff of her nursing home, The Cedars in McPherson, Kan., set up a system so this long-time seamstress can sing and sew, two of her favorite hobbies. That’s innovation and action.
Ninety-three-year-old Esther Zuburan’s wish was to stay in the same East Harlem neighborhood this Cuban immigrant has called home for nearly 60 years. As a participant in the Cabrini Center for Nursing and Rehabilitation’s “nursing home without walls” program, Esther receives arthritis pain care from a home health aide in the same apartment where an activities coordinator taught her how to use a video camera and make films from her window. So far, she’s made more than 85 films, and the credits keep rolling. That’s innovation and action.
The AAHSA community is defined by innovation and action. From the bedside to the boardroom to the halls of Congress, we are all working to advance innovation, quality, technology and transformation. Through Quality First, the Institute for the Future of Aging Services and the Center for Aging Services Technologies, we fight for public policies, connect you with thought leaders and provide learning opportunities to spark innovation and action in your organizations. And since we know none of this can continue with the broken financing system we currently have, we are moving forward to advance a new vision for aging-services financing that will empower consumers, ensure choice and allow people to receive the services they need, when they need them in the place they call home.
The French philosopher Albert Camus said, “In the depth of winter I finally learned that there was in me an invincible summer.”
You know there is an invincible summer in all the people we serve. And through innovation, you draw out the invincible summer in the John Robbins’ and Esther Zuburans of our country. This isn’t just a nice thing to do. It’s an essential element of who you are: the mission-driven, not-for-profit providers who meet needs in creative ways, past, present and future. You are innovation and action.
LarryWilliam L. Minnix, Jr., D.Min.
AAHSA President and CEO
