Wednesday, March 3, 2010

Need Long-Term Nursing Care? Meet Anna

If you're looking for long-term nursing care for your parent, you might want to meet Anna.*

It's 7 am. Outside her picture window, blue jays devour their breakfast from a bird feeder. Inside, prayer journals and devotional books sit ready at her desk. After a hearty meal of bacon and eggs, Anna will take a leisurely whirlpool bath in a spa, complete with fluffy towels, lotion and bath salts.

Anna lives at Warm Beach Health Care Center in Stanwood, Washington. It's one of hundreds of nursing homes nationwide involved in a sweeping movement begun in 1991. With names like Eden Alternative, Pioneer Network and Person-Directed Care, these programs aim to make nursing homes more like home.

In traditional nursing homes, residents rise, eat, bathe and sleep in lockstep fashion. Late risers are jolted awake at 6 am whether they like it or not. Night owls are put to bed with the chickens. Times for meals, baths and activities are set for the benefit of staff and schedules, not residents.

In 1991 Dr. Bill Thomas and his wife Judy Meyers Thomas decided, “Enough is enough.” They began with their nursing home in rural New York, determined to eradicate the three plagues: loneliness, helpless and boredom.

Thomas wrote: “We'll bring in 100 birds, two dogs, four cats, three rabbits and a flock of laying hens. Then we'll plow the lawn and start a larger organic vegetable garden outside our residents' windows.”

Eden Alternative was born.

Nursing homes since then have modified the cultural change emphasis to suit their staff, residents and locale. Many leaders have ripped up schedules, flow sheets and the lousy, tasteless menus.

They've introduced pets and plants and built playgrounds for children. And they've divided long stark halls into functioning neighborhoods, where residents and staff laugh and cry with each other.

The Federal Government has even ponied up funds for training nursing home staff in these voluntary programs. Several years ago in Washington State, 33 nursing homes including Warm Beach signed up for the three-year program called “Person Directed Care.”

Now when Warm Beach staff contemplate program changes, they ask, “Is this what the residents want?”

At residents' requests, staff have already remodeled the bathing rooms, added a continental breakfast for early risers, and divided the resident population into “neighborhoods,” with permanent caregivers. Residents choose a name for their neighborhood. They plan baby showers for staff, enjoy take-out Chinese and celebrate birthdays.

The new culture has trimmed staff turnover. Aides enjoy their permanent assignments, since they have five days a week to bond with the residents. Creativity has surged. On a clinical note, pressure sores and falls have decreased.

When I entered Anna's room, she handed me a thick guest book to sign. During our time together, as staff entered the room, she introduced me with comments like, “They're so good to me," and "Dawn puts lotion on my back every morning. It feels so good."

How do you find one of these nursing homes? Sometimes the nursing home's website will list an affiliation. Otherwise, when you visit in person, ask about “Eden Alternative,” “Pioneer Network,” or “Person Directed Care.”

*changed name.

For more information on cultural change, try this link:

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