One Nursing Home's Journey

EXPERIENCE
Dispatches From the Front:
More Than Bingo and Balloon Tosses
“Good grief,” the elderly woman muttered to a fellow resident, “they never let us rest around here. Now they’ve got us out watering flowers!”
Deborah Heath, DON, chuckles as she recalls the grumbling. For one thing, residents at Lenawee County Medical Care Facility in Adrian, MI, help with tasks like watering flowers only if they want.
For another, the woman’s com- ments are the kind heard in any normal household as family members go about their daily chores—and that is the whole point. The normalcy that came by turn- ing Lenawee’s conventional nursing home into seven distinct households is now transforming the lives of residents and caregivers alike.
“There’s more to activities than bingo and balloon tosses,” says Heath. “Here, you wrap silverware, set the table, help plan meals...one gentleman picks up all the laundry and trash every morn-
By Keith Schaeffer
ing. Isn’t that so much better than sitting around waiting?”
Waiting to die is what she means to say. Like the woman in hospice who thought she had come to Lenawee to live out her last few days.
“She’s going to the county fair next month,” says Heath, noting that a grow- ing number of residents have survived and left hospice care within the last year.
Elders are reclaiming their lives in more ways than one. There is less weight loss and more gain, lower rates of pres- sure ulcers and falls, and far fewer resi- dents using nine or more medications.
“We started the year with 30 people on anti-psychotic meds and in May we had 15...a big drop,” says Heath. “All the stuff they (proponents of the Household Model) told us was going to happen has happened.”
Breakfast on the patio, private resi- dent rooms, alternative bathing strate- gies—“it’s all helped behavior-wise... doing different interventions rather
than giving them a pill,” says Jeanette Raymond, LPN.
Also, residents’ pain is addressed more quickly now that all cross-trained staff know how to assess pain with the aid of a simple questionnaire, notes Heath.
Waiting Lists for New Employees & Residents
The new culture is proving less pain- ful for staff, too. Turnover has dropped from 39 percent in the old model to 12 percent in the households.
“We have a waiting list of (nurses’ aides) who want to work here...most of the leadership that was here before the transition is still here,” says Kathy Aube, Administrator.
“People out there know what we’re doing and they want to be a part of it,” adds Heath.
A small number of nurses’ aides resigned from Lenawee early in the trans- formation because they were too task-ori- ented or didn’t want additional responsi-
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