Page 5 - One Nursing Home's Journey

“How are we going to cook breakfast, serve it, and get the residents up in the morning?” asks Wendy Meijer, CNA. She wonders who will answer the call light if she is frying eggs. Will everyone on the household team pitch in and do their share when the rush is on?
II. Three Weeks After Move-In: So Far, So Good
Angie Garland, CNA, says she doesn’t do well with “change all at once.”
She has worked in the same facility in the same hallway with many of the same residents for the last eight years. She was understandably skittish when asked to leave her old hall for a neighborhood serving a constant turnover of residents undergoing rehabilitation. She agreed to do it, hoping that by confronting her fear of change she would overcome it. She’s glad she did.
“It’s breaking up the monotony...now I’m working with different people, getting different ideas from them and they’re getting ideas from me,” she says.
She likes the personal contact her small neighborhood of 12 residents affords: “We have a living
Her dual role as Clinical Dietitian and Neighborhood Coordinator is working out as co-workers pitch in. The dietetic managers have lightened her clinical duties by taking over some of the nutritional assessments, and the neighbor- hood nurse leader is helping her stay on top of her coordinator responsibilities. Frequent meetings and learning circles are enabling her to build relationships with staff, residents and family members.
The first couple of weeks were chaotic, but now “it’s actu- ally better than I ever thought it would be,” says Aube, the Administrator.
She is pleased that management personnel are helping care for residents, in turn leaving nurses and CNAs more time to organize caregiving.
“Leaders in my neighborhood have taken on more owner- ship than I thought they would,” she says.
Still, she sees a need for staff adjustments to make work- loads more equitable, a challenge complicated by the change in floor space, added responsibilities for cross-trained staff and higher populations of residents with dementia in some neigh- borhoods than in others.
room where we can pop in a movie...sit down and watch with them for a few min- utes. It’s just more like a home.”
Also, as residents begin making special requests for breakfast, she and others are scrambling to learn each elder’s dietary restrictions.
After only a couple of weeks, there is
already a discernible change for the better
in the feeling of the facility and the caregiv-
ing, says Heath, DON. Residents look better and happier, CNAs are more involved with them and staff members once separated by departments are cooperating and working together.
One problem, says Rathbun, is that kitchen staff leave before she and other neighborhood caregivers can get residents to breakfast. Also, as residents begin making special requests for breakfast, she and others are scrambling to learn each elder’s dietary restrictions.
“But we’ve got only 14 residents. The other halls have 22, and I’ve been hearing nightmares about their halls,” she adds.
Raymond feels overextended and ineffectual serving as LPN in one neighborhood and coordinator in another. Either
“When they stumble, they’re not saying ‘here, fix this,’ but rather ‘here is what’s happening and can you help me work out a plan?’” she says.
“So far, so good,” agrees Hiltner. Elders’ food intake has increased, and “we’re getting a lot of positive comments from families and residents.”
‘One of the best in the nation’
Being chosen to receive funds from the state Long-Term Care Facility Innovation Design Supplemental (FIDS) Program is indicative of the attention Lenawee’s success with the Household Model is receiving from state and local policymakers and the long-term care industry.
It also is a testament to Lenawee’s efforts from the very beginning to educate county commissioners and state legisla- tors about culture change.
“We invite them to all of our celebra- tions, ground-breaking ceremonies and anything that we can...that has helped them know what we are doing,” says Aube.
A steady stream of state and national awards has been the cause for many
of those celebrations. Over the last
role is demanding, and with
a nurse away on maternity leave, she must pick up the slack by being nurse to both neighborhoods. As a result, she worries she’s neglecting some of her responsibilities as coordinator.
But overall she believes the transition is going smoothly. Other staff members are help- ing pick up the extra load, “like the housekeeper who helps out with the residents,” she says.
For Meijer, the burden of cooking special orders for breakfast isn’t turning out
to be as heavy as she feared. Most residents like what comes already prepared in crock pots from the central kitchen, and she is happy with the teamwork that is develop-
five years, Lenawee has received the Governor’s Quality Care Award (2002), the Healthcare Association of Michigan’s Facility Excellence Award (2004 and 2006) and the National Association of Healthcare Assistants’ National Facility of the Year Award (2005).
“We’ve got the best facility in the state of Michigan and one of the best in the nation,” County Commissioner Richard Bailey said of Lenawee during a ground- breaking ceremony for its new household. (From Adrian Daily Telegram, June 27, 2006, article by David Frownfelder.)
County commissioners like Bailey and state legislators have readily gone to bat for Lenawee when difficult issues arise, says Aube.
“If you are doing a good thing, every- body helps support you,” she says.
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