Interesting story! Who else has heard about the 'greenhouse effect'? http://www.granitefallsnews.com/life...-care-attitude
What comes to mind when you think “nursing home”? A nursing station, perhaps. Long gray corridors, a big gray dining room, small rooms similar to dormitories or hospitals.
The typical image of a nursing home doesn't look much like home. The first time Kevin Stoneking, assistant administrator at Clayberg Nursing Center in Cuba, Ill., saw a different kind of nursing home, he saw the problem.
"What have we done? All these years we've worked in long-term care, and we've institutionalized our elders. We've herded them like cattle to bed, to bathe, to the dining room," said Stoneking.
The nursing station? In the new way of thinking, it's a fortress, a barrier between residents and staff. Medical carts? Another institutional icon that's on the way out.
Stoneking and Clayberg Nursing Center are part of a national trend to make nursing homes more home-like. The trend goes by a variety of names: culture change, the greenhouse effect, the Pioneer Network. But it boils down to resident-centered care in every aspect, from what time residents eat or sleep to the architectural design of the home.
"Everybody working in long-term care would just as soon not have nursing homes," says Dave Weiman, coordinator of the Culture Change Coalition in Peoria, Ill, which sponsors monthly meetings to promote resident-centered care. "We think being at home is better."
But nursing homes aren't disappearing any time soon, if at all, he says. The next best option is to change attitudes, operations and design of long-term care facilities.
Many nursing homes are attempting some elements of culture change, such as giving residents more choice about what and when to eat.
Culture change proponents say that design and layout, such as the long corridors and nursing stations, also affect attitude and environment. But it can be costly to undertake the design aspects of culture change unless a long-term care facility already had plans to remodel or rebuild.
Nursing homes on the cutting edge of the trend are so much more home-like that a traditional certified nurse’s aide might not be called a CNA.
Instead of traditional, institutionalized, long-term care facilities, residents live in small settings of 10 to 12, each with a private room and bath. A staff member, who may or may not be called a CNA, has the same or more qualifications. But the same person may also cook meals and serve them family-style.
Matt Neukirk, administrator for Bel-Wood Nursing Home in Peoria, Ill., says newly proposed designs for his nursing home includes more resident-centered care options, particularly for Alzheimer's patients. Instead of an 80-bed unit, plans for the new facility's Alzheimer's unit feature four 20-bed home-like areas, Neukirk says. Each area will have its own kitchen, dining room and activity room.
"Ideally, we'd like to build 20-bed units all over the place, but that's not financially feasible," Neukirk said.
Though Bel-Wood is licensed for 300 beds, the proposed design has been scaled back to 214 beds, including the Alzheimer's unit, with room for expansion as baby boomers age.
From what he's seen, Weiman agrees that the proposed Bel-Wood designs incorporate some of the culture change model. But a two-story building as planned goes against the movement, which emphasizes easy access to outside for all residents. Weiman says he hasn't been able to convince the building committee that private rooms, a hallmark of the culture change model, would also be cheaper in the long run.
"You recover capital costs a lot quicker, and there's less infection and accidents," Weiman says.
The current plan is an affordable compromise, according to Neukirk. Rooms will be semi-private, but they'll have a low dividing wall separating the living quarters to give the appearance of a private room.
Neukirk's concerns about costs are "incredibly legitimate," says Lois Cutler, author of "Practical Strategies to Transform Nursing Home Environments." As the title implies, her research has targeted how existing nursing homes, such as Clayberg, can redesign on a dollar.
Clayberg, a county nursing home with 49 beds and 65 employees, was built in the 1960s. So far, the staff has instituted the culture change model more in daily operating habits than structural changes.
It was not easy, Stoneking says. But change never is. However, by making the center more resident-friendly, they have made residents' appetites and health improve, which has cut down on medication and food supplement costs. They've also charted fewer falls and behavioral problems, which also benefits staff.
"We can't change the building, but there's been a great change in attitude," Stoneking says.