Putting the long-term care industry on its head
by Charles C. Case Jr.The last issue of Health & Wealth pointed out the following characteristics about baby boomers: they are not retiring, but demanding more quality to their lives; they are paying more attention to their health and fitness; and they are demanding that their technology be simple to use. You can now add one more commodity boomers are insisting upon when placing their parent’s into a long-term-care facility – choice.
It is a new wave of culture change beginning to sweep our country’s long-term-care industry.
In 1997, a group of 33 experienced and caring professionals, with a burden for the changing needs and demands of aging, met in Rochester, New York. By 2000, the Pioneer Network held their first national conference with 60 attendees. More than 1,100 individuals from 48 states attended the 2007 conference.
The values espoused by this concerned group include:
• Staff knowing each patient as a real person – individuals who can and do still make a difference;
• The ability to respond to the human spirit, as well as mind and body;
• The need to put a person before a task;
• The commitment that all patients are entitled to self-determination;
• The understanding that community is the antidote to institutionalization.
This community promotes growth and development of everyone, by practicing the Golden Rule. It aims to put the long-term-care field on its head. It puts patients ahead of staff, and needs before a set of rules or schedules.
Some long-term-care facilities in the West are transforming themselves into communities housing no more than 16 patients per unit. Each household feels like home. It resembles a cross between assisted living and independent retirement living – only it offers nursing care.
Beyond a main street that has all kinds of basic essential services (hair salons, shopping, post office), there are units divided into separate households, each having their own living room, kitchen, dining room, laundry room, fireplace, porch and den. There is even access to the outside, albeit well controlled.
At the core, invisible to the community or visitor, is a central nursing station. This unseen area still keeps charts and uses computers, but all behind closed doors. Every employee is required to be a Certified Nurse Assistant. The units are quiet, with no paging or call bells. Call lights are wireless and answered promptly. Residents go to bed and get up when they want.
Measurable outcomes from this culture change in one facility showed 66 percent of the residents experienced positive weight gain within 6 months and a decreased incidence of urinary incontinence, to name just two.
This new culture change in the long-term-care industry is happening because the baby boomer children of the residents are demanding it. This transformation of changing a sterile, medical, nurse-driven environment into a household/neighborhood with the intention of creating a home-like environment is something to keep your eye on in the months to come. Although not present in Massachusetts yet, look out. It is coming to a long-term-care facility near you sometime in the future.
Charles C. Case, Jr., Esq., is an estate planning and elder law attorney with a nationwide practice. He is located in Centerville and can be reached directly at (508) 790-3050.
Published in Cape Business November/December 2007
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