Elders traveled from all over East TN in their formal attire to dance the night away. This year’s event theme was “Time Of My Life” and many Elders did in fact have the time of their life. The scene was set with perfect decor, great food, and an atmosphere of excitement as the night got started.

Glenda Trentham, Quality of Life Director at Pigeon Forge Care and Rehab said ” The ladies from our home never had the opportunity to attend their prom. This was a first for them both and they were all smiles.”

The prom’s decorating and theme committee consisted of Elders living at SHC of Rogersville. They planned the entire event and helped to get decorations and gifts ready for the attendees from other homes.

All in all, both Elders and Stakeholders did have “the time of their life” meeting and building lifelong friendships with each other as well as “shaking a leg” on the dance floor!

When I think of all the ways I connect to others, my heart is always warmed with many memories of relationships built and precious times together.

Signature HealthCare At The Courtyard understands how important connectedness is to well being in the individuals living with them. Elders living at the home have formed an Elder Mission Team and are often found doing community mission projects.

This week they participated in a project to renovate a local community park. The Elders saw the need to provide a face lift to a local park and were able to partner with Clay Wells, an employee from the City Parks Department. Mr Wells provided the supplies for the project and the Elders along with many volunteers from their families provided the labor to get the job done!

Elders worked hard to remove graffiti and the weathered look of the picnic tables and benches by applying a fresh coat of paint.  The Elders wanted local children to have a clean park to play in this summer.

Over the past several months the Elder mission team has also done things such as delivering school supplies to children at a community school, making dog biscuits for a local animal shelter, and sponsoring a local 5k walk/run.

Nursing homes have typically been branded as a place where “life stops” or where “people are waiting to die”. In order to break the “stereotypical” branding there must be a new revolution in health care. Events such as the one sponsored by SHC Courtyard, help fight the stereotypes surrounding both aging and the nursing home industry as a whole by showing the community how important the role of Elderhood truly is. After all, it is Elders who truly teach us all how to make community.

I have been thinking a lot lately about gifts and talents in our lives. I think about how many of the ”talents” that I have took much time and effort to cultivate into something useful. We have all heard if you don’t “use it” you “lose it” spoken of many things during the course of our lives.

I would like to think that as I age, my talents would still be appreciated. I hope that I wouldn’t be “thrown” away or “disregarded as someone who can still (one of the most offensive words regarding age out there)  write or paint” but would instead be welcomed into a community where I could grow, flourish and share the things that are important to me as well.

Spic, an Elder who lives at Kenilworth Care and Rehab has been sharing his many gifts and talents with the community. During his life, he has loved to paint and fix up homes for those he cares for. He has recently joined the maintenance team at Kenilworth to assist them with painting and other projects at the home.

The home has been busy creating a “garden” in which culture can flourish and have planted many seeds of change along the way. Some of the small environmental changes they have made include bringing in the vending machines for Elders to have easier access to them and bringing more plants and greenery into the home. Nursing Assistants are also busy hosting “gatherings” with the Elders and many of the Elders are participating in daily community meetings.

We all have things we would love to share with others. The Elders who live in our homes are no different, they should have opportunities to grow and share the wisdom they have aquired over their lifetime.

Spic could have represented someone who has lost much because of detoriating health or other conditions but instead the team looked at him as a contributor to the community they are building. Spic said, “I want our HOME to look good for everybody who visits”.

Those are probably some of the most beautiful words you can hear in long term care. After all, we are striving to be home for those who need one.

I think back to my first impression of nursing homes. I can remember the first time I walked in a nursing home at the age of 10 or 11 and Elders were yelling for me to help them from their rooms. I can visually remember restraints and the overwhelming feeling of sadness that accompanied my visit. I was only there with a church group, walking through to sing Christmas carols but yet it left a mark on me.

My next visit to the nursing home would be when I went to work in one at the age of 19. I didnt’ know what I wanted to do with  my life, but I knew I wanted to work with Elders. That’s when I learned how institutionalized the processes there really were. I can remember Elders being admitted so quickly because everyone had to get back to their own “work”. I remember pages and pages of paperwork that “had” to be accomplished and the dim room with no belongings that awaited them as they arrived. I remember thinking how impersonal this process really was and how sad this day must be for the one who was coming to live there.

Unfortunately over the years, the admission process hasn’t changed drastically. There have been additions of welcome committees, welcome teams, and welcome baskets but nothing that is really personal to the Elder who is joining the community.

What if it were different? What if Elders were actually well known to the community prior to their arrival. What if the room was set up with items the Elders loved already?

The team at Washington Rehabilitation and Nursing Center in Chipley, Florida think that first impressions mean everything to Elders joining their family. The team has recently started visiting with Elders who are coming to live with them prior to admission. During their visits they are able to identify things the Elder enjoys and “can’t live without”. When the Elder is admitted they are greeted with a welcome basket that is individualized to their likes! One Elder who recently was admitted for therapy and returned home stated ,”The baskets are the nicest gift a person could get coming here”! Christa Wesley, Marketing Director for the home said, ” the baskets are a way to ease the transition from their home to our home. It is also a way to say thank you for trusting us with their care.”

Let’s face it, the transition from living in their personal home to living in a nursing home is hard. Elders, who have lost so much already, many times lose their identity when they become admitted to nursing homes.Everything changes when you have to move your belongings into that small room and then choose what will stay there with you. It can be an agonizing experience and many times there is a great feeling of loss associated with it. Compile that loss with strange people, new surroundings, and physical ailments and you have a perfect recipe for disaster.

Washington Rehab is doing a wonderful thing by taking time to know Elders and then demonstrating the knowledge they have acquired into something tangible the Elder can see. This brings a sense of community to the Elder as soon as they arrive at the home and eases anxiety surrounding the move for the families as well.

You had me at hello. This continues to prove to be true. In fact, in the world of long term care, hello may be one of the most important words we can say!

Looking at what it means to be institutionalized, it reeks of activities like bingo, ball tosses, and the dreaded laundry folding. While all these things may have their place in life (I suppose), I can’t imagine waking up one day and saying, “I can’t wait to go to ball toss today” OR “It’s time to fold towels all day”. The sore point is that typically the balls aren’t even fun balls that are being tossed about and the towels are typically only white towels with no color. While there may be a level of engagement in some of these things, have we ever stopped to question ourselves on why that is? Is it because the Elders have become so rigid in the thought that it is all they can do? Is it because we have placed limitations on them without knowing their capabilities?

I also began to think alot today about our vision statement as a company. There are five words that stand out to me in that statement. Real quality of life initiatives are the five little words that call my name each morning. Looking at those words, I started to mentally categorize some things that fulfill this mission statement because bingo and ball toss surely don’t reflect it! 

There have been some amazing stories that were given to me recently that really bring this mission to life. People always look for the big things like our trips to Myrtle Beach or the overnight camping trips that we plan for Elders but fail to  recognize the other things that happen each and every day in our homes.

For example, the therapy department at Washington Care and Rehab in North Florida recently helped an Elder regain a wonderful quality of life. She is living in the home and unable to do most things due to a debilitating disease she has. She has always been an avid reader and had no quality of life because she couldn’t turn the pages on her books any longer. Therapy was able to teach her to operate a Nook and now she is reading again. She is in charge of the book reviews for the home and has a spot on the bulletin board where she shares them. This to me is an example of a “real quality of life initiative”. Her point of need was met because those around her wanted her to be the best she could be. I think her quality of life would be much different somewhere else where individualized care is not at the forefront of the hearts of the stakeholders.

Another wonderful story took place at Pine Ridge Care and Rehabilitation where an Elder who loves to paint has been given free reign to paint a mural for the neighborhood in which he lives. This will be a living work of art. How beautiful it is for him to be an active part in creating the community around him.

Recently at Signature Healthcare of Trimble County, Elders wanted to start a service project in which they could help the children in the hospital feel more love. They started a “real quality of life initiative” in which they sewed heart shaped pillows for the children and will deliver them when they are completed.

The key component in all of these “activities” are that they are not only engaging, they are real. For too many years, nursing homes have filled Elder’s days with activities that are not always meaningful and sometimes even childish.

As I look back at those five words and connect it to the wonderful stories I have heard recently, I realize more than ever that it is truly the “little” things in life that make us feel content and happy.  Engagement, purpose, meaning, and real quality of life initiatives like these are what will eventually transform the world of Elders living in long term care facilities. When all of those things happen, then life changes in the home. The focus is different. It is no longer about how many activities are on the calendar but more about the quality of the things the Elders choose to do.

Please respond and let me know about the “real quality of life initiatives” in your home and how it has transformed life for the Elders who are living there. These are the stories that will eventually change the landscape of long term care forever.  

Geneva, who lives at Clinton County Care and Rehab in Albany, Ky speaks quite a bit about what it means to be at home below:

Geneva Cross had been awaiting the arrival of Ms. Kitty for about a week and was so excited to finally get to hold her in her arms.  It was just like the old expression “a kid in a candy store”!!  Watching the connection between the two of them was such a heartfelt experience for all of us. Smiling, Geneva held her pet in her arms and stated, “I know now that I do have a purpose here and it is to take care of Ms. Kitty!” These were Geneva’s words when we received Ms. Kitty a month ago (Dec. 17, 2012). When you ask her about Ms. Kitty now, she will tell you that she lives each day to take care of her cat. Geneva tells me everyday, “I love Ms. Kitty and she loves me!” I am greeted every morning by Ms. Kitty loving on me as she rubs on my legs waiting for me to greet her with a “hello, Ms. Kitty” and Geneva telling me a story about her and Ms. Kitty last night. Just the other day I asked her how her life was before Ms. Kitty came into it and she stated, “Well, It was good, I enjoy all the things here, but…” I then asked her how her life was here now and she replied, “Oh, I love it so much! Ms. Kitty has given me a true purpose in life and I love her!”With tears in her eyes, she also said, “Ms. Kitty is special to me and I wouldn’t take anything for her!”

Ms. Kitty has not only changed life for Geneva, but also for other Elders at our Home and also our staff.  Everyone takes the extra time to go and greet Ms. Kitty and Geneva. She tells me every so often, as she smiles, that she has more visitors now than she used to have. I personally have never been a cat lover, but Ms. Kitty has changed my perspective on cats.  I told this to Geneva and she stated, “I’m so glad. I knew Ms. Kitty could do it. She helps me everyday. I no longer have any bad days.” Personally, if I feel the stress or tension rising, I just go visit Geneva and Ms. Kitty and when I leave the room, there is no more. Ms. Kitty is such a true blessing to all of us here at Home.

 Ms. Kitty is our very first pet to live at our Home. She is 12 years old and graces the hallways daily with her presence, giving love as well as receiving love from our Elders.

Story submitted by Michelle Shelton, QOL Director, Clinton Care and Rehab

Wow! That sounds like home to me! Geneva liked being at the home and “did” things but nothing compared to the joy she has in her heart now that she has Ms Kitty living with her! The word “homelike” is usually contrived of decorations that are intended to bring some resemblance of home to the environment. For Geneva, the only thing that would bring “home” to her was the arrival of Ms Kitty. Home could never have been equated through activities programming or furniture itself. It was the relationship she was missing. It was the love she had for her cat and the affection the cat showed back to her that her heart was yearning for. These are things that could never be replaced through remodeling a physical environment but only given as a gift through the power of personal transformation. The beautiful gift of home that was given to Geneva through the arrival of Ms Kitty from the stakeholders who cared enough about her to give it.

Family style dining is a part of a new initiative the home has to bring more autonomy to the Elders living there. This type of dining is much different from the way most typical nursing homes facilitate meal time. Often in skilled nursing facilities, trays crowd the tables and portions are served up prior to the meal. With family style dining, the food is served in big bowls and the Elders choose their foods and portion sizes.

In my home, I don’t use trays on my table and my husband certainly does not dish up my plate without a thought as to what I may want to eat. The exciting thing about family style dining, is it offers the Elder the autonomy to choose which foods he/she would like to eat and control how much they want of each item.

Freedom of choice is one of our most basic rights as humans. Autonomy is important to our overall well being. How can we exist if we are never given opportunities any longer to make changes regarding our own lives? Too often in long term care settings, those choices are overlooked and Elders are robbed of their most essential human right. Offering flexible meal times and meal choices are only a few ways that we can help restore those rights.

I would agree with the Elder who said this brought a special feeling. Yes, I imagine it brought a feeling of life, of purpose, of meaning, and dignity. We can all say that without a doubt those are the most “special” feelings of all.

You may ask, why remove the nurse’s station? The nurse’s station symbolizes everything that is institutional. It reminds us of a hospital, not a home. The nurse’s station is often the ”center” of activity in long term care facilities. In my home, the kitchen is the center of activity. When I am cooking, my family is always there. We have many good memories in our kitchen. The kitchen table is a place where we have sat down for many dinners, played many family games, and had many great bonding experiences. 

At Riverview, the new center of their home will involve a new living space, complete with the things the Elders have asked for. When they met with the Elders last week, they requested the smallest but most important symbols of a home setting. They wanted a telephone in their living room. A telephone! We are always searching for ways to change things and make them bigger and better. In our excitement to bring change, we sometimes miss the most simple of requests that are also the most profound. 

Some other accomplishments that Missy and her team have made over the past 12 months include creating empowered teams of Elders and Stakeholders to advance culture change projects, implementing an Internet Cafe that is almost ready to open in the home, working through a process to begin person directed bathing practices and many other initiatives.

Riverview is currently the third rural home with less nurse’s stations. Pickett Care and Rehab took out all of their nurse’s stations a few years ago and Westmoreland Care and Rehab was able to take out their nurse’s stations at the end of 2012.

Congratulations to Missy and the Riverview team for beginning a new phase in their culture change journey. The best is yet to come!

Knowing another’s likes and dislikes is so much more than completing an assessment in a rushed state because there are five more waiting. It has to be about true friendship. Friendship is the one thing that makes us feel loved, special, and human. When we become friends, it means that you are willing to give up your time, love, and energy to share parts of your world with me.

I received recently the following story from the Dietary Department at Westmoreland Care and Rehab in regards to their recent changes in offering more person directed dining.

“Just recently one of our regulars, Mr. Joe, had to go out to the hospital at 4:00am. When Joe returned back to our home we had just started serving our made to order breakfast, and Joe told the paramedic, “Stop and let me off! She knows me and what I want. I’m hungry.” The paramedic stopped and let him off of the stretcher.

You should have seen him! He still had the paper pants on from the hospital and his legs couldn’t move fast enough to get to his table.

Just their excitement alone makes the whole day start off with a smile!

-Patsy and Tom

How powerful are his words? He said she KNOWS ME and she KNOWS what I want! He could not wait to get home. To jump off the hospital stretcher and go to the table to get his favorite meal served up. He was comfortable in his home. He didn’t feel the need to change clothes and he had confidence that Patsy would know exactly what he would want to eat.

This is friendship in its finest hour. There was no pretense, no disappointment, just the love that joins them and the true knowing that follows that love. Friendship is the most basic building block in humanity. It is something we learn in kindergarten and develop the remainder of our lives. If we truly desire to change the culture of aging in skilled nursing communities we must build relationships (become friends with) and truly know the Elders who call our homes their home.

As I sat down to really reflect on the year with all its ups and downs, I realized this year I have had such a wonderful opportunity to grow and learn from some amazing people who influence long term care across the globe. However, I also realized I learned the most this year from the Elders who came in and out of my life over the past 12 months.

Some things I picked up this year from our Elders:

1) Relationships are the most important part of living. Yes, I learned that this year. Deep down, I always knew it had to be true but when those frail arms of a precious Elder I adore reached for me to hug her, it was with knowing in her eyes. Our bond with each other was able to overcome the test of time, distance, cognitive loss and frailty. Relationships are indeed the most important part of life. In 2013, I hope we can all form relationships that not only enhance our lives but teach us things that mere words cannot.

2) Love comes when you least expect it. This year I got to meet two Elders who fell in love while living in a nursing home. They did not expect to fall in love but they did. The beauty of the moments they shared together made me feel like an intruder or maybe even someone watching a movie unfold. The caring that shone in their eyes when they looked at each other melted my heart and made me hopeful that true happiness has no boundaries or specific moments in time.

3) Never take anything for granted. A powerful moment for me this year took place during our Elder Vacation week to Myrtle Beach. One Elder from East Ky told me the trip was the best of his life. He had always wanted to visit the ocean but could not read to navigate the road signs to get himself there. He actually thanked me for taking him. Wow! I want to thank him for a life lesson.  I learned that I have been so extremely blessed with education and abilities to go places that some people only dream of going. We take what we have for granted. I plan to focus in 2013 more than ever on making others dreams and wishes come true.

4) Risk makes life worth living. Yes, as I watched two Elders para-sail in the middle of the ocean, I realized that risk is essential to life. When those ladies waved goodbye to me from the life raft that transported them to the middle of the ocean so they could take the flight of their lifetime into the air, I was terrified for all the things that could go wrong. When they came back to shore with the breath of excitement in their voices and a new light shining in their eyes, I realized how invigorating the trip had been for them. Upside risk is a powerful thing.

5) Appreciate every moment of life. Yes, I learned this year that we should delight in the things that are around us. Take time to stop and drink in the beauty of nature or the simplicity of a bird singing its morning song. Life is a one way road and we don’t get to turn around and travel it again. We should do our best to remember everything along the way.

As 2012 comes to an end, I cherish each moment I spent with Elders this year who in some way impacted my life. Their footprint on my life’s journey will always be evident. In preparing for the new year, it is my hope for all of us that we are able to paint the blank slate with fulfilled dreams, beautiful moments, and enlightening wisdom that only our Elders can reward us with.