Episcopal Church Home
You can tell just by looking at them what kind of day they’re having or if something’s wrong. That’s how we want it to be here.”
Person-centered care is based on the idea that the individuals who live and work in a nursing home and the relationships between them are the most important part of the nursing home and should be the driving force of everything that goes on there. It recognizes that daily life and care are personal matters, unique to each person, and cannot be successfully fostered through other-dictated, one-size-fits-all routines and policies. Once the desires and ingenuity of those who live and work in nursing homes are valued and acknowledged, they can create a better life in the nursing home together.
Episcopal Church Home in St. Paul, MN is an excellent example of a Household Model built on person-centered care. From the first day a resident moves into a household, staff make it a mission to discover their preferences and interests and get to know them so well that, as Household Coordinator Rebekah Taylor says, “You can tell just by looking at them what kind of day they’re having or if something’s wrong. That’s how we want it to be here.”
When a resident moves into ECH, it is policy that within the first three days household staff talks with the resident and family to fill out a “resident preference” sheet. “It’s a detailed exploration of their life; their family, faith, what they’ve done their whole life, dining preferences, what she likes to drink…” Taylor says. She adds that they consider this to be just as important as the mandatory assessments.
Once the sheet is filled out, staff gather in a learning circle to go over the information on the sheet and talk about what they’ve learned about the resident. They invite the resident to join them to talk about him or herself. At the first household meal, the resident is introduced to the other residents in the household and they also do a learning circle with the other residents to get everyone acquainted. Each household keeps a binder of the resident preference sheets in their team room where it can be easily referenced and updated.
But it doesn’t stop there. Really knowing the residents and building relationships in the household is an ongoing process. From time to time, household staff will do a sort of “Resident Trivia” game where staff find out specific information about residents such as who lived on a farm, who met her husband at a dance, etc. The staff of Sister Annette House have a dry-erase board in their staff room for posting discoveries about resident preferences and notes about one-on-one time shared. After a week, the info is taken down and added to the activities log and resident preference sheets.
This awareness of resident preferences is the foundation for an environment where daily life is filled with normal activity. The residents craft the activities schedule and, Taylor says, “There are just a lot of spontaneous things happening during the day, (the most common being) smaller groups of people doing what they like to do.” One resident wanted to start a cribbage club with anybody throughout ECH who might be interested. Staff helped him make posters and get it organized. One resident wanted spices with her meals, so shakers of cinnamon-sugar, nutmeg and cloves sit at her place in the household dining room. And when a resident really wants to just be left alone in her room with her favorite TV shows, the staff go out of their way to dig up some TV trivia to share in what little conversation the resident will allow.
Person-centered care, the kind that makes for normal life the way we want to live at home, is made possible at ECH by making it part of their vision, policy and everyday life. “What the residents want” is a mantra visitors will hear and see over and over.
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