< Culture Change

Resident-Directed Care

Synopsis

Learn about the importance of making each individual elder's wants, needs and personal pleasures the highest priority in their care.

Northern Pines: Resident-Directed Care

This is about decisions made by the resident, or closest to the resident, with family as partners in caregiving. This is about individualized caregiving as promoted by the ombudsman with the blue and gold ribbon campaign. This is about hearing a family member state that the last care conference - the first held under the ARC person-centered care plan model - was the best ever: "It was all about Milt and his preferences, not his alimentation and elimination."

The story of "Caleb's Basket" speaks of stones representing the great events of life, pebbles representing the important activities in life, sand representing the spontaneous moments of life, and water representing the meaningful relationships that are essential to life. All of these things together are needed to fill the basket of life and make it worth living.

This is not a new idea. Native American philosophy tells us to at all times be aware of our surroundings and others' needs, to live in the moment, to listen with our heart, to never argue or disagree with an elder, and to never rush.

This is about life's daily pleasures. A resident sleeping in the sunshine, playing with a cat, having a candy bar every day. This is about elders seeking a better way to live out the twilight of their lives, like the Minnesota resident who wrote us the letter reproduced below. This is about our resident who was deeply depressed upon admission to the traditional nursing facility, who chose his room during the construction of it based on which room would hold his desk, his music stand, his personal items, and said, "Are you kidding me? Is this still the nursing home? You mean I get to live here? Then I can play my harmonica again, write music by this window, have my friends visit." This is about the most recent tenant from our attached senior housing with services complex who came to Northern Pines after a hospital stay. She moved into a private room with her own furnishings in the remodeled area, and gave up her apartment after three days, saying, "Why would I want to go back there? This is just as nice and besides, you get all the help you need, all the time, any time." This contrasts starkly with the usual pattern of tenants actually struggling to keep their apartment long past "safe and appropriate" to avoid moving "over there" to the nursing home.

This is about meaningful relationships. Tom Hennan says it all in "Soaking up Sun": "I sat by my grandfather soaking up the sun while his silence taught me all the secrets he knew."

November 3, 1999

Linda Bump,
Northern Pines Administrator

Dear Madam:

Recently, I read an article in the Rochester Bulletin about your facility, and I am interested as a near future nursing home patient. Would you please favor me a brochure or any information about your home?

I am 91 years old, slightly arthritic, and use a cane after two knee replacements eleven years ago. Otherwise I am active, alert, like to read and can generally fill my time with other things.

I am sending a self-addressed envelope, would you please send me the above-mentioned material? Will you accept patients out of your local area? And when? Looking anxiously for your reply.

Thank you,
A. H.