MIDDLEBURY–Helen Porter Rehabilitation & Nursing has received a grant of $23,700 from the State of Vermont in support of its efforts to pursue a new “transformational project” to define, implement and evaluate an innovative model of resident care.
The grant comes from the “Enhancing Quality of Life” program via the Vermont Department of Disabilities, Aging and Independent Living (DAIL) and will support Helen Porter’s efforts to work collaboratively with their board, physicians, residents, families, staff and the broader Addison County community to change their long- established “medical model” of care to a new “social model/person-centered model” according to Helen Porter administrator Neil Gruber. “Our overarching goal is to pursue a culture change within our organization to enhance the quality of life for our residents and build a positive community that fosters high quality and compassionate care in a manner that promotes independence, respect and dignity”, he said.
According to Gruber, this process of “culture change” will not simply be a cosmetic improvement intended to improve how our organization appears internally and externally—it truly will impact and change the fundamental way that residents, families, staff and community experience the organization via very specific changes.
“The basis for this culture change project is our sincere belief that the traditional model of nursing home care and the current perspectives, interactions and relationships that exist within our facility and many others does not represent the very best environment for providing the highest quality resident care” he said.
“We have presented to our board of directors our plans to embark on an intensive period of transformation over the next several months that began with the drafting of a new Mission Statement and Vision Statement to serve as the foundation for our work. These statements will be our reference points and guide the many concrete actions, decisions and changes that we will pursue” Gruber said.
He added that these statements are being developed in concert with residents, families and staff, and will be based on a core list of “values”. “In our preliminary conversations with these internal members of our HPHRC family, the initial list of these values include: respect for each person as an individual, promoting the highest level of dignity for residents, promoting greater collaboration and teamwork, ensuring autonomy and independence, building a positive community, fostering healthy relationships and pursuing excellence in everything we do”.
The project coordinator, Nancy Schaedel, is excited to have received this grant and is very enthusiastic to implement a number of new initiatives. “As we move forward, we do so in order to create a safe and caring environment, which fosters both positive relationships and a sense of community. We envision a home filled with love, dignity and quality service, and working together as a team to ensure a sense of collaboration and open communication, where every person is valued as an individual and as a member of a larger community” she said.
Beyond creating new Mission, Vision and Value statements, HPHRC will undertake a comprehensive effort to educate residents, family and staff about what “culture change” is and how to accomplish it. “Changing from a medical model to a social and person- centered care model will require that we change our appearance, philosophy and language, such as changing our terminology from “nursing units” to “neighborhoods” and giving these new neighborhoods names as selected by our residents, families and staff,” Gruber said.
“In our early conversations with our residents, families and staff about our plans to move forward with this project, we have received some important and specific feedback that could define our efforts including: less noise on the units, quicker answers to call bells, more privacy, freedom to eat what they want and knowledge of menu prior to meal service, a coffee shop that is always open, freedom to sleep as late as they want, clutter free hallways, and mirrors at wheelchair height,” he said.
Although the implementation of this culture change transformation will encompass many specific activities, outreach efforts, a new “wellness programs”, etc…over time, one of the primary programmatic changes Gruber envisions is the establishment of a new end- of-life “Namaste Care Program” for residents with Dementia. This program will be modeled on the highly successful program at the Vermont Veterans Home and will address the physical, spiritual and psychological needs of the residents.
In anticipation of this new program, the administration of HPHRC has already identified a physical space within the facility that can easily be transformed to serve as the Namaste Care unit. They also have received a donation of $4,500 from the family of one of their residents that Gruber anticipates using these funds to support the creation of this space.
According to Schaedel, this Namaste Care Program has been successfully implemented in several nursing homes and hospice organizations. She says that Namaste Care strives to maintain the highest quality of life possible for individuals with severe and terminal dementia. This care involves the creation of a special room that provides a quiet, peaceful environment for residents in the last stage of their disease. Meaningful activities are individualized for each resident and a continuous presence of staff members provide both physical and sensory stimulation. This “high-touch” care can be taught to all staff as well as family members. “The family members, particularly, appreciate the attention given to their loved ones,” she said.
She added “The need for programs that would be suitable for individuals with severe and terminal dementia is strong if we are to prevent them from progressing into a vegetative state and help them to continue to enjoy personal contact and stimulation.”
Schaedel says that Namaste Care provides residents and their families with quality care that addresses not only physical but also emotional and spiritual needs. “It reminds us that individuals with advanced dementia should not be isolated in their rooms, but need to live their last days in a pleasant environment receiving loving care from all staff and families,” she said.
The Components of our Namaste Care Program will include Development of a personalized mission statement, development of criteria to determine which residents would benefit, staff selected based on the desire to work with Namaste Care residents, special education and training, soothing and comfortable environments, comfort care approaches, special programming, and grief comfort and bereavement service referrals.
“As we move forward with this effort and these internal improvements, we envision that we will do so in communication and collaboration with other area organizations” Gruber said. “We have had preliminary conversations, for example, with members of the “Addison Respite Care Home” organization (which is developing plans for improving services to area people in hospice care), the “Living Well” organization in Bristol (which offers a variety of outreach programs and services to improve the quality of life of elderly people such as their “Living Arts” program), and others” Gruber said.
As a part of the culture change project and the implementation of the Namaste Care Program, Gruber says that Helen Porter will actively engage these organizations and others in our community in an ongoing dialogue regarding how we can collaborate with programming or long-term projects that will enhance and/or increase services available to the residents of HPHRC and the elderly population of Addison County more broadly.
“We are very excited to have received this grant, and we believe that our project will greatly improve the quality of resident care at HPHRC, and also serve as a model for other Vermont nursing homes” Gruber said.