a place to call home
TRANSCRIPT
TThhee TTiiddeess ooff CChhaannggee
Our Community’s Demographics are Shifting According to Portland State University’s Population Research Center,
there are currently an estimated 70,357 people living in Oregon who are over 85 years of age, with over 25,000 residing in the Portland-Metro area.
The US Census Bureau projects Oregon’s 85+ population to grow to 121,741 by 2030, with most residing in the Portland-metro area.
The National Jewish Population Survey found that 19% of Jewish Americans are over the age of 65, while only 13% of the general American population is over the age of 65.
A Pivotal Point in Long-Term Care is in the Near Future A greater number of people will need services. Elders and their families want increased independence, personal choice,
and options for aging in place.
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GGuuiiddiinngg PPrriinncciipplleess
Principles which Guide Cedar Sinai Park’s Cutting Edge Response to Evolving Care Needs
Value Proposition: How we present ourselves
Old – Jewish and high quality
New – The highest quality and Jewish
Privacy and Dignity Elders who move to our campus should be able to retain the same
privacy and dignity which we all experience in our homes.
Personal Choice and the Continuum of Care Leadership in responding to our elders’ evolving care needs. Person-centered care. A spectrum of choice in care services.
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Our Original Continuum of Care
Assisted Living
Nursing Care
Congregate Housing
Adult Day Services Residential Care Our Developing Continuum of Care
and Case Management
Client Choice Special Needs Housing Kehillah Housing
Residential Care Robison Jewish Health Center
Adult Day Services CSP Adult Day Services
Independent Housing Rose Schnitzer Tower
Home Care Sinai Family Home Services
Home Health To be developed
Robison Jewish Health Center
Nursing Care New Household
Model
Congregate Housing May Apartments
Assisted Living Rose Schnitzer Manor
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New Skilled Nursing Facility
Haver Academy
Refurbished RJHC
Adult Day Services offers elders a supportive environment with social and recreational activities.
Adult Day Services will continue to offer a way for our community’s elders to age at home with loved ones while also providing rest and respite to family caregivers.
CSP Adult Day Services
Sinai Family Home Services offers a range of in-home care services including personal care, housekeeping, shopping, meal preparation, medical assistance, transportation, and respite care.
Sinai Family Home Services
Rose Schnitzer Tower is a 17-story, 235-unit affordable housing apartment complex that serves low-income elders and people with disabilities. Over time, CSP expects to introduce new supportive services that will further enhance residents’ ability to safely age in their current home.
Rose Schnitzer Tower
The Haver Academy will provide essential training to staff throughout the organization in order to prepare them for successful implementation of the social model of care.
Intensive training will support staff in developing leadership, communication, and conflict resolution skills. Training will prepare staff to empower residents and support elders’ autonomy, diversity, spontaneity and personal choice.
Also, the publicly accessible curriculum and training center will assist the community’s long-term care organizations in implementing the social model of care.
RJHC remodeling efforts will allow CSP to efficiently utilize the current building for a longer period of time.
The remodeled building will house the following services: - Three residential care
facility households - Skilled nursing facility
households - Adult Day Services - Rehabilitation
The new skilled nursing facility will be a social model nursing home comprised of multiple individual households each with a living room, kitchen, dining room, and private rooms/bathrooms for residents.
The household model nursing home will offer a physical environment that supports the natural patterns of home life. The program of care will center on residents’ independence, dignity and personal choice.
Cost and feasibility will drive the size of the new nursing home. Under current evaluation is the option of 72 vs. 96 beds. At present, it is most likely that we will build for 72 while keeping open the option of adding an additional 24 beds in the future.
In collaboration with Oregon Department of
Human Services, CSP is in the process of designing an innovative, comprehensive program which will enable
elders – including those with limited financial
resources – to age safely at home rather than within
an institutional setting.
Key to this program is active consumer choice and a person-centered
approach to care.
CLIENT CHOICE &
CASE MANAGEMENT
Home and Community
Based Services
It’s not just “home-like”…
IItt iiss HHoommee..
Current Robison Model
• Companion rooms.
• Double-loaded corridors.
• Dining hall with set hours for meals.
• Bathing down the hall.
• Locked Alzheimer’s unit.
• Rehabilitation room.
• Many communal activities.
New Household Model
• Bedrooms surrounded by communal living space.
• Food service available on demand with meals prepared in households and resident participation available.
• Bathing in your own private bathroom.
• Exit-seeking residents with dementia can be cared for in secure households.
• Rehabilitation in households rather than institutional space.
• A range of choice in community activities including public, semi-private and private activities.
• Private rooms.
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Semi-private spaces – Kitchen, living room, dining area, and library help sustain meaningful connections to family and friends.
Home environments are associated with improved behavioral health. Source: Ziesel, J., Selverton, N.M., Hyde, J.S., Lawton, M.P., Holmes, W. (2003). Environmental correlates to behavioral health outcomes in Alzheimer’s special care units. Gerontologist, 43(5), 697-711.
Household model of care is associated with improved quality of life. Source: Kane, R.A., Lum, T.Y., Cutler, L.J., Degenholtz, H.B., & Yu, Tzy-Chyi. (2007). Resident Outcomes in small-house nursing homes: A longitudinal evaluation of the initial Green House program. Journal of the American Geriatrics Society, 55(6), 832-839.
Residents’ individual choices and personal control are central to care. The organization meets the needs of residents rather than residents
having to conform to the needs and set structures of the organization.
Private spaces – Bedroom and bathroom support residents’ privacy, dignity, and personal preferences.
People, including our eldest and most frail, have the right to control decisions made about their lives.
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Person-Centered Care
Privacy and Dignity
Empirical Support
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Residents will continue to receive the excellence in professional medical care which has long been our hallmark of service.
Building on Our Tradition of Excellence
The innovation resides in our fusion of social care values into the highest levels of professional medical care.
A Clinical Care Team That Provides Consultation, Guidance and Support
Each household will be served by a clinical support team made up of nurses, social workers, dieticians, and physical therapists.
The clinical care team is responsible for delivering high quality care and acts as a resource to residents and direct care staff.
Empirical Support In a recent longitudinal study, Dr. Rosalie Kane and colleagues found
that the quality of care in the household model Green Houses at least equaled the traditional nursing homes; on measures of residents’ functional status, the Green House surpassed traditional homes.
Source: Kane, et al. (2007).
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Giving care staff the tools they need enables them to provide our elders with the best care possible.
Flattened Organizational Structure Places increased decision-making authority upon those who work with
and are most familiar with residents’ needs and wants.
Self-Directed Care Teams
Each caregiver is a member of a self-directed team and is trained to identify and support residents’ individual care needs and personal choices.
Intensive staff cross training prepares caregivers for new leadership roles with greater responsibilities.
Professional Leaders Provide Care Teams with Regular
Guidance and Consultation Nurses, social workers, and physical therapists regularly work within
each household to provide care teams with guidance and consultation.
Empirical Support Self-directed care teams are associated with the following: improved
resident care and choices; increased staff performance; increased staff empowerment; improved procedures, coordination, and cooperation between certified nursing assistants and nurses; and implications for reduced turnover.
Source: Yeatts, D.E. & Seward, R.R. (2000). Reducing turnover and improving health care in nursing homes: The potential effects of self-managed work teams. Gerontologist, 40(3), 697-711.
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What qualities and values from Robison Jewish Health Center do you want to hold on to?
As we move into a new household model of care, what do you want to make sure we include?
As you think about the new household model, what questions do
you have?
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We are eager to receive your feedback. Please feel free to call, email, or come in and talk with us.
David Fuks Debbi Bodie 503-535-4307 503-535-4303 [email protected] [email protected]
Our Vision for the Future…
Take it home, share it and talk about it. Let us know what you think.
TThhaannkk YYoouu!!