In the tenth chapter of his book titled, Jump the Curve (understanding the exponential growth of technology), author Jack Uldrich discusses the need for ‘Learning to Unlearn.’ He would suggest that, not only is it important for us to learn new concepts, but we must also ‘learn to unlearn’ the outdated concepts. We must refresh (re-program?) our brains to accept new versions of reality and to be open to project future realities in a hyper-changing world, without clouding ourselves with outdated education, notions and trivia that can get in the way with new learning!
In my 26 years of administrative experience in long-term health care (nursing home), I am astonished to see the amount of change in virtually every aspect of resident care.
In 1984, the average resident lived in our nursing home for 6.5 years. Today our statistics show our average length of stay is about 9 months! In the ‘old days,’ nursing home residents would line up (typically in wheelchairs) an hour or more before meal times in a long hallway, waiting for the ‘magical’ moment when the food was ready and a mad wheelchair dash was created, as dozens and dozens of seniors eventually made it to ‘their’ assigned table. Basic nursing care was provided, but it pretty much was to maintain one’s condition, all with very basic medical equipment. Any real medical ‘episodes’ meant a trip to the local hospital. A part-time physical or occupational therapist occasionally appeared, thus any aggressive ‘therapy’ was not likely. Resident rooms typically held 2, 3, or 4 people. Bathrooms were located at the end of the hall. Activities were few and far between with the usual bingo, card playing, or singing providing the full array of activity options. Highly waxed and polished linoleum floors, offset by cream colored painted block walls, was the interior design which permeated the entire building, including resident rooms! Nursing homes were basically considered the ‘final destination.’
It’s now 2010! It’s time to UNLEARN your old nursing home lessons! It’s time to LEARN the new nursing home reality! ‘Cause WOW have things changed! Meet the new nursing home!
The new nursing homes are generally referred to a Health and Rehabilitation Centers, indicative of a huge change in the health care ‘focus.’ In the past, the goal was generally to provide care and comfort. Today, the focus is on rehabilitation and a possible discharge sending residents back to their ‘real’ homes! This is why statistically the average length of stay is just 9 months (though appropriately, many live some long wonderful years as residents or as we prefer ‘Community Members!’), instead of 6.5 years in the past! Last year we had over 80% of our residents return to their homes, who entered seeking sub-acute care and rehabilitation!
At the Cedar Lake Health and Rehabilitation Center, a huge effort has been made to make mealtime a time of fine dining, choice and dignity! Each household (about 30 residents) has its own beautiful kitchen and dining area. Most food is prepared right at the individual household kitchens by training cooks who become part of the care team. Meals are available at the decision of the resident and a time that feels right! Choice of menus and custom meals are the goal. Mealtime is a wonderful time of conversation and relaxation!
Highly skilled nurses and certified nursing assistants, with advanced medical equipment, computerized records, immediate access to physicians, and advanced training has brought medical effectiveness to new levels.
Today, resident rooms are all private or semi-private. Carpet, wood grains, colors, accents, paintings, soft lighting, and music in the air create a stark contrast to the old nursing home environment.
With a plethora of new and exciting activities, our nursing home residents participate in computerized ‘brain exercise,’ pontoon boat rides, casino days, ‘senior’ proms, dog shows, county fairs, golf cart rides through the woods, fishing,
and oh yea, bingo!
With a very strong focus on rehabilitation, large teams of physical, occupational and speech therapists work with a single therapy goal of pursuing discharge for each resident! Bottom-line: In the old nursing home, administratively our goal was to ‘fill’ all the resident beds [Get people IN to the nursing home]. Today the goal, is to empty of resident beds [Get people OUT of the nursing home]. Time to unlearn and relearn your thinking about the status of nursing homes!
