Welcome HOME!

A NAHCA Training Resource that will help your team put Home at the Heart of all that you do!

Home

What if your Long Term Care wasn’t a Facility, but a Home? What if the building were your house and the dining hall was a cafe? What if the workers weren’t employees and the clients weren’t residents, but all instead were members of a family? What if staff meetings were family circles?

Would you like to see satisfaction , pride, and buy-in go up while depression, isolation and medication use go down? Would you like your workplace to be a place where everyone felt heard and valued? Would you like it if there was a blueprint that already existed to help you make this happen?

There is. Welcome Home!

About ‘The Welcome Home’ Project

As a child, Lori Long naturally felt at home with her elders. “I love senior adults. They are amazing mentors, and I love to hear their history,” says Long. Long and her family built and operated Greenbrier Village, a facility offering five levels of care to senior adults for over fifty years. Long’s parents first invested their time, resources, and love. “It is hard to describe the respect and admiration I feel for all the older people I have known over the past 50 years,” says Long.

Since the 1980s, federal regulations have required long-term care facilities to follow a rigid medical model. However, 20 years ago, that model began to shift. A culture change took place, allowing a more “choice-based” model. Long knew Greenbrier needed to create a system based on choice, a system where residents feel at home. “So, we started learning just who our residents are,” notes Long. “What they want. When they like to get up. What they like to eat, or how they celebrate things like birthdays or holidays.”

Long knew from experience and years teaching administrators and social service directors that she needed to be smart about creating an organizational model to maintain the home. The Welcome Home Project was her answer. “Just like building a house, there is a foundation first,” explains Long. “Then the walls go up, etc. The same is true with The Welcome Home organizational guide. There has to be a commitment that everything we do falls under the umbrella of creating ‘home.’ Each of us is part of a designated home, and no matter the job, we are all homemakers. The home’s foundation has a rhythm that allows each organization to maintain the home through daily, weekly, or monthly processes. These processes already exist, but now it is with the vision of home.”

The overarching goal of the Welcome Home Project is to maintain the home through the management structure, policies for quality care, the physical environment, and daily activities. This is done by creating a home environment and routine in a non-restrictive setting. The Welcome Home Project provides different processes to organize the work on the homes to avoid being a “medical institution” and instead promote the comforts of home.

In the years since they implemented the project, the Homes of Greenbrier created a real home for their residents. It is a home that includes privacy, interpersonal warmth, stimulating opportunities for personal development, and encouragement to contribute to the development of others. It also fosters a strong commitment between residents and staff members. From their first day, the Residents’ are treated as valued members of the home.

At Greenbrier, several dedicated staff members greet residents. Traditional institutional titles now include descriptors like mentor, nurse leader, life-enrichment guide, and environmental mentor, all in the resident’s selected home. Residents decorate their rooms to their liking and make their space personal and familiar to them. They can schedule their own activities, such as reading a book in the community living area, taking a nap in their room, playing board games with other residents, or building and painting a model car. In addition, Welcome Home maintains that home-like foundation with weekly “Learning Circles”. At these circles staff and other residents meet to allow new residents or staff to introduce themselves to others, share input on group decisions, and discuss ideas about daily activities and other life enrichment opportunities.

“Last but most important are the amazing staff that work at Greenbrier Village,” notes Long, “They are the true heroes who have a calling to work with residents. In getting ready to launch the program, I asked Certified Nurse Assistants, Nurses, and all categories of staff, ‘Would you want to go back and work without Welcome Home?’ It was unanimous, ‘No!’. The staff and the residents love the Welcome Home Project!”

The Concept of Home

“It is not home-like. It is not family-like. It is a real home and genuine family.” — Lori Long.

To understand The Welcome Home Project, you must first purge all preconceived notions of what nursing homes used to be: regimented atmospheres focused on medical needs. Today, the residents of The Welcome Home Project thrive on choice.

For Greenbrier, the shift from facility to home started with a year of research. A charter steering committee identified and implemented the needed changes. From the research, they created a training program. Each of these three steps was integral to the creation of the program.

The decision made was to start with food.

In 2005, The Homes of Greenbrier in Enid, Ok, opened the Rose Garden Café. The change transformed their cafeteria into a restaurant-like atmosphere. Residents could choose what they wanted to eat and when they wanted to eat it. “Before Welcome Home, we herded them all up, herded them in for breakfast. They did not have a choice. They did not have a menu,” recalls Rhea Donna, Life Enrichment Director at the Homes of Greenbrier. “It took a shift in mindset,” explains Syd Smith, the registered Dietician at Greenbrier. Smith has worked at Greenbrier for 35 years. “We had to retrain our minds to think of a restaurant kitchen rather than a facility kitchen. That took some time, but once our cooks got the system down, giving choices as far as the food goes eliminated much dissatisfaction.”

The café program quickly expanded, and The Four Seasons Cafe at Greenbrier’s Assisted Living and The Burgundy Café at their Apartments opened. Jim Thorpe, who worked at Greenbrier for more than 30 years, notes, “As an administrator here during that time, the largest complaint I had was the food. Once we went to the café where people could order and get what they wanted and take the time to eat what they wanted, my complaints went down drastically. A year after we were in, I can tell you that if I had one complaint a month, it was amazing.”

The success of the cafés prompted more change as Residents began to choose activities and outings. The Welcome Home Project began to take shape and evolve. “Introducing the Welcome Home concept caused everyone to take off their institutional cap and put on their creative thinking cap,” states Mike Weatherford, Marking Coordinator, and Family Guide at Greenbrier, “It started slow and then just exploded throughout the whole facility.”

The Welcome Home Project ensures there is a staff solely dedicated to life enrichment. Using a “Learning Circle” conducted regularly, staff work with residents to plan birthday parties, holidays, and trips. “That is how we become a family, through eating together, celebrating together, doing ‘life’ together,” explains Long. “Our residents are people. They are somebody’s mom, daughter, sister, grandparent,” explains Katie Cerezo, Administrator at Greenbrier. “We are building relationships with them and making their life meaningful. We have our jobs, we have things we have to do every day, and there might be things in that job that are not glamourous, but at the end of the day, the other part of our job is to build relationships and know you made a difference. We are people taking care of people!”

People see a difference in what they are doing there. They feel the difference.

The Welcome Home Project ensures there is a staff solely dedicated to life enrichment. Using a “Learning Circle” conducted regularly, staff work with residents to plan birthday parties, holidays, and trips. “That is how we become a family, through eating together, celebrating together, doing ‘life’ together,” explains Long. “Our residents are people. They are somebody’s mom, daughter, sister, grandparent,” explains Katie Cerezo, Administrator at Greenbrier. “We are building relationships with them and making their life meaningful. We have our jobs, we have things we have to do every day, and there might be things in that job that are not glamourous, but at the end of the day, the other part of our job is to build relationships and know you made a difference. We are people taking care of people!”

People see a difference in what they are doing there. They feel the difference.

Emphasizing Life Enrichment on the Home: Living Life to the fullest

One program to highlight in Welcome Home is Living Life to the Fullest. This is part of the life enrichment initiative. Every week residents choose the activities, whatever they suggest, and staff work to make them happen. Greenbrier’s Life Enrichment Guides organize and run the Live Life to the Fullest weekly meetings. “We ask questions like what do you like to do? What would make this feel like home to you? Then we tailor their care to them. It is not a blanket approach for everyone. You make your own choices,” explains Angela Terrell, Event Coordinator, and Life Enrichment Guide at Greenbrier Assisted Living.

The program is named Living Life to the Fullest simply because that is the goal. The staff here are passionate about encouraging residents to enjoy daily life. “They still have life to live, they are still entitled to that life, and we want them to have the best quality of life they can,” says Angela. “Often, they have been alone for some time when they move in. They have lost the idea that life is still fun. They can still enjoy and find new things to do, new hobbies!”

“With these meetings, life got full,” remarks Mike Weatherford. “They had choices where they did not have choices before. The whole environment aesthetically began to feel more like home. There is nothing better than taking care of happy people. With Welcome Home, attitudes changed, and the whole atmosphere just lit up.” Meagan Mathers, Infection Prevention and MDS Manager at Greenbrier Village, says the most significant evidence of change is in the residents. “I had a resident today talking to someone in the clinic, and she said, ‘I want to go home.’ He responded, ‘Oh no, you live here now,’ and she said, ‘I know, I need to go to my room to nap.’ They truly do feel like it is home.”

It is their home. It is their life. Weatherford, Mathers, Long, and Thorpe say their job is to help them live it.

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