Lexington, KY - It is starting small, but the Wesley Village retirement community in Wilmore, Ky., wants to serve as an example of how Kentucky can improve the lives of its older adults.
In 2011, it became the first in the state to adopt a new concept in nursing home care: building a facility that is more like a home and less like an institution, where caregivers act more like personal companions and less like the provider of a specific service.
The result of implementing their “small house” concept, where 10 residents share a home with its own kitchen, living, dining and easily accessible but secure outdoor area, has been a big improvement not only for the residents, but for the people whose job it is to serve them.
“There are a lot of changes that need to be made [in nursing homes], and that is what we are trying to do with this small home,” said Alan Beuscher, vice president for community relations at Wesley Village.
Instead of dealing with several different staff members for different areas of care — dietitians, activities leaders, cleaning staff — there will be just a few staff members who cross-train in all aspects of providing care.
And instead of a schedule set by the staff, the personal preferences of the residents determine the schedule and the activities.
Beuscher said residents can get up when they want, get themselves a cup of coffee and sit down with the newspaper — outside if they wish — and eat breakfast when they feel like it, the same as any homeowner would do in his or her home.
A caregiver companion can provide help, and two staff members, who are responsible for keeping the home clean, providing meals, facilitating activities and monitoring the health and hygiene of the residents, are always available during working hours. Beuscher said it is what people would expect if they were hiring someone to come into their homes to provide care.
The result has been not only happier, healthier residents, but a huge increase in job satisfaction for the caregivers and a huge drop in turnover among the staff. While it does require more upfront training for the caregiver companions, who are certified nursing assistants, not having to constantly train new people more than makes up for it.
Keith Knapp, a gerontologist and CEO of Christian Care Communities, described the new caregiver role as “more of a surrogate son or daughter.”
When Christian Care Communities begins providing senior care at Ashgrove Woods in 2013 and a facility planned in Midway in Woodford County, that same approach will be used to staff its assisted living and memory care units.
“We are sold on this model,” said Knapp.
This idea was first implemented in Mississippi in 2003 under what Bill Thomas, the concept’s originator, called the “Green House” principles. The Green House name has been franchised, but the ideas behind them have been used in several states. While Wesley Village is the first in the state to open such a facility, it invites nursing home operators and retirement communities in to see how it works.
Wesley Village’s Holloway Cottage is a memory care unit, where Beuscher said maintaining familiarity and consistency are especially important to the well-being of the residents.
“The No. 1 variable in quality of care is consistency of care, and a lot of that is lost in larger nursing homes,” Beuscher said.
And while annual turnover among the staff is more than 80 percent at traditional nursing homes, Beuscher said those following the new model have cut that to 20 percent or less.
Christian Care Communities already has begun transitioning to the “Green House” model for senior care at its facility in Bowling Green, Ky.
“We are building service around personal relationships,” Knapp said. “Instead of ‘Did we get all the tasks done today?’ we are asking, ‘Is the client happy with us?’”
Ashgrove Woods provides Christian Care Communities with its first opportunity to start out using the “Green House” model.
“It’s not that the services will be different, but it’s how they will be delivered,” Knapp said.
Knapp said all of its Kentucky facilities will eventually use the concept.
And Beuscher is hopeful that the concept will spread. He said the plan under Wesley Village CEO Glenda Creech was to build multiple small-house units at the retirement community.
The recession meant building on a smaller scale at first. At Wesley, they would like to have five or six small-house units and not just for memory care units. As the economy recovers, he hopes other retirement facilities in Kentucky will follow suit.
“It is an idea whose time has come,” Beuscher said.