Home, small home

Here’s my latest article on McKnight’s Long-Term Care News:


Home, small home

In 2014, I wrote, “I finally visit a Green House (and it blows my mind).” The Green House is designed with a spacious common area, private bedrooms and showers, unobtrusive medical items and universal workers practicing person-centered care. The model shows that it’s possible to make dramatic lifestyle improvements in long-term care.

It seemed that Green Houses were the answer, if only there weren’t so many traditional facilities already in place. Traditional nursing homes can participate in culture change programs with great success if their leadership is committed to the philosophy through the transition period and beyond. They can retrain staff, add plants and pets and remove nursing stations, but the standard long hallways have remained – until now.

Last week I had the opportunity to speak with Rebecca Priest, LNHA, LMSW, Vice President of Skilled Services, at St. John’s Home in Rochester, NY. She’s presiding over one of the most exciting changes in LTC to come down the pike since, well, Green Houses.

St. John’s is taking a conventional nursing home built in the 1960’s with 32 beds to a hall and turning it into 22 small homes modeled after the Green House Project. Each floor is being systematically transformed into homelike environments with a large space for cooking, dining and socializing and universal workers called “Shahbazim” who are central to the model’s success.

Rather than having aides, housekeepers and laundry workers, the Shahbazim do it all. “The Shahbaz role,” Priest says, “is highly skilled and not for everyone. Shahbazim need to collaborate and be part of a highly sophisticated work team.”

Cross-training staff and flattening the work hierarchy reduces the likelihood that workers will find themselves in “systematically disempowered situations where they are set up to fail.” As a resident I knew used to say, “Amen to that!”

For the entire article, visit:
Home, small home


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