The distances in the Rice Care Center’s newly renovated east wing are shorter for aging legs to walk.
There are private rooms and baths, a dining room overlooking a garden, and a kitchen serving up meals and coffee whenever the residents want.
Most of all, the environment says “home.”
When Bev Bruse accompanied a resident out to the garden on a recent morning to cut fresh roses, they began chatting about flowers.
“I found out she really liked her gardening when she was at home,” said Bruse, the household coordinator for the skilled care facility’s east wing.
Moments like this between residents and staff are among the many outcomes the Rice Care Center hopes to see as it makes the transition this year and next year into a redesigned facility
The $6 million project is transforming not only the physical appearance of the 1960s-era nursing home but the resident experience as well.
“It’s a total 180,” said Troy Barrick, Rice Care Center administrator. “It’s all for the residents.”
Gone are the long institutional hallways and double rooms, replaced with self-contained, neighborhood-like units where residents can live, socialize and be cared for. Instead of tiled floors, there’s carpeting. Shared spaces are made homelike with armchairs and large windows that let in plenty of light.
Although the appearance is the most obvious change, the real change goes much deeper, Barrick said.
The new model of care places residents at the center - their needs, their preferences, their likes and dislikes, he said. “It is totally resident-driven. ... Everybody gets a say.”
Rice Care Center already does this to some extent, Barrick said. “We try to let residents have more variety of meals. We try to let them sleep in and have a bath when they like.”
But the creation of neighborhoods, each with its own staff, will enable a resident-centered culture to develop much more fully, he said.
Central to the concept is a cross-trained staff capable of providing breakfast, changing a sheet, taking a resident outdoors for a walk and responding to whatever the need happens to be.
“It breaks down departmental silos and blends them all together,” Barrick said. “It’s empowering the staff to have freedom to make changes.”
Although some functions will continue to be specific to nurses and certified nursing assistants, the model allows all the staff to be more flexible, and it will increase the overall direct contact between staff and residents, he said. “It gives us more time to do those spontaneous things. The staff will ‘belong’ to that household. It helps promote the institution of family. Staff will get to know the residents very well. Residents and families will get to know the staff.”
To reinforce the sense of community, each wing of the Rice Care Center is getting its own entrance and a new name. The east wing is now called Cushman Cottage after Col. Cushman Rice, whose bequest provided the money that built Rice Memorial Hospital. The west wing has been named Sophia House after Rice’s mother, the first woman to serve on the Willmar School Board.
It’s a model that has been taking hold in long-term care. In facilities where it has been implemented, residents have less loneliness, boredom and depression. Their quality-of-life measures improve. They become more engaged and mentally alert. They even walk more often.
In the two months since the first 15 residents moved into the renovated portion of the east wing, Bruse and the rest of the staff have seen the change. “People who didn’t say much in the past are speaking up,” Bruse said. “We’ve seen them come alive.”
Ten more residents will move into Cushman Cottage this month when the renovation of the east wing is completed. In October, work will start on Sophia House.
When the project is done, each neighborhood will have 25 residents. The facility also has 23 beds in Therapy Suites, its short-stay and rehabilitation unit, and will add seven more rehabilitation beds.
Because staff training is critical to the success of the new culture, a consultant was brought in earlier this year to help make the transition. It’s a lengthy process that has involved rewriting the nursing home’s policies and procedures, revising job descriptions and even creating some new positions, including two household coordinators, Barrick said.
By early August, all 112 of the Rice Care Center’s staff will be fully cross-trained - including the administrative team, who will become certified as nursing assistants. New job descriptions go into effect in mid-August.
It has taken effort, Barrick said. “Change is hard. That is not a new lesson.”
“For some of us that have been around a long time, this is a radical change,” Bruse agreed.
But they’ve been buoyed by what they’ve seen so far.
Bruse worked in the housekeeping department for many years and had little opportunity to be directly involved with residents. “Now I’m in the middle of it and getting to know the residents better,” she said. “We’re learning new roles and I think most of us are enjoying it. The staff is taking more ownership.”
The goal is an environment that’s attuned and responsive to each resident’s needs: emotional and social as well as physical, Barrick said.
“We engage everybody even if they’re not able to come out. They have a name. They’re part of a household,” he said. “This is a place where they can still have the best years of their life. We want to make that happen for them.”