A New Day

Rise in the presence of the aged, show respect for the elderly and revere your God.
Leviticus 19:32

“A year for the St. Martin’s history books” is how some describe 2007. The St. Martin’s Trustees set the course for a new day in eldercare with approval of “The Cottages at St. Martin’s” project. The capital campaign continued, financing for the first six Cottages was obtained and groundbreaking was held in August. A commitment to change eldercare led to St. Martin’s beginning over 50 years ago. Since then we have constantly sought new ways to improve care of elders and to maintain each individual’s dignity, comfort and safety.

The Cottages project is no different. The Cottages are new homes for elders eligible for nursing home care, based on the Green House model created by Dr. Bill Thomas, geriatrician and visionary for change in long-term care.

We’re not building a new institution which would simply be a new version of what we have today, we are fundamentally changing the way eldercare is provided. We’ve decided that just because someone is frail, he or she should not be limited in living options. Today, frail elders live in medical-model institutions. But through technology and new care models we can create environments that truly become home. Our plan is to create something that looks, smells, and feels like home—because it is!

Rather than using departmentalized staff, the Cottages will be staffed with a new position called a “Shahbaz”. The position of Shahbaz has been described as the midwife of elder hood. A Shahbaz will manage the household along with the elders living there. They will perform the duties of Certified Nursing Assistants in assisting with elders’ personal care; and through additional training and certification they will prepare and serve meals. The elders can help in any way they choose.

The Clinical Support Team, nurses, physicians, and therapists visit the home regularly to provide needed care. And using technology, immediate assistance can be summoned in case of emergency.

This model is simple. Today’s nursing homes developed over many years based on circumstances of the time. As new hospitals were built in the post-World War II era, the old hospitals were transformed into “homes for the aged” which eventually became nursing homes. This model to efficiently “house” frail elders was duplicated over and over throughout the years. Thoughtful and committed organizations, like St. Martin’s, are now working to create change.

My hope for long term care is that this new direction in eldercare takes hold. That more and more organizations adopt a small, home environment rather than the outdated institutional model. It’s past time we chart a future that is intentional toward real change.

It is a new day at St. Martin’s.

2 comments:

Elder Earline said...

Thank you, Terry. Few rise in our presence these days. I am in my eighties so believe me when I say the times have changed-it is definitely a new day.

I am so glad to learn of the course chosen by St. Martin's in the Pines to change the evironment of care for elders like me. I'm relatively new to this virtual world, but am excited to learn more about your plans to be the first to bring this GREEN HOUSE to Alabama. I have to admit, the first thing I thought was "it seems like everyone is trying to go green nowadays!"

I had no idea there was a such thing as a geriatrician, but thank God for Dr. Thomas inspiring you to model the new environment after "home." I just wish they still made house calls like back in the day.

But now, you begin to lose me with the "Shahbaz." It's just kinda hard for me to wrap my brain around the word. Are they supposed to be like an au pair for the aged? It seems like these individuals will carry an awful lot of responsibility though.

Okay, well thanks for listening to me and best of luck to you in creating the change you have committed to. It will be quite remarkable as best as I can tell. Be sure to keep us posted on your progress.

Terry R said...

Dear Earline,
Thank you for the encouragement! Please stay tuned to the blog, the next post will explain in more detail the term and role Shahbaz. Your description "au pair for the aged" is right on track. Dr. Bill Thomas, creator of this model, often refers ot the term as the "mid-wives of elderhood". Thanks again for the comments.

The Cottages at St. Martin's Project

It’s simply home...
With an on-going commitment to the enhancement of quality of life for elders, St. Martin’s in the Pines is pursuing a unique and revolutionary care model for those requiring long-term skilled nursing. “The Cottages at St. Martin’s”, the first six residential-style nursing homes to be built in Alabama and part of a national movement known as THE GREEN HOUSE® Project have been in operation since late 2008. As a pioneer in the state, St. Martin’s serves as a beacon of hope for culture change in long-term care.

The GREEN HOUSE® model creates a small, intimate community for a group of 10 elders. A radical departure from traditional skilled nursing homes, The GREEN HOUSE® home alters size, interior design, staffing patterns, and methods of delivering skilled nursing services.

Its primary purpose is to serve as a place where elders can receive assistance and support with activities of daily living as well as clinical care, but without the assistance and care becoming the focus of their existence.

The physical transformation is only one element of the GREEN HOUSE® model. Staff responsibilities are dramatically different from those in a conventional nursing home. The traditional certified nursing assistant receives a new role of universal care worker called a “Shahbaz”. Each is given additional training, in ways to protect, sustain, and nurture the elders living in The Cottage and to take on a broader array of responsibilities, including facilitating meaningful activities, cooking, light housekeeping and laundry. Each house is also served by a clinical support team of nurses, medical directors, social workers, physical therapists, and others. These professionals are not stationed within the houses, but visit according to a schedule, much like a home-health model.

Privacy...Dignity...Autonomy...Home...Small...Cozy...Family...Nurturing
...Safe...Smart...GREEN

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