Alaskans are on the verge of a cultural shift - threatening to send your non-compliant parents to a nursing home isn’t going to work any more, they will prefer to live there than with you.
Blame it on the new Seward Mountain Haven Long Term Care Facility. This small, picturesque, and quirky community decided that it likes the old and infirmed, and that they deserved a better level of care than what was currently available in the Alaskan market. Seward discovered the innovative Green House Model of elder care, an approach Seward City Finance Director Kris Erchinger feels is more humane.
“They are not called patients or residents, they are called elders,” advises Erchinger. “And in a nutshell, that is the difference between this facility and most others. The Green House Model restores dignity by returning them to a homelike environment.”
Developed by Dr. William Thomas, the Green House model creates a small intentional community for a group of elders and staff that focuses on the relationships that flourish during the last stage of ones life.
A radical departure from traditional models, the primary purpose of Seward Mountain Haven is to serve as a place where elders can receive assistance and support with activities of daily living and clinical care, without the assistance and care becoming the focus of their existence.
It is intended to de-institutionalize long-term care by eliminating large nursing facilities and creating warm, habilitative, social settings.
Seward’s old long term care facility, the Wesley Rehabilitation and Care Center, was like most in the state. Staying there was like staying in an old hospital. The institutional facility consisted of two buildings located under the dark shadows at the base of a mountain, which served well beyond their effective life spans.
According to the City of Seward, the buildings house mechanical and electrical systems for which parts are no longer available. Some portions of the buildings have been closed to access due to serious safely concerns, including structural collapse of one section of the building.
So when it came time to re-build, it also became time to re-locate the new facility to a prime residential neighborhood known as Forest Acres; a large sun-soaked campus with breathtaking views of the surrounding mountains and old growth spruce forest.
The Providence Hospital website says that Seward Mountain Haven will offer all the quality medical services of an institutional nursing facility in the setting of a traditional home – with a hearth, a shared dining room and kitchen, private bedrooms and bathrooms.
The flat roofed cement block buildings have been replaced by what appears to be upscale houses with massive timbers, wood shingles, and large divided-light windows. Gone is the institutional kitchen that filled plastic trays three times a day, replaced by residential-style kitchens with inviting countertops and a warm fireplace.
The Green House Model is a change in not only the architectural approach, but also organizational structure, staffing patterns and the philosophy of care.
“What I like most about this project is that it returns freedom of choice about care,” explains Erchinger. “If you feel like folding socks or baking cookies you can. You get to pick what color your room is painted. You can bring in your own furniture and decorations for your bedroom. The house gets to decide if they want pets or a piano.”
Having elders active in making decisions most of us take for granted, such as planning menus and activities, and controlling their own schedules, has been proven to be beneficial to overall health. A University of Minnesota study found that Green House elders reported less decline in late-loss activities of daily living such as bed mobility, transfer, eating, and toileting.
Compared to those in traditional nursing care settings, they had less prevalence of depression, increased sense of privacy, dignity, and individuality, and more meaningful activity, relationships, and food enjoyment.
Green House elders were also found to experience more active participation by family members and better relationships with direct care staff. Generally, the study found that elders who lived in Green House homes experienced a better quality of life and improved health, and that is the kind of care Seward felt it needed to offer its community.
“A lot of the bureaucracy is eliminated,” explains Erchinger. “The caregiver closest to the elder has the most say in how care is given. The decision making is directly tied to the wants and desires of the individual.”
So if an elder wants pancakes for breakfast at 11:00 a.m., instead of eggs at 8:00 a.m., they can expect the pancake brunch at a well set table with music, flowers, and good conversation with people who care about one another.
If someone wants to read a book while looking out the great room’s expansive windows onto the beautiful scenic vista at midnight, it is okay. The elder is free from the limitations of an institutional schedule and lives a comfortable daily life - sleeping, eating, and engaging in activities as they choose.
Families are encouraged to share meals, participating in activities, volunteer time and services, and help the elder to decorate their personal space. Well-behaved family pets also are welcome to visit if elders in the house have no medical restrictions.
There is easy access to all areas of the house including the kitchen, laundry, outdoor garden, and the patio. Safety features are built into the house to minimize injury.
“Tracks in the ceiling can be used to assist in lifting an elder out of bed and into the shower, significantly lowering the risk of accident and injury to both patients and caregivers,” suggests Erchinger. The small size of the Green House home promotes less use of wheelchairs.
A $1.6 million Denali Commission grant covered planning and design on the 34,000-square-foot facility that would house 40 residents in four separate Green House Model homes. The bulk of the remainder of the $29 million cost was financed by the City of Seward via revenue bonds.
The Wesley’s resident population consisted of around 30 individuals, 90% of whom come from other Alaskan communities. The Wesley served a unique niche in Alaska, as it included patients with multiple and physical diagnoses, patients whom no other Alaskan facilities would admit. The Wesley patients are now enjoying their own rooms at the new facility. The patient costs for Seward Mountain Haven are equivalent to the traditional Medicaid costs for nursing homes.