Green House Presentation

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Green House Presentation

• March 24, 2006
• Pinecrest Medical Care Facility
• Darlene Smith, RN, DON

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Planting the Seeds of ChangeThe Green House
at Pinecrest
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(No Transcript)
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Green House Organization

• The Elder
• The Shabazim (Elder Assistants)
• The Sage
• The Clinical Support Team
• The Guide
• Clinical Support Team Nurses
• DON, Activities Director, Therapy, Dietician,
  Social Worker

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The Elder
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The Elder

• At the center of the organizational structure
• Decision making is kept as close to the elder as
  possible
• If unable, the individual closest to the elder
  who has the training and expertise to make the
  decision, does so with within the framework of
  the known wishes of elder family

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The Shabaz
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The Shabaz

• The role of a Shabaz is to provide care to the
  elder
• Activities of daily living such as meal
  preparation, dining, laundry, housekeeping,
  dressing, bathing, grooming, recreation and
  socialization

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The Sage
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The Sage

• A member of the community who participates as a
  volunteer
• Provide advice and guidance to the Shabazim
• Visit Green House regularly and participate in
  house meetings
• Has no authority to direct activity

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The Sage

• Held to confidentiality regarding any
  communication with the Shabaz except if the
  information involves elder abuse, neglect or
  potentially dangerous circumstances
• Any of the above would be reported immediately to
  the Guide

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The Shabazim
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The Shabazim

• Shabazim function as a self-managed work team
• They monitor and report the outcomes of their
  work to the Guide

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The Clinical Support Team
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The Clinical Support Team

• This interdisciplinary team consists of
• Physical, Occupational Speech Therapists
• Social Worker
• Dietician
• Recreation Therapy
• Nurses

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The Clinical Support Team

• The Clinical Support Team members work under the
  direction of the Physician and the outcomes of
  their work are monitored by the Guide, Director
  of Nursing and the Medical Director
• Nurses report to the DON

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The Clinical Support Team

• Determines clinical needs of the elders and
  decides how those needs will be met
• Visits to provide clinical services
• Collaborate with the Shabaz regarding the elders
  clinical status, delegate clinical treatment,
  review effectiveness and modify treatment if
  necessary

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Care Planning Meetings

• Held at the Green House with the elder, the
  Shabaz and members of the Clinical Support Team
• Family is notified and invited if the elder
  wishes them to attend
• The meeting is coordinated by the Clinical
  Support Team in collaboration with Shabaz

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The Guide
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The Guide

• A licensed nursing home administrator who guides,
  directs and monitors the quality of care and the
  quality of life of the elders in the Green House

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The Guide

• Responsible for evaluating the outcomes of the
  work of the self managed work team of the
  Shabazim
• All Shahbazim are supervised and directed by the
  Guide

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Clinical Support Team Nurses
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Clinical Support Team Nurses

• Responsible for monitoring the clinical status of
  the elders
• Responsible for visiting each elder on each
  shift, performing daily general assessment of
  clinical status
• Results discussed with Shabazim and documented in
  elders medical record

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Green House Education
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• The education of all who contribute to the Green
  House is of fundamental importance.

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Green House Education

• The best designed structure, the most cutting
  edge technology, and the best business plan are
  wasted resources if all of the participants in
  the Green House are not educated.

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Green House Education

• If the Green House is to be a place which is not
  a mini-nursing home or a new version of assisted
  living, it must embody a cultural change.

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Green House Education

• A Green House is a vessel for the enactment of a
  humanistic, interactional philosophy of growing
  old.

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Green House Education

• The philosophy of the Green Houses hold that it
  is a space where frail elders and those who
  support them come together to maximize the
  wellness of the aging individual.

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Green House Education

• The quality of life an elder achieves is the
  result of interactions between the elder, other
  people, and the environment.

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Green House Education

• Rather than simply train staff, it is necessary
  to re-educate all who participate in the Green
  House.
• Elders, their families, volunteers, clinicians,
  visitors and the community all need to understand
  the Green House philosophy.

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The Green House Participants attempt to

• Provide Privacy
• Recognize and value individuality
• Honor autonomy and choice
• Foster spiritual well being
• Create a sense of safety, security and order
• Facilitate physical comfort

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The Green House Participants attempt to

• Foster enjoyment
• Provide opportunities for meaningful activities
• Offer opportunities for reciprocal relationships
• Promote functional competence
• Convey the importance of an individuals dignity