David Wolterstorff, AIA, President WAI Continuum

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W A L K E R M E T H O D I S T
W A I C O N T I N U U M
Presentation for Care Providers Convention
Expo REPOSITION YOUR ALZHEIMERS ENVIRONMENT
PROGRAM
PRESENTED BY David Wolterstorff, AIA, President
WAI Continuum Jonathan Lundberg, COO Walker
Methodist
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Repositioning Program and Service Changes

Case Study Walker Methodist Alzheimers Unit
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WHAT IS REPOSITIONING?

• Redecorating or Remodeling?
• Metamorphosis moving from one thing to something
  similar yet totally different

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WHAT LEAD WALKER TO CHOOSE REPOSITIONING?

• Had a solid Alzheimers program in place.
• Had competent staff in place.
• Customers were typically satisfied.

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WHAT LEAD WALKER TO CHOOSE REPOSITIONING?

• Primary dissatisfaction from staff, residents and
  families relating to physical plant.
• Wanted to create an environment that encouraged
• More typical human interactions
• New behavior patterns
• Family community involvement
• Wanted to position the unit more competitively in
  the market with new and emerging options.

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DID REPOSITIONING MEET OUR EXPECTATIONS?

• Yes! But in ways we had not envisioned at the
  process start.
• Some areas of the unit are used differently than
  originally planned.

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Repositioning Environmental Changes
One of the most difficult challenges addressing
facility problems is providing bold solutions
that use only the existing area defined.
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WHAT WAS THE EXISTING AREA AT WALKERS ALZHEIMERS
CARE UNIT?

• Two floors were brought into the design scope
• 2nd floor had 41 beds
• 1 Triple
• 5 Doubles
• 28 Privates
• 3rd floor had 42 beds
• 1 Triple
• 5 Doubles
• 29 Privates

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Existing Floor Plan
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WHAT PROBLEMS EXIST?

• Long corridors
• Very limited space available for dining,
  activities, day room and family visits.
• Large number of residents in one area 41
  dementia residents.
• Residents were restless with higher stress levels
  than were desired.
• Remodeled Been there, done that. Same results
  shortly after remodeling. It did not work.

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THE EXISTING ENVIRONMENT
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THE EXISTING ENVIRONMENT
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WHAT GOALS WERE CREATED?

• Take a holistically different look at the space
  to create a skilled dementia unit, yet make it
  totally different within a 1M budget.
• Create smaller neighborhoods to help in care
  giving by reducing the large number of people
  into smaller families with separate dining,
  activity and day room spaces.
• Reduce the feel and look of the long corridors.
• Prevent the reduction of beds.

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Existing Floor Plan
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Existing Physical Plant Layout 16,213 Sq.
Ft. Common Areas Highlighted 1,178 Sq. Ft.
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Existing Floor Plan
Look at big picture first. What must be saved?
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Existing Floor Plan
Look at big picture first. What must be saved?
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Repositioning Strategy
Create 3 Neighborhoods
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Resident Path Circulation
Existing Floor Layout Long, daunting corridors
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Resident Path Circulation
Repositioned Floor Plan Shorter, more manageable
walking distances
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WHAT SOLUTIONS WERE CREATED?

• Maintained bed count
• Created family-like neighborhoods
• Reduced the long corridor look
• Created an environment that assists staff in care
  giving and even became a part of care giving.

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CREATED A NORMAL ENVIRONMENT

• Park benches
• Home façade
• Porches
• Town center or gathering area
• Apple orchard
• Fruit stands
• Flower shop
• Dog house

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Repositioned Floor Plan
Common Space Before 1,178 Sq. Ft.
Common Space After 2,750 Sq. Ft.
2nd Floor 41 Beds
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Repositioned Floor Plan
3rd Floor 42 Beds
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Creative Concepts
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Creative Concepts
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Creative Concepts
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Creative Concepts
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THE END RESULT
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THE END RESULT
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THE END RESULT
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Repositioning Project Results

Was Repositioning Successful?
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WAS THERE AN IMPROVEMENT IN QUALITY OUTCOMES?

• Census
• Turnover
• Falls
• Various Quality Indicators

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Resident Behaviors
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Incontinence
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Weight Loss
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Psychopathic Meds
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Percentage of Falls
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Percentage of Falls with Injury
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Occupancy Percentage
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Annualized Turnover Rate
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Family Satisfaction Survey 2 Raines
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Family Satisfaction Survey 2 Raines
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Repositioning Other Project Examples

Elim Buffalo Elim Milaca Mala Strana
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ELIM HOME BUFFALO
Before
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ELIM HOME BUFFALO
After
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ELIM HOME MILACA
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ELIM HOME MILACA
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THRO COMPANY NEW PRAGUE
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THRO COMPANY NEW PRAGUE