Grancare Nursing Center

Community

Leadership

Resident-Directed Care

Grancare

Meadowood

Meadowlark Hills

Leelenau Memorial

Liberal Good Samaritan

Lyngblomsten Care Center

Chandler Hall

"Not many owners... are out there working on the floor. It should be mandatory!"

- Donna Zunker

Synopsis

Donna Zunker is the owner and administrator of Grancare Nursing Center, a home adopting the philosophy of the Eden Alternative, which utilizes many of the concepts and ideas central to culture change. She tells us about her first year of implementing these new ideas, and of her plans for the future.

The Story of Grancare Nursing Center

It seems like only yesterday that I attended the Eden Associate training in Burlington, Wisconsin. We have been in a whirlwind of activity since. Consequently, I neglected to keep you posted on how we were doing here in Green Bay. Let me give you a summary of where we are.

Prior to the training, I knew this was the philosophy I wanted my Nursing Home to live by, and since my husband Donald and I are the owners, it was an easy process. Thankfully, my husband readily agreed with me, so the journey began. The groundwork had already been laid, since many of the concepts were in place. The meetings with the leadership staff, general staff, Elders and family all confirmed my belief that this was the right way to proceed.

Changing the culture was the first order of business. The facility was plagued with temporary staff due to the tight labor market in Green Bay. Although we always had high standards (at least, we thought so), we re-examined this and made a commitment to enforce our standards. A new absentee policy was put into effect and followed (the key words). Staff members were trained in this new culture we wished to foster. Many embraced it, some who could not chose to leave. Our "negative minds" were quickly weeded out. It was tough. While we were trying to recruit caring staff to take the place of those that left, I worked many, many shifts as a CNA. Although very tiring, what a neat experience it was! Those who embraced these new ideas got more excited as we talked about the possibilities of what we could do as we cared for the Elders together. Not many owners, I take it, are out on the floor working as a CNA - it should be mandatory! Gradually, as the word got out in the community, CNAs from other facilities came to us saying, "I heard it was different here." We became very selective in our hiring decisions. Although it was very tempting to take the first body that walked through the door, we didn't. In addition, if someone did a good job throughout the interview process but changed personalities after being hired, they were coached immediately and either changed and stayed, or left. Lois Butkovich, our Director of Nursing, has been instrumental in assuring that our new standards are adhered to.

Because of all our hard work, our Home has eight neighborhoods. Nursing assistants and nurses care for the same Elders each day. We have dropped the institutionalized language (although sometimes we do slip up). For example, we refer to our neighborhoods by their names, and we've dropped some of the medical terminology, like "nourishment time".

The "East Lounge" has been turned into the GranCafe. Patty Farley, RN, the Mayor of Turnaround Circle, along with the Elders, decided that they would cook their own breakfast each morning. Nurses, nursing assistants, social workers and whoever else is available helps out. We have had no weight loss problems since the inception of this program. In addition, food waste has decreased. Elders have an opportunity to come together, in a very home-like and non-intimidating setting to meet and get to know others. Friendships have blossomed, and some folks have discovered they were shirttail relatives!

Wendy Wallace, a Certified Nursing Assistant, started Spa Day. She took a room that obviously shows its age and turned it into a place of pampering for the Elders. She has found that this has improved skin integrity, obviously does a much better job of getting clean, and most importantly helps the Elder relax those stiff arthritic bones. As she applies lotions to thin fragile skin and does their hair, soft music is playing in the background. Wendy has turned the Nursing Home bath day, which I always thought of as an assembly line of hosing people down, into a beautiful experience our Elders long for and deserve.

Twenty birds of various types are singing throughout the facility, most living with the Elders in their rooms. We were very fortunate to have Dr. Sara Wolfe donate her talents to keeping the birds healthy. Carly, a golden retriever, joined our family about two months ago. Carly is ten years old and spent most of her adult years bearing puppies that would go into training as companions for the blind. Carly had 33 puppies, and 23 of those became successful seeing eye dogs. Dr. Neil Reichsteiner has graciously taken on Carly's medical care. Dr. Neil visited Carly this past week and was amazed at the things being done in our Home. Carly has adjusted well to her new home and is a comfort to many of the Elders. Putty the cat is not a cuddling cat but we all have fun watching her antics.

The Zonta club has made six wheelchair-accessible and portable gardens for the home. It didn't take much to find the green thumbs! We have so many ladies excited about the gardens. We are just starting this venture and have so many ideas, we have a hard time deciding what to do first. My vision is to create a variety of different gardens. I am anxious to have healing gardens at the bedside of someone who is terminally ill.

We attempted to become certified as a Day Care Center for children and found out we really have to jump through a lot of hoops for that. Not wanting to abandon the idea, Stacie Rosera decided to create a playroom out of an area that was wasted space. This space, which is very open and accessible to the Elders, will have the look of a child care area when completed. When family visit with children, they can have a safe and fun place to play while grandma or grandpa watch. Various times throughout the month, staff members will bring their children while they are working, and that provides everyone with activities for the day.

Our goal after the first of the year is to eliminate tray service at meal times. We have dabbled in several ideas but have not come up with the best way yet. However, we won't give up.

We have so many things going on it is hard to name them all. I do know that we have come a long way in this past year, but we also have much to do yet.

When I have a minute, I will sit down and put some numbers together. I am sure our medication usage is down. Our staff turnover rate is definitely down, we have improved continence, and Elders and staff are both happier. I realize having the numbers to back up our accomplishments will help in spreading the word.

Thus far, we are the only home in Green Bay undertaking this sort of culture change. I have encouraged other Administrators to recognize and adopt our ideas. As of now, they still think I am crazy.

Whenever I have an opportunity, I speak to community groups and organizations. The word is getting out. The Home is still full; in fact, we could fill more than the 75 beds we have. Staffing remains a problem with the tight labor market. Caring individuals are still needed.

After the first of the year, I will also begin massage therapy for the Elders and staff. We were fortunate to have a CNA join our staff who is also a certified massage therapist. I am very excited to get this going.

And that's not all! Donald and I, along with a partner, have purchased 55 acres of land in Green Bay and are in the process of developing an Elder community. Certainly not like the communities that I have toured throughout Wisconsin - this needs to be different. In fact, I received a call from Ken Saiki, a landscape designer from Madison, Wisconsin who is interested in culture change. We have met, and he will be joining our design team for the community. When I told him what I wanted to do with gardens, both inside a building as well as outside, he understood immediately what I was trying to accomplish. We will begin construction in April if all continues to go well. I only wish the financial resources were unlimited, that surely would make things easier.

Throughout the year, I made many plans to attend additional training sessions. I always cancelled because it seemed we were on the brink of something great at the Home, or more likely, I was needed to work as a CNA. I do know now that I need interaction with others involved in culture change. It seems like I have reached another level, and I need help. Does that make sense?

I look forward to our paths crossing again in the coming years.