Farewell to corridors crowded with pushcarts, over-sized dining halls, institutional decor and mind-numbing predictability.
Hello to spontaneity, relaxing in the kitchen over a cup of joe, hanging out with friends in the neighborhood and having a
say in decision making.
Yes, it's going to be a lot more like home for folks at the Meadowood Health Center in Worcester, PA, pending completion of
a construction/renovation project designed around the concept of community and neighborhoods.
"The idea is to provide opportunities for people to have relationships.. to be able to get to know each other and to make
decisions," says Jenny Sheckells, Administrator for the Health Center. The 12-year-old retirement community is home for about
430 independent living, nursing and personal care residents.
The project, expected to be completed in two years, involves renovating the Center's existing structure and constructing a
new 48-unit building to provide more community space for informal gatherings, consolidate operational offices away from living
quarters, and cluster groups of residents, about 12 per group, into their own "neighborhoods."
"[The plan] mimics the community where the residents lived originally," says Sheckells. "The concept is to have smaller,
close-knit groups where the residents can be a real strong part of the decision making."
Resident services and personal charts will be centered in the neighborhoods where the elders live, and gone will be the
impersonal and less accessible central nursing station and the constant buzz of call lights. Disruptive traffic like service
carts through the neighborhoods will be kept to a minimum.
Staff will be permanently assigned to a particular neighborhood and cross-trained to enable them to step out of rigidly
defined roles to meet the immediate needs of their residents. This will allow spontaneity back into the residents' lives,
give them more choices about what to do on a given day, and strengthen bonds with their care providers, says Sheckells.
Some 18 months of planning were involved in the estimated $10 million project before it was approved by the Meadowood Board
of Directors in September. During that time nearly everyone had a chance to put in their two-cents worth.
A team of 25-30 people regularly met around the table, representing residents, all levels and departments of staff, board
members, construction contractors, an interior decorator, a civil engineer, and special consultants on dementia and the Eden
Alternative.
Sheckells and the various department heads spent hours going over every detail with the architects-from light switch
placement to how the mirrors are hung-to make life more convenient for residents.
"We're trying to make it as much like their home as possible," says Sheckells.
There will be a family room in each neighborhood for informal gatherings, a "large, airy, sunny country kitchen" where
residents can watch or help in food preparation, smaller dining rooms to afford privacy and a cozy atmosphere, and a specialized
spa room for bathing, massages or aromatherapy.
Each neighborhood will have a different dÈcor so residents can identify with certain areas, an especially important
consideration for those with dementia.
"Maybe you go down one hallway and it's the Victorian type, and you go down another and its more the Ocean City shore house
look," says Sheckells. "We've been working with our designer to incorporate Feng Shui to find that aesthetic balance," she adds.
Communications with all involved is a critical element in the process.
"My number one concern is the least amount of disruption to the residents as possible.. letting them know every step of the
way what to expect, what could happen, what might happen," says Sheckells.
The project has absorbed at least 25% of her time since she joined Meadowood in February 2000, but it's been worth it.
"I've learned so much [including how] to shed some of my conventional thinking. I've spoken with people who are incredibly
knowledgeable about what we can do for our residents."
She urges facilities that are considering a culture change to get as much information as possible.
"Talk to people who are doing it. Find out who the Eden certified facilities are and learn if there are things you can do to
make it work for your community. If there's a good idea out there it really should be shared."
For those without funds for a major renovation or building project, don't despair.
"You don't need millions of dollars to facilitate cultural change," says Sheckells. "You just need commitment to
resident-centered care, patience during the education process, and a team willing to shed their 'this-is-the-way-it's-always-been'
attitude and to move to resident-centered decision making."
