Person-centered care offers hospitality to residents and their families
By BETSY TAYLOR
On an unexpectedly snowy day late last winter in Louisville, Ky., a nurse at Nazareth Home brought a resident into a comfy common room. The nurse spritzed lavender essential oil in the air, helped the woman from a wheelchair into a comfortable recliner and positioned her so she could enjoy the blazing fireplace — actually a video of a fire crackling on a flat screen television.
"It's so warm and cozy in here," the resident remarked.
Nazareth Home cares for residents in need of short-term rehabilitation, long-term skilled nursing care and residential memory care. Sponsored by the Sisters of Charity of Nazareth, the 168-bed facility demonstrates the congregation's values of simplicity and hospitality in part by providing simple pleasures that make residents feel relaxed and even pampered. Staff members use music and other forms of sensory stimulation including soothing touch, pleasant smells and unhurried conversations to add to the quality of residents' days.
Jennifer Benton, a certified nursing assistant at Nazareth Home, visits with resident Marie McClellen in the Namaste Room.
Mary Haynes, president and chief executive of Nazareth Home, said, "We believe a person-centered care way of living fits with simplicity and hospitality — welcoming strangers and honoring the individual." The home extends these values to its involvement with residents' family members and loved ones, with programs that make them feel welcome and provide simple ways they can enjoy pleasant experiences with their relatives during visits. Nazareth Home follows approaches developed in two trademarked programs, Namaste Care and Music & Memory.
Author and geriatric consultant Joyce Simard originally developed Namaste Care to engage the five senses of individuals with dementia who may not be able to easily communicate their spiritual, emotional or physical needs. Nazareth Home uses the approach with its patients living on its memory care units.
Music & Memory, a program of the Music & Memory nonprofit organization, employs custom playlists shaped to the tastes and personal histories of individuals to entertain and engage their attention. At Nazareth Home, residents, staff and student volunteers create the music playlists that residents listen to on iPods or iPads. Not infrequently, the music will trigger a memory and a resident will share a personal story with a staffer or family member.
Jennifer Campbell, assistant professor of music theory and history at Central Michigan University, brought Music & Memory to Nazareth Home along with a group of gifted Kentucky high schoolers. Campbell was working with the students through a summer program at Bellarmine University, located across from Nazareth Home. The students visited Nazareth Home about three times a week, engaging with residents, helping residents build their individualized playlists and teaching residents to use iPods and iPads to listen to their music choices.
Kim Hobson, Nazareth Home's director of nursing, said, "It really opened our eyes to who our elders are," as the elders discussed their likes and dislikes in music and shared favorite songs. The students and residents bonded, as they discussed music. Residents shared memories as they listened to tunes, and one who heard piano music talked about how she had played the piano for many years. "She really seemed to come to life," Hobson said.
Vince Romeo, a 23-year-old resident at Nazareth Home, has been nonverbal since he suffered a brain injury in an automobile accident in 2009. Romeo's mother, Lynda Romeo, said he enjoyed some "guy time" with students close to his own age during the project. "All these small things draw him out," she said.
Vince Romeo's friends and the staff at Nazareth Home continue to recommend songs to update his playlist. Hobson said Romeo's whole body relaxes when he listens to the music. "He gives a thumbs-up, and you can see his smile, his pearly whites, when he hears his playlist," Hobson said.
Residents also use the iPads to check news websites, communicate with family and friends through Skype and Facebook, to watch movies and to play games.
Honoring the spirit within
In some cases, staff at Nazareth Home say they've been able to lessen residents' psychotropic medications, as the music and interaction give the older population a way to soothe themselves or buoy their moods.
Namaste Care began as a program for nursing home residents with advanced dementia; it has since expanded to many assisted living and hospice communities. The program bridges nursing care and spiritual care by building nurturing into a resident's day. "Namaste means to honor the spirit within," said Gretchen Houchin, program director for Charity Court, Nazareth Home's memory care unit.
The nursing home used a $5,700 grant from the Sisters of Charity of Nazareth to renovate and furnish a common room as its "Namaste Room." Staff and family members bring residents to the room to enjoy the outdoor views and amenities. Some people use the "smart" television linked to the Internet to watch YouTube videos of grandchildren, or they may prefer a nature video of birds in the wild. Seasonal fruit, fresh juices and lollypops are offered to residents who enjoy them; a CD player can be used to play calming music; staff or a family member might massage a resident's hands.
Staff members help shape Namaste Care by offering their particular skills. One staffer provides reflexology, a pressure-point touch to relieve tension; another is good at painting nails. Staffers have some flexibility to their days, so that they are able to bring the residents they care for into the Namaste Room. Family members are encouraged to visit the room with their loved one, too, and take part in Namaste Care, which can create a more meaningful visit for the family. "People do want to spend time with a loved one, but they don't quite know what to do during a visit," Houchin said.
Tiffany Terriaco, Charity Court's nurse manager, said when residents are admitted to Nazareth Home, the facility gathers a life story about them, including their hobbies, interests and career background. In Namaste Care, they learn more about what each resident finds to be a comfort.
Staff enjoy the approach too because "it's not about cognitive impairment; it's finding what they enjoy."
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