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Many dimensions to good care of seniors needing assistance

The move to a senior living facility can be one of the most difficult experiences in most people’s lives. It can strain family bonds, drain seniors’ wealth and, for the facilities themselves, place them in the challenging role of being an arbitrator among competing interests as they work to accomplish a smooth transition.

Once the move has happened, the truly difficult part comes: keeping up the quality of life. Whether it’s in independent living, assisted living or memory care, treating seniors with dignity is expected, but so is progress and constantly evolving care to better improve quality of life. According to the U.S. Census Bureau, about 1.4 million Americans resided in nursing homes nationwide in 2014, and about 5 percent of the 65 and up population lived in a nursing home, assisted living facility or independent senior living community. About half of those residents suffered from Alzheimer’s disease, a number expected to rise with the aging baby boomer population.

Stepping into Jewish Senior Life’s Farash Tower, one notices the warm scent of hot soup wafting from Leo’s Delicatessen. A stone-lined fireplace flickers by a convergence of wooden tables in the main lobby. It’s inviting, and CEO Mike King said that’s exactly the point. The facility is there to make the transition from one home to another easy.

Mike King

Mike King

“On the independent side, it’s just like it sounds. That’s a choice-based decision—maybe my house is too big, I’ve got too much yard to take care of (or) maybe it’s time to scale down and be part of a community where I can be ensured of safety, where I’m getting a hot meal when I need it,” King said. “We spend a lot of time working with individuals and couples with issues around their houses, (specifically) down-sizing, because if you live in a house for 40 years, you’ve got a lot of stuff.”

King said seniors talk about the independent living side of Jewish Senior Life as “like a cruise ship” because of all of the amenities at their disposal. The biggest metric for King on the quality of independent living is the level of choice and freedom. JSL is a large campus and features gardening, recreation rooms, a library, art rooms and access to a long list of other activities seniors might be interested in.

“Most adjust really quickly, and what’s nice is we have a continuum of care, where you might come in to our independent living, and as you age in place, you can move to our assisted living on campus, and then if you need skilled nursing care, you can come over to our Jewish Home,” King said. “You never have to leave campus if you don’t want to.”

At St. Ann’s Community, Vice President of Housing Jennifer Blackchief sees a similar dynamic necessary to creating high-quality of care: consistency, stability and focus on the needs of the residents. But she also sees another vital component to keeping seniors active, and that’s keeping them a part of the community, not just senior communities but the community-at-large.

Blackchief refers to the “dimensions of wellness” as the backbone of St. Ann’s approach to senior living. Created by the Substance Abuse and Mental Health Services Administration, a division of the U.S. Department of Health and Human Services, the dimensions of wellness are eight facets of mental and physical health: emotional, environmental, financial, intellectual, spiritual, occupational, physical and social.

“So not just your standard exercise classes, but things the entire community can participate in from a physical movement standpoint,” Blackchief said. “So getting out and doing nature walks, going to the local farms for apple picking, engaging in yoga and other meditation practices that hit both the physical aspects of wellness but also the spiritual aspects.”

Culinary courses, history lessons, seminars and all sorts of other activities fill in the educational portion in an effort to keep seniors engaged and active. Those aspects of senior living can keep early-stage Alzheimer’s patients engaged as well, but as the dementia progresses, a different type of care is necessary. According to the Alzheimer’s Association, one in 10 adults over the age of 65 has Alzheimer’s disease.

“We all care—families for their loved ones, our staff for our residents—that intrinsic feeling of wanting to do the right thing is already present,” Blackchief said.

St. Ann’s ensures that staff members are constantly learning how best to work with dementia patients. The community recently hosted a seminar with Alzheimer’s expert Teepa Snow to better calibrate their approach to treatment.

St. Ann’s approach is similar to JSL, where about 70 percent of residents are suffering from some form of dementia.

“We took it upon ourselves a decade ago to have a memory care center of excellence, where we wanted to make sure everybody in the organization, from my position on down, understood the challenges around those suffering from memory loss and how to deal with that,” King said. “We partner with the Alzheimer’s Association. They come in here on a regular basis and do training, and the staff has a chance to talk with them on how to deal with this different behavior.”

JSL has an off-campus building known as Marion House, on South Clinton Avenue, which is an assisted living facility oriented toward memory care patients.

In-home services

But senior living facilities are only a small part of long-term care. In-home services are growing increasingly popular, with about 12 million Americans receiving some form of home health care, according to Johns Hopkins University.

HCR Homecare operates in 26 counties across New York and employs about 600 clinicians. All in-home care providers are registered nurses.

“I think that everyone agrees that with the complex patients we’re seeing, a person with more education is better,” said HCR founder and CEO Louise Woerner. “In addition to that, many of our nurses have a special certification,” which includes such areas as wounds, palliative care and cardiac care.

For HCR, technology is playing a major part in the home care they provide. X-rays, chemotherapy and other services once relegated to hospital visits are now available in the home. Woerner describes those services as a response to a pattern of people leaving hospitals “quicker and sicker.”

“Some of the people we’re seeing are recovering, and it’s pretty acute, so our folks have to be more prepared than they were a few years ago when they stayed in hospitals a little longer,” Woerner said. “We have a relationship with St. John Fisher College’s School of Pharmacy, for example, because nurses have been saying that some of the things they’re asked to administer in the home were only administered in the intensive care unit when they were in nursing school.”

According to census figures, by 2030, for the first time in American history, people over 65 (78 million) will outnumber those under 18 (76.7 million). With one in five Americans being a senior citizen, long-term care and senior living will become even more vital resources. For King, it’s a future he believes JSL is prepared for.

“Values are really important,” King said. “We have a really high ethical standard. We’re always trying to make sure we’re doing the right thing.”

gfanelli@bridgetowermedia.com/(585) 653-4022

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