Teresian House

Resident Systems Transformations

 

Resident systems at Teresian House include the following transformations that provide a resident centered focus:

1) Create an inclusive community and "home" for residents, families, and the outside community that is constantly communicating and reinforcing resident choice.

2) Work is organized around maintaining resident's autonomy and preferences. 

3) Inter-disciplinary, cross-trained teams operate throughout the organizational structure with an objective of putting residents before task and taking advantage of synergies in the organization. 

4) A relatively flat organizational structure with the resident at the top of the organizational chart is prioritized (allowing for effective communication among and between inter-disciplinary teams and residents).

5) Staff-resident interaction is a priority and staff "know" residents.

Below are examples of resident systems at Teresian House that affect positive resident and family outcomes.

Admissions and Move-In

• Residents and families view the "Realistic Expectations" video (excerpt above) when touring the building or beginning the application process. The video provides a straightforward, honest account of potential difficulties during move-in and transition including a smaller living space, anxiety associated with the change, and shared congregate spaces.  
• Admissions staff greet the resident to provide a familiar face during the move-in process.
• A welcome card and plant are placed in the resident's room by the Social Worker.
• The resident is also greeted by the Geriatric Technician (direct-care worker), Registered Nurse and Social Worker from their care team. They discuss sleeping, eating and bathing preferences of the resident to establish a plan for a daily routine.
• Staff assist the resident with move-in and set-up any equipment. Wi-fi is available in each room for computer use.
• The Social Worker and  Activities Coordinator work with the resident and family to develop a comprehensive social history of the resident's life. This history is shared with the rest of the collaborative team.
• The GT calls family the day of move-in and the following morning to report on the resident's adjustment and to begin to establish a relationship with the family.

Resident Centered Living

• Residents work with a Resident Care Team that includes a Resident Care Coordinator (RCC), a Registered Nurse, Geriatric Technician, Social Worker, Activities Coordinator, Dietary, Housekeeping, Therapy, Pastoral Care, Maintenance and others.
• Consistent assignment of staff allows residents to develop relationships with those caring for their daily needs. "Before Sister Pauline, residents used to get up at 5:30 am. Now, that is gone. They get up leisurely when they want to." - Registered Nurse
• Pastoral care is established for residents of all faiths. Roman Catholic Mass is provided each day in the Infant of Prague Chapel and televised to residents that wish to view it in their rooms. Protestant and Jewish services are also provided for residents of other faiths.
• Information technology is available to residents through Wi-fi access in all rooms, training and technical support from the IT department, and webcams for residents to "cyber" connect with friends and families across the country.
• Activities at Teresian House are extensive. In House Special Events also involve home-wide participation from residents, families and staff. Events include the Annual Wheelchair Bowl, St. Patrick's Day Pub Night, Dancing with the Residents, the Halloween Spooktacular, and a version of American Idol.
• Staff is trained to identify physical, psychological, and emotional conditions that require special attention. Medical care and therapy is one-on-one for the resident to ensure individualized treatments and results. Plans are underway to minimize the need for residents to travel to hospitals including dialysis treatments, digitized medical records and portable, interactive computer systems to transmit diagnostic data.
  

Food and Enhanced Dining

• Food is available to residents 24-hours a day in neighborhood kitchens.
• Conversations between staff and residents at mealtimes are encouraged. Staff are provided information about the resident to support meaningful conversation. In addition, the Director of Rehabilitation created a notebook with "conversation starters revolving around foods, meals and cooking."
• Tables have tablecloths, glass dishes, and full table settings. Adaptive equipment such as a  built up spoon to reduce tremors is used extensively to promote resident independence.
• Condiments are offered for every meal including pureed food. "Would you eat a hamburger without any condiments? The same is true for a pureed hamburger. Lack of ketchup or the resident's favorite condiments will affect the taste and ultimately their dining experience." - Trainer for Dining Enhancement
• Cloth napkins are used instead of bibs.
• Pureed foods are "slurried" to maintain appeal.
• Music, lighting and atmosphere are all designed to promote a high quality dining experience.
• Kitchen cleanup occurs only after residents have finished their meals.
• Residents view their own meal tickets to establish accuracy.

Resident Centered End of Life Care - End of Life Care is highlighted at the end of this case study. Click here to read more about the End of Life program. 

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