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1. Green House Presentation March 24, 2006
Pinecrest Medical Care Facility
Darlene Smith, RN, DON
2. Planting the Seeds of ChangeThe Green House at Pinecrest
4. Green House Organization The Elder
The Shabazim (Elder Assistants)
The Clinical Support Team
Clinical Support Team Nurses
DON, Activities Director, Therapy, Dietician, Social Worker
5. The Elder
6. The Elder At the center of the organizational structure
Decision making is kept as close to the elder as possible
If unable, the individual closest to the elder who has the training and expertise to make the decision, does so with within the framework of the known wishes of elder & family
7. The Shabaz
8. The Shabaz The role of a ?Shabaz? is to provide care to the elder
Activities of daily living such as meal preparation, dining, laundry, housekeeping, dressing, bathing, grooming, recreation and socialization
9. The Sage
10. The Sage A member of the community who participates as a volunteer
Provide advice and guidance to the Shabazim
Visit Green House regularly and participate in house meetings
Has no authority to direct activity
11. The Sage Held to confidentiality regarding any communication with the Shabaz except if the information involves elder abuse, neglect or potentially dangerous circumstances
Any of the above would be reported immediately to the Guide
12. The Shabazim
13. The Shabazim Shabazim function as a self-managed work team
They monitor and report the outcomes of their work to the Guide
14. The Clinical Support Team
15. The Clinical Support Team This interdisciplinary team consists of:
Physical, Occupational & Speech Therapists
16. The Clinical Support Team The Clinical Support Team members work under the direction of the Physician and the outcomes of their work are monitored by the Guide, Director of Nursing and the Medical Director
Nurses report to the DON
17. The Clinical Support Team Determines clinical needs of the elders and decides how those needs will be met
Visits to provide clinical services
Collaborate with the Shabaz regarding the elders? clinical status, delegate clinical treatment, review effectiveness and modify treatment if necessary
18. Care Planning Meetings Held at the Green House with the elder, the Shabaz and members of the Clinical Support Team
Family is notified and invited if the elder wishes them to attend
The meeting is coordinated by the Clinical Support Team in collaboration with Shabaz
19. The Guide
20. The Guide A licensed nursing home administrator who guides, directs and monitors the quality of care and the quality of life of the elders in the Green House
21. The Guide Responsible for evaluating the outcomes of the work of the self managed work team of the Shabazim
All Shahbazim are supervised and directed by the Guide
22. Clinical Support Team Nurses
23. Clinical Support Team Nurses Responsible for monitoring the clinical status of the elders
Responsible for visiting each elder on each shift, performing daily general assessment of clinical status
Results discussed with Shabazim and documented in elder?s medical record
24. Green House Education
25. The education of all who contribute to the Green House is of fundamental importance.
26. Green House Education The best designed structure, the most cutting edge technology, and the best business plan are wasted resources if all of the participants in the Green House are not educated.
27. Green House Education If the Green House is to be a place which is not a mini-nursing home or a new version of assisted living, it must embody a cultural change.
28. Green House Education A Green House is a vessel for the enactment of a humanistic, interactional philosophy of growing old.
29. Green House Education The philosophy of the Green Houses hold that it is a space where frail elders and those who support them come together to maximize the wellness of the aging individual.
30. Green House Education The quality of life an elder achieves is the result of interactions between the elder, other people, and the environment.
31. Green House Education Rather than simply ?train staff,? it is necessary to re-educate all who participate in the Green House.
Elders, their families, volunteers, clinicians, visitors and the community all need to understand the Green House philosophy.
32. The Green House & Participants attempt to? Provide Privacy
Recognize and value individuality
Honor autonomy and choice
Foster spiritual well being
Create a sense of safety, security and order
Facilitate physical comfort
33. The Green House & Participants attempt to? Foster enjoyment
Provide opportunities for meaningful activities
Offer opportunities for reciprocal relationships
Promote functional competence
Convey the importance of an individual?s dignity