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Innovations in Nursing Home Care

Redefining long-term care at HSL and how Dr. Atul Gawande’s views are impacting the future of nursing home care
Innovations in Nursing Home Care

I just finished reading Being Mortal: Medicine and What Matters in the End by Atul Gawande, MD, MPH. In his book, Dr. Gawande, a nationally known surgeon, writer, and public health researcher, discusses end-of-life care, the many issues with traditional nursing home care in this country and the ways in which long-term care should be re-imagined.

Parts of the book paint a dreary picture of nursing home care that is all too common. The truth is, he is right, and the industry as a whole has failed our aging population by providing a sub-par model of care for so many decades. I applaud Dr. Gawande’s research and leadership in this area. We can no longer continue to do things the way they have historically been done, just because it is convenient.

For many years, the Hebrew SeniorLife team has focused on driving culture change in long-term care environments, starting with our own. As an organization, we are committed to redefining the experience of aging. To that end, we understand the extreme importance of focusing on patient and family-centered care. Significant work has been done here to develop a model that focuses on the wants and needs of our residents and staff, and creates a better environment for everyone.

I’m also proud to say that Dr. Gawande prominently cites our organization and residents in his book as examples of the way nursing home care “should” be. A big takeaway is the importance of independence and autonomy for seniors. This is something we strive to offer in our communities and we are very cognizant of asking “What goals are the most important to you?” and “What are your fears and concerns?” We understand the importance of decisions being driven by the perspective of the senior.

At Hebrew Rehabilitation Center, we’ve implemented five practices to help redefine our long-term care that are consistent with Dr. Gawande’s perspective:

  1. Respecting the voices of our residents
    We truly listen to our residents and work hard to meet not only their needs, but their wants as well.
  2. Re-establishing relationships
    Relationships are central to living a happy, fulfilled life. We work with our residents to re-establish relationships that are meaningful and important to them.
  3. Re-emphasizing individual choice
    We want our residents to have a choice on absolutely everything that matters to them: food, activities, what time they go to bed, what time they wake up, and more. We develop activities based on the choices of our residents.
  4. Re-imagining home
    Recreating a home environment is essential to our changing culture. To that end, our staff views themselves as guests in each resident’s home and we are careful to respect their space.
  5. Re-empowering staff
    We empower our staff by giving them the tools and resources they need to take the best care of our residents.

In addition, we’ve developed a video that features our extraordinary staff and illustrates the culture changes we’re making throughout our long-term care communities.

This culture change means providing the best services possible to seniors and their families at all stages of their life, including end-of-life. We want to ensure our model empowers those we care for to live all phases of life on their own terms.

As Dr. Gawande points out, end-of-life education is critical to helping people understand their options, examine the concept of what a good death can mean, and evaluate those options from an informed standpoint when the time comes to make very personal decisions. Part of his book focuses on the true benefits hospice care can provide to patients and their family members.

At HSL, we have established a hospice program founded on the principals of loving kindness and honoring life. Our multi-disciplinary hospice teams take a holistic view of patient needs at end of life, appreciating social and spiritual elements that contribute to a sense of well-being. Hospice care is meant to honor life during its final and very special stage.

As a country, we have a long way to go to make sure that we’re taking care of our aging population in a way that puts their wants and needs first. I’m proud to lead an organization that has created a model to which others can aspire and implement.

About Long-Term Care at Hebrew Rehabilitation Center 
We take pride in providing seniors with long-term care that redefines the nursing home experience. The basic tenet of care in Hebrew Rehabilitation Center’s nursing home long-term care communities is that resident preferences come first. Our vision for long-term care emphasizes the dignity, health and independence of seniors. Our innovative programming—along with a dedicated staff of Harvard Medical School-affiliated physicians, geriatric specialists, nurses and more—can be experienced in three communities in Massachusetts: Hebrew Rehabilitation Center Boston, Hebrew Rehabilitation Center Dedham at NewBridge on the Charles, and long-term care at Orchard Cove in Canton. We welcome older adults of all backgrounds, faiths and cultures.

Louis J. Woolf's picture

About the Blogger

President and CEO, Hebrew SeniorLife

Lou Woolf joined Hebrew SeniorLife in 2009 as President and was elevated to President and CEO in February 2013. Lou is committed to redefining the experience of aging for the thousands of seniors served by HSL’s integrated system of health care, senior living communities, research and teaching, and dedicated to supporting HSL staff’s extraordinary commitment to do exactly that every day. Prior to joining HSL, Lou served as Executive Vice President and Chief Operating Officer at North Shore Medical Center, the largest community hospital system in Partners Healthcare System. He also spent 10...

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I am very interested in what you are doing and how you are doing it. I was very impressed myself by Dr. Gawande's book and pleased to read how much it influenced Louis Woolf's thinking.
Thank you for your feedback, Ms. Meyer!

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