Membership
Meeting Minutes
2009
Jump to minutes: April 9, August 13,
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MEMBERS PRESENT: Meredith Burrus, Carrie Ermshar, Mark King, Laurie Loughlin, Ryan Myracle, Ken White
GUESTS: Carol Mace – State Government Liaison
TEF requested the State Government Liaison’s presence at this meeting because discussion topics included the State of Tennessee.Laurie convened the meeting at 11:10 a.m.
Carol announced that Tennessee now has 2 new Eden Educators – Ryan Myracle and Cyndi Milenski – bringing our total to 6. There are 2 Certified Eden Associate Trainings scheduled in Tennessee for this spring. See Item #1 and Item #4 in the “Mark Your Calendar” section at the end of these minutes for more details.
Laurie stated that recently she has received TEAC Membership Applications from several people who found the form on our website, http://www.tneden.org. She will check with our website manager to see if this indicates a real jump in activity, and she urges members to utilize the website more to communicate with the group. If any members have relevant news items they would like to share about their facilities, send them to Laurie at lldoublel@yahoo.com for posting on the website.
Ryan and several other Cornerstone Health Services Group employees attended the Leadership Training given by Nancy Fox at Fair Acres Manor in Colorado. Actually experiencing life in a facility well along on its Eden journey was eye-opening to several staff members, who are now much more ready to let go of the institutional way of doing things. Resident Councils at Cornerstone homes are going well because the issues raised there are being addressed. He also related that an elder who would not enter Douglas Nursing Home without her beloved cat was allowed to bring it and, although they had never had an animal in the home before, it worked out well. Ryan is worried that a series of articles the Jackson newspaper is about to do on nursing homes will slant heavily toward the negative, so he plans to contact the paper in hopes it will also cover the positive developments occurring due to long-term care culture change. One of those improvements is the upcoming installation of software designed specifically for elder use by It’s Never Too Late in all 6 Cornerstone facilities.
Meredith declared that Community Care of Rutherford County also hopes to add the It’s Never Too Late software and has applied for a grant to cover the cost. Ken added that right now CCRC’s focus is on completing their current construction project. Their new storage/maintenance building is almost completed. When that’s done, they will tear down an old wing to make room on their campus for 3 small houses. They have found that lack of privacy is a major issue for their residents, so there will be 95 private rooms.
Carol informed the group that the new ventilator unit at Bordeaux Long-term Care will open during Nursing Home Week, 5/11-17/09. Also, the Tennessee Board for Licensing Healthcare Facilities has approved Jefferson County Nursing Home’s application to build Green Houses, and bids are now being accepted. And Kingsport Senior House ACLF is preparing to submit plans for the construction of a couple of small home model buildings on its campus.
The attendees were curious about issues that have come up pertaining to construction of the Green Houses and small houses already in progress at Ave Maria Nursing Home in Memphis and Wharton Nursing Home in Pleasant Hill. Carol responded that they mostly pertain to guidelines set by the American Institute of Architects (AIA) and the National Fire Protection Association (NFPA), specifically the turnarounds for ambulances, gas fireplaces with auto-shutoffs, having a separate building for administration and a separate dining room for staff. She is available to assist facilities intending to construct household, Green House, small home or other similar models as they go through the process. You can reach her at Carol.Mace@state.tn.us.
Following the publication of the Five Star National Survey, Mark wrote a letter to the Centers for Medicare and Medicaid Services (CMS) pointing out that the State of Tennessee counts direct nursing care hours differently from the federal government and that this discrepancy contributed to the preponderance of low scores at many long-term care facilities in our state. He received a reply from Thomas Hamilton, who headed the survey, confirming that the systems are in fact different. Mark hopes that this will lead to a reconciliation of the 2 methods so that future scores will more accurately reflect the state of care being given here.
Carrie concurred, and added that the scope and severity of any issue detected should also be factored in. She advised the group that the Tennessee Association of Homes and Services for the Aged (TNAHSA) will hold its annual meeting in August in Franklin. For more details, see Item #7 in the “Mark your Calendar” section at the end of these minutes.
Normally, at this time of year we would have mailed proposal packets out to those facilities that have indicated a desire to apply for a TEAC $5,000.00 grant. However, because the state budget has yet to be approved and we are therefore not yet assured of our funding to cover those grants, the grant application process has been put on hold until further notice.
Carol let the members know that TEAC will be doing a presentation at the Meharry Gerontological Consortium Senior Conference being coordinated by Ruth Garrett, most likely on 05/15/09 but confirmation to be provided at a later date. For more details, see Item #2 in the “Mark Your Calendar” section below.
Quotes of the month:
“The biggest part of culture change is changing hearts.” – Ken White
“It creates disharmony to assume there needs to be a fight between regulation and empowering individuals. Resident care isn’t an either-or. There needs to be a conscious, intentional effort to communicate with no negative outcomes.” – Mark KingCarol adjourned the meeting at 1:30 p.m.
Mark Your Calendar:
1. CERTIFIED EDEN ASSOCIATE TRAINING – Wednesday, 04/29 – Friday, 05/01/09, 8:30 a.m. – 5:00 p.m., Cornerstone Health Care, 56 Casey Jones Lane, Jackson, TN 38305; register at education@edenalt.org or (512) 847-6061
2. MEHARRY GERONTOLOGICAL CONSORTIUM SENIOR CONFERENCE – Wednesday, 05/13 – Friday, 05/15/09, West End United Methodist Church, 2200 West End Avenue, Nashville, 37203
3. TEF BOARD OF DIRECTORS MEETING – Thursday, 5/14/09, 7:00 p.m. at Laurie’s house.
4. CERTIFIED EDEN ASSOCIATE TRAINING – Tuesday, 06/02 – Thursday, 06/04/09, 8:30 a.m. – 5:00 p.m., Fletcher Assisted Living, 40 Fletcher Drive, Pleasant Hill, 38578; register at education@edenalt.org or (512) 847-6061
5. TEAC VIDEOCONFERENCE – Thursday, 6/11/09, 11:00 a.m. – 1:30 p.m., in Humboldt, Knoxville, Memphis and Murfreesboro; see the “TEAC VIDEOCONFERENCE SCHEDULE 2009” for details.
6. TEF BOARD OF DIRECTORS MEETING – Thursday, 7/9/09, 7:00 p.m. at Laurie’s house.
7. TNAHSA ANNUAL MEETING – Tuesday, 08/04 – Wednesday, 08/05/09, Marriott Franklin at Cool Springs, 700 Cool Springs Blvd., Franklin, 37067
8. TEAC MEMBERSHIP MEETING – Thursday, 8/13/09, 11:00 a.m. – 1:30 p.m., in Nashville; see the “TEAC MEMBERSHIP MEETING SCHEDULE 2009” for details.
9. TEF BOARD OF DIRECTORS MEETING – Thursday, 9/10/09, 7:00 p.m. at Laurie’s house.
10. TEAC VIDEOCONFERENCE – Thursday, 10/8/09, 11:00 a.m. – 1:30 p.m., in Humboldt, Knoxville, Memphis and Murfreesboro; see the “TEAC VIDEOCONFERENCE SCHEDULE 2009” for details.
11. TEF BOARD OF DIRECTORS MEETING – Thursday, 11/12/09, 7:00 p.m. at Laurie’s house.
12. TEAC MEMBERSHIP MEETING – Thursday, 12/10/09, 11:00 a.m. – 1:30 p.m., in Nashville; see the ‘TEAC MEMBERSHIP MEETING SCHEDULE 2009” for details.
Submitted by Laurie Loughlin
MEMBERS PRESENT: Andrea Baron, Meredith Burrus (via phone), Carrie Ermshar, Ruth Garrett, Stephanie Gibbs, Wanda Hicks, Laurie Loughlin, Angie McAllister, Barbara Meadows, Ryan Myracle, Kort Nygard, Carol Wesson (via e-mail), Linda Williams (via e-mail), Rachel
GUEST: Carol Mace – State Government Liaison
TEAC requested the State Government Liaison’s presence at this meeting because discussion topics included the State of Tennessee.
Kort convened the meeting at 11:15 a.m.
Carol M. presented Kort with the approved TEAC grant contract for this fiscal year (07/01/09 – 06/30/10) and stated that all of the facility grantee contracts have been submitted for final approval and signatures.
Barbara reported that QSource has received additional money from CMS (Centers for Medicare and Medicaid Services) to recruit more facilities into its 2 collaboratives on restraint reduction and pressure ulcer reduction.
Meredith, who is one of Tennessee’s Eden Educators, called in to let everyone know that a CEAT (Certified Eden Associate Training) is being planned from 09/01-03/09. Laurie will circulate a flyer to the membership as soon as it is completed. For more details, see Item #2 in the “Mark Your Calendar” section below.
Carrie declared that Vincent Davis, Susan Frazier, Frank Gattuso and Roger Mynatt did an excellent job presenting the Green House Project at the recent TNAHSA (Tennessee Association of Homes and Services for the Aging) Annual Meeting and that the session was well-received.
Linda e-mailed attendance regrets because, due to a weather cancellation earlier in the week, the staff at Ivy Crest ACLF (Assisted Care Living Facility) in Pulaski is taking residents on a pontoon boat cruise on Tims Ford Lake at the same time TEAC is meeting.
In follow-up to an idea brought forth at the July TEF Board of Directors Meeting, the possibility of using a Real-Time Calendar where all long-term care culture change stakeholders could post their meetings and events to avoid conflicts, Kort has contacted members of some organizations who use Real-Time Calendars and been told that they aren’t efficient because entities misuse them by loading them with notices mainly about fundraising efforts to benefit themselves rather than as a means of focused goal coordination. Ruth and Wanda believe one could work if it was tightly managed.
Angie, as the Quality of Life Director at Pickett Care & Rehabilitation Center in Byrdstown, realized that, because the area is so rural, many elders have not had the opportunity to participate in a variety of experiences, and she is determined to open what doors she can. Some of their residents have been jet skiing, kayaking, go carting and on helicopter rides. She spoke of one paralyzed World War II Air Force hero whose picture has been hung in the Mighty Ace Museum in Savannah, GA. The Air Force will be flying him (accompanied by staff) and his crewmates down there for an honors ceremony.
Rachel oversees the Children’s Camp Program at Pickett Care which is in operation during summer and holiday school breaks so that staff members can bring their children to work. The kids interact really well with the residents and wish they could come all the time! They have gone on intergenerational outings to the zoo and the Gatlinburg Aquarium. Pickett Care has arranged for a teacher to come into the building for Spanish lessons to heighten multicultural awareness.
Carol W., who is attending the Pioneer Network Conference in Little Rock, AR, with 7 co-workers from Tennessee Health Management, e-mailed that several of their homes are currently diving into culture change by preparing to remove nurses’ stations, initiate total care assignments, admit animals and improve dining services.
TEAC Board member Ronnie Steinberg is also at the Pioneer Network Conference representing TEAC.
Ryan advised that all 6 Cornerstone homes have implemented IN2L (It’s Never Too Late) software, and staff and residents are loving it. Cornerstone will be holding a company-wide Eden Leadership Training in September. He and Cyndi Milenski recently attended an Eden at Home Training and are hoping in the future to offer this training to their care partners and family members of their residents because of its hands-on nature. He is also hopeful that a newspaper reporter who has visited some of the homes will write an article for the Jackson Sun that puts nursing homes in a positive light for a change.
Andrea has recently opened Every Day Living, a Home for the Aged (RHA) in Joelton. She is very happy to have found TEAC and worries about the current generation of seniors, many of whom were culturally conditioned to accept what authority figures tell them and don’t stick up for themselves. One of her residents, who uses a walker, loves to cook but refrained because she was told she shouldn’t because of her weak legs. Andrea has encouraged her to cook when she wants to; they sometimes prepare meals together; and the woman’s mobility has improved. Another one of her residents is responsible for the hummingbird feeder.
Kort interjected that, through his geriatric psychology practice, he has come to realize that having meaningful work where “if I don’t do my job something bad happens” is important to the mental health of some residents, and he is lobbying for elders who want them and can handle them to get real jobs in the facilities they inhabit.
Stephanie referenced a study by Dr. Bill Thomas showing that the use of psychotropic drugs, which is usually one of the top 3 medication categories for MCOs (Managed Care Organizations), drops significantly in homes that apply the Eden Principles, wherein elders retain more control over their lives.
Ruth, who is a consultant at both Vanderbilt and Meharry Medical Schools, added that there is real misunderstanding about how the aging process affects people both physically and psychologically. She takes medical students to visit the range of facilities that serve the elderly – wellness centers, RHAs, ACLFs and nursing homes – so that they see the full spectrum. She suggests that we explore collaborating with the Area Agency on Aging and the Tennessee Vulnerable Adult Coalition (TVAC).
Kort is currently presenting seminars for Cross Country Education on “Psychiatric Disorders of an Aging Population”. He has found that the elderly, particularly those showing signs of dementia, are generally not thought of as fitting patients for cognitive rehabilitation, even though it can produce good results. He strongly believes that all people are entitled to be brought back up to their potential, whatever that is, and that this lack of treatment is a symptom of ageism, which is very pervasive in American society. Along with Joe and Melanie Adair, he has started the Southeast Advocacy Center for Elder Rights in the Chattanooga area to address how ageism affects how people receive medical care. Anyone wanting further information can contact Kort at knygard2@gmail.com.
Carol M. reminded the group that Kort, Joe and Melanie have coauthored The Sage Movement: Replacing Ageism with Sageism put out by Waldenhouse Publishers, Inc.
Wanda, who has a background in healthcare marketing and acute care facilities, believes that at this time the long-term care culture change movement is in an excellent position to move forward and make significant changes if we can show government “where the rubber meets the road” in terms of how specific implementations can result in cost savings.
We have called a Special TEAC Membership Meeting on 09/10/09 to draw up a list of potential uses for federal CMP (Civil Monetary Penalty) funds and flesh out an action plan for same that we can present to the Tennessee Department of Health. Please see Item #3 in the “Mark Your Calendar” section below and RSVP to Laurie at lldoublel@yahoo.com if you plan to attend.
Kort adjourned the meeting at 1:35 p.m.
Quote of the Month: “In almost every circumstance you can turn a negative into a positive.” – Ruth Garrett
.
Mark Your Calendar:
1. THCA ANNUAL MEETING – Sunday, 8/16 – Wednesday, 8/19/09, Nashville Convention Center - “Hitting the High Notes of Quality Care”.
2. CERTIFIED EDEN ALTERNATIVE TRAINING – Tuesday, 9/1-Thursday, 9/3/09, Jefferson County Nursing Home, Dandridge; contact Jim Hammond at education@edenalt.org for details and registration.
3. SPECIAL TEAC MEMBERSHIP MEETING – Thursday, 9/10/09, 11:00 a.m. – 1:30 p.m., to discuss federal CMP funds, location TBA
4. TEF BOARD OF DIRECTORS MEETING – Thursday, 9/10/09, 7:00 p.m. at Germantown Cafe.
5. TEAC VIDEOCONFERENCE – Thursday, 10/8/09, 11:00 a.m. – 1:30 p.m., in Humboldt, Knoxville, Memphis and Murfreesboro; see the “TEAC VIDEOCONFERENCE SCHEDULE 2009” for details.
6. TEF BOARD OF DIRECTORS MEETING – Thursday, 11/12/09, 7:00 p.m. at Germantown Cafe.
7. TEAC MEMBERSHIP MEETING – Thursday, 12/10/09, 11:00 a.m. – 1:30 p.m., in Nashville; see the “TEAC MEMBERSHIP MEETING SCHEDULE 2009” for details.
Submitted by Laurie Loughlin
MEMBERS PRESENT: Andrea Baron, Stephanie Gibbs, Kristie Johnson, Laurie Loughlin, Angie McAllister, Barbara Meadows, Debbie Meredith, Ryan Myracle, Kort Nygard, Linda Williams
Kort convened the meeting at 11:00 a.m.
Stephanie was proud to announce that, thanks to the Choices Act, on 03/01/10 Tennessee will become the first state where MCOs (Managed Care Organizations) will have a complete continuum of care; physical, mental, behavioral and long-term care needs for qualifying TennCare recipients, whether they reside at home or in facilities, will be handled under the same umbrella, allowing for enhanced delivery of services.
Linda told the group that Ivy Crest raised $400 at its recent yard and bake sale. Their garden has been a great success this year, especially in its yield of bell peppers and tomatoes, and with their Eden grant money they have added a butterfly bed with lighting. She recently discovered 2 games the residents really enjoy: “The Corn Hole Game” and balloon volleyball. A country ham breakfast is planned for Christmas Eve.
Debbie added that at Bordeaux Long Term Care, wheelchair basketball is the current craze, which started after the Advocates bought the hoop. Also, as a follow-up to their volunteer work at Bordeaux while Hard Rock Café was undergoing renovations, some of the employees who are also songwriters will be writing lyrics with the elders.
Ryan reported that several of the Cornerstone homes have recently adopted house dogs. All but one are working out very well; the home where things aren’t running smoothly adopted a puppy whose temperament is not suited to group living which is now residing with a staff member and occasionally brought to visit the home. Ryan urges all in Edenizing homes to review Eden’s animal guidelines before bringing an animal into the facility. Debbie informed the group that Bordeaux invited the Director of Metro Animal Control to visit the facility so she could see what they were looking for in an animal, and that the Director then chose and delivered the animals to Bordeaux. If you have an animal control agency or humane shelter in your area, Debbie strongly recommends adopting through it, as they do temperament testing. If you don’t have any such organization where you are and are situated relatively close to Nashville, you can contact Judy Ladebauche at Metro Animal Control, (615) 862-7928, as she has helped homes outside the city as well. In other news from Cornerstone, Ryan and other staff have developed a version of the Eden At Home Workshop which they use as a support service to residents’ family members; they hope to present this workshop at the 5th Eden Alternative International Conference in June 2010. (See Item # 8 in the “Mark Your Calendar” section below for details.)
Angie recounted lots of goings-on at Pickett Care & Rehabilitation Center. The World War II flying ace mentioned in the August minutes was driven to Savannah, GA, where he was honored at the Might Ace Museum and got to visit with other surviving squadron members. He also donated personal items to the museum. Back in Byrdstown, 54 residents participated in their Halloween masquerade ball. Her grandmother, who recently became a resident, has suggested opening a thrift store, which she has had experience running. Volunteers already run a country store at the facility. Angie is currently working on a Senior Ballet presentation. For Christmas, the residents will be getting a Labradoodle. It was supposed to be surprise, but somehow the information has been leaked!Barbara was happy to inform the group that nursing homes in the QSource Advancing Excellence Program in our state have made remarkable progress toward meeting the CMS (Center for Medicare & Medicaid Services) goal of 0 restraints; we are not quite there yet, but she has no doubt we will be.
Kort reflected on the “dignity of risk”. If we make life for long-term care residents more like home, there are going to be more risks, and there will be accidents as people live as they choose to.
Andrea is worried about the emotional states of her residents at Every Day Living during the Christmas season. They are referrals from the Veterans Administration who have serious psychological issues, and some are already in extreme distress due to rejection from their families to come home for the holidays. Every Day Living is a family business, and Laurie suggested that Andrea propose to the residents that they are all now a new family who should start their own traditions.
Along with Joe and Melanie Adair, Kort has founded the Southeast Advocacy Center for Elder Rights in Chattanooga. They recently had their first meeting, and will be having another one in the spring to plan a workshop where participants committed to justice for seniors and those with disabilities will break out into different interest groups and develop plans of action. Anyone interested in learning more can contact Kort at knygard2@gmail.com.
Melanie, Joe and Kort have also written a book, entitled The SAGE MOVEMENT: Replacing Ageism with Sageism: a Call for Culture Change, which is also available through Kort.
Kort adjourned the meeting at 1:35 p.m.
Mark Your Calendar:
1. TEF BOARD OF DIRECTORS MEETING – Thursday, 01/07/10, 7:00 p.m. at City House, 1222 4th Avenue North, Nashville, TN 37208
2. CERTIFIED EDEN ASSOCIATE TRAINING – Wednesday, 01/13 – Friday, 01/15/10, 8:30 a.m. – 5:00 p.m., Bordeaux Long Term Care, 1414 County Hospital Road, Nashville, TN 37218; for more details and to register, contact Jim Hammond at education@edenalt.org.
3. TEAC VIDEOCONFERENCE – Thursday, 02/04/10, 11:00 A.M. – 1:00 P.M.; see the “TEAC VIDEOCONFERENCE SCHEDULE 2010” for locations.
4. TEF BOARD OF DIRECTORS MEETING – Thursday, 03/04/10, 7:00 p.m.
5. TEAC MEMBERSHIP MEETING – Thursday, 04/01/10, 11:00 a.m. – 1:30 p.m., in Nashville; see “TEAC MEMBERSHIP MEETING SCHEDULE 2010” for details.
6. TEF BOARD OF DIRECTORS MEETING – Thursday, 05/06/10, at 7:00 p.m.
7. TEAC VIDEOCONFERENCE – Thursday, 06/03/10, 11:00 A.M. – 1:00 P.M.
8. 5th EDEN ALTERNATIVE INTERNATIONAL CONFERENCE – Sunday 06/13 – Tuesday, 06/15/10 at The Westin Tabor Center, Denver, Colorado
9. TEF BOARD OF DIRECTORS MEETING – Thursday, 07/01/10, 7:00 p.m.
10. TEAC MEMBERSHIP MEETING – Thursday, 08/05/10, 11:00 A.M. – 1:30 P.M.
11. TEF BOARD OF DIRECTORS MEETING – Thursday, 09/02/10, 7:00 p.m.
12. TEAC VIDEOCONFERENCE – Thursday, 10/07/10, 11:00 a.m. – 1:00 p.m.
13. TEF BOARD OF DIRECTORS MEETING – Thursday, 11/04/10, 7:00 p.m.
14. TEAC MEMBERSHIP MEETING – Thursday, 12/02/10, 11:00 a.m. – 1:30 p.m.
Submitted by Laurie Loughlin