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12/14/06 (back to top of page)
MEMBERS PRESENT: Jerry Blasingame, Jeanne Caudill, Bobbi Dyer, Laurie Loughlin, Kort Nygard, Laura Savage, Lynn Wise
GUESTS: 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 11:10 a.m.
Carol announced that dates for the TEAC 2007 meetings have been set. They will take place on the 1st or 2nd Thursday of each month. We have done our best to avoid conflicts with our partnering organizations and to accommodate participating TEAC members. All dates are listed in the "Mark Your Calendar" section of these minutes.
Laura has learned that CMS (the Centers for Medicare and Medicaid Services) is reaching out to educate Medical Directors about the benefits of long-term care culture change and suggested that we contact the Tennessee Medical Directors Association, which we will do. She also suggested that since CMS is beginning the Advancing Excellence in America's Nursing Homes campaign, TEAC should enlist as a LANE (Local Area Network for Excellence) partner. Additional information concerning this campaign can be accessed at http://www.nhqualitycampaign.org.
Meredith Burrus and Dava Snyder will be conducting an Eden Associate Training in Jackson this month for employees of the 5 Cornerstone facilities that have committed to Edenizing.
We want to determine interest in setting an Eden Associate training schedule for the first half of 2007. Therefore, we request that a representative from each organization with people needing this training contact Carol Mace at Carol.Mace@state.tn.us and let her know approximately how many staff and volunteers they want to send during the next 6 months so that we can plan accordingly.
Discussion continued on the possibility of introducing legislation that would allow the State of Tennessee to access and utilize federal CMPs (Civil Monetary Penalties) to improve quality of care and further culture change efforts. It was noted that such draft legislation would need to be presented to possible Tennessee House and Senate sponsors for introduction and filing shortly before or immediately after the beginning of the legislative session which occurs in the middle of January. Carol offered to assist in the drafting of any such proposed legislation. It was also noted that the Coalition would need to discuss any such proposed draft legislation with the Department of Health and other stakeholders. Kort wants to hold a planning meeting involving representatives of all major long-term care stakeholders regarding this issue, and also to develop a basic Strategic Plan for TEAC. He proposed 2 possible dates: Friday, 12/29/06 from 12:00 p.m. - 4:00 p.m. or Thursday, 01/04/07 from 1:00 p.m. - 5:00 p.m. All members interested in participating in this process are urged to contact Kort at knygard2@gmail.com to let him know if they would be available on one or both dates. The meeting will be held on the date the majority of participants can attend, and the location will be announced.
Kort stated that he sees a need for the establishment of one central office where a staff person is available and dedicated to assisting facilities obtain and share information on culture change and that this would certainly be a good use of some of the penalty money.
Jeanne suggested that the Public Guardianship for the Elderly Statute could possibly be used as an example when drafting any such proposed legislation as it established the Public Guardianship office and staffing.Discussion then turned to both Kort's and Jeanne's concerns over that statute's failure to include the requirement for a mandatory multi-disciplinary, objective assessment prior to a declaration of incompetence of an elder.
Bobbi informed the group that Lewis County Manor has been restraint-free for over a year. Laura added that at a recent meeting in Atlanta, she found out from Laurie Gyscek, the QIO (Quality Improvement Officer) for Middle Tennessee, that Tennessee's use of restraints overall has come way down.
Kort advised the members that the Pioneer Network has offered to help us and has asked for suggestions on how to do that. It was noted that the Pioneer Network has not really been active in Tennessee, and most TEAC members were not very knowledgeable on what types of services they could offer us. Carol said she was aware that they have a speakers bureau but would have to so some research on their website to see what other services they offer. Members with suggestions on how the Pioneer Network can assist TEAC should contact Kort at knygard2@gmail.com.
Carol raised the question as to what types of training the Coalition wanted to conduct utilizing the grant money currently allocated f or such before the end of the fiscal year on 6/30/07. "A Tale of Transformation" by Action Pact, Inc. had been previously discussed as well as sessions on the Green House Model and/or the Household Model. Kort proposed holding a 3-day training in conjunctions with THCA and/or TNAHSA broken up over the course of the year so that participants could come, get some specific ideas on how to achieve culture change, pick which ones will work in their homes, apply them, then come back a few months later to report on their progress and pick up some more ideas. Laura believes that a format that allows attendees to share successes and failures makes the most lasting impressions. Carol likes the idea of sharing information and proposed another conference call (in follow-up to the one held on 07/27/06) where TEAC members could share what they are doing with each other.
EHO (Eden Home Office) informed us that they have developed 2 marketing videotapes; one is for consumers, the other for providers. The tapes are about 8 minutes each and will be sent to Mentors, Educators and registered Eden facilities. Once those entities have received their copies, requests for additional copies can be made to EHO.
Laurie reported that 41 people attended the 11/20/06 "Animals in Eden" seminar given by Dr. John Pitts.
Laurie shared some of her thoughts re animals and will continue to do so over the next several meetings. She posed the question, "What does an Eden home do when the needs of an elder do not fit into a system in place in that home?" The Eden Alternative is a set of 10 principles which Eden homes use as guidance tools and apply as they see fit to best end loneliness, helplessness and boredom for their residents. Since its inception, the Eden Alternative has encouraged facilities, when and if they are ready, to adopt house animals, and these animals have greatly enhanced the quality of life for residents. However, there are many elders who already have their own companion animals when the time comes that they can no longer live independently. If such elders request entrance into Eden homes with their beloved pets, should they be made to fit into the system, which allows only house animals, or should the system adapt to accommodate their needs?
Eden homes are resident-centered, where elders can make many of their own choices on how to conduct their daily lives and participate in fulfilling activities. But isn't the ability to continue a relationship with someone you love an even more important factor in maintaining a person's well-being?
Laurie related a story recently on the news. While covering the St. Louis nursing home fire that killed 10 people, a reporter went to the veterinary clinic across the street. There resides the cat of a resident of that nursing home, who has been boarding the cat at the vet since entering the home, because he couldn't bring the cat with him. He comes to the vet clinic for several hours every day to care for and play with his cat. The staff hadn't seen him that day and was hoping he hadn't been one of the people killed in the fire.
This shows how strongly people are bonded to their animals. But most elders are not going to find long-term care facilities across the street from a vet and wouldn't be able to pay the permanent boarding fees even if they did. Most elders in this man's situation are forced by circumstance to separate permanently from those they love. And this cannot be good for them, or for their animals.
During Hurricane Katrina, most evacuees were prevented by policy from bringing their pets out of harm's way with them. This caused so much anguish that during Hurricane Rita the following month, policy was changed and evacuees were instructed to bring their pets with them, and one year later a federal law was passed requiring all rescue agencies who want federal reimbursement to rescue pets with their people. It is Laurie's hope that the long-term care industry will extend its compassion to residents who are pet owners.
Tennessee Edenizing homes that are interested in participating in our pilot project of accepting companion animals can help lead the way. Like any pilot project, this is largely new territory, and each home should assess its feasibility. Homes that have already accepted companion animals are encouraged to contact Laurie at doublel@bellsouth.net with their stories. We want to gather as much information as possible on all aspects of the process - what works, what doesn't work, the joys, the problems, the logistics, etc. - so that we can put a program together to share knowledge with homes around the country.
Kort adjourned the meeting at 1:10 p.m.Mark Your Calendar:
1. TEAC MEMBERSHIP MEETING - Thursday, 01/11/07 at 11:00 a.m. in the 2nd Floor Conference Room (main entrance to building is on 2nd floor) at the THA (Tennessee Hospital Association) building, 500 Interstate Blvd. So., Nashville, TN 37210, (615) 256-8240. Directions: Take I-440 to the Nolensville Road exit. Go north toward the Fairgrounds about ½ mile. Go through the light at Polk Avenue and immediately turn right at the next light on Woodycrest Drive. Take the first left onto Interstate Drive. The THA building is the first on the left. Directions with mileage can be obtained from www.mapquest.com.
2. TRAIN THE TRAINER TRAINING (by invitation) - Monday, 01/22/07 - Friday, 01/26/07
3. TEAC MEMBERSHIP MEETING - Thursday, 02/08/07
4. TEAC MEMBERSHIP MEETING - Thursday, 03/01/07
5. LEADERSHIP TRAINING - Wednesday, 03/29/07 - Thursday, 03/30/07, in Wimberley, TX, $300/person
6. TEAC MEMBERSHIP MEETING - Thursday, 04/05/07
7. TEAC MEMBERSHIP MEETING - Thursday, 05/03/07
8. TEAC MEMBERSHIP MEETING - Thursday, 06/14/07
9. TEAC MEMBERSHIP MEETING - Thursday, 07/05/07
10. TEAC MEMBERSHIP MEETING - Thursday, 08/02/07
11. TEAC MEMBERSHIP MEETING - Thursday, 09/06/07
12. ANNUAL EDEN EDUCATOR CONFERENCE - Wednesday, 09/19/07, in Ithaca, NY
13. ANNUAL EDEN MENTOR CONFERENCE - Thursday, 09/20/07 - Friday, 09/21/07, in Ithaca, NY
14. TEAC MEMBERSHIP MEETING - Thursday, 10/11/07
15. TEAC MEMBERSHIP MEETING - Thursday, 11/01/07
16. TEAC MEMBERSHIP MEETING - Thursday, 12/06/07
17. 4TH INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 5/08 IN Columbus, Ohio.Submitted by Laurie Loughlin
11/16/06 (back to top of page)
MEMBERS PRESENT: Meredith Burrus, Laurie Gyscek, Laurie Loughlin, Laura Savage
GUESTS: Carol Mace - State Government Liaison
TEAC requested the State Government Liaison's presence at this meeting because discussion topics included the State of Tennessee.
Carol announced that the first "Train the Trainers" seminar of 2007 will be held in Texas. We are hopeful that the 2nd might take place in Tennessee. She and Meredith have been looking into Fast Track training to allow more Eden Associates to become certified in a shorter period of time. Meredith stated that, now that we no longer have regional coordinators, she has been getting a lot of requests for training. This is an excellent indication that interest in the Eden Alternative, and culture change in general, is growing.
Laura reported that the recent THCA Culture Change seminar proved to be very energizing to the attendees. In particular, Alice Truluck's presentation garnered an overall rating of 4.9 out of 5 for both content and delivery, and they plan to have her back. Meredith suggested that TEAC partner with THCA for the next one.
Laura expressed concern about the public's negative perception of nursing homes, when, in fact, most are providing good care. She feels it is important that we watch our verbiage, so that, while we seek constantly to improve, we don't discount the good that already exists.
She also brought up the issue of staff resistance, stating that people are wary of change and concerned about whether or not regulations allow certain implementations. She wondered about the best way to address this potentially serious impediment to culture change. Meredith responded that the best way is for educators to address these questions directly with the individuals so that all aspects of each one's doubts can be explored and resolved. Carol added that it is best if someone from Tennessee does the explaining so that Specifics particular to our state are imparted.
Laurie G. informed the members that the Centers for Medicare and Medicaid (CMS) has a wonderful new tool for teaching culture change in a new website, www.cmsinternetstreaming.com., which is providing a 4-part series. The first section, entitled "Reducing Falls by Eliminating Alarms", has already been presented but the web cast, tape and text can all be downloaded. You will need to subscribe to "Medical Newswire" to access the information. When you subscribe, you can also see the calendar and learn when the other 3 sessions will be presented. For more information, contact Laurie G. at lgyscek@tnqio.sdps.org.
Meredith told the group that Community Care of Rutherford County is drawing up plans with an architect to replace the old back part of their building with 2 19-person houses; the bedrooms will be private or semi-private with a partition wall, and they hope the project will be completed in 3 years.
Laurie G. gave an update on the Statewide Culture Change Collaborative Group. One goal is to reduce restraint use to 2% or lower. Overall, the group has reduced to 8.4% from 14% 2 years ago, with the intensive group down to 4%. She also noted that since people are coming out of hospitals into nursing homes with pressure ulcers, nursing home staffs are starting to teach hospital staffs how to treat them.
Re the revised TEAC brochure that Debbie Meredith is working on, Meredith suggested that, in exchange for being mentioned, Eden homes across the state could contribute money toward the printing which would enable us to do the brochure in 4 colors instead of 2 colors which will be required if we use state grant funds.
Members gave Laurie L. suggestions of people and organizations she can contact in an outreach effort to have Eden Associates talk to them about what TEAC is doing and hopes to accomplish.
Carol reiterated TEAC's desire to meet with all other major culture change stakeholders in Tennessee to develop legislation to acquire federal Civil Monetary Penalty (CMP) funds to improve long-term care in our state.
Carol adjourned the meeting at 1:45 p.m.
Mark Your Calendar:
1. TEAC MEMBERSHIP MEETING - Thursday, 12/14/06 at 11:00 a.m. in the 2nd Floor Conference Room (main entrance to building is on 2nd floor) at the THA (Tennessee Hospital Association) building, 500 Interstate Blvd. So., Nashville, TN 37210, (615) 256-8240. Directions: Take I-440 to the Nolensville Road exit. Go north toward the Fairgrounds about ½ mile. Go through the light at Polk Avenue and immediately turn right at the next light on Woodycrest Drive. Take the first left onto Interstate Drive. The THA building is the first on the left. Directions with mileage can be obtained from www.mapquest.com
2. 4TH INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 5/08 IN Columbus, Ohio.Submitted by Laurie Loughlin
9/21/06 (back to top of page)
MEMBERS PRESENT: Donna Ray Anthony, Jerry Blasingame, Patty Brinkley, Meredith Burrus, Bobbi Dyer, Janet Farrar, Laurie Gyscek, Patsy Hooker, Mark King, Laurie Loughlin, Debbie Meredith, Kort Nygard, Stephen Potash, Laura Savage, Wayne Schumann, Shara Stodola, Linda Williams, Rod Wolfe
GUESTS: 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 11:20 a.m.
Kort started the meeting with a Learning Circle, asking the question, "Why are you here?" The top responses were: 1) to learn how to do Eden 2) to assist facilities in culture change process 3) to network with others 4) to advocate for elders 5) to use position to make media aware of long-term care culture change and 6) to help those whose rights are taken away when they enter long-term care. In light of the fact that so many are looking for specific actions they can take, he decided that future meetings will devote more time to members discussing their successes and problems in Edenizing their facilities. Kort also brought up the feasibility of having regional meetings in 4 areas (Memphis, Nashville, Chattanooga and Knoxville) to make it easier for Eden Associates and long-term care professionals who have not yet started Edenizing but would like to learn more about it to have a forum to assist each other. Debbie told the members that administrators, staff and some residents from 4 nearby facilities had attended Bordeaux's outreach program on 5/31/06.
Laurie L. reminded everyone that we still have free copies of the Eden Handbook available to those wanting a step-by-step guide to long-term care culture change. There is a limit of 1 per facility. Send your request to Laurie at lldoublel@yahoo.com. Put "Eden Handbook" as the Subject and include your name and the name and address of your facility in the body of the message.
Patty informed the group that CMS has developed a guide by which facilities can rate themselves on their culture change progress. She will send this to Laurie L. who will then forward it to TEAC members.
Carol reported that our State audit on 9/8/06 went smoothly and she is expecting a good report.
The discussion then turned to regulatory issues, and the fear of citations that persists in impeding culture change. Kort reminded the group that Judy Eads is working on this issue through her committee that is exploring regulatory barriers to culture change and suggested that facilities cultivate relationships with surveyors, inviting them to visit in advance of implementation of certain changes to advise them of intent and get their input. This way the changes would be made in compliance with State regulations, eliminating or greatly decreasing deficiencies. Shara added that regulations actually start on the federal level, and that certain changes need to "trickle down" from Washington, D.C.
Linda feels it is very important to orient family members to the Eden Alternative as soon as their loved one becomes a resident to avoid misunderstandings and get them on board to assist in the Edenizing process.
Laura announced that THCA will be hosting culture changes sessions across Tennessee in early November. (See "Mark Your Calendar" for more information.)
Quote of the Day (from Mark King): "If you're looking for a boring place, don't do Eden. It's a journey that changes and changes you."
We are looking for a new Treasurer to join the Board of Directors. Please forward your suggestions to Kort at knygard2@gmail.com.
Kort adjourned the meeting at 1:00 p.m.
Mark Your Calendar:
1. TEAC MEMBERSHIP MEETING - Thursday, 10/26/06, at 11:00 a.m. in the 5th floor conference room at the Tennessee Department of Health Division of Healthcare Facilities, located in Metrocenter at Suite 501, 227 French Landing, Nashville, TN 37243. Directions from:
a) DOWNTOWN - take 8th Avenue North until it becomes Metrocenter Blvd.
b) I-65 - take Exit 85 (Metrocenter Blvd.); head north on Metrocenter Blvd. and away from downtown.
c) I-40 EASTBOUND - take exit 208B onto I-65 North; get off at 1st exit, Exit 85 (Metrocenter Blvd.); head north (left) on Metrocenter Blvd. toward Metrocenter and away from downtown.
d) I-40 WESTBOUND - take Exit 208 onto I-65 North; get off at 1st exit, Exit 85 (Metrocenter Blvd.); head north (left) on Metrocenter Blvd. toward Metrocenter and away from downtown.
ALL: from Metrocenter Blvd., turn right at 1st street, Dominican Drive; turn left at 1st street, French Landing; cross Vantage Way; 227 French Landing is about ½ block on your right; the sign says "Heritage Place".
2. TEF BOARD OF DIRECTORS MEETING - Thursday, 11/2/06, at 7:00 p.m. at Laurie's house.
3. THCA CULTURE CHANGE SESSIONS: Tuesday, 11/07/06 - Knoxville; Wednesday, 11/08/06 - Nashville;
Thursday, 11/09/06 - Memphis. For details, contact Laura Savage at lsavage@thca.org.
4. TEAC MEMBERSHIP MEETING - Thursday, 11/16/06, at 11:00 a.m.
5. ANIMAL CARE IN EDEN HOMES - Monday, 11/20/06 from 8:30 a.m. - 11:30 a.m. with John Pitts, DVM, co-author of "The Eden Alternative Animal Welfare Guidelines" Location TBA.
6. TEAC MEMBERSHIP MEETING - Thursday, 12/14/06, at 11:00 a.m.
7. 4TH INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 5/08 IN Columbus, Ohio.Submitted by Laurie Loughlin
8/24/06 (back to top of page)
MEMBERS PRESENT: Donna Ray Anthony, Jerry Blasingame, Patty Brinkley, Carrie Ermshar, Melodie Fyke, Conita Grigsby, Laurie Gyscek, Laurie Loughlin, Debbie Meredith, Kort Nygard, Steve Potash, Ginger Simpson, Shara Stodola, Linda Williams
GUESTS: 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 11:20 a.m.
Laurie G. gave the statistics on our 7/27/06 Culture Change Conference Call. We had 36 callers, which was around the expected amount. Most callers were from nursing homes, and those who completed the electronic evaluation afterwards were overwhelmingly positive in their comments. Everyone present who had been involved with the call agreed it had been an uplifting experience.
Kort told the group that Judy Eads, who chairs a state task force trying to identify and change Tennessee regulations that impede culture change, has asked for a list of relevant materials that can be dispensed to facilities requesting information. Members contributed suggestions to Kort.
Carol announced that the Eden Associate Training at the Joseph B. Knowles Home in Nashville earlier this month drew 48 attendees, which is a record.
Kort reported that the "Train the Trainers" seminar he attended in Sherburne, NY, this month was invigorating and packed full of important information. Of the 14 candidates, 4 were from Tennessee, the other TEAC members being Meredith Burrus, Dava Snyder and Tim Spears.
Debbie Meredith produced drafts of both the new TEAC brochure she has designed and a handout Laurie G. will keep at her booth at the THCA conference at the end of the month. The brochure contains many photos sent in by Edenizing facilities. Members contributed suggestions for the final versions and appreciate Debbie's diligence, expertise and willingness to take on these projects.
Laurie G. will also have over 300 copies of The Eden Handbook at the THCA booth and will give 1 copy to any facility at the conference that requests it. These books were purchased by the Board of Directors at a steep discount as a way to spread our message.
Kort asked if any of those present who work in long-term care facilities would be willing to act as informational contacts for other long-term care professionals in the state who have questions about the Edenizing process. Many hands went up. If there are any members reading these minutes who were not at the meeting but who would also be willing to do this, please notify Kort at knygard2@gmail.com.
To further the topic brought up during last month's meeting, Kort initiated discussion about partnering with other like-minded agencies. Members volunteered to make contact with employees of certain agencies with whom they are acquainted.
In follow-up to her notification at our July meeting that CMS plans to bring long-term care stakeholders together in each state to brainstorm about potential quality improvements, Laurie G. informed the group that Qsource will take the lead for this event in Tennessee (date TBD) and that participants will be divided into groups discussing topics which will include staff turnover, consistent assignment, resident and staff surveys, restraints, pressure ulcers, chronic pain and depression.
Kort adjourned the meeting at 1:20 p.m.Mark Your Calendar:
1. TEF BOARD OF DIRECTORS MEETING - Thursday, 9/7/06, at 7:00 p.m. at Laurie's house.
2. TNAHSA ANNUAL MEETING - Monday, 9/18/06 - Tuesday, 9/19/06 at the Opryland Hotel, Nashville - For more information, contact Carrie Ermshar at cermshar@tha.com.
3. TEAC MEMBERSHIP MEETING - Thursday, 9/21/06 at 11:00 a.m. NOTE DIFFERENT ADDRESS: Tennessee Department of Health Division of Healthcare Facilities, Suite 501, 227 French Landing, Nashville, TN 37243. This is in Metrocenter.
Directions from:
a) DOWNTOWN - take 8th Avenue North until it becomes Metrocenter Blvd.
b) I-65 - take Exit 85 (Metrocenter Blvd.); head north on Metrocenter Blvd. toward Metrocenter and away from downtown.
c) I-40 EASTBOUND - take Exit 208B onto I-65 North; get off at 1st exit, Exit 85 (Metrocenter Blvd.); head north ( left) on Metrocenter Blvd. toward Metrocenter and away from downtown.
d) I-40 WESTBOUND - take Exit 208 onto I-65 North; get off at 1st exit, Exit 85 (Metrocenter Blvd.); head north (left) on Metrocenter Blvd toward Metrocenter and away from downtown.
ALL: from Metrocenter Blvd., turn right at 1st light, Dominican Drive; turn left at 1st street, which is French Landing; cross Vantage Way; 227 French Landing is about ½ block on your right - the sign says "Heritage Place".
4. CELEBRATE SENIORS DAY - Friday, 10/6/06 from 10:00 a.m. - 2:00 p.m. at Bordeaux Long Term Care, 1414 County Hospital Road, Nashville. For more information, contact Debbie Meredith at debbie.meredith@nashville.gov.
5. TEAC MEMBERSHIP MEETING - Thursday, 10/26/06, at 11:00 a.m.
6. TEF BOARD OF DIRECTORS MEETING - Thursday, 11/2/06, at 7:00 p.m. at Laurie's house.
7. TEAC MEMBERSHIP MEETING - Thursday, 11/16/06, at 11:00 a.m.
8. ANIMAL CARE IN EDEN HOMES - Monday, 11/20/06 from 8:30 a.m. - 11:30 a.m. with John Pitts, DVM, co-author of "The Eden Alternative Animal Welfare Guidelines".
9. TEAC MEMBERSHIP MEETING - Thursday, 12/14/06, at 11:00 a.m.
10. 4TH INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 5/08 IN Columbus, Ohio.Submitted by Laurie Loughlin
7/27/06 (back to top of page)
MEMBERS PRESENT: Donna Ray Anthony, Patty Brinkley, Meredith Burrus, Elaine Currie, Carrie Ermshar, Melodie Fyke, Katy Gammon, Laurie Gyscek, Mark King, Laurie Loughlin, Debbie Meredith, Kort Nygard, Shara Stodola, Linda Williams
GUESTS: 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 11:30 a.m.
Laurie L. displayed alphabet posters she had picked up at a steep sale and offered them to representatives present from Edenizing homes.
Kort announced that this meeting would focus on ways we can grow our organization. He wants to expand the Board of Directors and started a brainstorming session on the feasibility/advisability of partnering with other like-minded nonprofits.
Carrie declared that we should partner with some quality organizations for a stronger assortment of resources but must be careful to maintain our own identity. She suggested studying national-level entities and adapting their models to the State of Tennessee.
Mark cautioned that, if we enter a larger picture, we have to guard against becoming territorial, self-preservationist and self-serving, always remembering that the reason we formed was to improve the lives of long-term care residents.
The members drew up a list of organizations we should approach, which include but are not limited to: AARP, THCA, TNAHSA, Alzheimer's Association, American Medical Directors Association, Alliance for Retired Americans, Tennessee Department of Health, National Ombudsman Association, Council on Aging, Commission on Aging, National Citizens Coalition of Nursing Home Reform. Individuals with contacts at any of the above volunteered to initiate dialogue. Carrie added that a lot of those mentioned were meeting to figure out how to make central resources centers work. Kort stressed that we need to be clear about why we exist and what we hope to accomplish and should probably draw up letters of introduction, tailoring each one to show how we could complement the initiatives of each potential partner.
Laurie G. informed the group that on 8/1/06 a national campaign will start to bring long-term care stakeholders in every state together, from which nursing homes will be recruited to participate in quality improvement efforts in their states.
Kort wondered if we should revamp the grant program, giving out fewer grants with more money. Laurie L. pointed out that this might cause loss of interest, as fewer facilities would be able to partake. Carol advised that we can't revise the regulations; we would have to change the law or tap into the federal Civil Monetary Penalty (CMP) to increase the number of grants and/or dollar amounts of those grants. Carrie reminded the group that Florida long-term care facilities have access to federal CMP and promised to research this. Shara feels strongly that struggling facilities who express interest are the best places to implement the Eden Alternative and thinks we should keep the current grant system but set up a separate one for such institutions. She also believes there should be separate homes for non-elderly residents, whose needs and issues often differ greatly from the majority senior citizen population.
Laurie G. explained the mechanics of conference calling.
Kort adjourned the meeting at 1:15 p.m.
From 1:30 p.m. to 2:30 p.m. the Culture Change Conference Call was held. A copy of the agenda is attached. Laurie G. will bring the list of those who called in, plus results of an electronic evaluation sent to the callers following the conference call, to our next TEAC meeting on 8/24/06.
Mark Your Calendar:
1. EDEN ALTERNATIVE ASSOCIATE TRAINING - Tuesday, 8/8/06 - Thursday, 8/10/06 at Joseph B. Knowles Home Assisted Care Living Facility, 1010 Camilla Caldwell Lane, Nashville. To register, contact Penny Wade at edenalt@austin.rr.com.
2. TEAC MEMBERSHIP MEETING - Thursday, 8/24/06, at 11:00 a.m. in the 1st floor "Tennessee" conference room at the THA (Tennessee Hospital Association) building, 500 Interstate Blvd. So., Nashville, TN 37210, (615) 256-8240. Directions: Take I-440 to the Nolensville Road exit. Go north toward the Fairgrounds about ½ mile. Go through the light at Polk Avenue and immediately turn right at the next light on Woodycrest Drive. Take the first left onto Interstate Drive. The THA building is the first on the left. Directions with mileage can be obtained from www.mapquest.com.
3. THCA ANNUAL MEETING - Sunday, 8/27/06 - Wednesday, 8/30/06 at the Gatlinburg Convention Center - Facility registrations are accepted. For more information, contact Laura Savage at lsavage@thca.org.
4. TEF BOARD OF DIRECTORS MEETING - Thursday, 9/7/06, at 7:00 p.m. at Laurie's house.
5. TNAHSA ANNUAL MEETING - Monday, 9/18/06 - Tuesday, 9/19/06 at the Opryland Hotel, Nashville - For more information, contact Carrie Ermshar at cermshar@tha.com.
6. TEAC MEMBERSHIP MEETING - Thursday, 9/21/06 at 11:00 a.m.
7. CELEBRATE SENIORS DAY - Friday, 10/6/06 from 10:00 a.m. - 2:00 p.m. at Bordeaux Long Term Care, 1414 County Hospital Road, Nashville. For more information, contact Debbie Meredith at debbie.meredith@nashville.gov.
8. TEAC MEMBERSHIP MEETING - Thursday, 10/26/06, at 11:00 a.m.
9. TEF BOARD OF DIRECTORS MEETING - Thursday, 11/2/06, at 7:00 p.m. at Laurie's house.
10. TEAC MEMBERSHIP MEETING - Thursday, 11/16/06, at 11:00 a.m.
11. ANIMAL CARE IN EDEN HOMES - Monday, 11/20/06 from 8:30 a.m. - 11:30 a.m. with John Pitts, DVM,
co-author of "The Eden Alternative Animal Welfare Guidelines".
12. TEAC MEMBERSHIP MEETING - Thursday, 12/14/06, at 11:00 a.m.
13. 4TH INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 5/08 IN Columbus, Ohio.Submitted by Laurie Loughlin
06/22/06 (back to top of page)
MEMBERS PRESENT: Donna Ray Anthony, Bob Blakey, Patty Brinkley, Carrie Ermshar, Melodie Fyke, Laurie Loughlin, Debbie Meredith, Shara Stodola, Linda Williams
GUESTS: Carol Mace - State Government Liaison
The Board requested the State Government Liaison's presence at this meeting because discussion topics included the State of Tennessee.
This was a working meeting. Members prepared packets containing introductory information about TEF/TEAC, an invitation to the culture change conference call on 7/27/06 and notice of the Eden Associate Training 8/8-10/06. These packets were then mailed to all 664 long-term care entities in Tennessee.
Please read the "Mark Your Calendar" section below carefully for details about these and other important events upcoming over the next several months.
Mark Your Calendar:
1. TEF BOARD OF DIRECTORS MEETING - Thursday, 7/6/06, at 7:00 p.m. at Laurie's house.
2. TEAC MEMBERSHIP MEETING - Thursday, 7/27 /06, at 11:00 a.m. in the 1st floor "Tennessee" conference room at the THA (Tennessee Hospital Association) building, 500 Interstate Blvd. So., Nashville, TN 37210, (615) 256-8240. Directions: Take I-440 to the Nolensville Road exit. Go north toward the Fairgrounds about ½ mile. Go through the light at Polk Avenue and immediately turn right at the next light on Woodycrest Drive. Take the first left onto Interstate Drive. The THA building is the first on the left. Directions with mileage can be obtained from www.mapquest.com.
3. STATEWIDE CULTURE CHANGE CONFERENCE CALL HOSTED BY QSOURCE - Thursday, 7/27/06 from 1:30 p.m. - 2:20 p.m. This will take place directly after the TEAC Membership Meeting; members attending the TEAC meeting are urged, if possible, to arrange to stay through the call, as some questions will be best answered by long-term care professionals currently active in the Edenizing process. The call-in number is (800) 615-2820; the pass code is 848325. For more information, contact Laurie Gyscek at lgyscek@tnqio.sdps.org.
4. EDEN ALTERNATIVE ASSOCIATE TRAINING - Tuesday, 8/8/06 - Thursday, 8/10/06 at Joseph B. Knowles Home Assisted Care Living Facility, 1010 Camilla Caldwell Lane, Nashville. To register, contact Penny Wade at edenalt@austin.rr.com.
5. THCA ANNUAL MEETING - Sunday, 8/27/06 - Wednesday, 8/30/06, at the Gatlinburg Convention Center - Facility registrations are accepted. For more information, contact Laura Savage at lsavage@thca.org.
6. TNAHSA ANNUAL MEETING - Monday, 9/18/06 - Tuesday, 9/19/06 at the Opryland Hotel, Nashville - For more information, contact Carrie Ermshar at cermshar@tha.com.
7. CELEBRATE SENIORS DAY - Friday, 10/6/06 from 10:00 a.m. - 2:00 p.m. at Bordeaux Long Term Care, 1414 County Hospital Road, Nashville. For more information, contact Debbie Meredith at debbie.meredith@nashville.gov.
8. 4TH INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 5/08 IN Columbus, Ohio.Submitted by Laurie Loughlin
05/18/06 (back to top of page)
MEMBERS PRESENT: Bob Blakey, Patty Brinkley, Carrie Ermshar, Melodie Fyke, Laurie Gyscek, Laurie Loughlin, Debbie Meredith, Steve Potash
GUESTS: Carol Mace - State Government Liaison
The Board requested the State Government Liaison's presence at this meeting because discussion topics included the State of Tennessee.
As Kort was unable to attend the meeting, he requested that Carol facilitate it, and she convened the meeting at 11:30 a.m.
Laurie L. announced that Pam Jackson from Community Care of Rutherford County, unable to attend the meeting because of an event at CCRC, is concerned about the immediate future of Eden training since no one has been able to get in contact with Susan Dean and the national office is currently in the process of restructuring. Carol reported that it appeared plans were being made to train Eden mentors to conduct Associate training in some states, but that the details were still being worked out. Laurie L. volunteered to ask Nancy Fox about this next month at the 3rd International Eden Alternative Conference.
Carol noted that she and Kort had discussed the need to confirm Eden Associate training for new grantees for this summer following the meeting last month and that Kort had contacted the Eden home office about scheduling someone to do the training. She stated that neither she nor Bordeaux had received any response to repeated calls, e-mails and a certified letter from them to Susan since March, and that the certified letter was returned undelivered. Kort had notified her that Carol Ende could do the training either 6/28/06 or 8/8/06 but was unavailable on the dates originally being held for Susan in July, though she would check with other trainers as to their availability. She added that they had agreed to go with the proposed 8/8/06 training because it was likely the grantee contracts would not be signed and in effect before the end of July. This was because the proposal submission dates had been pushed back due to contract approval delays. Kort had then contacted Carol Ende and confirmed the training for the week of 8/8/06. Carol asked Bordeaux to cancel the July dates being held and see if 8/8/06 was open. The members agreed this was a workable solution, and it was suggested that a notice about the training be included with the invitation to participate in a conference call and a brochure to be mailed in June. (See the "Special Request" at the end of these minutes for more details on the conference call and brochure.)
Carrie told the group that the title for TNAHSA's September conference (see "Mark
Your Calendar" for more information) is "Creating the Future" and that there will be a public policy panel comprised of national and local experts whose discussion will center on various aspects of implementing culture change.Laurie G. has been promoted to Program Manager at Qsource. We congratulate her and are glad she brings her expertise to TEAC.
Carol advised the members that she has received grant proposals from 16 facilities and that the TEF Grant Review Committee will meet tomorrow, 5/19/06, to review them and make recommendations to the Tennessee Commissioner of Health.
Carrie stated that she contacted the AHSA lobbyists and was informed that the Florida counterpart to TNAHSA, FAHA (Florida Association of Homes for the Aging) was currently utilizing funds from federal CMPs (Civil Monetary Penalties) and making them available to long-term care facilities through grants. She plans to place a call to the Director of FAHA to investigate the possibility that Tennessee might be able to access federal funds to assist facilities in culture change. The grants that TEF/TEAC currently facilitate come from CMPs levied by the State of Tennessee, not the federal CMPs which are always significantly larger in amounts imposed. Carol stated that she could also contact the Florida survey agency to inquire on the criteria they are using to access these funds since their use is governed by federal regulation.
Carol reported for Kort that he had been in contact with Laura Savage of THCA and that at the association's upcoming conference (details will be forwarded when available) they have scheduled a training/discussion with May Bennett of Bordeaux and other administrators of Edenizing homes on implementing culture change.
At our last meeting on 4/20/06, Tamara Murphy of CCRC, who was also unable to attend today due to an event on that campus, had suggested that intelligent cost shifting to offset the startup costs of culture change is an important aspect of successful implementation of the Eden Alternative. Everyone agreed that the high staff turnover rate experienced at most long-term care facilities is one of the most serious drains on funds, time and morale, and the rest of the meeting centered on how to reverse this problem.
Bob declared that, as an industry, long-term care is mired in archaic management practices and that new personnel policy modules promoting employee worth and stressing frequent training are necessary to stem the tide of staff resignations and apathy.
Steve added that it is not enough to have a good policy; the policy actually has to be implemented, which often doesn't happen.
Laurie G. said that, in her experience, staff surveys really help uncover the sources of dissatisfaction and can help homes initiate corrective action.
Melodie reported that when they realized at Mary Queen of Angels that most of the turnover occurred in the first few days of employment, they instituted "shadowing", where prospective hires were paired with employees for a few days so they could see what their jobs would entail and management could see if they would be a good addition.
She also explained that when she asked a group of her CNAs for input on how to handle those among them who were not pulling their weight, they replied that, rather than having to continue putting up with slackers just to keep the shifts fully-staffed, they would like those people to be terminated and would be willing to shoulder the burden of extra hours until new CNAs could be hired and trained.
Patty expressed her concern as an ombudsman that being under the control of unhappy/undertrained staff can be very negative for the elders, who don't deserve to have to end their days like that. This is one of the main reasons TEAC must press forward with culture change.
SPECIAL REQUEST OF REGISTERED EDEN HOMES AND 2005 GRANTEE HOMES: In keeping with the consensus of the membership that at this time our priority should be outreach to long-term care professionals in Tennessee about the Eden Alternative and the benefits of culture change, at the next TEAC Membership Meeting on Thursday, 6/22/06, we shall mail updated brochures to all long-term care facilities in the state (there are over 800) along with a letter inviting them to participate in a conference call hosted by Laurie Gyscek, our QIO (Quality Improvement Officer), on Thursday, 7/27/06. Debbie Meredith has graciously offered to revise the brochure for us, and she has asked for photos and stories about how Eden has made life better for residents and staff at different stages of your journeys for possible inclusion so that the brochure will show statewide representation. Please send these to Debbie via e-mail or regular mail within the week so she will have time to design and print the brochure before the mail-out on 6/22/06. Here is her contact information:
Debbie Meredith
Bordeaux Long Term Care
1414 County Hospital Road
Nashville, TN 37218
(615) 862-6860
debbie.meredith@nashville.govCarol adjourned the meeting at 1:30 p.m.
Mark Your Calendar:
1. NATIONAL SENIOR HEALTH AND FITNESS DAY - Wednesday, 5/31/06, at 2:00 p.m. at Bordeaux Long Term Care, 1414 County Hospital Road, Nashville; an open session of their Laughter Club.
2. 3rd INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 6/7-9/06, Cairns, Queensland, Australia.
3. TEAC MEMBERSHIP MEETING - Thursday, 6/22 /06, at 11:00 a.m. in the 3rd floor TNAHSA (Tennessee Association of Homes and Services for the Aging) reserved conference room at the THA (Tennessee Hospital Association) building, 500 Interstate Blvd. So., Nashville, TN 37210, (615) 256-8240. Directions: Take I-440 to the Nolensville Road exit. Go north toward the Fairgrounds about ½ mile. Go through the light at Polk Avenue and immediately turn right at the next light on Woodycrest Drive. Take the first left onto Interstate Drive. The THA building is the first on the left. Directions with mileage can be obtained from www.mapquest.com.
4. TEF BOARD OF DIRECTORS MEETING - Thursday, 7/6/06, at 7:00 p.m. at Laurie's house.
5. TEAC MEMBERSHIP MEETING - Thursday, 7/27/06, at 11:00 a.m.
6. TNAHSA ANNUAL MEETING - 9/18-19/06 AT THE Opryland Hotel, Nashville; registration packets to be mailed to TNAHSA members and licensed facilities in late May/early June.Submitted by Laurie Loughlin
04/20/06 (back to top of page)
MEMBERS PRESENT: Carrie Ermshar, Laurie Gyscek, Denise Hallowell, Pam Jackson, Ella Lawrence, Laurie Loughlin, Debbie Meredith, Cassie Mistretta, Tamara Murphy, Kort Nygard, Stephen Potash, Shara Stodola, Linda Williams
GUESTS: Carol Mace - State Government Liaison
The Board requested the State Government Liaison's presence at this meeting because discussion topics included the State of Tennessee.
Kort convened the meeting at 11:05 a.m.
Laurie L. explained problems she's been having with the list-serve bouncing certain e-mail addresses, identified the institutions where this is happening, and went over corrective measures with members from said institutions.
Debbie announced that Bordeaux Long-term Care is hosting an open session of their Laughter Club on Wednesday, 5/31/06, at 2:00 p.m. to celebrate National Senior Health and Fitness Day and to introduce other facilities in Middle Tennessee to the true meaning of "culture change" and "Edenization" . Everyone who would like to laugh with their Clown Troupe and experience culture change firsthand is invited. See "Mark Your Calendar" for the address. For more information, contact Debbie at debbie.meredith@nashville.gov.
Carol told the group that the State of Tennessee has approved our grant application package and that said packet will be mailed shortly to all facilities that requested it and will be placed on the website the same day.
Carrie informed the members that Doug Pace, who now resides in Washington, D.C. and works at AAHSA, has been appointed their National Director for Culture Change. He is scheduled to attend the Tennessee Culture Change Task Force meeting in June and will be back in Tennessee on 9/18/06 to deliver educational information at the TNAHSA Annual Meeting. Carrie will attempt to persuade him to stay in town long enough to attend TEAC's meeting that same week. For more information about the Annual Meeting see "Mark Your Calendar" and/or contact Carrie at cermshar@tha.com.
Kort steered the discussion toward ways of achieving and speeding up culture change. Steve feels strongly that showcasing 3 or more Edenizing homes in the state, where long-term care professionals and the general public could actually see how the Eden Alternative works, will be the most effective way. He also thinks that monetary rewards for homes that initiate culture change, getting waivers tied to reimbursement, will provide powerful incentive. Carrie added that 41 states have waivers for home and community services, the most progressive being Oregon, Oklahoma, Arkansas and Massachusetts. Kort wondered how those states were able to effect a groundswell of change. Carrie answered that persistence, and contact with those persons who are in positions to authorize changes, were key. She volunteered to contact the AAHSA legislative lobbying group to inquire as to whether there are any proposals to revise the federal Medicaid regulations to authorize the use of nursing home civil monetary penalty funds to provide long-term care facilities with construction/renovation grants to promote culture change.
Shara declared that staffing is a major issue. If you are short-staffed, which many long-term care facilities are, how do you implement the Eden Alternative when it requires a lower staff-to-resident ratio? Tamara believes that intelligent cost-shifting is necessary. Carrie said that it is also important that people understand that the Eden Alternative is a continuing process, not a project with a beginning, middle and end.
Kort then asked, "What can we, the Tennessee Eden Alternative Coalition, do RIGHT NOW to bring more long-term care professionals on board with the Eden Alternative and help move culture change along?" Several ideas were bandied about. Revising our brochure and circulating it to all long-term care facilities in the state was deemed the most effective start. Debbie volunteered to redesign the brochure. Laurie G. stated that through her QIO office she can facilitate a conference call about culture change for all long-term care professionals who want to participate. Laurie L. suggested that a cover letter go out with the revised brochures announcing the date and time of the conference call.
Carol informed members that Action Pact is looking for facilities to host 2 of its programs: "Tale of Transformation" - 1 day, and "Neighborhood Dining Innovations" - 2-day. She contacted Action Pact for additional information on the courses and will be sent a copy of the DVD and workbook for "Tale of Transformation" to review. If you are interested in hosting one or the other or both, contact Carol at Carol.Mace@state.tn.us. She can provide you with course cost and contacts information.
Kort adjourned the meeting at 1:20 p.m.
Mark Your Calendar:
1. TEF BOARD OF DIRECTORS MEETING - Thursday, 5/4/06 at 7:00 p.m. at Laurie's house.
2. TEF GRANT REVIEW COMMITTEE MEETING - Wednesday, 5/17/06 and possibly Friday, 5/19/06 at the THA building; see next item for directions, times TBA
3. TEAC MEMBERSHIP MEETING - Thursday, 5/18 /06 at 11:00 a.m. in the 3rd floor TNAHSA (Tennessee Association of Homes and Services for the Aging) reserved conference room at the THA (Tennessee Hospital Association) building, 500 Interstate Blvd. So., Nashville, TN 37210, (615) 256-8240. Directions: Take I-440 to the Nolensville Road exit. Go north toward the Fairgrounds about ½ mile. Go through the light at Polk Avenue and immediately turn right at the next light on Woodycrest Drive. Take the first left onto Interstate Drive. The THA building is the first on the left. Directions with mileage can be obtained from www.mapquest.com
3. NATIONAL SENIOR HEALTH AND FITNESS DAY - Wednesday, 5/31/06, at 2:00 p.m. at Bordeaux Long-term Care, 1414 County Hospital Road in Nashville.
4. 3rd INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 6/7-9/06, Cairns, Queensland, Australia.
5. TEAC MEMBERSHIP MEETING - Thursday, 6/22/06 at 11:00 a.m.
6. TNAHSA ANNUAL MEETING - 9/18-19/06 at the Opryland Hotel, Nashville; registration packets to be mailed to TNAHSA members and licensed facilities late May/early June.Submitted by Laurie Loughlin
03/16/06 (back to top of page)
MEMBERS PRESENT: Conita Grigsby, Stephanie Harville, Pam Jackson, Laurie Loughlin, Debbie Meredith, Kort Nygard, Stephen Potash, Shara Stodola, Donna Sutherland, Linda Williams
GUESTS: Carol Mace - State Government Liaison
The Board requested the State Government Liaison's presence at this meeting because discussion topics included the State of Tennessee.
Kort convened the meeting at 11:10 a.m.
Kort announced that he has spoken with Laura Savage regarding TEAC's participation in the September eldercare conference being coordinated by THCA.
So far, Bordeaux Long-term Care and St. Peter Villa have signed on to host open houses for long-term care professionals at non-Edenizing homes to show them what we are about. Laurie reminded those present, and via these minutes reminds those reading, that there is money in this year's TEAC budget to give $250.00 to up to 6 facilities to do these open houses as long as the event takes place no later than 6/30/06. Other facilities wanting to participate can contact her at doublel@bellsouth.net.
Carol advised the group that application packets for the 2006/2007 $5,000.00 grants will soon be mailed out to those who have requested them. Any facility that has not yet contacted her but would like to apply for a grant should let her know ASAP at Carol.Mace@state.tn.us.
Pam reported that the day care center at Community Care of Rutherford County has opened and is a heartening success. Enrollees are children of both county employees and the general public. They are forging grandchild/grandparent bonds with the elders, visiting them often in their rooms and causing the residents to come out of their rooms to give wheelchair rides, have storytelling sessions and participate in other activities.
Debbie told the members that Bordeaux has received a grant from the Community Foundation of Middle Tennessee to send 2 employees to the World Laughter Tour. Bordeaux has been holding clown classes for staff, residents and the general public and is now a certified laughing site. They have found that focusing on laughter has truly lightened the mood at their facility. They are planning another workshop soon. Those taking the class can receive CEUs. Anyone interested can contact Debbie at debbie.meredith@nashville.gov.
All members are urged to communicate news about what is happening at their homes via our website at www.tneden.org. Click on the "News" link to see what others have reported. Send any news to Laurie at doublel@bellsouth.net, and she will forward it to our webmaster for inclusion in the site.
Kort initiated a brainstorming session regarding non-regulatory barriers to long-term care culture change. Shara stated that the Eden Alternative needs to incorporate nurses more into the matrix. They have a critical role pertaining to medical decisions, and some feel that the Eden system devalues them. Pam has noticed that, while there are benefits to the shared responsibility in Eden, there are also drawbacks, one being that some employees have adopted the attitude of "If I can't do it my way, I won't do it." On the other hand, in some neighborhoods staff members have trouble taking ownership. Conita added that in Memphis there is a shortage of techs; they rely partially on agencies, and this affects cohesion. Donna thinks that even though the dress code is casual, some staff members still don't know how to dress appropriately and would benefit from guidelines being included in the Eden training.
Stephanie declared that sometimes administrators are all fired up about Eden but don't know how to sell it to their staffs, and that training to help them do that could really improve the rate of acceptance. Pam recited the Action Pack formula:
DxVxFS>R
"Dissatisfaction x Vision x First Steps must be greater than Resistance"
and also noted that people who are not actually involved in the culture change process will not be aware of the barriers and that it is important for us to point these barriers out to them.Steve feels that even though we are focusing on non-regulatory barriers to culture changes, state regulations should provide some means for those homes that want to embrace culture change to do so without the fear of citations, and that if employees and volunteers know they will be able to do certain things, they will come on board more easily. We must deal with the negatives to get to the positive.
To wrap up the discussion, Kort asked what the main barriers to long-term culture change are and received the following responses: money, availability of licensed nurses, staff continuity, lack of time, managing change and regulations (from both standpoints of what they sometimes require and how some long-term care professionals use them as excuses to avoid culture change).
Kort adjourned the meeting at 1:40 p.m.
Mark Your Calendar:1. STATE OF TENNESSEE CAREGIVERS CONFERENCE - Thursday-Friday, 4/6-7/06, MTSU School of Nursing; Eden Alternative founder Dr. Bill Thomas will speak on both dates, $50.00/person.
2. TEAC MEMBERSHIP MEETING - Thursday, 4/20 /06 at 11:00 a.m. in the 3rd floor TNAHSA (Tennessee Association of Homes and Services for the Aging) reserved conference room at the THA (Tennessee Hospital Association) building, 500 Interstate Blvd. So., Nashville, TN 37210, (615) 256-8240. Directions: Take I-440 to the Nolensville Road exit. Go north toward the Fairgrounds about ½ mile. Go through the light at Polk Avenue and immediately turn right at the next light on Woodycrest Drive. Take the first left onto Interstate Drive. The THA building is the first on the left. Directions with mileage can be obtained from www.mapquest.com
3. TEF BOARD OF DIRECTORS MEETING - Thursday, 5/4/06 at 7:00 p.m. at Laurie's house.
4. TEAC MEMBERSHIP MEETING - Thursday, 5/18/06 at 11:00 a.m.
5. 3rd INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 6/7-9/06, Cairns, Queensland, Australia.
6. TEAC MEMBERSHIP MEETING - Thursday, 6/22/06 at 11:00 a.m.Submitted by Laurie Loughlin
02/03/06 (back to top of page)
MEMBERS PRESENT: Donna Ray Anthony, Laurie Gyscek, Pam Jackson, Mark King, Laurie Loughlin, Tamara Murphy, Kort Nygard, Stephen Potash
GUESTS: Carol Mace - State Government Liaison
The Board requested the State Government Liaison's presence at this meeting because discussion topics included the State of Tennessee.
Kort convened the meeting at 11:20 a.m.
Kort told the members that at a recent meeting to determine regulatory impediments to culture change chaired by Judy Eads, Assistant Commissioner for the Bureau of Health Licensure and Regulation, he stated that he thought most of the resistance was non-regulatory, after which she asked him to form a subcommittee to explore this aspect. Mark agreed with Kort that the reasons are psychosocial, that a combination of pride and a need to "package life" have been hindering progress. Laurie L. added the fear of being sued. Donna Ray wondered if the state's installing a merit system similar to the one coming from the federal government would increase willingness to change. Pam thinks that as Baby Boomers approach the need for long-term care, this very vocal group will demand and bring about improvements. Tamara interjected the fact that some long-term care facility employees at all levels have a problem with the Eden Alternative's egalitarian approach and feel that there are certain duties they should not have to perform. She feels that the CNAs (Certified Nursing Assistants) will come on board if the DONs (Directors of Nursing) and Eden Alternative Coordinators will let them make decisions and suggested devising a nurse's aide training program. Donna Ray believes that there are federal grants already available to train CNAs on properly interacting with residents by designing schedules around the residents' wishes and needs. Mark declared that sharing information from facilities that have already installed a particular process will help homes that have not yet made decisions about how to approach culture change. Kort posed the idea of having a "movers and shakers" conference to discuss this issue. Steve wants to form a group with representatives from all appropriate agencies. Carol advised that however we proceed, we will need to find a way to bring the parties to the table.
Laurie G. informed the group that in 9/06 THCA (Tennessee Health Care Association) is sponsoring a 6-hour seminar on all aspects of long-term care culture change. The cost will be $125.00/person and sessions will be held in Knoxville, Nashville and Jackson. Representatives from the Rhode Island QIO (Quality Improvement Organization), who are the lead QIO nursing home managers in the country, will be featured speakers. Steve stated that he hopes important financial aspects will be addressed, and Laurie G. replied that they will be. More information will be distributed to TEAC members as soon as it becomes available.
Laurie L. reported disheartening results in her attempts to have an Eden Alternative representative speak about the importance of architecture in long-term care reform to faculties and students at the 2 universities in Tennessee that have architecture departments. No one at one of them would return her calls or e-mails; the director of the department at the other one told her he had canvassed his faculty and none of them were interested in presenting a program on housing for the elderly to their students even though he did point out to them that Baby Boomers, the largest segment of America's population, will start turning 65 in 2011. Laurie will now pursue the state chapter and 6 local chapters of the AIA (American Institute of Architects).
Dates of TEAC Membership Meetings were set for the rest of our current fiscal year, which ends on 6/30/06. Please refer to the "Mark Your Calendar" section below.
Laurie G. is hopeful that a recent restraint collaborative conducted by Tennessee QIO can be used as a model to eliminate the use of restraints in long-term care facilities. The 15 homes included in the initiative were given 10 measures to implement in hopes of reducing the use of restraints to 2% and asked to submit monthly data. At the outset most personnel felt that this would be impossible, but at present 10 of the 15 are at 2% or below. The eventual goal is 0% use of restraints. Anyone seeking more information on this study can contact Laurie G. at lgyscek@tnqio.sdps.org.
The group previewed an Action Pact video titled "Dynamics of Elderly Caregiving" in which Lavrene Norton interviews the administrators of 3 long-term care facilities in different parts of the country that have made dramatic and successful strides into culture change. TEAC will lend this video to any institutions interested in showing it to their staffs. If you would like to borrow it, contact Carol at Carol.Mace@state.tn.us.
Kort adjourned the meeting at 1:45 p.m.
Mark Your Calendar:1. TEF BOARD MEETING - Thursday, 3/02/06 at 7:00 p.m. at Laurie's house.
2. TEAC MEMBERSHIP MEETING - Thursday, 3/16 /06 at 11:00 a.m. in the 3rd floor TNAHSA (Tennessee Association of Homes and Services for the Aging) reserved conference room at the THA (Tennessee Hospital Association) building, 500 Interstate Blvd. So., Nashville, TN 37210, (615) 256-8240. Directions: Take I-440 to the Nolensville Road exit. Go north toward the Fairgrounds about ½ mile. Go through the light at Polk Avenue and immediately turn right at the next light on Woodycrest Drive. Take the first left onto Interstate Drive. The THA building is the first on the left. Directions with mileage can be obtained from www.mapquest.com
3. STATE OF TENNESSEE CAREGIVERS CONFERENCE - Thursday-Friday, 4/6-7/06, MTSU School of Nursing, Eden Alternative founder Dr. Bill Thomas will speak on both dates, $50.00/person, registration form will be distributed in near future.
4. TEAC MEMBERSHIP MEETING - Thursday, 4/20/06 at 11:00 a.m.
5. TEAC MEMBERSHIP MEETING - Thursday, 5/18/06 at 11:00 a.m.
6. 3rd INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 6/7-9/06, Cairns, Queensland, Australia.
7. TEAC MEMBERSHIP MEETING - Thursday, 6/22/06 at 11:00 a.m.Submitted by Laurie Loughlin
12/12/05 (back to top of page)
MEMBERS PRESENT: Mark King, Laurie Loughlin, Tamara Murphy, Kort Nygard, Stephen Potash, Shara Stodola, Brenda Vanhoose , Linda Williams
GUESTS: Carol Mace - State Government Liaison
The Board requested the State Government Liaison's presence at this meeting because discussion topics included the State of Tennessee.
Kort convened the meeting at 11:30 a.m.
Mark King announced that Dr. Bill Thomas will be speaking at the Annual Tennessee Caregivers Conference, which will be held at the MTSU School of Nursing in Murfreesboro on 4/6-7/06. Dr. Thomas will speak Thursday evening and conduct a breakout session Friday. The fee will be $50/person, and CEUs will be awarded. TEAC has agreed to contribute some grant funds to the cost of bringing Dr. Thomas in and also will moderate a 1-hour breakout session on Green Houses. Community Care of Rutherford County (CCRC) and THCA are among the sponsors, and they are seeking more. Mark is helping to coordinate the conference, and any facilities willing to assist in sponsoring Dr. Thomas should contact him at mking@rutherfordcounty.org. More details will be provided to TEAC members as they become available.
Kort wanted the rest of the meeting devoted to discussing the top results of our recent ballot.
1) E. "Approach the State of Tennessee about removing regulatory obstacles and including Eden or Eden-like principles in its regulations similar to what CMS and the QIOs are doing on a national level to motivate long-term care institutions to embrace culture change." - Carol commented that the State facility regulations should contain few regulatory obstacles to culture change but that her boss and the Assistant Commissioner have stated willingness to review any regulations identified by facilities as being an obstacle to implementing culture change plans. Laurie suggested that the State be approached about providing incentives to nursing homes similar to what CMS is doing on the federal level. Steve wants at least some of the Principles of Eden embedded in the Department of Health's code. Shara added that a substantial portion of the problem right now for Bordeaux Long-term Care in planning to construct Green Houses is financial, because TennCare has not reimbursed Metro General Hospital for indigent care and is now in trouble, in addition to which $15,000,000 in additional federal funds expected by Metro Hospital Authority, of which Bordeaux Long-term Care is a part, has not come through.
2a) D. "Approach senior citizen groups about partnering with us, which could extend our influence and add manpower." - Kort declared that the upcoming Annual Tennessee Caregivers Conference in April 2006 will give us an excellent opportunity to touch base with other organizations concerned with eldercare and/or that we might organize a meeting with like-minded nonprofits to brainstorm and form a unified agenda. Linda knows an influential member of the Alliance for Retired Americans, who are very proactive proponents of aging in place. She will contact him to see if there is a regional office in or near Tennessee. Carol promised to send her some Eden brochures to share with him and a local physician.
2b) G. "Educate long-term care professionals about what the Eden Alternative really is by inviting them to TEAC meetings and speaking at their meetings on national, statewide and local levels; gaining the support and partnership of industry leaders could make a big difference in the speed of culture change." Linda suggested that, since doctors own or have stock in many long-term care facilities, we inform as many of them as possible about the Eden Alternative. She will forward information re TEF/TEAC to an officer of the Tennessee Medical Association. Kort feels that an effective way to spread the message of Eden would be for Edenizing homes to hold open houses with a short program on the Eden Alternative for personnel of non-Edenizing homes in their areas. Laurie will send out an inquiry about this to the membership.
7.) H. "Have more frequent TEAC meetings to keep momentum going." Although this item didn't get a single vote, it was advocated by those present, so it was decided to have TEAC membership meetings every month instead of every other month.
Kort adjourned the meeting at 1:45 p.m.
Mark Your Calendar:
1. TEF BOARD MEETING - Thursday, 1/12/06 at 7:00 p.m. at Laurie's house.
2. TEAC MEMBERSHIP MEETING - Thursday, 1/19 /06 at 11:00 a.m. in the 3rd floor TNAHSA (Tennessee Association of Homes and Services for the Aging) reserved conference room at the THA (Tennessee Hospital Association) building, 500 Interstate Blvd. So., Nashville, TN 37210, (615) 256-8240. Directions: Take I-440 to the Nolensville Road exit. Go north toward the Fairgrounds about ½ mile. Go through the light at Polk Avenue and immediately turn right at the next light on Woodycrest Drive. Take the first left onto Interstate Drive. The THA building is the first on the left. Directions with mileage can be obtained from www.mapquest.com
3. STATE OF TENNESSEE CAREGIVERS CONFERENCE - Thursday-Friday, 4/6-7/06, MTSU School of Nursing
4. 3rd INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 6/7-9/06, Cairns, Queensland, Australia.Submitted by Laurie Loughlin
10/27/05 (back to top of page)
MEMBERS PRESENT: Laurie Gyscek, Laurie Loughlin, Bobbie Mitchell, Tamara Murphy, Kort Nygard, Stephen Potash, Judy White, Linda Williams
GUESTS: Carol Mace - State Government Liaison
The Board requested the State Government Liaison's presence at this meeting because discussion topics included the State of Tennessee.
Kort convened the meeting at 11:20 a.m.
Laurie L. told the group that one of the sessions at the recent Australia America Association Annual Meeting featured the new field of "disease management". Private firms, whose clients are health insurance companies, hire nurses to maintain regular phone contact with chronically ill patients, many of whom are elderly (the focus has been mainly on diabetics), to make sure they are taking their medications properly and discuss any concerns or problems they are having for early intervention. The insurance companies have reported savings on claims of up to 23% because these patients see their doctors less frequently and have fewer hospitalizations and visits to the ER. Laurie didn't know if this kind of service would be appropriate for long-term care because there is constant medical supervision anyway, but wanted the membership to be aware of this development in case it could be adapted to be helpful, especially on campuses that include independent living accommodations.
Carol declared that, immediately following our meeting, she would be conducting training for representatives from each of the 2005 Grantees so that they will understand what the State of Tennessee requires of them.
In follow-up to a suggestion made by Minda Brackman at our August meeting, Laurie L. announced that she has contacted 3 architectural entities to inquire about the possibility of Kort speaking to their groups about the Green House and Household models. 2 look promising.
Kort feels it is important to set firm direction for TEAC and wanted the rest of the meeting dedicated to discussing areas of interest the members think are the most important for us to pursue to be more successful in bringing the Eden Alternative to long-term care facilities in Tennessee. Many ideas were brought forth which he decided should be sent out to the entire membership for a vote. Laurie L. will put them on a ballot which will be sent out under separate cover.
Members indicated that they would like more contact with each other. Any members who have questions, concerns, or ideas they want to share with other members can send them to teac@yahoogroups.com. All appropriate e-mails will then be forwarded on the list-serve to everybody.
Kort adjourned the meeting at 1:35 p.m.
Mark Your Calendar:
1. TEF BOARD MEETING - Thursday, 11/17/05 at 7:00 p.m. at Laurie's house.
2. TEAC MEMBERSHIP MEETING - Monday, 12/12 /05 at 11:00 a.m. in the 3rd floor TNAHSA (Tennessee Association of Homes and Services for the Aging) reserved conference room at the THA (Tennessee Hospital Association) building, 500 Interstate Blvd. So., Nashville, TN 37210, (615) 256-8240. Directions: Take I-440 to the Nolensville Road exit. Go north toward the Fairgrounds about ½ mile. Go through the light at Polk Avenue and immediately turn right at the next light on Woodycrest Drive. Take the first left onto Interstate Drive. The THA building is the first on the left. Directions with mileage can be obtained from www.mapquest.com.
2. 3rd INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 6/5-9/06, Cairns, Queensland, Australia.Submitted by Laurie Loughlin
08/25/05 (back to top of page)
MEMBERS PRESENT: May Bennett, Minda Brackman, Carrie Ermshar, Conita Grigsby, Laurie Gyscek, Ella Lawrence, Laurie Loughlin, Cassie Mistretta, Tamara Murphy, Kort Nygard, Stephen Potash, Tim Spears, Linda Williams
GUESTS: Carol Mace, Jere Younger - State Government Liaisons
The Board requested the State Government Liaisons' presence at this meeting because discussion topics included the State of Tennessee.
Kort convened the meeting at 11:20 a.m.
As there were several new members at this meeting, Kort began by giving a brief history of TEAC/TEF, stressing that our primary focuses continue to be advocacy, outcome research and public education. Because our organization is run by only 4 part-time volunteers, he announced that in order for us to spread the message of the Eden Alternative more rapidly, one of our major goals is to get an office and hire 2 full-time staff. To accomplish this we will need help in fundraising and grant writing. Any members who would like to contribute their time and skills to this, or can recommend someone, are encouraged to contact Kort at knygard@earthlink.net.
He then asked that we go around the table stating our thoughts about and hopes for TEAC and why we came to the meeting:
Tim (Community Care of Rutherford County [CCRC]) wants to know what other Edenizing facilities are doing and thinks it is important that our group finds ways to reach facilities that are not yet Edenizing.
Tamara (CCRC) feels that in order for change to occur, we have to make time to enact it no matter how busy we are, and she came to see how she could contribute to changing the current culture of long-term care.
Jere (Tennessee Department of Health) is concerned about long-term care residents and wants collaboration between regulatory and non-regulatory agencies as we are all focused on improving quality of care.
Steve (Nashville Metro Bordeaux Hospital [Bordeaux]) stated that in order to achieve our goals we will need a strong strategic plan and should actually partner with the State of Tennessee to effect culture change in long-term care facilities across our state in a timely manner because an awful lot needs to be done.
May (Bordeaux) views TEAC as a support group where it is good to share and brainstorm. She is worried that changes in government reimbursement structures will not give facilities the monies they need to deliver the care that residents deserve. She believes in reality vs. concept - that if we can make a change tomorrow, even just a small one, it can improve lives and is as important as the long-term goals we set; in fact, these small steppingstones are what eventually accumulate into culture change.
Carol (Tennessee Department of Health) declared that it is important for TEAC to support its members and vice versa, and that the discussions at these meetings are a good way for us to identify what the members' needs are in order to be more responsive to them.
Minda (Bordeaux) comes to get information, strategies and practical problem solving. She made the suggestion that, since architectural changes to facilities would make it a lot easier to deliver the 10 Principles of the Eden Alternative to residents, it would behoove us to educate the architects of long-term care facilities about various layouts such as those used in the Green House Project and Resident-Centered Care so that when they are designing new building or renovating existing ones, they can incorporate these ideas. Everyone thought this was a great idea, and Laurie L. volunteered to investigate getting us on the agendas of meetings of any architectural societies in the state. Carrie added that we should also target colleges and universities with architecture departments.
Ella (Bordeaux) informed the group that she has just completed Eden Associate training. She thinks we should see what's being taught about long-term care in educational institutions and try to reframe the thinking there so that people just entering the workforce will already be proactive towards culture change.
Conita (St. Peter Villa) stated that her facility has been Edenizing since 2000 and that they have been very successful in providing their residents with choice. She also mentioned that the entire St. Peter Villa community has rallied around a homeless artist suffering from terminal cancer. They organized a sale of his artwork, and the Memphis newspaper, Commercial Appeal, ran an article about the artist and the event.
Linda (Ivy Crest) advised that although she has much fewer residents (24) than the other facilities present, she still experiences a lot of the same situations and roadblocks that larger places do and is grateful for the communications she receives from TEAC and for the opportunity to talk with fellow Edenizers.
Laurie L. (TEF/TEAC Board of Directors) said that, although she is not a long-term care professional, she became involved with TEF/TEAC after experiencing the decline and death of 5 elderly family members. She wants to improve long-term care as a whole, and her special passion is to keep the elderly and their pets together. As an animal rescuer, she has seen firsthand the devastation when an elder is forced to surrender a beloved companion he/she is no longer able to fully care for. She has spoken with Dr. Thomas and Jude Rabig about this, and if any facilities in Tennessee are interested in being a pilot for an Eden home where residents can bring their own pets, they are willing to work with the facility on the special issues involved, as is the TEF/TEAC Board.
Laurie G. (Q Source) told the group that as the QIO (Quality Improvement Officer) for Middle Tennessee, she is here as a vehicle to pass along to us information that she gathers and resources she identifies. Her organization is currently collaborating with 15 nursing homes to work with intensely on culture change. These facilities will then be used as models to teach all the other homes.
Kort (TEF/TEAC Board of Directors) started our group in 1997 determined to better the lives of America's elders through facilities in Tennessee. He feels it is important for us to stay in touch with what the Eden Alternative is doing worldwide because a unified paradigm shift will have more impact.
Cassie (Sunbridge Care and Rehabilitation) wants to learn how to be a change maker. She is aware that when an administrator leaves an Edenizing home, if that person's replacement is not interested in the Eden Alternative, the home reverts to the medical model. She wants to leave a legacy for residents so that the home's infrastructure will have the ability to continue the Eden Alternative even if key personnel depart.
Carrie (Tennessee Association of Homes and Services for the Aging [TNAHSA]), our host, thinks one reason the Eden Alternative has not taken root in many places is because it is viewed as a project instead of culture change and that it is important for us to partner with other groups with similar goals and research alternative sources of funding.
The group then viewed "The Green House Project", the first of 5 newly acquired videos that will be shown at successive TEAC meetings. These videos are available through the TEAC Lending Library. Contact Carol at Carol.Mace@state.tn.us for information.
We have added 2 new pages to our website, www.tneden.org - "Links" and "Member News". Any TEAC members employed by facilities or agencies that have websites they would like to link or news they would like to disseminate can send their website address and/or news to Laurie L. at doublel@bellsouth.net. This will be a good way for TEAC members to share information and happenings with each other and will provide greater exposure of Edenizing facilities in Tennessee to the public at large.Kort adjourned the meeting at 2:00 p.m.
Mark Your Calendar:
1. TEF BOARD MEETING - Thursday, 9/22/05 at 7:00 p.m. at Laurie's house.
2. TEAC MEMBERSHIP MEETING - Thursday, 10/27 /05 at 11:00 a.m. in the 3rd floor TNAHSA (Tennessee Association of Homes and Services for the Aging) reserved conference room at the THA (Tennessee Hospital Association) building, 500 Interstate Blvd. So., Nashville, TN 37210, (615) 256-8240. Directions: Take I-440 to the Nolensville Road exit. Go north toward the Fairgrounds about ½ mile. Go through the light at Polk Avenue and immediately turn right at the next light on Woodycrest Drive. Take the first left onto Interstate Drive. The THA building is the first on the left. Directions with mileage can be obtained from www.mapquest.com.
2. 3rd INTERNATIONAL EDEN ALTERNATIVE CONFERENCE - 6/5-9/06, Cairns, Queensland, Australia.Submitted by Laurie Loughlin
June 16, 2005 (back to top of page)
MEMBERS PRESENT: Laurie Loughlin, Kort Nygard, Shara Stodola
GUEST: Susan Dean, Eden Alternative Region 2 Coordinator; Carol Mace, State Government Liaison; Dan SloanKort convened the meeting at 7:20 p.m.
Kort reported on the St. Louis Accord, a joint meeting of several organizations interested in improving eldercare. The response was double that expected, with people there from all 50 states plus the District of Columbia. There were 7 from Tennessee. The QIOs (Quality Improvement Organizations) hired by the federal government will be rolling out a new program this summer which will emphasize culture change in nursing homes and include as a benchmark the lowering of facility staff turnover rates. The major incentive behind this effort is the possibility that Medicaid reimbursement could soon be based on facility outcomes, including measures of pain, restraint use, decubitus ulcers and depression.
Susan Dean stated that in South Carolina, lack of proper supervision is a major reason for staff turnover, and that the system would greatly benefit if Directors of Nursing were trained in supervisory skills. Shara concurred, and added that in some facilities there are no registered nurses at all.
Shara also noted that the turnover problem extends to management. The average length of stay for an Administrator is 18 months and for a Director of Nursing is 6 months. She is also concerned that the statistics collected in the new QIO program might not accurately reflect the quality of care. For example, facilities like Bordeaux which take in residents whom other places won't accept because of certain health problems (e.g., bed sores acquired in a hospital), won't look good on paper because of the higher percentage of medical conditions that will appear.
Susan Dean announced that she will be doing the next Eden Associate training in Tennessee at Nashville Metro Bordeaux Hospital 8/8-10/05. Anyone interested in registering can contact Susan at skdean@earthlink.net.
Susan will then do the makeup session of Culture Change #3 on 8/11/05 in Memphis at St. Peter Villa. Anyone interested in registering can contact Carol Mace at Carol.Mace@state.tn.us.
Because attendance at these TEAC meetings has been so poor, two alternatives were suggested: 1) that we change the meeting time to day instead of evening; 2) that we institute regional meetings. Laurie volunteered to poll the membership to see if either or both of these would increase participation. Results will be discussed at the next TEF Board Meeting on 7/7/05, and information regarding the next TEAC membership meeting will be sent with those minutes.
Kort adjourned the meeting at 9:25 p.m.
Mark Your Calendar:
1. TEF BOARD MEETING - Thursday, 7/7/05, 7:00 p.m. at Laurie's house.
2. 3rd INTERNATIONAL EDEN ALTERNATIVE CONFERENCE- 6/5-9/06, Cairns, Queensland, AustraliaSubmitted by Laurie Loughlin
April 14, 2005 (back to top of page)
MEMBERS PRESENT: Pat Buckner, Laurie Gyscek, Kort Nygard, Shara Stodola
GUEST: Carol Mace, State Government LiaisonKort convened the meeting at 7:15 p.m.
Laurie Gyscek reported on the new Centers for Medicare and Medicaid (CMS) and Quality Improvement Organizations (QIO) NIHFT Reporting tool for nursing homes that is scheduled to be out in January 2006. This reporting tool will be utilized by a selected group of nursing homes in each state which QIO are to identify. The selected facilities will be provided the software and are then to collect and submit by way of the Internet facility information and data. The tool will assist the QIO in measuring their success at improving quality of care in facilities and includes patient and staff satisfaction surveys which will are to be conducted annually. The tool targets areas such as reduction in staff turnover, pressure ulcers, and pain and depression and allows the QIO to generate reports. She also noted that CMS has recently reduced their expectation of the QIO to affect an average decrease in staff turnover of 50% to a lesser percentage. When queried regarding the possibility of inclusion of the Eden grantee nursing homes in the Tennessee target group she indicated that this might be feasible.
Shara discussed Bordeaux's recent addition of two dogs to the facility and how she has received some resistance from staff and family members but that the residents are quite pleased with their presence. She noted that they chose to name one of the dogs Mac in honor of Metropolitan Animal Control from where they had been adopted and that both dogs were adapting well to the facility. One of Nashville's television stations recently did a story on their adoption of the dogs. Shara also discussed her efforts toward the facility's development of an effective nurse aide training program to address the situation of aides not having enough education to pass the certification exam. She noted that she had recently hired another coalition member and trained Eden Associate, Minda Brackman.Susan Dean will be conducting an Eden Associate training course at Bordeaux on May 23-25, 2005. She was unable to arrange to hold it at Community Care of Rutherford County as they had requested, but will try to hold her next training there, possibly in late summer. Carol noted that Susan had not gotten back with her yet on possible dates for the conduction of the fourth Culture Change training sessions.
Carol stated that she had recently been contacted by Wharton Nursing Home in Pleasant Hill which is currently raising funds to build a replacement facility and is hoping to build a Greenhouse. They were questioning if the Greenhouse model would have trouble meeting the State's regulations. Carol said that she was currently exploring this area with the Division of Health Care Facilities' engineering director. Laurie stated that Assistant Commissioner Judy Eads had also recently indicated in a meeting that she intends to put together a task force to review the Division's regulations with regard to the building and operation of Greenhouses.
Kort reported that Community Care of Rutherford County is planning to charter a trip to Kansas to visit a successful Eden facility there which he is hoping to also go along on.
When discussion turned to the 3rd International Eden Alternative Conference being held in Cairns, Queensland, Australia, it was noted that an airline is currently running a special for travel to Australia through 2006 of approximately $1000. Call 1-800-DOWNUNDER OR 1-800-36-968-6337 for information.
Kort gave a short update on the report findings the Coalition is required to submit to the Department of Health and the respective General Welfare, Health and Human Resources Committees of the Tennessee Senate and House of Representatives by the end of June 2005.
Kort adjourned the meeting at 8:45 p.m.Mark Your Calendar:
1. TEAC MEMBERSHIP MEETING - Thursday, 6/16/05, 7:00 p.m. at the Chinese Garden Restaurant, 150 Donelson Pike, Nashville, (615) 871-0536. Directions: Take I-40 to Exit 216C, which loops around to the right onto Donelson Pike; continue for about 1.5 miles; restaurant is on the right and has a big neon sign (if you get to Lebanon Road, you have gone too far).
2. 3rd INTERNATIONAL EDEN ALTERNATIVE CONFERENCE- 6/5-9/06, Cairns, Queensland, AustraliaSubmitted by Laurie Loughlin
02/10/05 (back to top of page)
MEMBERS PRESENT: Dawn Hancock, Laurie Loughlin
Laurie convened the meeting at 7:05 p.m.
She reported that Kort, who had been detained in Chattanooga and was therefore unable to attend, had phoned to let her know that very encouraging results have been obtained from a survey he and his partners in New Senior Concepts have been conducting for a year at one of the facilities they manage. They took baseline data on residents 12 months ago (at the start of their programs) in the areas of activities of daily living, ability to take care of oneself and depression versus optimism; recent follow-up shows definitive improvements in all 3 areas. They are in the process of putting this into the proper form for us to report these findings to the State of Tennessee at the end of our legislative period 6/30/05.
Dawn interjected that the activities director at Sunbridge Care and Rehabilitation in Ardmore, one of our 10 grantees this year, has just completed a comparison in similar areas between Sunbridge, which has just started the Edenizing process, and Community Care of Rutherford County (CCRC), which is much farther along in the Eden Alternative, showing less depression among residents at CCRC. She will forward a copy to the Board of Directors so that these figures can also be included in our report to the State of Tennessee.
Laurie has been in contact with Carol Mace, our State Government Liaison, regarding the Grant Review Committee for the 2005/2006 Tennessee Edenizing Foundation grants to 10 Edenizing facilities. Carol is in the process of putting application packets together and choosing potential dates for the Grant Review Committee to meet this spring. Current grantees are reminded that in order to be eligible to receive a 2005/2006 grant they must have completed all paperwork required by their 2004/2005 grant.
Dawn detailed much activity at CCRC. Their child-care center building has been delivered and awaits connection to plumbing, electricity, etc. They are holding a Sweethearts Dance on Valentines Day at which a King and Queen will be crowned in each neighborhood. The following day CCRC will welcome its first dog. And Dawn is currently in contact with Susan Dean, our Region II Coordinator, to set up an Eden Associate Training at Middle Tennessee State University in Murfreesboro sometime in March.
Laurie added that Carol Mace had told her she is also in contact with Susan Dean to arrange dates and locations for session 4 of the Culture Change series which had to be cancelled last year.
As soon as we have definitive information on both of the above educational opportunities, Laurie will notify the TEAC membership.
Laurie adjourned the meeting at 9:00 p.m.
Mark Your Calendar:
1. TEF BOARD MEETING – Thursday, 3/10/05, at 7:00 p.m. at Laurie's house.
2. TEAC MEMBERSHIP MEETING – Thursday, 4/14/05, at 6:30 p.m. in the private dining room at Chinese Garden Restaurant, 150 Donelson Pike, Nashville, (615) 871-0536. Directions: Take I-40 to exit 216C, which loops around to the right onto Donelson Pike; continue for about 1.5 miles; restaurant is on the right and has a big neon sign (if you get to Lebanon Road, you have gone too far).
3. 3rd INTERNATIONAL EDEN ALTERNATIVE CONFERENCE – 6/5-9/06, Cairns, Queensland, Australia.Submitted by Laurie Loughlin
12/09/04 (back to top of page)
MEMBERS PRESENT: Pat Buckner, Laurie Gyscek, Dawn Hancock, Laurie Loughlin, Kort Nygard, Shara Stodola
GUEST: Carol Mace, State Government LiaisonKort convened the meeting at 6:45 p.m.
Laurie Gyscek introduced herself. She is the Q-Source Representative for Middle Tennessee. (East Tennessee and West Tennessee also each have a Q-Source Representative.) Q-Source is our state's Quality Improvement Organization (QIO). QIOs have been mandated by the Center for Medicaid and Medicare to work with long-term care facilities to assist them with culture change, to develop more of a resident focus and to improve quality. The Eden Alternative has come to the attention of the Federal Government as one avenue of this culture change, and it sent many QIO representatives to the 2nd International Eden Alternative Conference in Tacoma in October.
Laurie G. told the group that Q-Source is already working with 117 of the 327 nursing homes in Tennessee on decreasing the amounts of pain, restraints and pressure ulcers experienced by residents. Next year their goals are to add depression and culture change to this list of issues addressed and to effect an average decrease in staff turnover of 50%. This is much needed in light of a study of CNA turnover commissioned by THCA (1990?) which found that the average turnover was 150%.
Kort posited the theory that we might be able to spread the adoption of the Eden
Alternative by long-term care facilities more efficiently if we could get the State of Tennessee to take an active role such as the one the federal government is taking via its support of the QIOs. He thinks the best way to accomplish this would be to have a health economist collect and analyze financial data comparing Edenizing and non-Edenizing facilities in Tennessee. If the outcome is, as we suspect, that resident-centered care costs the State of Tennessee less, it would be powerful incentive for state officials to promote the Eden Alternative.The 10th Principle of the Eden Alternative stresses the importance of leadership. Kort is dismayed by the fact that when an administrator leaves an Edenizing home and is replaced by someone who has no interest in Eden, the home reverts to the medical model.
Usually the administrator moves to a facility where the board/corporation does not support the Eden Alternative. Hence, where there was potential for 2 Eden programs, there ends up being 0. He feels that this is one reason why the philosophy isn't taking hold in Tennessee as rapidly as it could. He feels that the medical model is so ingrained in our culture that even newcomers to the field who are not trained that way slip right into it, so training needs to actively counteract that.Dawn reported that the proposed child-care center at Community Care of Rutherford County (CCRC) recently received approval from the Fire Marshall. Next, and hopefully, last, is approval from Building Codes. Gannett Communications has awarded a $1,000 grant to CCRC for a walking trail. And CCRC was also a beneficiary of the Festival of Giving, a fundraiser held at the Stones River Mall in Murfreesboro.
Shara focused on issues pertaining to her staff at Bordeaux Long-term Care, particularly the CNAs/techs. Many who are excellent at their jobs do not have enough education to pass the certification exam. They are also subject to verbal abuse from some residents' families, who view them as lackeys. In hopes of promoting respect and understanding, she is thinking of developing an orientation for families to educate them about all the difficult duties the CNAs perform for the residents. She would also like to see the interdisciplinary group, "Pieces of Eden" brought to the state, as she thinks they provide effective and entertaining training.
Pat added that some of the techs, even though they lack formal education, are highly innovative with restorative care and should be recognized and appreciated for their contributions and efforts.
On a heartening note, Shara stated that several of the techs have expressed interest in visiting techs at other Edenizing homes to share information, and she plans to arrange that. Also, Baxter, the therapy dog at Bordeaux, received the THCA Volunteer of the Year Award, and the Bordeaux Babes received the THCA Innovation Award.
Carol hopes to schedule the 4th Culture Change seminar for early 2005 in each section of Tennessee. She will advise us as soon as she confirms dates with Susan Dean. At a recent meeting she learned of the proposed "Southeast Consortium for Culture Change", which would combine the states of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia into one Eden Alternative District. The concept proposed is to embrace and support all types of culture change efforts throughout the Southeast and supply states and facilities with additional information, training, assistance and resources effectively.
Kort adjourned the meeting at 8:45 p.m.
Mark Your Calendar:
1. TEAC MEMBERSHIP MEETING – Thursday, 2/10/04, 6:30 p.m. in the private dining room at Chinese Garden Restaurant, 150 Donelson Pike, Nashville, (615) 871-0536. Directions: Take I-40 to Exit 216C, which loops around to the right onto Donelson Pike; continue for about 1.5 miles; restaurant is on the right and has a big neon sign (if you get to Lebanon Road, you have gone too far).
2. 3rd INTERNATIONAL EDEN ALTERNATIVE CONFERENCE- 6/5-9/06, Cairns, Queensland, AustraliaSubmitted by Laurie Loughlin
10/07/04 (back to top of page)
MEMBERS PRESENT: Pat Buckner, Dawn Hancock, Laurie Loughlin, Kort Nygard, Shara Stodola
Kort convened the meeting at 6:45 p.m.
Shara shared the positive experience she and other employees at Bordeaux Long-term Care had recently in touring the Green Houses in Tupelo, MS. They spent time with and sat down to a meal prepared by the residents of one house. They also met with staff, including the Medical Director. Tupelo was the first Green House site, and those involved in the planning and execution of the development willingly divulged what they would do over and what they would change. This firsthand information will help Bordeaux plan its Green Houses wisely. They are currently seeking funding, deciding where on their acreage to locate the Green Houses and determining the order in which the residents should be moved into them.
Kort signed necessary paperwork provided by Carol Mace at the Tennessee Department of Health. She has informed him that the deadline for the activity reports is approaching and is assisting him in their preparation.
Dawn reported on recent developments at Community Care of Rutherford County (CCRC). An engineer has completed the final draft of their plan for a child-care center, which she will present to the Planning Commission tomorrow. Middle Tennessee State University (MTSU) has donated 15 seats to its home games, which residents are enjoying attending. Several elders are also involved with a local soccer club which practices on CCRC's field several times a week. Others will be participating in Health Walk, and she is also taking interested elders on a Meals-on-Wheels route.
Kort informed the group that the Bounce Back Program, a rehabilitation approach he and his partners in New Senior Concepts are using at the 2 ACLFs they manage, is having success. At one facility residents are retaining their activity levels; at the other, approximately 30% have increased MDS scores.
Shara stated that progress is being made at Bordeaux in keeping their residents engaged with the rest of the world. Their "Bring Your Pet to Work" program is a joy for residents and employees alike, so successful that a "Bring Your Baby to Work" program is in the works. She is also in discussion with the Director of Metro Animal Control about dogs that would be suitable for adoption.
Shara also told the group that Nashville's U.S. Congressman, Jim Cooper, has expressed interest in what they are doing at Bordeaux. Laurie suggested that we invite Representatives Cooper and Bart Gordon, whose district includes Murfreesboro, to a future TEAC meeting. Kort responded that one of our educational forums might be a better choice. TEAC members living in other areas of the state might also consider exposing their local/state/federal government representatives to the benefits of The Eden Alternative in hopes of enlisting their support for our efforts.
The rest of the meeting was spent discussing the difficulties some staff members are having adjusting to the Eden Alternative, particularly techs. Shara declared that some resent having to leave their home units when they are called to assist in another area. She also indicated that many are poorly educated and in need of life skills training. Pat interjected that she is often approached by staff on the front lines who ask her where they can get counseling for personal problems. She told the group that it is unrealistic to expect employees with low self-esteem weighted down by personal issues to be able to rapidly absorb change and the additional information that must be learned as a result. Laurie asked if it would be appropriate to offer life skills training to staff on site. Kort proposed that resident elders who once practiced nursing might be enlisted to help teach the aides. Dawn suggested that CCRC and Bordeaux continue to exchange information and offer mutual support, as both are facing many of the same challenges.
Kort adjourned the meeting at 9:15 p.m.
Mark Your Calendar:
1. TEF BOARD OF DIRECTORS MEETING – Wednesday, 11/10/04, at 7:00 p.m. at Laurie's house
2. TEAC MEMBERSHIP MEETING – Thursday, 12/09/04 at 6:30 p.m. at Chinese Garden Restaurant, 150 Donelson Pike, (615) 871-0536. Directions: Take I-40 to Exit 216C, which loops around to the right onto Donelson Pike; continue for about 1.5 miles; restaurant is a red brick building on the right; if you get to Lebanon Road, you have gone too far.)
08/12/04 (back to top of page)
MEMBERS PRESENT: May Bennett, Minda Brackman, Pat Buckner, Meredith Burrus, Laurie Loughlin, Kort Nygard, Shara Stodola
Kort convened the meeting at 7:00 p.m.
Meredith announced that Dawn Hancock was meeting with the Rutherford County Planning Commission re the child-care center Community Care of Rutherford County is hoping to build and that they are aiming for a December opening. (Dawn has since relayed that their plan was approved unanimously.) She was also happy that their team won the Beanbag Toss event at the Senior Olympics sponsored by THCA in Nashville this spring.
Minda and Shara declared that their respective facilities, Harpeth Terrace Convalescent Center and Bordeaux Long-term Care, had both had excellent state surveys.
The members shared their plans to add animals to their campuses. Pat is hopeful that some residents in need of therapy who have closed off from people will open up through interaction with the animals.
Kort distributed copies of the original (1999?) Strategic Plan, and, after everyone had had time to review it, initiated discussion to prioritize the 4 purposes of TEAC, which are to Communicate, Advocate, Research and Educate about the Eden Alternative.
He expounded on the Research element, explaining that per the Tennessee State law which passed unanimously in 04/02, we need to supply the State of Tennessee with comparative statistics in 06/05, when the term covered by the legislation ends. (Anyone interested in reading this legislation can go to www.legislature.state.tn.us, click on "Legislation" then "Archive" underneath it; click "Select Assembly" and choose "102nd G.A. 2001-2002"; in "Type Bill Number to Look Up" put either "HB2624" or "SB2830"; click "Find Bill Information".) His company, New Senior Concepts, will supply data showing that the programs instituted at the 2 ACLF's they manage have resulted in improved levels of independence ADL (Activities of Daily Living) for the residents.
Shara felt it was important to include nursing homes in the report and suggested using the state survey results of Edenizing homes to show how much improvement utilizing the 10 Principles of Eden brings. May added that seeing the rise in Quality Indicators at Edenizing Homes would probably be the best incentive for other nursing home administrators to explore the Eden Alternative for their own facilities. Minda thought that the data in the reports required of the 2004 Grantees would also be valuable and should be included. Laurie suggested that interviews with residents who had entered prior to Edenization would make good case studies; they could testify to the positive changes the Eden Alternative has had on their lives. Pat concurred. Kort stated that we need to find a professional outcome researcher to put all these statistics together for us. If any TEAC members would like to recommend a person or firm for this task, please contact Kort at knygard@earthlink.net.
The consensus of the members was that the most effective way to Communicate, Advocate and Educate would be to market the Eden Alternative by publicizing Edenizing facilities. This would show long-term care professionals and the public alike how much better long-term care can be. Minda pointed out that it is only when the public is aware of the benefits of the Eden Alternative and people start demanding it for themselves and their loved ones that culture change will come.
Related to this, on 07/28/04 Laurie sent a press release to newspapers in all 10 of the 2004 Grantee cities. She has no way of knowing if any of the papers outside Nashville published the notice or a related article. She would like someone at each of the facilities to e-mail her at doublel@bellsouth.net to let her know. As showing these clippings could improve TEAC's future chances of obtaining grants and passing legislation, if something has appeared in print, she asks that a copy be sent to her at the following address:
Laurie Loughlin
Tennessee Edenizing Foundation
PMB #215, Suite 103
73 White Bridge Road
Nashville, TN 37205.The group decided that members would benefit from getting together more frequently, so from now on, TEAC meetings will be held every other month in the even months of February, April, June, August, October and December. Since meetings are generally attended only by Eden Associates in Middle Tennessee, Kort suggested that we follow Susan Dean's concept of regional meetings so that members in East Tennessee and West Tennessee will also have the benefit of conferring with their peers in Eden. Members in East Tennessee and West Tennessee who would be interested in getting together can contact Kort at knygard@earthlink.net.
May plans to bring some of her staff at Bordeaux Long-term Care to Tupelo, Mississippi, to tour the Green Houses.
Meredith proposed that between TEAC meetings members visit each others' facilities and also send groups of employees so can all get ideas from each other. Pat agreed that mutual support is important when you are at the forefront of change.
Kort adjourned the meeting at 8:30 p.m.
Mark Your Calendar:
- 2004 GRANTEE TRAINING – Monday, 09/13/04, 11:00 a.m. – 1:00 p.m. at Bordeaux Long-term Care, 1414 County Hospital Road, Nashville. Carol Mace will conduct this session and planned it to precede Eden Associate Training so that those grantee administrators and coordinators who are not yet Eden Associates and wish to become so could take care of both trainings in 1 trip. NOTE: EACH GRANTEE FACILITY IS REQUIRED TO SEND THEIR ADMINISTRATOR AND/OR EDEN ALTERNATIVE COORDINATOR TO THIS TRAINING. For more information, contact Carol at Carol.Mace@state.tn.us.
- EDEN ASSOCIATE TRAINING – Monday, 09/13/04, 2:00 p.m. – Thursday, 09/16/04 at Bordeaux Long-term Care, 1414 County Hospital Road, Nashville. Susan Dean, Region 2 Coordinator, will arrive from South Carolina to conduct the training. To register, contact Susan at skdean@earthlink.net.
- TEAC MEETING – Thursday, 10/07/04, 6:30 p.m. in the private dining room at Darfons Restaurant & Lounge, 2810 Elm Hill Pike, Nashville, (615) 889-2053. (Take I-40 to Exit 216C, which loops around to the right; go approximately ½ mile to Elm Hill Pike; turn right, restaurant will be on left.)
- 2ND INTERNATIONAL EDEN ALTERNATIVE CONFERENCE – Sunday, 10/24/04 through Wednesday, 10/27/04 in Tacoma, Washington. For conference info and registration, contact Carol Ende at cende@edenalt.com.
Submitted by Laurie Loughlin
05/13/04 (back to top of page)
MEMBERS PRESENT: Pat Buckner, Laurie Loughlin, Kort Nygard
Kort convened the meeting at 7:00 p.m.
Laurie reported that the "Culture Change Symposium: Celebration of Elderhood" sponsored by Eden Alternative Region 2 on 05/07/04 in Charlotte, NC, was interesting and informative, with sessions on a variety of topics including bathing techniques, enticing food preparation and animal care in long-term facilities.
Laurie also told of a potential pilot site she has been made aware of in Franklin. She will arrange for the TEF Steering Committee to meet the landowner in June.
Pat announced that the residents of Bordeaux Long Term Care have started a newsletter and are using it as a very appropriate tool to further a sense of community and bring about realistic positive changes.
The members then turned to choosing a different restaurant for TEAC Quarterly Meetings. Pat had several suggestions of reasonably priced establishments that have meeting rooms. Gerst Haus Restaurant, located at 301 Woodland Street in East Nashville close to Tennessee Titans Stadium, was the unanimous choice. Directions will be provided closer to the next meeting, which has been set for 6:30 p.m. on Thursday, 8/12/04. Laurie will reserve the meeting room.
At the 8/12/04 meeting Kort wants us to revisit and prioritize our Strategic Plan. The 4 elements of the plan are: advocacy, education, communication and research. Kort wants input from as many members as possible on how we can best serve you in each of these areas. If at all possible, please plan to attend.
Kort adjourned the meeting at 8:40 p.m.
Submitted by Laurie Loughlin