Transforming a Nurses' Station into a Living Area

I was at our on-site yoga class the other day and Ted Tucker, our Chief Human Resources Officer, shared that he was out in the neighborhoods the evening before and was pleased to see that when he stopped at the West Neighborhood, he found two residents eating their dinners while one nurse was charting in the kitchen. This may not sound like something to get excited about, but it's a small step in creating an environment that feels like home.

Back in January 2009 the renovation and transformation of the West Neighborhood nurses' station into a kitchen, dining and living space for residents was completed. Nurses still do their paperwork here, but now it's a mixed use area for both residents and nurses. Residents have a living area where they can watch TV and relax, and there's a dining area adjacent to the kitchen where they can eat their meals with one another. One of the biggest challenges has been the adjustment of using the same space as a living area for residents and and a work area for nurses.

In moving toward creating a more home-like environment for residents, one of the goals for this Neighborhood is to be able to serve meals family-style instead of on individual trays. While residents are currently encouraged to sit together to eat, a family-style meal would mean that residents could choose what they want to eat and if they want to have seconds. One can imagine that the social interactions that occur around a dining room table may be much more dynamic than those in a cafeteria.

Warming the Human Belly

Yesterday I shared a story that spoke about how we can help to nurture the human spirit of the people around us. Whether they be residents, clients, family members, or co-workers. Today I'd like to share a story about what I call "warming the human belly" or filling your tummy with the most onolicious home-cooked food. Yesterday I also had the good fortune to sit in on ethnic cooking with Bruno Wong. Before moving to Hale Makua Bruno was quite the cook. Teresa, our Activities Director, shared that he used to cook dinner for one of his neighbors when they had to work. Bruno told me that this is actually the first time he's cooked since coming to Hale Makua.

Bruno learned how to cook from his mother and mother-in-law. His specialties being mostly Chinese dishes, he opted to cook cold chicken with a side of soup broth for his fellow residents. Since he was feeding a fairly large crowd, Bruno went shopping at Foodland the day before and bought two really large, whole chickens. Each chicken taking an hour to boil. Once the chicken was cooked he sliced the chicken (bones and all) with his own butchers knife, and put the pieces into Chinese ceramic bowls that he brought special for this dish. He garnished the chicken with oyster sauce, green onions, and sizzling hot oil. It smelled wonderful! The residents were all saying how good it was, and I knew they weren't kidding because they had only eaten lunch a couple of hours earlier.

Lifting the Human Spirit

I have to say that it makes me proud and lifts my spirit knowing that I work for an organization where even the CEO takes part in creating meaningful interactions with residents and clients. It isn't every day that the head of a company takes the time to share his love of music with others. Today the residents of Hale Makua Wailuku's Molokai Neighborhood were treated to guitar playing and singing by CEO, Tony Krieg.

A few months ago Tony shared with me his own personal Luana goal, which I have deep respect for. His goal is to have at least one meaningful interaction with a resident or client a day. As someone who typically isn't involved with direct care, I thought it was a rather ambitious goal, however on several occasions I have seen him personally greeting new residents or in a deep conversation about their life before coming to Hale Makua.

To me it seems like these little things, like greeting someone by name when passing by them in a hallway or taking an interest in whatever is going on in their lives, really does lift the human spirit. These little things can take just moments out of our day, yet they can really mean a lot to those around us.

Computer Training Stems from Luana

This month our Administrative Secretary embarked on a project of her own design with the goal of helping residents who expressed an interest in learning how to use a computer or various computer programs. This idea stemmed from a meeting at which we discussed what someone who has an administrative role in the organization, and relatively little direct contact with residents, could do to help stamp out the plagues of loneliness, helplessness and boredom. The project is to setup and implement a computer training program for residents based entirely on what they would like to do on a computer. Whether it be using Skype to video chat with relatives, searching for things on the internet, setting up a Facebook account to keep up-to-date with friends, learning how to use email, etc.

To-date there are two residents who have begun actively taking advantage of these one-on-one sessions, however the hope is that more residents will become interested as computers provide endless possibilities for social interaction, learning, and entertainment.

Putting the "Home" in "Nursing Home"

In my previous posting, I shared a photo of resident Helen Oliveira's newly decorated room, however there have been several residents whose rooms have been redecorated over the last year. The first room belongs to Marge Champlin, who moved into the Ilima Neighborhood at Hale Makua Kahului back in November 2008. When she saw her room for the first time she thought she was staying in a hotel. There were fresh cut roses by her bedside, a beautiful painting hanging above her bed, and touches of vibrant colors throughout her room.

Upon learning that her mother would be moving to Hale Makua, Marge's daughter, Melissa, wanted to ease the transition of her mother's move by creating a living environment that her mom would be comfortable in, one that felt as much like the home she was leaving as possible. She found inspiration in the things that her mother loved, like painting and flowers. The result was the transformation of a standard bedroom into a personalized room perfectly suited for her mom.

"I Want to Go Home"

This phrase, "I want to go home", is probably a familiar one. We've all heard it from time to time, however for most people this phrase may come as a surprise when the person saying it wants to return home to their residence at a nursing home. This morning our Activities Director, Teresa Lopes, stopped me in the hallway to share a story that resident Helen Oliveira's family member had shared with her. They had brought Helen to their home to celebrate a family birthday. When dinner was done Helen told her son that she wanted to go home, her friends were waiting for her and would be wondering where she was if she didn't get back to Hale Makua soon.

With Luana our goal is to really transform Hale Makua into a place that feels like home to the residents so that residents are happy to call Hale Makua their home. Or as our CEO, Tony Krieg, says "we want to put the 'home' back into 'nursing home'". Part of this effort includes encouraging residents and their families to personalize the decor in resident rooms, which can include hanging photos and artwork on the walls, bringing in bedding linens, lamps and plants, hanging window coverings, etc.

Helen's daughter-in-law recently redecorated Helen's room for her birthday. Pictured here is Helen in here newly decorated room.

Resident Fantasy Football League Winners

Hale Makua Kahului residents and staff participated in a Fantasy Football league for the past 16 weeks in which residents were arranged in a competitive league, earning "fantasy points" by using the statistics of real football players. The idea to start a Hale Makua Kahului Fantasy Football team cam about one morning when Activities Director, Teresa Lopes, was talking to residents John Bellini, Joseph Thomas, and John Opunui at breakfast. She was telling them about her family's Fantasy Football League, and their large trophy that goes to the new winner's home each year after the season. The guys thought this would be fun and wanted to start their own league.

Today participants in Hale Makua's resident and staff Fantasy Football league got together to present the winners with trophies. The first place winners were the Activities staff. Second place went to former Hale Makua resident and current Maui PACE participant, John Bellini. Roberta Kapuaala received third place. The participant with the lowest score, Joseph Thomas, was presented a banana bouquet.

Decentralizing Activities

Activities Director, Lynsey Capone, started working at Hale Makua Wailuku in July of last year and she has done a tremendous job at finding new ways and activities to imbue residents' daily lives with variety and spontaneity, the antidote to boredom. According to Lynsey, "No one program or activity will occupy everyone, ever. With this understanding, we have set out to decentralize activities at Hale Makua Wailuku. We have a core group that involves most individuals, but in the neighborhood day rooms we also have smaller groups. This allows for more individual-appropriate alternatives for residents who are not interested in Bingo games or baking that are regularly scheduled on the calendar."

Some of the benefits that we anticipate arising from the decentralization of activities are:

• Residents with limited attention spans and impaired cognitive skills will remain engaged in diversional tasks and activities for longer periods of time when the activities are throughout the neighborhoods rather than a traditionally structured group
• Residents can utilize their exiting skills and abilities, which are the antidotes to helplessness
• There is an enhanced relationship between residents and staff, as it helps staff to view residents as a person rather than a diagnosis

Our Activities teams encourage residents to participate in regularly scheduled events and activities designed to improve their quality of life. Activities such as crafts, games, classes, and special celebrations are scheduled daily. Yoga and shuffle board are just a couple of the new activities that Wailuku residents are able to choose from. The Activities staff also encourages residents to develop and cultivate their own interests and hobbies.

Luana in Action

I think that it's such a great way to start off the New Year when I come to work in the morning and a co-worker shares not one, but two great examples of Luana in action. Hale Makua Kahului's Restorative Nursing team consisteing of Carolyn Corpuz, Beth Poe, Imelda Casabay, Cecilia Albano, and Adel Della with the help of Mar Sol and Erllie Cabacungan threw two different parties over the last month at the request of residents who frequent the Restorative Care gym. The first party was held in honor of December birthday boys Joseph Thomas and Bruno Wong.The Restorative Nursing team along with Erllie prepared a home cooked meal for Joe, Bruno and some of their friends who also reside at Hale Makua.

As 2009 came to a close, several residents began talking about the foods that they'd love to eat for a New Year's celebration. Overhearing their conversation the Restorative Nursing team took it upon themselves to throw a dozen residents who frequent the Restorative Nursing gym a New Year's Day party with a feast of pancit, chicken papaya, stew, shrimp cocktail, garlic shrimp, lumpia Shanghai, and banana lumpia. The celebration was completed with beverages for a toast to bring in the New Year.

These events addressed several Eden Alternative Principles including:

• Principle 3: Loving companionship is the antidote to loneliness. Residents deserve easy access to human and animal companionship.
• Principle 5: A resident-centered community imbues daily life with variety and spontaneity by creating an environment in which unexpected and unpredictable interactions and happenings can take place. This is the antidote to boredom.
• Principle 8: A resident-centered community honors its residents by de-emphasizing top-down bureaucratic authority, seeking instead to place the maximum possible decision-making authority into the hands of residents or those closest to them.