Providence Business News at PBN.com had an inspirational article about a group called Nursing Home of the Future. They are a team of professionals who are trying to understand the difficulties of living in a nursing home and recommending changes to how we care for our vulnerable adults.
The members of the Nursing Home of the Future team spent whole days with residents of the Tockwotton Home, hearing their stories, watching them in their rooms, in the dining area, in exercise class, at the card table. They saw how hard it is for seniors on walkers to use the bathroom. Realized how they might just stay in their wheelchairs for hours just because moving is too difficult. Noticed that even with all the activities on the calendar, there’s really very little to do all day. They saw how institutional, rigid and unhomelike life can sometimes be.
This project aims to change the situation. Armed with reams of information gathered through site visits, interviews and research, and helped by partners from health care and academia to industrial design, the team hopes to reinvent long-term care for a generation of baby boomers.
“The Nursing Home of the Future is exactly the reason we created the Business Innovation Factory,” BIF founder, Chairman and “Chief Catalyst” Saul Kaplan said in a recent interview. “To bring a community of innovators together to come up with solutions to an issue we all face.”
The goal is to ensure older Americans get “the kind of experience as they age that they deserve.” “We want to create a series of laboratories where we can roll up our sleeves and come up with solutions,” said Kaplan. “We want to work in health care, education, in the consumer space, in the citizen space, looking at public safety solutions.”
The nursing home project began in the spring, as a collaboration between BIF, Tockwotton and a diverse group of experts, including the MIT AgeLab, Brown University and Rhode Island School of Design faculty, Quality Partners of Rhode Island and the design firm Tellart.
For Phase I, which started in early summer and cost about $160,000, Kaplan, project director Melissa Withers and 14 others set out to document every aspect of life at Tockwotton, a 30-bed assisted living center and 42-bed skilled nursing facility in Providence’s Fox Point neighborhood.
They had group discussions and one-on-one interviews with the Tockwotton staff, residents and family members. They learned how everything is done – how meals are served, medications dispensed and transportation arranged. They watched the staff give manicures, style hair and do makeup; they sat in on exercise sessions, games and TV time.
And they learned about life as a frail elder, watching seniors struggle on walkers and in wheelchairs, and nurses’ aides feeding residents when they couldn’t feed themselves, carrying them in and out of bed and escorting them to the toilet and the shower.
Team member Allan Tear analyzed every part of the bathrooms, quickly identifying design flaws such as the toilet paper’s placement behind the seat, where it would be hard to reach, and the sink so far and inconvenient that many seniors on walkers don’t even try to use it.
“I sat in the shower chair, where the PVC piping of the structure, the medical green synthetic backing fibers and the jammed wheels it rested on, along with the toilet seat for a chair, did nothing to make me relax,” she wrote. “I tried to imagine sitting there naked as someone washed me … I felt ill at ease and exposed.”
Speaking with the seniors was especially instructive, the team found.
How do you take all this knowledge and translate it into better nursing homes? That is the challenge for Phase II. That’s when active experimentation will begin, guided by an “opportunity map” the team used to set priorities in different areas.
To better care for seniors’ bodies and minds, they want to create stimulating games and activities; design special furniture and technologies to maximize comfort and reduce pain; and come up with innovative low-risk physical activities, among other ideas. They want to re-design bathrooms – toilets, sinks, shower areas – to make them easier to use, more welcoming and much safer, not just in the nursing home, but in assisted-living homes and for seniors’ own homes, so accidents that lead to institutionalization are prevented.
They want to use assistive technologies for a wide range of purposes, from remote monitoring of bathroom visits and wireless biometric monitoring, to communications devices and medication reminders for seniors who might forget their pills.
Indeed, the cost and logistics of caring for the baby boomers as they age is a big incentive to make big, dramatic changes in elder care, the team members stressed. Already, there are more than 15,000 nursing homes in America, and $125 billion was spent in nursing home care in 2006. But with the boomers, the elderly population will more than double.
Nursing home “culture change,” a movement within the industry that aims to make facilities more homelike, is making a difference, but not enough, team members said. Seniors can stay up late if they want, for example, but Tockwotton feels eerily quiet and dark at night.