CommCare® : The Caring Company

or salads are available in addition to the main meal and the alternate meal offered. Future plans for meal service include setting up "on-demand dining," with an entire salad bar or soup and sandwich bar available to everyone. Additionally, residents, family and staff have been raving about the hydration station, which is now available 24/7 with juices, coffee and hot cocoa.

Baton Rouge Healthcare Center has also created its first "neighborhood" model, which promotes shared living and
dining spaces within resident halls to create more of a community-like atmosphere. What's more, the residents in these neighborhoods feel more at home with their designated neighborhood coordinator, as they decide independently when they each want to eat, bathe and wake!

Transforming the residents' rooms into personal and meaningful themes has also been a big hit among the residents, family and staff members. Staff members have relished their time working with the residents to find decorations that fit each of their desired room themes. The Saints, the LSU Tigers and even butterflies are just some of the themes that have been implemented thus far.

The residents now also enjoy the newly-added Tea Room and what they refer to as the "Man Cave" for socializing and visiting with family, friends and fellow residents. The local Baton Rouge General Hospital donated the big screen TV in the "Man Cave," along with wall pictures representing the residents' era in sports, film/music and U.S. history.

Residents here also enjoy soft-serve ice cream, along with coffee and hot chocolate from the hydration station. Additionally, a snack area and a refrigerator stocked with cereal, fruit, yogurt and bottled water are available to all residents at all times of the day.

Bayou Vista honors its residents' preferences for bed times and bath times, so they can bathe at any time of the day, and sleep in if desired.

The staff here raised money to commission a local artist to paint a mural throughout the halls of the dementia unit. This mural portrays New Orleans scenes to enhance the experience of the residents that live in this area.

Listening to residents' interests led to adding activities that appealed to them. Based on their feedback, Bayou Vista now offers small group activities, as opposed to having one big group activity. Some of these selected activities include participating in sewing classes, making hand-made ornaments for the facility Christmas tree, dressing the tree with decorations like stringed popcorn and cranberries, and caring for the plants around the facility. Additionally, the residents now enjoy playing pool, thanks to the staff members who raised money to purchase a pool table upon their request.

D'Ville House has also extended its mealtime hours, and residents can now eat whenever they want. For instance, breakfast no longer must be served for every resident at 7:30 a.m. Rather, residents can sleep in and enjoy breakfast until 9 a.m. This in turn has created happier, more content residents who feel that they are in a more private, homelike atmosphere. And if they choose to sleep in past 9 a.m., they can enjoy pastries at the hydration station, which is available 24 hours a day and also offers coffee, hot chocolate and punch. Additionally, residents at D'Ville House may also enjoy soft-serve ice cream for 10 hours each day.

The availability of linens in resident rooms for personal use at any time is another change that's made a big difference for residents at D'Ville House. Towels and wash cloths are now in the drawers of the residents' rooms, and are no longer limited to bath time use.

daily operations. The evening meal experience is one improvement that has been incepted from these learning circles. Residents and staff members now feel as though they are in a restaurant during this meal time, as water glasses are filled at the table and appetizers and bread are served to the residents. The staff members present a variety of desserts on trays, and residents may select one or more of them.

Additionally, Greenbriar has modified the dining room, so that most of the residents can sit anywhere they want and can even enjoy watching TV in one section of the room while they eat. The residents needing special assistance are seated in the front area of the dining hall, and they are served first to give them the opportunity to socialize with other residents after meals. Because of the new dining room layout, staff members are now able to pass trays for all three meals within 25-30 minutes instead of an hour. Subsequently, these staff members welcome the dining changes because the dining process as a whole is more efficient, and they are able to better serve residents in need of assistance. This revamping of the dining room has also been well-received by residents, as instead of multiple service times for meals, the residents are welcomed to dine when they are ready during the meal service times, and they can sit at any table to socialize with friends.

The facility has also expanded the beverage program to include flavored water (like mango), cranberry juice and cappuccino throughout the day. The staff members pass out these beverages as wanted or needed.

The sound of silence is a new motto at Greenbriar, as overhead paging has been limited solely to announce activities. This minor adjustment has been very successful, as both residents and staff members have expressed their enjoyment with this more peaceful atmosphere.

dine when they want within each meal's time frame.

During resident council meetings, the residents have the opportunity to decide on menu options, program activities and the frequency of those activities. Because of resident insight and preference, red beans and rice are now offered as a dinner option every Monday to honor family traditions. Residents can also determine the Meal of the Month, which historically has included crawfish boils, barbecued ribs, steak and shrimp.

And once a month, miniature horses now come to visit the residents as part of their pet therapy!

household coordinator. The household coordinators act like cruise ship directors, as they oversee all of the activities and day-to-day operations within the households.

Beyond the facility construction is the mindset of team work among the employees. Each household at Natchitoches has a set team of staff members, who have been crossed-trained, so that nurses, CNAs, housekeeping staff and even office staff partake in the responsibilities of all aspects of resident care. These household teams promote bonds with the residents and allow for Natchitoches to better meet the daily needs of each resident.

With the household model, residents enjoy three to four-course meals and coffee while dining on glass plates and China. They use cloth napkins in place of bibs, much like they would if dining in their own homes. They can also sleep for as long as they want, and enjoy breakfast made-to-order when they wake up.

The residents at these households enjoy two refrigerators – one regulated containing the proper food stuffs to cater to the residents during meal times; and the other one containing any treats and personal food items from friends and family.

Like many other CommCare facilities, Natchitoches conducts routine learning circles, with staff members and household residents, so more culture-related ideas can be introduced and implemented.

All of these modifications at Natchitoches are changing the psychological well-being of the residents, as the staff has done a complete assessment to sustain the highest quality of life possible for them. Additionally, staff members pride themselves on being receptive to culture changes that benefit the lives of the residents, and the staff understands that this commitment is rewarded in seeing residents happy and thriving.

, along with condiment caddies containing items like hot sauce, hot pickles, and salt and pepper for residents to season food to their liking. Place mats have replaced trays, even for those who dine in their room; and residents enjoy their meals with drinking glasses and everyday China. Additionally, the facility's hydration station offers soft-serve ice cream, juice, water, hot chocolate and coffee at all hours of the day.

Oak Haven offers its residents their own mini refrigerators in their rooms, so they can store and enjoy their own snacks and meals. Other snacks are also served in the kitchen during the day and on carts during after-hours.

Oak Haven reinforces the notion of resident empowerment by giving its residents the choice to take baths or showers whenever they want. And if residents want to sleep in, they can enjoy a short-order menu of items, such as waffles.

Residents are surrounded by the same staff on a daily basis, so that they may feel comfortable and enjoy their familiarity with them. As the facility transitions into a four-neighborhood model, the nurses' station will be eliminated to create even more of a homelike, community-oriented environment for everyone.

Based on feedback from staff-resident learning circles and the resident council, Oak Haven continues to create menu items and resident-directed activities that enhance the cultural experience at this facility. Residents look forward to deciding on their "Meal of the Month" at the resident council, where they can choose what they want (i.e. steak or hamburgers) and make a final decision on the meal based on a vote. Quilting, pea shelling during the summer time, Ladies Night Out and Couples Night Out are some of the communal activities that have been introduced through learning circles and/or resident council.

The facility makes a point to celebrate its residents through "Resident of the Month." The staff members profile the life of a resident each month and post this resident's story on the lighted community bulletin board. Each resident is also honored on their birthday with special birthday cakes.

areas (as opposed to draping their clothes on wheelchairs), and can use special lotions offered at these spas.

The facility now offers more restaurant-style service for dining, with courses that include salads and soups. Tables are set like they would be at a restaurant, with condiment caddies, more dessert options and uniform liberalized diets for most residents. Additionally, the staff offers residents 24-hour refrigerator and microwave access; On Demand Dining, with four to five food options (like chili cheese dogs, hamburgers, and fruit plates); and other ready-made foods that residents can access 24 hours a day.

Old Jefferson allows mini refrigerators in every resident room, so that residents can feel more at home and heat up their foods in the microwaves provided on each hallway. Unique to this facility are the Otis Spunkmeyer cookie ovens, which allow for residents to bake their own cookies when they want them.

Additionally, based on a vote of the residents, Old Jefferson is expanding the activity room on the north end of the facility to include a living room area. This new room, which initially lacked common space, will be designated for the residents residing in that section of the building.

Old Jefferson has also enhanced its pet therapy program, so that more cats and dogs visit the residents once a week.

but Scrappy, the therapy dog, visits the facility five days a week. Scrappy can be seen cuddling with residents, riding in wheelchairs with them, or sunbathing outside while they enjoy some fresh air. Scrappy is very active at Ridgecrest and has monthly columns in both the monthly newsletter and Panache magazine. In his literary pieces, he is always writing about his wonderful experiences at Ridgecrest

As part of its home-like culture, Ridgecrest offers a library and two Wii Nintendos (one for activities and one for therapy) to all of its residents. The Wii Nintendos are popular among the residents, as they really enjoy their ease of use, and the Wii games are a substitute for more high-risk physical activities like bowling and tennis. Additionally, all residents determine when they will have their baths and when they will go to bed; and they can enjoy weekly manicures upon appointment request, just as they would outside of the facility.

Residents have the opportunity to participate in planning the monthly calendar of activities and events, which include outings, arts and crafts, games, Internet time and more. They also look forward to voting at their Resident Council meetings on the venues for "Dine around Town," a monthly dinner that takes place outside of Ridgecrest. During Resident Council, residents are also allowed to critique the facility's menus and offer suggestions to fit their preferences.

In addition to communal amenities and activities, Ridgecrest offers a new neighborhood of seven suites with a separate dining and outdoor area that's conducive to household-style. These newly-renovated Ridgecrest Elite Suites are designed to accommodate residents seeking a semblance of their previous home lifestyle. Personal items such as furniture, artwork, bedding and draperies from home all play important roles in lending familiarity for the residents.

The existing seven private suites offer enough room to accompany a living area, a bedroom area, a private lavatory and sink. The semi-private suite offers a couples suite or accommodations for two people with individual bedroom settings.

The Grand Room is the epicenter of the suites, as this space doubles as a dining room and group activities space. A multi-use buffet, refrigerator, microwave, coffee station, snack area, large flat screen TV, games, and arts and crafts are available in the Grand Room. During meal times, The Grand Room's two round tables are set with seasonal decorations or fresh flowers, table clothes and napkins. Beverages are poured from glass pitchers, and meals are served on plates instead of trays, in a home-style manner.

Fresh fruit and quick breakfast options are provided for suite residents that choose to skip breakfast time. These residents can make waffles from the general freezer (just like they would from home), and enjoy long hours for all meals. They can even make a plate for themselves to take back to their room

Learning from the success of Ridgecrest's first neighborhood will guide the facility with its neighborhood expansion plans.

condiment baskets at every dining room table, so residents can season their meal, just as they would at home. Additionally, Rio Sol has replaced bibs with linen napkins, and the staff members now serve food on non-divided plates (as opposed to traditional, cafeteria-like rectangular plates with dividers).

Rio Sol has been holding resident council meetings to promote staff-resident interaction and glean feedback from both parties. From these meetings, Rio Sol implemented its first lunch outing excursion for the residents, and the facility plans to coordinate other outings based on resident vote.

Beginning in March, 2012 the residents here will be able to choose the times that they prefer to shower or bathe. The next big culture change at Riverlands involves converting the hallways into local neighborhoods, with familiar street names, to evoke more a tight-knit, community-oriented atmosphere.

will visit frequently to play live music. The facility's tables are set with linen napkins and tablecloths, and residents may choose to refrain from wearing clothing protectors. The residents are also given more choices, like with the dessert cart that goes around the tables during meal times. Each resident (diabetic or not) can have more than one dessert, which may include strawberry cheesecake, chocolate cheesecake, and brownie delight. Staff members bring residents their choice of beverage (i.e. coffee, tea, punch, lemonade) and water to tables, just like patrons experience at restaurants.

Soft-serve ice cream is provided at the residents' disposal throughout the day and at night, along with a beverage bar that offers hot chocolate, punch, coffee and tea. Breakfast is served from 7 a.m. to 9:30 a.m. to accommodate both early and late risers; and continental breakfast is offered to all residents a few times each month. Some mornings, the residents can enjoy made-to-order omelets and pancakes. On Mondays, the facility honors residents' preference for traditional red beans and rice as a dinner option. Also, fish is offered on Fridays for Catholics and other residents who prefer a non-red-meat option.

The Columns also allows residents to choose their bathing times (whether they prefer to be bathed in the evening, afternoon, or even late at night), 24 hours around the clock, just as they would bathe when they want at their own homes. The Columns has revamped its Whirlpool rooms, so they are spa-like; which makes them more inviting and less institutionalized.

This year, the facility also started offering an intergenerational program where students from Jonesville Block High School visit with the residents three times a week and engage in exercise, bingo, and other activities and games.

Over the last year, The Columns acquired Precious, a Yorkshire Terrier, who makes her way throughout the facility, greeting the residents who want to see her. These residents treat Precious as if she is the facility mascot, and one resident in particular lets her sleep in her room.

Some additional culture changes are the negation of overhead intercom paging, which has created a more tranquil environment for everyone at The Columns; and designating functional roles for residents who seek them. For instance, one resident was a seamstress at an earlier age, so she now assists the facility with fixing buttons and stitching. Another resident, who was a dry cleaner, now irons clothes at the facility.

One other additional culture change experienced at The Columns is the learning circles, which have given the staff and residents the opportunity to discuss concepts and issues they wouldn't normally have a chance to discuss or learn. From this circle, staff members implemented the use of dining mats for bed-ridden residents who are unable to eat in the dining room, so eating in their rooms feels more home-like and less "tray-like." The idea of getting a pet like Precious came from these learning circles as well.

its Whirlpool rooms to make them more "spa-like." The men's newly-renovated spa room is sports-themed, with metal figures of basketball players, football players, and other athletes on the walls. Though the women's spa room is pending renovations, the female residents can enjoy the hair-styling services now offered in the facility's salon.

Currently, Remington, the Chorkie (Chihuahua/Yorkshire Terrier), and Teddy Bear, the rabbit, frequent the facility to play
with the residents.

As for activities, Tioga offers its residents a monthly Ladies and Men's Social, with beer and wine; and every year for Cinqo De Mayo, Tioga entertains residents with chips, salsa and margaritas.

Tioga is making additional strides toward resident-directed care, by gleaning insight and ideas from both staff members and residents through its resident council.