Category Archives: Health Care

News and Perspectives on Strategic Planning and Implementation Steps

Editors Note:  Periodically we post perspectives pieces in which we offer some broader thoughts on where our community is going.  We do this not only for each other, but to show our friends what is happening here.

As many know, our Strategic Planning document has been published, and concrete steps have been announced to move its items forward (see page 15 of our Courier dated Feb 26 to March 4).  This is a very important document for all of our lives, and not just because of the concrete steps, such as completely repositioning our health care, that are being and will be undertaken under its banner.

Every few weeks, the Committee, which is a Board Committee with heavy resident and staff participation, will be releasing an update on activities and plans in the Courier.  Residents will also be hearing about that in various fora, including the RA Council and the Community Meeting.

Indeed, such an update is in the most recent Courier.  It includes the very important news with respect to the critical health care partnership, that:

After a significant amount of due diligence, we have narrowed potential partners down to 3 providers. We are continuing due diligence and believe a final recommendation will be made to the Board in June for their endorsement.

Similarly with respect to the physical redesign of the Creighton Center (which is of course deeply integrated with our conceptual redesign:

A Request for Proposals (RFP) has been developed and has gone out to several national and local architectural firms. An ad hoc committee of the Strategic Planning Committee will oversee the RFP process and final recommendations on an architecture firm. We expect this process to be completed by the end of June as well. 

The is no need to note what a wonderful acceleration this represents.

The Report notes that the “Collington Culture and Stakeholder Engagement” implementation rollout will begin in September, and the other two will start in 2019. This delay will enable us to take full advantage of what we are learning about how best to work together in the initial groups and apply that will the next ones.

Speaking for my self, I feel very confident that these processes will be rich in resident input, and that the transformative quality will be clear from how things work out  Just look at the Landing Bistro and the new Physical Therapy staff and spaces.  These both reflect the values and principles processes established in the Srategic Planning process.  I hope that these will similarly increasingly influence everything here at Collington.

 

 

 

 

Meet Dr. George Hennawi – As described by his colleagues – A great guy, a straight shooter, his patients love him

On April 19th, a much anticipated program took place as over 100 Collingtonians packed our auditorium and an unknown number watched from home on channel 972. Dr. Peter Fielding, Chair of the Health Services Committee, introduced us to Medstar Gerontologist, Dr. Hennawi.

Dr. Hennawi presented his vision for medical care here at Collington based on a model already in place in Baltimore. As he demonstrated his enthusiasm, his presentation included statistics documenting this model of care’s success. Watch for yourself, understand the future of gerontology and how we may be part of that trailblazing experience!

Vitalize360 Launching This Week — Meet and Greet Friday in the Game Room

This is the week that our Vitalize 360 program gets its real launch and sign-up opportunity.  A project of Kendal, it provides us Collington residents the opportunity to get a “life coach,” who will help us bring together whatever resources and help to decide what they want to achieve next in our lives.  If one of us does not yet know what this is, our new staffer Kim Rivers will help us figure that out too.  Once a goal is identified, Kim will help pull together the Collington resources, staff and residents, to support the process.

Often this is thought of in traditional medical terms, such as achieving a particular “vital sign” milestone, or getting physically strong enough to, for example, get on a plan to visit grandchildren.

But many of us feel that the most exciting engagements that this makes possible are more intellectual, political, academic, etc.  Dianna Cox, who runs the project, and was here for a great presentation yesterday, gave an example of a man who had decided to challenge his golf club’s men only policy, and did so successfully.  (Other more transformative possibilities might come to mind.)

Tomorrow, Friday March 9 at 10:30 in the Game Room, there will be a meet and greet to get to know  Kim and learn more about the project.

Here is the PowerPoint that Nancy Cox presented.

Here is a short video:

It is important to note that Vitalize 360 is a key pat of our strategic plan, both as a specific element, and as something that will help build culture-transformative energy.

Indeed, a recent article in the Journal of Aging Research and Healthcare, here, concludes:

In this project, COLLAGE [Vilalize at one location] 360, a comprehensive assessment system and wellness coaching program that focuses on prevention and wellness was implemented in one continuing care retirement community. Following completion of two assessment tools through directed conversations with a wellness coach, older adults developed an individualized vitality plan that outlined life goals, supporting goals and action plans for goal achievement. Results from this program suggest engagement in the assessment and wellness coaching process via the COLLAGE 360 program translated into sample older adults sensing that they live in a more supportive environment when compared with elders not receiving any wellness coaching. In addition, the older adults had positive responses in the areas of mood and life satisfaction. Strategies to improve health and well being need an extended focus beyond the older adult‘s medical conditions and consider psychological, spiritual and social needs with personal preferences being paramount. These issues are foundational to a person- centered, health promotion approach needed among older adults.

Do not miss the opportunity.

 

A History of African American Hospitals in the U.S.

By Dr. Bud Gardiner

Join resident Dr. Bud Gardiner on February 15th at 2 pm in the Auditorium for this fascinating program.  Sponsored by the Health Services Committee.

ProvidentHospital

The health of African slaves was an issue concerning slave-holders but there was no organized attention paid to this issue.  In 1832, the Georgia General Assembly established a hospital “for the relief and protection of afflicted and aged Africans”.  Thus, the Georgia Infirmary was built south of Savannah. Over the years approximately 200 hospitals were established for black citizens under the auspices of governments, a variety of charitable organizations and groups of African American citizens and physicians. They were often tied to medical and nursing education. The bulk of them, of course, was in the southern states and had varying lengths of survival. With the impact of economic and social influences, (especially racial integration) only one such hospital remains. Their history provides a fascinating glimpse of an oppressed but resourceful segment of our population.

 

Preparing for Dementia — An Individual and Collective Responsibility at Collington

As we move forward with operationalising our Strategic Plan, a recent New York Times article on dementia specific advance directives may be useful. Specifically:

Dr. Barak Gaster, an internist at the University of Washington School of Medicine, had spent three years working with specialists in geriatrics, neurology, palliative care and psychiatry to come up with a five-page document that he calls a dementia-specific advance directive.

In simple language, it maps out the effects of mild, moderate and severe dementia, and asks patients to specify which medical interventions they would want — and not want — at each phase of the illness.

“Patients stumble into the advanced stage of dementia before anyone identifies it and talks to them about what’s happening,” Dr. Gaster told me. “At what point, if ever, would they not want medical interventions to keep them alive longer? A lot of people have strong opinions about this, but it’s hard to figure out how to let them express them as the disease progresses.”

As a community with a commitment to individual autonomy, I think the document will speak to many of our concerns, and perhaps most specifically the fear of wanting to reject additional treatment, but no longer having the capacity to communicate that.  As the article elaborates:

For each stage of dementia, the patient can choose among four options. “Full efforts to prolong my life” and “comfort-oriented care only, focused on relieving suffering” represent two ends of the spectrum.

Patients can also opt for lifesaving treatments — except when their hearts stop or they can’t breathe on their own, precluding resuscitation or ventilators.

Or they can opt to receive care where they live but avoid hospitalization. “For someone who doesn’t understand what’s happening, going to an E.R. or being hospitalized can be really traumatic,” Dr. Gaster said. The experience can lead to delirium and other setbacks.

There is debate about whether there should be a separate dementia advance directive, but the idea of specific focus on the issue has great value.  (I personally find the Maryland MOLST utterly incomprehensible, and do achieve that this document does within the MOLST would be a great feat of editing.).

In any event, our commitment to the value of the individual challenges us, in my opinion, to do what we can to make sure that those who wish have thought through these issues, and that our entire system support people in these choices, which certainly reflect only current law, and do not represent any change from that law.

There was at one point talk to Collington working to improve the MOLST.  Maybe now is the time, reflecting the leadership goal in our strategic plan.  Surely these issue have great implications for staffing, training, staff-resident relationships, and culture building.

Thanks, Collington, for being a place where these things are as much on the table as they are on our minds.