Category: Strategic Planning

Creighton Center and Wellness Center Repositioning

Contributed by Julia Freeman

Megan Barbour, Health Services Administrator and Director of Operations, and Peter Fielding, a resident member of the Collington Board, gave an overview of the current status of the planned repositioning of the Creighton Center and Wellness Center at a general meeting August 19. They head the Health Service Alliance, a planning group created by the Board’s Strategic Planning Committee that is leading the implementation of one key pillar of the Collington Strategic Plan – Health and Wellness. The presentations focused on the Creighton Center.

CEO Ann Gillespie opened the presentation by reading the Collington mission and vision statements. She also noted she breaks down strategic planning into four stages — and in her view, work on the Collington Strategic Plan is between Stage 2 and 3; however, the work of the Health Service Alliance, also at this stage, is moving toward later implementation stages win a few months.

Peter highlighted the input the Health Service Alliance has sought – from architects, expert in industry trends, market analysis, and features desired by residents. He emphasized that residents will continue to have a role as plans are further developed.

Megan highlighted some of the key architectural and functional goals for the revised space. The current Creighton Center space will be reconfigured to accommodate expanded capacity for assisted living, especially in the Potomac  (moderate support assisted living) and Brandywine (light assisted living) neighborhoods. The Arbor (memory support) neighborhood will be downsized by a third. Skilled nursing beds will be reduced. Megan noted that there is less demand and reduced Medicare funding for skilled nursing both locally and nationally.

Justin Reeves, CFO, reviewed the finances needed to accomplish the repositioning. The current estimate for both construction and soft costs is $25 million. He also noted that the Health and Wellness projects were just one component of an overall master plan for Collington. Multiple funding sources will be needed.

This program was recorded and can be found under Collington Publications: Recorded Auditorium Events. The slides may be found under Collington Publications: Community Meeting Presentations.  Another discussion session of the materials presented will be held in the near future. Watch the Courier!

Moving Modern Geriatrics to Take Advantage of Nurse, Family and Patient Intuitions

As our strategic plan moves forward in the health area, we are given a useful reminder in the New York Times of the value of instinct in alerting people to potential medical crises.  The Times article focus on the instincts of nurses, and is fascinating.  I have done a blog that asks if we can also take value from the intuitions of the family and the patient themselves

I suspect that we could “train” patients and families to be much more mindful about patient monitoring, including how to trust their instincts and how to communicate their feelings to the medical personal.  This, of course, should be accompanied by training of medical staff on how to take the most advantage of, and how to solicit such communications.  It is not hard to construct model ways of doing so.

I suspect that when things work, that is very much happening in our long term care facility already.  Nurses and care staff know the patients, and communicate with them regularly.  It makes such sense to empower them to raise their concerns, to train and encourage family and resident to do so too, and finally to ensure that all medical personnel not only listen to, but affirmatively seek such help as part of an inclusive team.

I am sure that this will fit in well with our general themes of community cultural change and inter-generational initiatives, as well as the specifics of modern geriatric medicine.

 

 

Our Intergenerational Music Program Featured as National Cutting Edge. Newspaper and TV

Collington is now the Poster Child for Intergenerational programs!

Samantha Flores and Collington are the featured story (with photo of our auditorium) in The New York Times reporing on a newly issued report on inter generation initiatives for seniors.  The story begins.

When Samantha Flores wasn’t taking classes at the University of Maryland for her master’s degree in cello performance this past academic year, she could often be found hanging out with a bunch of 80-somethings. Ms. Flores, 28, along with another music student, was participating in a new artists-in-residence program at Collington, a nonprofit retirement community in Mitchellville, Md.

As the article reported:

Marilyn Haskel, a 72-year-old resident of Collington involved in selecting the students, said the young people often invited fellow music students to practice on the grounds, resulting in pop-up concerts. With no family nearby, Ms. Haskel said, “it was delightful for me to sit down and have conversations about their careers and what they’re planning.”

When residents learned that Ms. Flores didn’t have a car, they often drove her to campus. Ms. Flores struck up close friendships with many of the residents, including one she met in September who had recently been given a brain cancer diagnosis.

“We bonded over Bach,” she said, engaging in lengthy conversations about him. When the man died in February, Ms. Flores played a piece he had requested at his funeral: Bach’s “Sarabande: Suite for Solo Cello No. 5 in C Minor.”

“I promised I wouldn’t cry, but you can’t help that,” she said. “It was a very emotional moment.”

The trigger for the article is a new report from Generations United and the Eisner Foundation survey of 180 intergenerational programs.

That report itself cites a Harris Poll that found:

[P]lenty of support for programs that bring diverse age groups together to fend off loneliness. Ninety-two percent of Americans believe intergenerational activities can help reduce loneliness across all ages.

Moreover,

A strong majority of Americans (94 percent) agree that older people have skills or talents that can help address a child’s/youth’s needs and 89 percent believe the same about children and youth addressing the needs of elders. More than four in ve Americans also say if they (85 percent) or a loved one (86 percent) needed care services, they would prefer a care setting with opportunities for intergenerational contact rather than one with a single age group. Americans were also clear that age segregation is harmful, finding that almost three quarters (74 percent) agree that “programs and facilities that separately serve different age groups prevent children/youth and older adults from benefitting from each other’s skills and talents.

Given all that is now happening in this field, way beyond music, we will need to keep innovatintg to stay in the lead — another major task for our strategic planning process.  Indeed, onsite child care was an idea that came up frequently in the process.

P.S.  One little thing I would like the photo committee to do is take on making a set of before and after photos of our residents, showing the huge impact grandchildren visits have on us.

P.P.S.  The TV version is on WJLA, here.

 

 

The Potential for Clinical Trials at Collington

As we move forward with our repositioning of health care at Collington,  of necessity the potential of Collington as a research location has taken a big of a back burner – but only for now.

This New York Times article is a timely reminder of how us seniors are often forgotten when it comes to clinical trials:

Salt matters to geriatricians. It’s associated with conditions many older people contend with, particularly high blood pressure, but also swelling and heart failure.

Though doctors frequently urge older patients to reduce salt in their diets, it’s not clear how much reduction is necessary to improve health, or even how much salt most people actually consume.

“There’s a lot of controversy, but that’s why we need the data,” said Dr. Covinsky. So he read on, until he reached the paragraph explaining that the study used “randomly selected, nonpregnant participants aged 20 to 69 years.”

He did a double-take. Once again, the population probably most affected — older adults — had been left out of an important study.

“How is this possible? Unacceptable!” Dr. Covinsky protested on Twitter. “I can think of no good rationale for this exclusion. This has got to stop.”

Indeed, I have been told by researchers that it is hard to recruit seniors for trials.  This may be for a variety of reasons, lack of trust, fear of the unknown, inconvenience, failure to understand modern protocols and informed consent.  As the Times adds:

Starting next January, [NIH] grant applicants will have to explain how they intend to include people of all ages, providing acceptable justifications for any group they leave out. The agency will monitor investigators to make sure they comply.

Moreover, there are often problems with exclusions of research candidates who have multiple medical conditions (like almost all seniors.)

This has all led to the idea that Collington may indeed be a perfect research partner.  We have many scientists here, and many with experience with statistics, data, and research protocols.  We are an easy to reach population, and we are also racially diverse — another important consideration.  Moreover, we might be able to help enroll and provide services associated with the research to those in the community.  (In particular, fear of not being helped with other conditions is a major deterrent to certain categories of patients.

So, as we move forward, lets keep this is mind.

Salt, anyone?

p.s. Dorothy Yuan adds the following thoughtful comment.

You have absolutely right that we have an ideal population for clinical trials.  I can already think of many parameters.  First, the age bracket is quite limited.  Second, living conditions are similar.  Third,  access to minimal  medical care is generally available.  Forth, although the daily menu provides a lot of choices it is still rather limited in scope. Fifth, and most important, easy access for researchers to do follow-ups.
Whereas these conditions are not suitable for all areas of study.  For example, salt intake will be rather difficult since we don’t prepare our own meals.  However, we would be ideal for many other studies.  
All we need is a way to advertise our availability.