My name is Ben Cornthwaite. I am a Licensed Nursing Home Administrator at a CCRC in Northern Virginia where I am responsible for the day-to-day operations of a 180-person nursing home and a 104-person Assisted Living facility. Throughout my four years here, I have learned and observed many things that we do extraordinarily well as well as things that require significant change. I continue to seek feedback from residents, families and staff in many areas in an effort to continue to make our home a better place to live and work. My latest attempt to better understand the key issues involved moving into the building that I manage for 7 consecutive days (and nights)!
My life as a resident began with a new name, Happy Sunshine. I simulated an experience similar to the profile of many everyday residents which included the following:
· Surgically repaired fractured hip (requiring the use of a wheelchair)
· Bladder incontinence (requiring the use of an adult brief)
· Visual impairment—courtesy of my Creator
· Total assistance from staff to perform all Activities of Daily Living
· 7 medications (M&M’s J)
My experience included eating all meals in the dining room, taking showers in the neighborhood bathing spas, participating in resident activities, participating in physical and occupational therapy, signing the new resident contract, dependence on staff members to respond to my call light, medical monitoring of my vital signs and weight, and consultation from the doctor, dietician, nurse, therapists, social worker and activities staff. Clearly the staff knows me, so my experience was most likely different than the average experience. However, I now can say that I have a new perspective on what it means to be a resident of my community. Additionally, I found new meaning in just what it takes for the staff to produce the exceptional outcomes that we expect of them each and every day.
Overall, my experience was very revealing—by in large very positive. I encountered many wonderful people doing many wonderful things. Additionally, I found some experiences to be frustrating and difficult. Although there are many actionable items of changes that I will make as a direct result of my greater understanding, there is one profound issue that I encountered that has brought new importance to my day-to-day management. The most revealing experience for me was not my own disability, rather, the disability that we create in our own design. Specifically, the disability that residents in wheelchairs face is profound and utterly unacceptable in creating and maintaining home. The following are plans to address this very important issue:
Our community’s Executive Team has agreed to spend one day in a wheelchair on campus to encounter accessibility obstacles throughout a normal day. It is my hope that this experience will provide all the information necessary for the interdisciplinary team to agree to urgently and strategically implement changes on our campus.
I will pitch to our Executive Director that our campus shuttle schedule should be delayed 10 additional minutes to allow for adequate time to pick up residents in wheelchairs. Currently, our shuttles do not pick up residents utilizing wheelchairs—despite being equipped with wheelchair lifts.
Resident bathroom doors will be equipped with dual-swing hinges to allow the door to swing freely in both directions—this will allow residents in wheelchairs the independence required to utilize the bathroom without staff assistance
Resident bathrooms in long-term care have been evaluated by an architect to shorten one of the walls which will allow for a wider doorway—this will grant residents greater ability to get in and out of the bathroom independently. In fact, we are evaluating removing the door all together and providing a curtain for privacy since these are all private rooms.
Standard room furniture will be evaluated and positioned in a more wheelchair-friendly design allowing residents full access to the useable square-footage in their room. We will also encourage residents to bring in their own furniture that may be more suitable to their needs. Our company’s designer has worked with me on creating this design.
Every wheelchair that is issued will come equipped with a pressure-relieving cushion as standard—wheelchair seats without cushions are cruel and unusual punishment!
I have challenged my Administrator peers at 10 other campuses to also commit to living at least one week in their own facility, thus igniting operational change
I have challenged key corporate leaders within the organization to also gain a first-hand experience at one of our campuses, thus igniting company changes
I have challenged my Administrator and professional peers across the country to commit to living at least one week in their own facility, thus igniting culture change
I have come to realize that the heart of the problems that I faced was mostly due to ageist and declinist thought. To me, it is rather simple to address the cosmetic features that promote significant obstacles to our residents in wheelchairs; however, it is now apparent to me that the real issue at hand is changing a profession’s mindset. We need to consider resident growth and ability in our design and operation—not the inverse of decline and disability. I will do my job different each day as a result of my learned experience—I carry my resident ID band with me each day as a reminder for what I must not forget. Specifically, I will do my part to empower my team and others around me to also confront ageism and declinist thought each and every day.
Throughout my experience, I saw, felt, and heard great satisfaction in the care that is being delivered, despite the frustrations that I also experienced. As the Administrator, I can only imagine that this lesson will allow me to continue to be a better leader for the place we call home. I believe that everyone deserves a little Sunshine.