Neighborhood Concept

[Guest Guest_guest]

I work on a long term facility that has 6 levels of care. My director heard about the Neighborhood concept at a conference. you divide hallways up and each staff has the same area for about a week and eventually all departments get involved in the activities, such as dietary, housekeeping, maintence ect. I think the concept is to reach all residents. Our facility has about 250 residents.

Has anyone else heard of this idea??

[Guest Guest_ErinE]

Yes, I believe what you are referring to is the "Neighborhood" concept. This is tied into the culture change of long term care as we know it today. Halls or stations are made to be as home like as possible with the residents of that area making up the neighborhood. Each neighborhood is named and staff become a universal worker. There aren't set times to get residents up or go to bed or eat meals. They do these activities on their schedule not the staffs'. It's becoming a huge part of the long term care industry and I'm sure you will be reading much more about it in the future!!

[StacieO 0]

Our facility is taking small, baby steps towards this. I'm excited for the move towards this, but it will not be an easy transition! There is alot involved, & getting ALL staff to "buy in" is very important. Our facility will also need to do some major re-construction if we hope to accomplish this & that takes tons of $$$, which we all know that SNF's are swimming in money! So - I don't see this being a change that will happen here in the next year, but we are slowly progressing in this direction. (I work in rural Minnesota, by the way.)

Stacie

[Guest Guest_lgravink]

Neighborhood Concept,

I work in a nursing home that has the neighborhood concept and it really works. We do not have the universal worker because it does not work. We have tried it and you still need to have skilled people doing individual jobs. There can be some blending but the paperwork component is huge thing that must be completed by a skilled professional.

Here is a little info about our neighborhoods. I work in a 237 bed SNF that is divided into 14 different neighborhoods with no more then 22 people living together. The residents eat, sleep, and live in the neighborhoods with the dedicated staff. It has been fun to see how each area has taken on their own identity.

We did spend a lot if money to remodel but most of it was spent to make a kitchen on each neighborhood ( or what most call each wing), but otherwise the areas are the same. We are a building that is not new and you just have to be creative.

For TR I am the director and I have 3 full time and 3 part time staff that have decicated neighborhoods that they coordinate and do activities on. They also do all the paperwork and carting for about 56 residents a piece.

If anyone has questiosn about how TR works in the neighborhood or culture change environment feel free to email me at

lgravink@lyngblomsten.org

[Vanessa 0]

The facility that I work for was the first in Wisconsin to utilize the neighborhood concept. We opened our second generation neighborhood last July. We do not, however, have universal workers. We have found that it works better if our CNA's have specific tasks. We do make them responsible for one-to-one activities for those residents who may not be in an organized group activity. Our SNF is divided into 3 units which are subdivided into households. There are between 9 and 11 residents living on each household. The environment is a very important aspect of the neighborhood concept. We have a neighborhood center (which is a common area for larger group activities and gatherings) and off each neighborhood center is 4 households (like spokes). Each household is self-contained: a kitchen, dining room, living room, utility room, sunroom and bedrooms. The tub room is between two households as is the courtyard. This environment has worked awesome for us - especially with our residents who have dementia. We have totally eliminated the need for alarming doors and wander guards. Our activity program is set up with two activity professionals (a COTA who is the AD for the unit and a program assistant) on each of the three units. So each unit program staff must deliver activities to between 36 and 44 residents each day. We often run mutliple activities at the same time in different households. For example, we may be doing an exercise group in household 6 while a craft group is happening in household 7 and a musical event is in the garden. It takes a lot of forethought and preparation, but it is definitely worth it. We still struggle with getting our nursing staff more involved, but we have seen challenging behaviors decrease since our move to the new unit. We keep each of the kitchens fully stocked as you might in your own home. Families and/or nursing staff will bake cakes or holiday cookies. We have nursing staff who really like to bake with the residents each morning just after breakfast. This environment seems so much more relaxed and calm and it shows in the resdents! If you want more info, please feel free to e-mail me at vfrank@EvergreenOshkosh.com