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Westminster-Thurber Community

Resident Systems Transformations

Photo of Shelby (a much beloved Westminster-Thurber Community dog) celebrating her 13th birthday, in her pink tutu, at a party with residents. Scroll to the bottom of the page to see a photo of Shelby relaxing after her party.

Based on case study findings, the below examples expand on the list of Resident Systems from Assessing Impact (previous page) and describe systems discovered through Westminster-Thurber's implementation process of organizational transformations. These are the systems identified as most likely to affect resident and family outcomes.

The below transformations are based on the Resident Systems table (displayed on the Assessing Impact page) and are those most likely to affect resident and family outcomes. Examples are listed below each strategy.

1) Create an inclusive community and "home" for residents, families, and the outside community that is constantly communicating and reinforcing resident-directed choice and focus. 

  • A resident-directed focus is utilized in marketing materials, so that residents and families are introduced to expectations regarding resident-directed care at an early stage;
  • Death and dying are honored. - A special session of grief counseling was conducted for staff members of the Pathway Home when the first resident passed away.
  • There are no uniforms at the Pathway home to delineate between community members and staff.

2) Work is organized around maintaining resident's autonomy and preferences with inclusive language supporting residents to be "known" as individuals instead of medical conditions.  

This will vary by the needs of each community area. Examples discussed below:

  • The Pathway Home - The Pathway Home utilizes self-managed staffing with a care partner lead for each operational area (e.g., scheduling, dining, housekeeping). Staff are cross-trained and able to help residents with multiple requests (going to the restroom, doing laundry, fixing a sandwich, and eating). Care partners are aware of individual resident interests to help encourage residents to engage in meaningful activities. Residents maintain personal schedules based on preferences and get up and go to bed when they choose. The Pathway Home is beginning to maintain a mixed acuity level of residents. Resident choice is documented in the care plan, and care partners are included in meetings. "We have one resident that loves to play the Sudoku game on my phone. We have so much fun." - Pathway Home Guide. 
  • Assisted Living Memory Care Apartments and Health Center - Westminster maintains consistent assignment of staff with care assistants which leads to a relationship of "knowing" individual preferences. Activities are frequent and meaningful.  Wii and It's Never Too Late are also utilized to increase resident engagement. Resident choice is documented in the care plan, and care partners are included in meetings. Residents can bring pets from home, or many adopt animals living in the community. "After her owner died, she came right into my room and never left. She is the light of my life." - Resident of Health Center describing her adopted cat.  

3) Inter-disciplinary, cross-trained teams operate throughout the organizational structure with an objective of putting residents before task and taking advantage of synergies in the organization. 

  • In the Pathway Home, it is an ongoing goal (discussed weekly at Care Partner meetings) to create a home where life's activities revolve around the elder.
  • Leadership and staff advocate for group-centered problem-solving approaches for resident and family issues.
  • Employees undergo formal Peer Reviews as part of the evaluation process to focus on team synergies and "check" each other on team efficacy.
  • Teams participate in new employee hiring and interviewing to maintain synergies and "fit" in the culture and organization.  

4) A relatively flat organizational structure with the resident at the top of the organizational chart is prioritized (allowing for effective communication among and between inter-disciplinary teams and residents).

  • "We look at everything we do, in terms of how it affects the elders. So, for example, team scheduling is more than just a staff issue. We look at it from the elder's perspective." - AL Coordinator.
  • In the Pathway Home, care partners advocate for elders, and clinical staff respond to care partner concerns and observations regarding an elder's health.
  • Elders take part in the interview process. For example, elders and families helped to choose care partners for the Pathway Home.

5) Staff-resident interaction is a priority and staff "know" residents. 

  • It is an expectation that staff and residents alike learn about one another's lives, hobbies and interests.
  • New employees are coached to draw elders into conversations and ask about life experiences.
  • Spontaneous interactions and engagement are encouraged. "One day staff and residents gathered around the piano and we all sang for an hour. It was completely unexpected, but it was just a wonderful example of the culture that we want to create." - Steve LeMoine, Executive Director.


Photo of Shelby resting after celebrating her 13th birthday with residents

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