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placeholder MAY 6, 2013   •   VOL. 51, NO. 9   •   Oakland, CA

In the Household Model, the resident decides when it's time to eat.
Courtesy photo

New model for senior living focuses on the individual

As an adult, you get up when you want to, and eat breakfast when you want to.

But if something happens — a stroke, a broken hip or simply frailty — you may find yourself getting up and eating breakfast when someone else wants you to.


"Nursing Homes, Assisted and Independent Living Environments Embrace the Household Model"

Who: LaVrene Norton,
founder of Action Pact
When: Thursday, May 16
6:45-8:15 p.m.
Where: Sisters of the
Holy Family Auditorium,
159 Washington Blvd., Fremont
Admission: Free
More information:
It doesn't have to be that way, says LaVrene Norton, founder of Action Pact. Action Pact advocates a change in the culture of senior living.

The "Household Model" of senior living puts the focus on the individual, not the institution. The Milwaukee, Wisconsin-based consultant will offer a presentation, "Nursing Homes, Assisted and Independent Living Environments Embrace the Household Model," May 16 at the Sisters of the Holy Family Auditorium in Fremont.

The event is free, and the public is invited to the presentation, which will include video, slides and the opportunity for "deep discussion," Norton said. She will include examples from some of the residences that have adopted the Household Model since 1996.

In this model, nursing homes, assisted living and even friend groups of independent and healthy elders are shaping into small, shared households of eight to 20 people. There's a kitchen and living room. Each resident has a private room. Operating costs are similar to that of traditional care.

Most importantly, residents retain choices, Norton said.

But a shift to this is nothing short of a change in culture.

To accomplish such a setup, Norton said, the three R's have to be taken into account. First, she said, is a renewal of spirit. "People went to work there for a reason," she said, noting some to make a difference, some because of an elderly relative. But along the way, workers get trapped into the institutional 'way it's done.'" This leads to high turnover of staff, and frustration in remaining staff members. The renewal of spirit component helps restore the "we could really make a difference" spirit.

The second step is renovating into home. That can begin with the change in how breakfast is prepared and served, traditionally in big rooms at set times.

"Institutionally, we say, 'They're fed,'" she said. "We don't say 'They eat.'"

In the Household Model, residents eat in a dining room next to a kitchen, where the meal is prepared. And the resident decides what time that will be.

"Literally hundreds of protocols and practices" need to be changed in order for that to happen, Norton said.

The third "R" is reframing the organization. "It's not a hospital," she said, "and not a hotel." Consider also, the number of departments: dietary, nursing, housekeeping, laundry. "No wonder a resident can never be in charge," Norton said.

Nursing home operators work under federal regulation, as well as regulations that vary by state. The regulations can be daunting in number: "more so than even nuclear power plants," she said.

But the Household Model can and does work, Norton said. Instead of departments providing care, in a Household Model teams go to work. The same people are assigned to the household regularly, providing for enhanced communication.

While more than 500 senior residents operate on the Household Model across the country, there are not many in California, Norton said. She points to Pilgrim Place, a community in Claremont, as an example of a working model. It is a senior residence for people who have spent their lives serving in religious and nonprofit organizations.

The movement to bring change to senior living options, Norton said, began with providers of care who wanted to deinstitutionalize nursing homes. They were concerned about "what is creating this sadness that envelops" residents and their families.

Norton said she is working with five communities of Sisters who are interested in the Household Model, which she considers "brilliant" for them. She said it was common for sisters, as they aged, to return to the Motherhouse, with its vibrant community of novices, sisters in training, vacationing sisters and the aging sisters.

Now, with fewer younger sisters, and an increasing number of sisters needing care, some orders have begun to run the Motherhouse like a nursing home, she said.

But now they're saying, Norton said, "We don't want to be more institutional and isolated when we need community and home the most."

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