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New JGS “Small-House” Model More Home-Like

By Stacey Dresner

LONGMEADOW – In a move being made by many nursing homes around the country, Jewish Geriatric Services (JGS) in Longmeadow is about to implement the “small house” model of care, which will transform its Julian J. Leavitt Family Jewish Nursing Home into a more home-like environment for its residents.

This small house model will first be adopted in JGS’s short-term rehabilitation area, and then will be phased into its long-term care facility. The project is set to get underway in the spring of 2014 when construction on the rehabilitation facility – called the “New York Unit” – is set to begin.

“The senior care industry has for several years been undergoing what I call a quiet revolution,” said Martin Baicker, president and chief executive officer of JGS. “Some people call it culture change, some people call it resident-centered care. Really, it is a deinstitutionalizing of the care we provide. This effort started here at JGS years ago. In the 1990s the nursing home here was renovated to make it feel more like a neighborhood or a home-like environment. The goal is to deinstitutionalize the way we provide care and make people feel like it is their home.”

Physically, the small house model takes the traditional nursing home with its long hallways lined by residents’ rooms and nurses’ stations and transforms it into smaller home-like areas.

Baicker said that the goal is to create small living groups, consisting of anywhere from 10 to 20 residents. “The general model is a central living area called the ‘hearth,’ surrounded by the residents’ rooms,” he explained. “So the people who live there share a living area, potentially an activities area…There is an actual kitchen where the meals will be cooked, also a central dining table where the people living in that house eat together as a group. It is small and it is conducive to people getting to know each other.”

The small house model isn’t just about the space where residents live, but it also means a change in the philosophy of care, Baicker said.

“The philosophy has been people working on the schedule of the institution. We have set times for meals, set time when we get you up, set times for activities…We are going to turn that upside down so the resident becomes the center of the action. Get up when you want, eat when you want, do what you want in terms of activities and live your life as if you are living in your own home.”

The way the center’s staff operates will change as well to include self-directed work teams where primarily CNAs (certified nursing assistants) but also licensed practical nurses and registered nurses will be a part of a team. “They come together as a team and care for a small group of residents…It improves the engagement among the members of the team but also improves engagement between the staff and the residents…They become much more engaged with the residents they work with. They are engaged now, but this becomes like a family. Studies have shown that in this kind of model, there is reduced medication usage, more engagement and more activity. So it is all positive.”

The small house model of care and the renovations planned were identified by the JGS’s Future Vision Task Force, which consists of selected board members, key constituents and JGS staff. The task force heard from a variety of elder care experts and visited centers around the Northeast that have already adopted the small house model. They discovered, Baicker said, that “this is the way to go. This is the future and this is what’s best for our elders. I think it is all that’s right in the mission of this organization and the future of eldercare in this country.”

“The small house model of care will foster a deeper sense of community,” added Sue Kline, chair of the board. “We look forward to sharing more about the small house plans in the coming months and we appreciate the support of the entire JGS community of caring.”

JGS has hired the architectural firm of Perkins Eastman and Judith Rabig, an expert in the small house design, to design the project. Rabig is a nurse and gerontologist who has created plans for more than 20 small houses across the nation. She is director of NASH, the National Alliance of Small Houses.

Pending internal feasibility studies, design and the approval process, JGS is hoping for construction to begin sometime next spring.

The short-term care facility should be completed within the next 10 or 11 months, Baiker said, then work would begin on the nursing home units.

“I really believe that we haven’t done anything this transformational since we moved to this campus in Longmeadow from Springfield,” said Susan Kimball Halpern, vice president of philanthropy for JGS. “We are a 100-year-old organization that is always forward-thinking. And I think it is such a credit to the board and Marty that they are investigating the way we have been, and going out into the field and assembling all these experts. Whenever we speak to people about it, they get excited. We are looking forward to seeing the plans come to reality and sharing it with the community. And we will be looking to the community for their support. I think people will buy in because we are building something that they themselves or their loved ones would want to use should they need our services.”

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