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Our Cape Vacation Story

Six Saint Elizabeth Home Residents and Staff Take a Trip

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It took a leap of faith to take this vacation and the collective mindset of “caring optimists” to make it happen.Six nursing home residents are very glad they said “yes”.

“Wouldn’t it be nice to take some residents on vacation to the Cape?” That’s how it all began, a simple question posed by the CEO of The Saint Elizabeth Community, Steve Horowitz, during a chat with a co-worker Sarah Bowater, about vacations. One month later six nursing home residents from Saint Elizabeth Home in East Greenwich, five employees of the nursing home and one spouse went on vacation together.

Upon their return Matt Trimble, Administrator of Saint Elizabeth Home is surprised by the effect the trip had on him, and he reflects, “this trip, to me, was much more than a few days on the Cape.To me, it was a taste of how quality of life for nursing home residents could greatly be enhanced through smaller home environments and empowered/cross trained employees.”

This is a vacation story that is quite unique.Often vacations are taken with family or close friends, not as often with co-workers and the individuals in their care. This is a culture change story, a first in Rhode Island, about changing the way we care for seniors who reside in nursing homes.

For Muffy, Betty, Margaret, Rose, Josie and Barbara, all long term care residents at Saint Elizabeth Home, this creative thinking resulted in a vacation trip to Falmouth in Cape Cod and by all accounts from those on vacation, it was fabulous! Initially Margaret and her husband “couldn’t believe it,” when asked if they’d like to go on a vacation to the Cape. Muffy said “yes” right away, but then thought “this is impossible, we all have walkers and need care.”

From September 21st- September 24th, these 12 individuals embarked on an overnight vacation, with perfect late summer weather and an amazing location.The caregivers were Saint Elizabeth Home nurses, Janelle Hackett and Lisa Lavigne, activity director Tara Zinno, and assistant director, Sarah Bowater and certified nursing assistant Amber Snell.

It took a team of individuals committed to making a difference, committed to person centered care, and willing to leave their own families, and become a “vacation family” to these six people, for this to be a success. The “team” included those staff that took the trip, and all those that helped plan the trip.

“Culture change is easy to read about and to talk about, but sometimes you need to take a big step, to leap,” says Janelle Hackett, Life Enhancement Coach at Saint Elizabeth Community. The Saint Elizabeth Home employees gathered to recount the trip after they returned and Sarah Bowater was at a loss for words, “I can’t even explain the significance of this trip.”“Regulations impose structure,” says Hackett, “and with this trip we were able to just be people at the Cape house, no titles, no patients or residents, or caregivers; we were just people on vacation.”

Looking back on the experience Tara Zinno says, “I give a lot of credit to our Administrator and CEO, as nervous as they were, they let us do it. And I will always remember from this vacation Margaret’s smile.”

Margaret was able to go on vacation with her husband. And her favorite memory of the vacation is “being together,” and her husband Anton adds and “going to Martha’s Vineyard, we used to vacation there for many years.”

Taking a trip like this required permission for the Rhode Island Health Department and on a federal level from CMS( the administrator of Medicare).Both agreed it was okay.And it took funding.This trip was paid for by money raised at Rose Bids, Saint Elizabeth Community’s annual fundraiser.

The staffing ratios were great, 1 to1 care.For each resident there was a Saint Elizabeth Home employee.And for one resident she had the companionship and loving care of her husband.A trip the couple would not have dreamed possible at this time in their lives.

Planning was crucial.“We planned for every potential disaster,” says activity director Tara Zinno, “and we planned out basic things like meals, and meds.We thought about every detail.”

Zinno and Bowater found the rental house and after discussions with residents and family members, 6 residents chose to go on the trip.The spouse of one of the residents was invited also. The ‘vacationers” ages ranged from 67 to 93 and medical conditions included arthritis, mild dementia, to congestive heart failure.

“The vacation house was in Falmouth right on the water,” says Bowater,” we could walk to the beach, and it was accessible, with a ramp right down to the sand.” The house had 7 bedrooms, and plenty of living space to spread out including a “sun porch where we would gather, and a dining room that could hold the whole group.”

Vacationing takes a hiatus from structure. And nursing homes are inherently full of structure.“It took awhile for the structure to go away- at first the “vacationers” wanted decisions made for them, but after a day, they were making their own decisions, choosing what they wanted to do and when,” says nurse Lisa Lavigne.“This trip made me see things in a different light.”Amber adds, “we could form personal relationships, to sit and bond and focus on the person.”

On the third day a group of 7 headed for the Martha’s Vineyard Ferry, for a day trip, with walkers, day bags, and medications. The group barely made the ferry after a bus ride from a parking lot 4 miles away. It was a wonderful day and was followed by a dinner out at a restaurant with Administrator, Matt Trimble.“They enjoyed the fact that, at breakfast that morning, half decided to go on the ferry trip and half went shopping in downtown Falmouth and it didn’t require a preplanned calendar or extensive planning,” says Trimble.

“Sitting at the dinner table with these 12 individuals that evening was one of the brightest moments of my 15 year career in nursing home administration,” says Trimble with great sincerity, he continues, “yes it was great to hear how much fun they were having and how much they enjoyed the ferry trip to the vineyard, but what was most impressive were the comments made by the residents about living in a small home setting. In just three days, the residents were boasting about things we all take for granted.”

“They enjoyed the fact that, they could get around the house without having to use their walker,” says Trimble.“They commented on how nice it was to bond with the staff and bond with each other, and loved the fact that, when they awoke, they were able to casually converse and have breakfast with the staff and each other. It was obvious that they had developed strong relationships with each other in just 3 days.”

“I wish all the staff could see what happens when “the regimental lifestyle is gone,” says Tara Zinno, and she continues, “how it all worked, and how it can work in a different setting.”

Upon returning to Saint Elizabeth Home the nursing home residents told stories about the vacation, about walking on the beach, and taking the ferry, and they had an extra “bounce in their steps.” Barbara said it was “fabulous,” she “loved it all, and recalls her time on the beach saying it was like “reverting back to childhood, walking with her footsies in the ocean and shoveling sand.” They have a wonderful shared experience, a vacation that they could not imagine possible at this stage of their lives.

“I had a marvelous time,” says Betty, “at first I was doubtful I could go and a little nervous- I’ve lived at the home for 5 years, but I was “so glad I went!” She continues, “everyone was so nice and pleasant and we were well taken care of. . . . I wouldn’t change a thing.”

Rose enjoyed her trip to Saint Patrick’s Church and her time on the beach, and was glad she went, she regrets “having not gone to Martha’s Vineyard.”

This trip has given the staff a view of how life can be different in a small house setting. How the needs of the individuals did not change, but how the provision of that care changed. The person making breakfast in the kitchen could also be giving medications. The personal relationships that were forged were done so because the group shared living space and shared experiences. This is a look at the future models of caring for seniors in smaller home settings with care givers doing multiple tasks currently provided by more than one person. It has the caregivers thinking about their roles in the nursing home and how they could change in the future.

The vacationers upon returning to the nursing home had a common wish and that is to do it again!

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