Graphical Abstract
In Baltimore, a comprehensive health center for older people learned a valuable lesson when it tried to forge a connection with the surrounding community: the best route to win hearts may be through the stomach.
Keswick, a nonprofit organization that manages hundreds of nursing, rehabilitation, and long-term-care beds, decided about 10 years ago that it wanted to help seniors in the wider community stay healthy. “Originally, we thought we’d offer a lot of chronic disease management programs for conditions such as diabetes and hypertension,” recalled president and chief executive officer Carmel Roques. But there was a problem: few people showed up.
“No one just says, ‘I’m going to just run down there and take a diabetes prevention program.’ They don’t do that even if they’ve had a crisis,” Ms. Roques said. “They’re not that motivated to start there. We realized we’ve got to lower the threshold.” The staff at Keswick came up with a solution: teach people how to cook healthy food.
Keswick turned an unused space into a demonstration kitchen and taught neighbors how to cook great-tasting food. Keswick staff members also opened a small gym with equipment for older adults and offered classes in yoga and tai chi.
Now, Keswick’s Wise & Well Center for Healthy Living program is getting raves in the local media and turning the community into a fan base through hundreds of classes. “People are connecting and receiving support to improve their health,” Ms. Roques said.
It’s not common for care facilities to reach out beyond their walls. But those that do are finding that community connections pay dividends, and not just in terms of doing good. The community members you impress today may turn to your facility first when they or their loved ones need care. As Ms. Roques put it, “They feel confident about coming back to us because they know us.”
Jeffrey Nichols, MD, CMD, former treasurer of AMDA – The Society for Post-Acute and Long-Term Care Medicine, has seen this in action. “The more familiar people are with you, the more successful you can be,” said Dr. Nichols, who is director of the geriatrics center at Gouveneur Diagnostic and Treatment Center in New York City.
So how do you get started at building bridges to the community around you? Start by analyzing the needs of the neighborhood, Dr. Nichols suggested. “Talk to local political and religious leaders and ask about what’s needed.”
And think creatively about what you have to offer at your facility, he said. “A lot of nursing homes have pleasant grounds and open areas that could be used for picnics or other kinds of outdoor community events,” he said. “In addition, nursing homes almost always have space for people to gather, and most activity programs end by about 4:00 in the afternoon prior to preparation for early dinners. There’s often a lot of available space that could be used for meetings later in the day.”
Think about opening your facility to the Boy Scouts and Girl Scouts, for instance. Or welcome groups like Alcoholics Anonymous. When he worked in a previous position, Dr. Nichols said, “we had an AA group that met in the evenings at our place. Four of our residents were alcoholics who were sober at that time. It was a tremendous support for them.”
Sometimes, he said, “the local needs can be more severe. I worked in an extremely poor immigrant community, and local leaders told us about the extreme prevalence of hunger and immigrants in need. We opened up a space at the nursing home for a food pantry. We didn’t provide most of the food — it came from all over, and people from the neighborhood could pick it up. We also started English as a second language classes and counseling for immigrants.”
Uptown Health Care, a Colorado nursing home, is making a difference through a similar approach.
The facility is in downtown Denver, and both staffers and residents watched with alarm as homeless encampments grew during the coronavirus pandemic, said physician assistant Allison Villegas, PA-C. “It bothered all of us,” she said, and everyone wanted to help. This year, Uptown Health Care came up with a program they titled Old Farts with Big Hearts, designed to help the homeless by giving them items they need.
Staff and residents have gathered items like food, blankets, socks, trash bags, deodorant, and water bottles. Residents have written positive notes to go in the bags of items — “We’ve been there, and it gets better,” for instance — and they have donated unneeded clothing.
“We went to an encampment and set up a table of all the clothing, blankets, and bags of items,” Ms. Villegas said. “Last time, we were able to take seven residents. We’ll do a drive every quarter and leave the bags again.” And the items change according to needs; in the summer, they include handy sunscreen and baseball caps.
“The residents and staff really enjoyed it,” she said. “Residents say they don’t have anything to give like money, but we’ve reminded them that they can give their time. They’ve said that’s really nice, and they like to get out of the building and see people after being cooped up during the pandemic.”
Dr. Nichols urges colleagues to consider the tremendous value that programs like these can bring to nursing homes and communities.
“People are so frightened of nursing homes. We’ve got to get past that if there will be any future where long-term care gets integrated into the rest of the society,” he said. “Reaching out to the community helps to break down those barriers. And remember: The more familiar people are with you, the more successful you can be.”
Randy Dotinga is a San Diego-based freelance writer.
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