Improving Comfort, Wellness and Quality of Life

On the Road with The Beatitudes Campus – June 2015

by Stacy Palmer

Our most recent On the Road took me to the desert climate of Phoenix where I had the pleasure to spend the day on The Beatitudes Campus, a faith-based community known as a leader in the field of aging services. With over 800 residents, Beatitudes Campus offers living environments for people age sixty and over from independent residences to assisted living and skilled nursing care to full spectrum memory support. Their organizational philosophy encourages balancing the art and science of caring, and focuses on living rather than aging.

My hosts for the day were Tena Alonzo, Director of Education and Research and Ivan Hilton, Business Development Director, Comfort Matters Program. They shared that the leadership team views the campus as a living laboratory – regularly looking for ways to improve their services and approach. They work hard to help remove the stigma around long-term care and make the campus a destination where people come to enjoy a vibrant lifestyle and experience joy with others.Ivan and Tina in front of the peace pole – a 50th birthday gift to the campus. It includes wishings for peace in six languages.

I was able to witness the impact of those efforts first hand as we toured the campus. There was a very positive and uplifting energy present in all of the areas we visited – not only through the environment itself but also among the staff and residents we encountered. In fact, Tena attributes much of the success of the community to the welcoming nature of the people who live there. With residents from 27 countries (who, interestingly, speak 90% of the world’s languages), tolerance and acceptance are key.

The Campus Life
Part of what keeps residents engaged and energetic is likely the array of programs and activities available. From shopping and event outings to live musical events, and movie and game nights onsite, there’s a full list of opportunities for people to participate in daily. Every Wednesday residents can even gather in the Lutheran Life Center for the weekly “Hootenanny” jive sessions – a popular campus tradition.

The dining room in Town Plaza Bistro features a rotating art exhibit.Exercise is encouraged with multiple classes such as water aerobics, yoga and dance in addition to a full fitness center with modifiable equipment and Lifestyle and Fitness Director Jon Shilling available to advise and assist. Jon continually reminds residents to keep in mind, “We don’t stop exercising because we get old. We get old because we stop exercising.”

People are also encouraged to continue learning through the Senior University program where instructors from the Phoenix area (and some community residents themselves) teach topics such as history, religion and conservation.

A key element of the Beatitudes Campus philosophy is the idea of person directedness – allowing residents to make personal choices. This practice is perhaps most prevalent in dining with the campus featuring a coffee bar onsite along with four restaurants that offer everything from a grill to fine dining by reservation. Even dining areas in the memory care units offer dynamic menus and open hours that allow residents to choose when they prefer to eat, different from the typical nursing home model.

Giving Back to the Community
The Back to School Sewing and Knitting GroupThroughout our campus tour, I was struck by the philanthropic nature of the community. One of the perimeter sections of the campus is filled with a large garden including flowers and fruits and vegetables all planted and maintained by residents. Some of the food grown there is donated to local food banks.

Tena and Ivan shared many other stories about the generosity of residents including a group of women called The Back to School Sewing and Knitting Group who make and provide new school clothes for children in the Phoenix area in need. There was also a recent resident campaign to raise money to have Pharaoh cats that had become prevalent on campus neutered.

Compassion and Innovation in Dementia Care
While Beatitudes Campus offers living environments to cover the needs of all older adults, much of their research and focus has been specific to residents with dementia or as they compassionately refer to them, people who have trouble thinking. Tena cited the growing prevalence of dementia in our society and the importance of helping people understand and address the vulnerability that exists and the need to change the way dementia care is delivered. Through tremendous grant-supported research Beatitudes Campus developed a Person-Directed Approach to Memory Support that:

• Incorporates each person’s life story into his or her care plan
• Promotes personal comfort at all times
• Creates a personalized homelike environment
• Anticipates each person’s needs rather than responding primarily to discomfort or behaviors
• Empowers caregivers to do whatever is needed to make each person comfortable

“People with dementia are experts on their own comfort,” explained Tena. They know when they are comfortable, they know when something makes sense to them and they know when it doesn’t. We had an opportunity to really change our personal practice to help people become comfortable, and change our systems to support people who have trouble thinking.”

Comfort is key and by focusing on that, Beatitudes Campus saw significant changes in their dementia population including reduced hospitalizations and emergency department utilizations, decreases in residents using antipsychotic medicine, reductions in weight loss and acting out and even reduced staff turnover. In fact, Vermilion Cliffs, the center for moderate to advanced memory support at Beatitudes Campus has had no turnover in the past few years.

Tena acknowledged a sense of advocacy from staff to help those who have lost their voice. That compassion and engagement was apparent as we walked through the multiple memory support neighborhoods as staff were extremely patient and friendly and residents seemed happy and calm even amongst some required fire alarm testing in the building during the visit.

In addition to the focus on comfort for the resident, the team shared a commitment to supporting families of dementia patients by connecting them with resources. They’ve developed programs to help families understand what is going on with their loved one’s mind and better educate them the disease process. They have also identified a need to help families through denial and grief and coach them to use local partners such as support groups from the Alzheimer Association.

Supporting their person-directed approach, they’ve also encouraged a shift in dialogue with caregivers to help bring the person’s voice back to decision making. For example, instead of burdening family members with questions such as “What would you like us to do with your mom?” they reposition to have the family consider mom’s wishes. “If your mom was advising you on how to handle this situation for someone else – before she got to her current state – what do you think she would have said?”

The Beatitudes Campus team is also developing an online course for families following the domains from the National Consensus Project’s Clinical Guidelines for Pallative Care:

• Structure and Processes of Care
• Physical Aspects of Care
• Psychological and Psychiatric Aspects of Care
• Social Aspects of Care
• Spiritual, Religious and Existenial Aspects of Care
• Cultural Aspects of Care
• Care of Imminently Dying Patient

The goal of the program is to better educate families and prepare them to be supportive caregivers for their loved ones. This focus on sharing knowledge was a consistent theme throughout my visit at the campus. They clearly have a commitment to sharing what they’ve learned in improving care practices to help organizations and people globally.

Comfort Matters
The ultimate goal at Beatitudes Campus was to create a model program of best practices in dementia care that could be replicated and sustained to improve quality of care and quality of life, through a uniquely person-directed and staff-empowered approach. They saw that vision come to life and are now sharing what they have learned about improving dementia care practices with other communities and care centers through Comfort Matters, a training and education program.

“We fully believed in this program,” said Ivan. “And not just to take care of the person and the family but also to make the experience better for the people who provide that care every day. We wanted to take that into other organizations so they can expand their experience as well.”

Comfort Matters works off simple, but powerful key concepts:

1. Comfort Care
2. Anticipation of Needs
3. Know the Person
4. Person-Directed Practice
5. Staff Empowerment

By the end of this summer, seven organizations will be participating in the program which provides education for all levels of care teams working with people with dementia, including dietary and housekeeping staff, activity specialists, recreational therapists, social workers, certified nursing assistants (CNAs), licensed nurses, physicians and administrators. To date, none of the organizations that have implemented the Comfort Matters philosophy have had to release a resident because they could not care for them – a great testimony to the model of comfort and compassion.

Greater Impact for All
Reminders of Beatitudes Mission and Values hang throughout the campus The Comfort Matters model was initially designed for patients who have trouble thinking, but the staff at Beatitudes Campus quickly realized that the principles could be applied in all areas. “We were able to take these same basic concepts and expand them into the campus because who doesn’t want to be comfortable?,” said Ivan. “Who doesn’t want everyone to know who they are? Who doesn’t want to have their needs anticipated? And who doesn’t want to be part of a team? We expanded on these principles in other areas, and it has impacted the campus as a whole in very positive ways”

The concepts and principles around comfort that have guided this organization truly are, as they acknowledge, simple but powerful. They represent a very drastic change in thinking for aging care, and an innovative one that puts the person at the center of the equation with respect and compassion. Their focus on making life better for dementia patients, and the impact their efforts and research can have on every long term care resident, is an inspiration to all.

“Beatitudes Campus has rewritten the rules on how we care for people who have trouble thinking and how we support the circle of family and friends who care for them,” said President and CEO, Michelle Just. “We envision a community like no other, where life is fully worth living and the body and spirit are equally fed.”

Special thanks to Tena Alonzo and Ivan Hilton for being such gracious hosts for my visit. I am inspired by their compassion for the community at Beatitudes Campus and their desire to share their research and learning to impact others.