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'Rise and dine' takes off

Residents at St. Mary's Nursing Center no longer have to rise and dine at 8 a.m. They now have the option of rising and dining when they feel like it between 6:30 and 9 a.m.

The new, relaxed program Destination Home is just one of the ways St. Mary's is changing its style to accommodate the residents rather than the residents accommodating the nursing center.

Director of Nursing Patti Boller said from the beginning, nursing homes have been run more like institutions, being very task oriented.

"It was the needs of the nursing home and not the needs of the residents," she said. "And we'd like to turn that around."

The first change came in January with consistent staffing. Rather than staff rotating whom they care for, the same staff will be assigned to the same residents. This way, residents won't have to repeat themselves as to the way they like to be dressed or have other things done for them, Boller explained. Plus staff will be working with the same co-workers, building on teamwork.

The second change comes with the Rise and Dine program at Café Central in the dining room, which started Tuesday. Rather than residents being up and fed all together at 8 a.m., they have the option of sleeping to whatever time and then getting up, getting ready and having breakfast at whatever time they choose between 6:30 and 9.

Resident Geneva Danielson said she's happy with the change because now she can go early for breakfast and sit and visit.

Nursing Manager Ann Jenson said Danielson told her earlier in the week that she and another woman were able to sit at the table and visit until they had nothing left to visit about.

"The peacefulness for the rest of the staff ..." Jenson said.

"Is phenomenal," finished Marsha Parker, nutrition services manager.

Besides the change for the residents, there have been changes for the staff as well. Housekeeping doesn't start until later, the kitchen staff now cooks for individuals rather than 50 people at once, the night nursing staff doesn't have to do extra to relieve the morning staff's hurry-and-get-done breakfast routine, and the therapy staff doesn't have such an influx at once.

Now the lights are kept dim and it's quiet in the hallways until 8:30.

"The hardest to change is to whisper," Jenson said.

"We're shushing each other all the time," Boller agreed.

Beginning at 5:30 a.m., residents can get a cup of coffee before breakfast as well.

Once in Café Central, residents can now order off a menu, like being at a restaurant.

Once having to get eggs and toast that were prepared at the same time for 40-50 people, residents get hot and fresh food.

"It's been a bit of an adjustment," Parker said.

But ask anyone, and they'd say it's been a positive adjustment, Jenson added.

"Residents just look happier," she said.

And with residents starting their days at different times, it's easier to get to therapy at various times too, rather than larger groups all at once.

These changes have been made on the first floor of the nursing center, and the same changes will be made to the second floor in March (consistent staffing) and April (Rise and Dine).

"We want to leave the oops behind," Boller said when the program moves up a floor.

Jenson said the change has brought some pleasant surprises too. She said most staff figured the residents would get up and come at 8 out of habit, but instead they came the entire span of the two and a half hours available.

Before the staff implemented the changes, they got together to discuss the impact it would have on all departments. There was also a focus group of residents to listen to their concerns and desires.

"There haven't been any big bumps in the road. We've tried to anticipate the hurdles," Boller said.

And if there are, hopefully the residents aren't affected.

"It's going to work out fine," Danielson said.

And with the change in breakfast time, new people can sit with new people each day. Although Jenson and Parker agree that Danielson's table fills up quickly.

While residents were welcome to sit and visit before the change, Jenson said they just didn't because there was such a feeling of schedule. The atmosphere is different now.

"It's just a much more peaceful morning," she said.

St. Mary's Nursing Center is planning for more changes in the future, some big and some not so big. Soon medications will be kept in each patient's room rather than having a meds cart that residents have to come to for their pills. Even the daily prayer over the intercom has been moved from 8 to 9 a.m.

With Destination Home becoming homier every day, the staff is working to make residents more and more comfortable, one step at a time.

"We're taking baby steps so we don't fail," Jenson said.

"We want to be successful," Parker agreed.