When participants of a leadership development seminar held in Arizona last fall were asked to name leaders who inspire them, they chose heroic figures you might expect – Mother Teresa, Nelson Mandela, Martin Luther King, Jr., Kathy Sommers … Kathy Sommers?

A certified nursing assistant (C.N.A.) at Bridgewater Retirement Community in Virginia, Sommers’ strength, devotion, and compassion immediately came to mind for seminar participant Jeff Boyd. “Truly, Kathy stands out,” he says.

Memories were still fresh in Boyd’s mind of the death of his mother a few weeks earlier at Bridgewater and the tender loving care she received from Sommers and other staff members.

As the end drew near and his mother slipped into unconsciousness, Boyd invited Sommers and two other staff members into the room to pray. With them and his mother by his side, “I have never felt the presence of the Holy Spirit so strongly,” he wrote in a letter to Bridgewater President and CEO, Rodney Alderfer, in which he singled out Sommers and 13 other staff members for praise.

Sommers’ growth as a C.N.A. into an inspiring leader is “monumental,” says Jeff Lambert, Vice President of Health Services. “It’s a beautiful example of what culture change has meant for us.”

It’s among a bounty of benefits for residents and staff that Bridgewater has harvested since beginning three years ago to transform its skilled nursing unit, the Huffman Health Center, into the Household Model – all of which were cause for enthusiastic celebration at Bridgewater’s recent 50th anniversary party.

Says Lambert:

– Resident engagement with the world beyond Bridgewater has greatly increased, requiring purchase of two new transport vehicles.
– Family engagement is on the rise. One particular family member is highly involved in her mother’s household by writing a monthly newsletter and participating in and planning activities.

– Satisfaction among staff team members is at an all-time high. They no longer leave Bridgewater to work at other area retirement communities.

“The model is really nothing short of remarkable … every little detail … from the way the rooms are outfitted to the way the dining room is set up” made the Joy Household a true home for his mother, says Boyd. “Everyone truly treated her as if she were a member of their family; that made her happy and therefore it made me happy.”

Driving Bridgewater’s culture change success are teams of residents, staff and families who from the beginning talked together about the changes they wanted in the daily life of elders and the work environment for caregivers. They focused on what real home looks, smells, and feels like, all the while listening to each other and struggling with disagreements. They endeavored to appreciate different points of view and acquire new knowledge and skills as they began making small systemic changes.

A Steering Team guided the way, charging action teams with doing the hard work of adjusting old institutional habits to person-directed practices – all based on residents’ long-held desires and how they had done things at home.

With building renovations still underway, work teams began making small, incremental changes. More choices decided by residents and staff together were offered at meal time. Upper management became directly involved with residents, participating with them in community circles. Non-activity staff learned about and helped fulfill individual resident’s daily pleasures. These initial, small changes helped everyone realize the possibilities of enhancing the daily lives of residents beyond the occasional activity or “program” that brings only momentary satisfaction.

The organization became intent on fostering opportunities for staff to make decisions collaboratively and use resident direction to plan and carry out their work. This built a strong foundation for creating a new organizational design that included household-based, self-led teams consisting of a variety of staff disciplines cross-trained into blended, versatile roles. While staff members continue to provide the services that best fit their skills and training, they now have the flexibility to assist residents with diverse needs that spontaneously arise.

Today, the center of daily living at the Huffman Health Center is not healthcare, but quality of life and relationships that in turn promote good health. Residents dictate their own schedules, awakening when they choose, eating what they want, and sleeping more soundly as a result. Relationships forged within the households help team members identify nuances of residents’ health changes so that more serious problems are prevented. Life pursuits, both individual and collectively, are slowly replacing the activities calendar. Household residents host friends and families, contribute to menu planning, and weigh in on when and what to do – or chose to do nothing at all!

For Boyd, “it was not only the level of care but also the high level of inter-personal relationships” that made Bridgewater home for his mother. “She first and foremost valued relationships, and at the end of her life it was a blessing for her to create even more relationships with the people at Bridgewater who were so open to that,” he says.

Now that the Household Model is providing a true home for its most frail elders, Bridgewater is turning its focus to bringing the same to other areas of its Continuing Care Retirement Community.

Though retirement is likely decades away, Boyd and his wife already are considering making Bridgewater their home when the time comes. It looks as though prospects for Bridgewater to eventually celebrate their 100^th anniversary are looking up.

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Read “Why do we Need Culture Change in Nursing Homes?” by Rodney Alderfer, President of Bridgewater Retirement Community, published in Inside Nielsen. Go to page 6.