They lived through the Great Depression, saved the Free World from tyranny, then jump-started the most robust national economic success story in modern history. Now, many members of the Greatest and Silent Generations are receiving the full measure of respectful care they have earned, thanks to a growing number of continuing care retirement communities and their forward-thinking administrators.
At the same time, these communities are also gearing up for the first cohort of aging Baby Boomers, who are already redefining what it means to grow old and upping expectations of how they want to be treated.
Among those retirement community administrators helping seniors more pleasurably navigate the latter end of life’s journey is Cherie Getlin, who has been Care Center administrator for Vi at the Glen in Glenview since 2004. Vi at the Glen is a Type A life care community, which means incoming residents are healthy enough to live independently. As their needs change, they can receive greater levels of unlimited care in the Care Center. When full, the Care Center at the Vi has forty-seven residents in Skilled Nursing Care, twenty-three in Assisted Living, and thirteen in Memory Support, and has roughly one hundred professional and service staff.
On its face, Getlin’s job is a fast-paced blur of resident visits, calls, meetings with staff and family members, reviewing quality measure data, training, operational and regulatory paperwork, and meeting with medical professionals to coordinate resident care. But non-stop efficiency is not the half of it. Primarily, she is animated by an unbending commitment to a compassionate team approach that focuses on creating and maintaining dignified, flexible, individualized care for every resident. “Twenty years ago the approach was much more institutional. It was one size fits all. There was a schedule, and residents were shown what to do,” Getlin said. Today, by contrast, the watchword is “choice.”
“The key is getting feedback from residents and their families and listening to what they are saying they want,” said the forty-five-year-old mother of two, who graduated from Glenbrook North High School in 1990 and has a master’s in health care administration from the University of St. Francis. “We are individualizing what we do for people, giving them a choice as to what they want to do for the day, allowing them to specify their routine. If you want a milkshake at two in the afternoon, you got it. This is what we do.”
Those choices are also made within the context of a team decision-making process. Every day she meets with the director of nursing, assessment nurse, social worker, lifestyle director, and managers from housekeeping and nutrition services. “We talk about any resident and other issues needing to be addressed, anyone who is in a situation that may need our intervention, discuss the day’s happenings, and try to be proactive in planning ahead and anticipating resident needs,” she said.
In tandem with increased freedom of choice, care at Vi, like many similar communities, has evolved toward more “non-pharmacological intervention” versus medication. “Residents don’t want to be taking drugs all the time. They don’t want a pill for everything. They want to find other ways that keep them healthy,” Getlin said. What all of that ends up looking like is a far cry from darkened stereotypes of institutionalized care.
To be sure, there are still plenty of group activities, which have been a staple in nursing homes for many decades. But at Vi, lifestyle staff, to some extent, has organized additional programs based on the residents’ functioning levels both physically and cognitively. Residents are welcome to join programs in any area of the building, and staff will get them there and back. They have also added lifestyle staff in recent years, and offer a wide array of art, music, pet, and other therapies. “We have people who have never painted before and are making beautiful paintings,” Getlin said.
Staff also learns which activities may interest which residents. For example, one resident, who was an accomplished piano player, is encouraged to attend every piano concert that Vi offers. A number of former church choir singers help lead the singing groups when they have musical entertainment. Residents who once enjoyed traveling weave fascinating tales about their adventures during frequent travelogue events. Dancing has become another popular feature. “People who love dancing really come alive when we are doing that,” said Getlin, who also leads a monthly women’s group where they discuss the “current hot topics.”
Getlin also sees to it that residents who don’t want to leave their rooms are engaged: “We do a lot of one-to-one programming, including cognitive stimulation, intellectual conversation, games, Sudoku, and books. If residents want or need a book on tape, we have them and we work closely with the public library to get whatever our residents request. We simply try to meet each resident’s individual needs and desires.”
Outings off the grounds are also on the rise, and moving forward “are going to be key,” Getlin said. There are group trips to restaurants, community theatre, and other active locations, but there are also individualized trips. “We take people on neighborhood scenic drives so, for example, they can see their old house,” she said.
As a means to meet the expectations of current and future generations of older adults, Getlin said Vi also expects to continue expanding partnerships with various outside organizations. One such partnership with students from Loyola Academy, a Jesuit high school in Wilmette, is already a resident favorite. In that program, students spend one-on-one time with residents, engaging them in activities like navigating their smartphones, computers, and other hi-tech gear.
All of the action, Getlin said, “helps people stay calm, to have a good quality of life, to enjoy their day. We’re not talking about acute care here, like in a hospital. The majority of residents need twenty-four-hour custodial care and supervision, provided by the nursing team. Many need encouragement to participate in meaningful programs while surrounded by compassionate people.”
The development of relationships between the staff and residents is another key element in the creation of a respectful environment, Getlin said. “The majority of staff is full-time, many have been here a long time, and we try to keep it consistent who is taking care of whom,” she said. “It is all about relationship building. Our staff gets to know the residents, and they become like family members. You know who you can joke with and who needs a more serious conversation. You get to know what they like and what they don’t like. Making them smile, making them laugh, that is part of what our staff enjoys.”
As people are staying healthier longer, and as life expectancies increase, the demographics at Vi are changing. Ten years ago, many residents moved in to Independent Living in their seventies. Now it’s the mid-eighties and closer to ninety at the Care Center. One woman who moved into Independent Living recently is ninety-nine. “I went to school with her grandson,” Getlin said.
As much as Vi and other like retirement communities have evolved to better meet the needs of today’s older seniors, Getlin is well aware that progress on that front must continue, both in terms of numbers of communities built and the service they provide. “The Baby Boomers are going to want an even greater sense of control,” she said. “They are going to want to choose their own destiny wherever they are. They are not going to follow our routine. We are going to have to fit into their routine.”
Like most health care administrators, Getlin must also cope with the ongoing reality that she is surrounded on a daily basis by sickness and loss. And it’s not only the residents in need of care, often it’s their families. “I’m thinking of one woman recently,” she said. “She just needed our professional opinion. That happens with a lot of families.”
When the emotional burden becomes particularly heavy, she said, “I just think back to why I got into this to begin with. I did so because it is really rewarding to help people and make a difference in their lives. I am learning so much from our residents daily. It makes it a win-win situation.” And while there is personal melancholy, there is also personal reward, she said. “It’s really just about helping others,” Getlin said. “I’m not the kind of person who just minds my own business. If I see a need, I am going to fill it, whatever that is, for anybody here. I always have a warm spot for our residents and their families. I feel like my enthusiasm just kind of pours over.”←