Happy Days are Here in Elder Care

Willy Sutton robbed banks because it was where the money was.  In our population, the group that is least honored, respected, and most deprived in the pursuit of happiness are frail elders.  They are typically locked in dementia units or placed in nursing homes for their own perceived safety.   We need to give them the opportunity to flourish and thrive instead of being regulated to warehousing.  The Elite Care/BIP Tech quest is to make sure frail elders continually achieve Happy Days.Happy Days Calculation

  Happy Days

Part of Elite Care’s triple bottom line accounting is to monetize how well we are doing from a social prospective.  We have decided to use Happy Days as our currency in this endeavor.  So, how do you calculate a Happy Day?  We started in the most obvious place… Google.  Unfortunately, Google didn’t have many Happy Days, unless you were interested in the The Fonz!  So we created our own rules, which are outlined in the following few pages.

What gets Measured gets Managed in Assisted Living!

Each of our Elite Care Extended Family ResidencesTM has approximately 12 residents. Through our caring environment and culture, our residents thrive.  They are happier, healthier, and live longer.  We attribute thirty Happy Days per month to each Resident when we are doing all the right things, or a total of 360 per month per household. Each House also has approximately nine Team Members whose calling is to serve Elders. If the Residents are happy we can assume that our Team Members are also happy.  The happiness and satisfaction of our Team Members is extremely important to us.  Nine team members (Staff) times twenty work days a month equals 180 Team Member Happy Days.  There are also additional Happy Days that the Family Members participate in by knowing that their loved ones are happy and being well cared for.  Family Members receive 50% of the total Resident Happy Days per month.  Each house potentially has 720 Happy Days per month if we achieve 100% of our metrics.   We are able to achieve more if family participation increases. The metrics are weighted on what areas we believe to be the most important indicators.

Calculating Satisfaction in Long Term Care

  • Resident Happy Day Calculation:
    • 12 (Residents/House) * 30 (Happy Days/Month) = 360 Resident Happy Days
  • Team Members Happy Day Calculation:
    • 9 (Team Members/per shift per house) * 20 (work days) = 180 Team Member Happy Days
  • Family Member Happy Day Calculation
    • 0.50 Family Happy Day for every Resident Happy Day = 180 Family Happy Days

Happy Days Calculation

 

Happy Days Calculation

The Mining, Processing and Delivery of Quality Elder Care

Our mission: Creating resident directed Residential Care Communities that enhance well-being through Belonging, Influence, & Purpose.

In prospecting for natural resources that would allow us to produce Happy Days in large quantities, we need a reliable and available supply of raw material.  The key ingredients for this are:

  • Loneliness = Loneliness
  • Irrelevance = Marginalization
  • Meaningless = Absence of Purpose. 

Once we have acquired the raw materials:

  1. First thing we do is create an environment that allows for maximum participation and independence. 
  2. Second we develop a culture where Belonging, Influence and Purpose (BIP) define our main product. 
  3. Third we do it in a Simple, Consistent and Routine (SCR) way that allows for wisdom (habits) to augment decline in mental and physical abilities.  Minimizing Cognitive Load
  4. Fourth we deliver clarity and transparency through technology. 

In general we weave together elements that allow our elders to regain their rightful place in society’s natural order.

Definitions

20% – Graceful Ending (Safe Environment):

Happy Days Possible: 144

How well we die is a direct indication of how well we live. It is everybody’s wish to live well and die quickly at home with family and friends. Our Residents are all in the top 5% of Medicare (average 89 years old, mild to significant dementia, multiple co morbidities and needing significant help in ADL’s) members who normally spend 7 or more days a in their last 6 months in the hospital.  Yet, Elite Care’s Residents spend less than .6 days in their last 6 months in the hospital.  The most weight is put on Graceful Endings because there are lots of tributary effects.

This is a major indicator of how healthy our residents are:

  • Dr. Eric Tangalos (Geriatrician at Mayo Clinic initial member on our advisory board) estimated that for every day you spend in the hospital it takes 7 days to readjust when you go back home. 

If our Residents are in the hospital then so are their Family Members.  In the typical Medical Model anxiety increases and dignity is lost, but by keeping them out of the hospital Happy Days are achieved!  In all of the blue zones (parts of the world where large percentage of the populations live past 100) Medical attention is not part of the success.

Based on these findings Elite Care will allocate 20% (108) of the potential 540 happy days, and remove 5.4 Happy Days for each night a Resident spends in the hospital.

10% – 911 Calls Made (Safe Environment):

Happy Days Possible: 72

Elite Care strives to minimize the amount of 911 calls made by keeping our Residents healthy and stress free.  The fewer calls made the better Elite Care is fulfilling their duty as excellent care givers.  911 calls are a direct indicator of the following:

  • Falls
  • Stress
  • Anxiety
  • Sickness
  • Health Complications

We allocate 10% (72) Happy Days, and take away (48) Happy Days for each 911 call per month.  If there is greater than 1 call the house receives zero Happy Days for this section. We average about .25 911 calls per resident per year estimated to be about 10% of national average 

5% – Family Night Attendees (Belonging-Influence-Purpose):

Happy Days Possible: 36

Once a month each Elite Care Extended Family Residence home hosts a fun night in honor of the Residents families.  This provides the families with an opportunity to consistently connect with their loved one and connect meaningfully with other families.  The larger the group the stronger the connections are within the extended family.  Our elders live vicariously through the lives of the younger generation the more we share the more joy we spread.

We allocate 5% (36) Happy Days, and take away 4.5 Happy Days for every family member under 12 and add 4.5 Happy Days for each family member over 12.  This is one of the bonus categories, because family is so very important to us.

5% – Outing attendance (Belonging-Influence-Purpose):

Happy Days Possible: 36

Elite Care plans weekly outings off campus each week.  All Residents are encouraged to attend. Outings are designed to give our Residents experiences that are memorable and pleasant while providing them a chance to connect with the outside community. When we are no longer able to participate in the community at large and enjoy those activities that we did when we were younger it is another reminder and milestone of our decline. A good example of this is when we are no longer able to drive.  Activities that are challenging and exciting allow Residents to bond and grow together.

We expect a minimum of 9 out of our 12 residents to attend each outing.  This makes for a total of 9 residents times 4.2 weeks in a month, a total of 37.5 attendees.  If everyone goes we collect 36 Happy Days. We lose 1.5 Happy Days for each attendee under 37.5 and gain 1.5 Happy Day for each attendee over 37.5.  This is one of the bonus categories because field trips have always been such an expression of living, learning and mixing with the community.

10% – House meeting participation (Belonging-Influence-Purpose):

Happy Days Possible: 72

House meetings provide Residents a platform to:

  • Voice any suggestions they have for improvements
  • Check in with the Team Members
  • Compliment the team on noticed improvements
  • Gives a forum to influence the house

This is one of the many ways Elite Care ensures they are providing excellent care.  We expect all members of the house to participate, 12 Residents’ times 4.2 weeks for a total of 50.4 attendees.  We subtract 1 Happy Day for each Resident fewer than 50.4 attendees, and add 1Happy Day for each resident over 50.4 attendees.

5% – High Tea (Belonging-Influence-Purpose):

Happy Days Possible: 36

Once a day all of the Residents are invited to sit and enjoy one another’s company over a cup of tea.  Each High Tea is run by a different Team Member providing them a chance to share their life experiences with the Residents.  This provides the Residents with:

  • Chance to participate vicariously through the Team Member’s life and passions
  • Opportunity to discuss their past, and mentor Team Members through their experiences
  • Chance for the Team Members and Residents to participate on an equal basis in life, which enforces the extended family.

We expect a minimum of 8 out of our 12 Residents to attend each High Tea.  This makes for a total of 8 Residents times 4.2 weeks in a month for a total of 33.6 attendees.  We subtract 1 Happy Day for each Resident fewer than 33.6 attendees, and add 1 Happy Day for each Resident over 33.6 attendees.

10% – Meals attended by residents (Belonging-Influence-Purpose):

Happy Days Possible: 72

3 times a day our Residents enjoy a healthy meal.  Each of these meals has specific benefits that contribute to their overall health.   This is a prime area where we can help our fellow man from facilitating their eating to listening to their needs.

  • Breakfast is a time when our chef can individualize their meal and provide for some food orientated mile stones.  Hot coffee, bacon and eggs just the way they like it. 
  • Lunch and dinner is a time of communion where they reunite with the rest of their group and establish themselves as a vital part of the whole.

We expect each resident to attend every meal when they are in the house, there are 12 residents’ times 3 meals a day times 30 days a month or a possible of 1080 meals for 72 Happy Days.  We subtract .5 Happy Days for each meal missed.

10% – Town Crier (Safety):

Happy Days Possible: 72

Twice a day, once at breakfast (Chef or AC), and once at lunch (AC or a team member) recounts how great yesterday was and describes the great activities for today.  Along with the house news, we talk about history, tell a joke, and ask for help/comments.  Elite Care’s goal is to maximize the advantage of malleable memory by implanting positive thoughts about what happened yesterday, and all the great things happening today.  If yesterday was great, and today is going to be great, this must be a great place to live.  The Town Crier provides Residents a forum to participate and bring in their life experiences.

We expect this to happen every day each time it is missed we subtract 2.4 Happy Days.

15% – Guests attending meals (Belonging-Influence-Purpose):

Happy Days Possible: 108

When the environment is welcoming to our guest (Family Members) it is welcoming to everybody.  Guests bring the world vicariously to elders.  Our Family Members bring an intergenerational presence that they share with our elders.  We expect all guests to share their presence with everybody around the table spreading their joy and experiences to all elders.  Elite Care believes we all act and perform better when we are on stage.

We expect 3 guests to show up each day per house or 90 attendees per month, we subtract 1 Happy Day for each visitor under 90 attendees, and add 1 Happy Day for each visitor over 90 attendees.

10% – Nurse Touch Base (Safety):

Happy Days Possible: 72

Each Two House Extended Family Residence has one nurse.  Every week the nurse meets with each Resident at the same time on the same day with the same script.  This enables the elder to anticipate the meeting and prepare themselves with questions.  Another key aspect to the Nurse Touch Base is it establishes the right for Residents to be honored by respecting their time and space.  This reinforces that their personal health care provider is proactive with their health.  If you think you are getting good care and your family thinks you are getting good care then you must be healthy, because you are getting good health care.  The placebo effect!  Our experience shows us that our Residents are more likely to mention concerns in a Simple, Consistent, and Routine environment.

Nurse Touch Base is performed each week or 48 times a month. We subtract 1.5 Happy Days each time one is missed without the appropriate reason, resident communication and makeup

Conclusion

Elders in general have a high propensity to be happy, it is Elite Care’s responsibility to create an environment where they are safe and comfortable enough to be who they are.