Reading a New York Times blog by Judith Graham on ‘Taking a Zen Approach to Caregiving’ I was intrigued to consider both my personal practice in caregiving as the leader of Green Hill, Inc., and how the staff at Green Hill has been trained to address many of the challenging issues that can arise in the care of our elders. Ms. Graham spoke about a concept called ‘contemplative care’ where caregivers are trained in meditation, coping tools and response paradigms that help them remain positive, and supportive during the sometimes trying and exhausting elder caregiving process.
In the final act of one’s life we do lose many of the freedoms that we once enjoyed as fully functioning and productive adults in society. Often one is required to move to a communal setting to receive the level of care a transitioning body and/or mind may require to have a healthy and comfortable life style, where strangers perform the most intimate functions for you and new relationships need to be formed. With the loss of control of our choices, our bodies and minds, we can become irritable and frustrated. Traditional nursing and assisted living care models are not devised to return choices to an elder. The feelings experienced by elders in these situations can make it difficult for caregivers to exhibit patience, to show continual love and support, and to not take an elder’s behavior personally.
At Green Hill the experience of incorporating The Green House® Home program with the creation of four new Green House Homes also changed the culture of care provided throughout our Green Hill residence. The Green House Homes look like a traditional home setting with private bedrooms and baths, living and dining rooms. The training of Shahbaz, the (certified nursing aide (CNA) in the Green House Homes is much more comprehensive and holistic than the training for a typical CNA in an institutionalized setting.
In a Green House Home the Shahbaz are encouraged to let go of preset schedules and work with each elder, and each other to craft the course of their day. Shahbaz perform all health, personal and home care tasks for the elder as a treasured family member would provide at home care. Shahbaz create a familiar relationship in the home through continuity, recreational activities, meal preparation and dining, nurturing and protecting the elder. The Green House Home training is elder-centric in all areas of care returning choice of living style, activities, and food desires to the elder, and it also frees the caregiver to create a relationship with each elder, to invest in their comfort and happiness. This intimate relationship increases the happiness of the caregiver and decreases the frustrations of the elder.
In institutionalized settings CNAs are required to keep seniors on schedules for all of their services. The seniors and caregivers have little choice as to how their days are crafted and results are quantified as to how many medications have been delivered, how many beds changed, when and how many meals are served, among other regulated activities. Keeping to the schedule is paramount to defining staffing needs and staffing time. This creates a tremendous amount of stress on caregivers and seniors alike.
In either case, caring for elders can be a stressful proposition. At Green Hill we employ meditation sessions for our staff and massage chair sessions to relieve stress and refresh spirits.
At Green Hill it's not unusual for me to walk into a Green House home after dinner and see the elders and the Shahbazim all together at the table talking, playing cards, or doing a puzzle. In the summer they may leave the dishes and go out and sit on the front porch to watch the deer roam the property and enjoy the sunset.
In the Times article it was asked how contemplative caregiving can help. It was answered that ‘people need to cultivate a relationship with aging, sickness and dying. To turn toward it rather than turning away, and pay close attention.’ That is a very valuable tool to being able to provide quality caregiving at the end of life. At Green Hill we take it a step further to say, we embrace living, the quality of life of our elders as they take those final steps in their lives. We fill their days with love and choices, experiences and friendships. That mission defines our Zen of Caregiving at Green Hill.