Comfort On the Move
By Ann Wyatt,
Manager of Palliative & Residential Care
Over the past few months, we’ve been asked to share our experiences in bringing Comfort Matters® to our three partner nursing homes in NYC: Cobble Hill Health Center, Isabella Geriatric Center, and The New Jewish Home on 106th Street. Representatives from Cobble Hill and CaringKind spoke about their approach to care planning and comfort at the national LeadingAge conference in New Orleans last summer, and Ann Wyatt from CaringKind presented, with Tena Alonzo from Comfort Matters®, at the national conference of the American Health Care Association in Las Vegas in October. More recently, Ann also provided a half-day education session to members of the Continuing Care Leadership Coalition in New York City.
Comfort Matters®, developed by Beatitudes Campus in Phoenix, Arizona, is a model of palliative care for people with advanced dementia who reside in residential settings. Palliative care does not mean giving up; it means taking active steps to discover what comforts someone and even gives him or her pleasure, and taking active steps to prevent or avoid unnecessary pain and suffering before they take hold. As an individual’s dementia advances, his/her actions, rather than words, are most likely to communicate distress. Unfortunately, all too often these behavioral expressions are not understood as distress; rather they are often assumed to be the inevitable consequences of the dementia itself. Palliation cannot occur if the reasons or triggers for distress are not known or understood. Anti-psychotic and anti-anxiety medications do not take away pain, nor do they comfort if someone living with dementia is hungry, cold, too warm, tired, or frightened by noises or activity in his or her environment.
Since developing their model, Beatitudes now accredits residential settings who have successfully implemented dementia-capable palliative care. All three of the homes we worked with now have dementia-care units accredited by Comfort Matters®. Since CaringKind introduced this model in New York, Beatitudes has gone on to work with several other homes in the area, including The Lillian Booth Actors Home in Englewood, New Jersey, The New Jewish Home’s Sarah Neuman Home in Westchester, and the Methodist Homes of New Jersey.
In April, the Health+Hospitals/Coler, working with Beatitudes and with CaringKind will begin implementation of an 18-month project with the aim of achieving accreditation. This effort, funded by the Fan Fox and Leslie R. Samuels Foundation, will build on work Coler has been engaged in since October, 2014. They have already achieved significant quality improvements and cost savings, and look forward to further progress.
CaringKind has also made presentations at a number of other NYC homes, and is continuing to do so. While we are sharing these standards for dementia-capable palliative care with long-term facilities, they really apply to any setting where someone with advanced dementia resides, whether it be a nursing home, assisted living facility, or at home. Advancing the implementation of these standards is a CaringKind priority.