Embrace Living: An Interview with Rebecca Priest
St. John’s has four retirement communities in Rochester New York that range from independent living and assisted living to rehabilitation and skilled nursing. Approximately ten years ago, the management of St. John’s, led by Charlie Runyon, Rebecca Priest, and Allen Power began a culture change in their long term living residences by becoming Eden Alternative certified. The Eden Alternative, founded by Bill and Jude Thomas, is an international nonprofit that provides education and support to long term living management and care partners. The Eden Alternative trains staff at long term living residences like St. John’s on the implementation of a care model that encourages connected relationships between the care partners and elders to improve the quality of life for both. This approach to long term care is called person directed long term living.
After Christopher Perna, President and CEO of the Eden Alternative, gave me a tour of the independent and assisted living neighborhoods, Rebecca Priest , the Administrator of Skilled Services, gave me a tour of St. John’s Home and the two Green House residences. All three residences looked and felt like home with a warm, peaceful atmosphere. At first glance, I could not differentiate staff from family members, since none were wearing uniforms. The choice to not wear uniforms creates an environment that does not send clinical cues and encourages independence and autonomy by the residents. The care partners have an operational structure that resembles the way a family member would behave when caring for their own relatives. Care partners share all the tasks, leading to shared accountability of quality and satisfaction. Additionally, care partners do not rotate through patients. This regular connection leads relationships that enable the care partners to anticipate the individual needs, wants, likes, and dislikes of each resident. The relationships are fulfilling to both the staff and the resident.
The outcomes of this relationship based care in the small home setting were impressive. Care partners at St. John’s spend more time with residents than what is required by the state. There are also more care partners per resident than in traditional skilled care homes and seventy five percent fewer staff calling in to say they are unavailable to work. There is also significantly higher satisfaction rates reported and better end of life experiences in the small home setting, versus traditional care.
In my interview with Rebecca, she shares the challenges and successes of their conversion to person directed living.