Supported Living, An Innovative Health Care Model

Supported Living at Horizon House is an innovative health care model designed to meet the social, mental, spiritual, and long-term health care needs of our residents—to serve the whole person, not just their medical concerns. We operate under Washington State Assisted Living regulations, combining a wide range of care and services to address the individual needs of residents in a home-like environment.

The Evolution of a New Model of Care
In 2005, Horizon House embarked on a strategic planning initiative to expand its campus and research new ways to deliver health care, consistent with state and national efforts to pioneer culture change in long-term care settings. Prior to that time, we provided the traditional nursing home and assisted living models of care. With our expansion, the nursing home and assisted living were essentially combined into a new model of care, which we called Supported Living.

A New Philosophy
The Supported Living model removes the transitions between levels of care that customarily occur in traditional settings, whereby a resident moves from independent living, to assisted living, and then to the nursing home. Supported Living, as the name implies, supports a resident making a single move when their care requires it and when living in an independent home is no longer a safe, viable option. Once a resident has transitioned to Supported Living, he or she is able to “thrive in place.” As care needs increase, the resident receives support in the comforts of his or her home. The resident, when most fragile, can forgo that difficult move to a nursing home setting and the need to develop trust for a whole new set of caregivers. Instead, residents can remain in their personalized apartments with their own belongings and receive the support they need. A variety of apartment types, ranging from one-bedroom apartments, to studios, to semi-private accommodations, are available. As of November 2015, we have completed a major addition to Supported Living, which now offers accommodations for 80, plus another 25 in Memory Support.

Support Services
Supported Living staff includes licensed nursing and elder care assistants (nursing aides) twenty-four hours a day, seven days a week; an Advanced Registered Nurse Practitioner (ARNP) is present five days a week. We also offer a variety of classes, programs, and meaningful activities designed to enhance resident quality of life. Ancillary support services are available, including social services, spiritual care, rehabilitative therapy, and wellness activities. Residents are encouraged to remain connected with friends and to participate in the programs and events of the larger Horizon House community. Although we have several dining venues in Supported Living, residents have choice and may dine in the main dining room, which is open to all residents in our community. Volunteerism is very robust and a number of Supported Living residents participate in programs that provide meaning and purpose, ranging from preparing food for homeless shelters, to sanding wooden toys to donate to children in need, to mentoring children through intergenerational programs.

Supported Living offers a “continuum of care” in a residential environment, ranging from light assistance to extensive care, including end of life with optional hospice care.

Dementia Care
Supported Living offers a secured, gracious environment for dementia care called Memory Support. This neighborhood provides for the comfort of those residents experiencing mid-to-late stages of dementia. In line with best practices in the field of dementia care, Horizon House partners with an Arizona organization, The Beatitudes. They are leaders in the delivery of compassionate, evidence-based care for those coping with mid- to late-stages of the condition. The program that we share, Comfort Matters, focuses on palliative measures to meet these residents’ physical, social, spiritual, and emotional needs. It is an intentional, person-centered approach that emphasizes knowing the whole resident, their background, past and present routines, what makes them smile, what foods they enjoy, what brings them comfort, and just as importantly, what causes them discomfort.

Since embarking on this partnership nearly a year ago, the outcomes for our residents with dementia have been remarkable. Morning time is quieter and calmer. Unnecessary medications have been discontinued, and the use of psychotropic drugs has dropped dramatically. Residents are showing fewer signs of distress or discomfort. Our goal, to enhance comfort, has been realized, and efforts are ongoing to ensure comfort as the residents continue on their individual journeys with dementia.

Outcomes
The aging process itself often forces unwanted losses of independence, dignity, freedom, and quality of life. Supported Living achieves a living environment that limits the losses associated with multiple moves between levels of care. It is a model that brings care and services to the resident, where the focus of daily living is actually living and enjoying life, rather than waiting for the next medical treatment or wondering about the next move. Research was conducted in late 2008 and at that time, from the inception of the Supported Living in 2005, fully 16% of moves were eliminated that otherwise would have taken place with the prior, traditional models of care.

Supported Living provides a residential environment that is vibrant and full of gracious space. A safety net of health care providers and services is always available, yet front and center is supporting the residents in their quests for meaningful and engaged lives. This is, after all, at the heart of Horizon House’s mission and its commitment to dignified aging and life fulfillment for all its residents. Please click here for a downloadable pdf of this Supported Living Possibility Paper.

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