The Resident & Family Experience

To the Hospital and Back: An Award-Winning Case Study

Mrs. Mary Smith, a resident at Crosby Commons Independent and Assisted Living community was sent to a local hospital emergency room on a Saturday evening for evaluation of a medical emergency.  Knowing that miscommunications can occur during this transitional process from the community to the ambulance and finally to the emergency room, Crosby Commons sent along a packet of information with the resident to assist the hospital staff in their initial assessment.  Included in the packet was:

• A letter from the community explaining all of the services we can and do provide, and an overview of the living environment where the resident resides;
• Demographic and insurance information; 
• A current list of medications; 
• Notes on recent medical concerns.     

Once the resident was stabilized in the emergency room, the ER staff planned to send the resident back to Crosby Commons later that night. The Director of Nursing called the ER physician to discuss in further detail the resident’s recent history of medical concerns, in addition to the reason sent to the hospital.  A comprehensive transition of care was discussed, including the services available at the assisted living community, which was not designed for the complex level of medical problems the resident was facing at the present time. Our (and the hospital’s) relationship-centered care philosophy of treating the "whole" person guided us to work with the physician to evaluate the surrounding medical conditions while the resident was at the hospital.  The physician expressed appreciation for the information provided by the Director of Nursing and decided to admit the resident for a complete workup as he then had a clearer understanding of the situation and justification for the admission.

Armed with the facts of the resident’s global situation (living environment, increasing medical problems, current medications) the physician, hospital staff and community nurse were able to create a plan to meet the resident’s complex medical needs through a short-term hospital stay, where an underlying medical condition was discovered.  The hospital stay was followed by a stint at a rehabilitation facility.  The resident eventually returned to the assisted living community, medically stable and with an actual increased level of independence.  Without the communication between the Crosby Commons nursing staff and the emergency room team, Mrs. Smith might have been assessed, and momentarily stabilized enough to be sent back to the community, only to have repeated medical emergencies which could have resulted in a compromised health status and possible long-term skilled nursing placement.  Through this focus on the Transitions of Care, Mrs. Smith was able to have her health needs accurately assessed and treated, with the end result of returning to her home and back to her baseline level of independence.

“My grandmother lives at Bishop Wicke Health Center. LIVES.She was not “placed” there by her family; she was not “admitted”. She was welcomed into her new home and has lived on the Wesley Village campus now for seven years. Envision a vibrant and exciting life at 96! A life in which you look forward to getting up in the morning. A life that is filled with love and respect. That is the life that my grandmother had first at Wesley Heights, and now at Bishop Wicke.

Beth Baker in her book, “Old Age in a New Age”, speaks of people moving into nursing homes and becoming what she calls generic old people. Unfortunately this truth plagues most aging service organizations. Not so at Wesley Village. In fact, the individualized and person-centered approach of the staff at Wesley Village was actually highlighted in that same book!

Imagine my surprise when I got a phone call that my grandmother was no longer confined to the wheelchair she had been in for two years, but walking independently. It happened because she did not become a generic old person to the staff of Bishop Wicke. Despite the fact she is 96, they treated her as the unique individual she is and worked with her to regain her independence.

Through my work in healthcare consulting, I have had the opportunity to visit dozens of organizations throughout North America. Large and small, stand alone or part of a campus, for profit and not for profit, some simple and some fancy. Not only does Wesley Village stand out as a superior organization in Connecticut, but it is a role model and leader in the field of aging services on a national level.

Seven years ago my grandmother and I chose Wesley Village as her new address because, quite simply, that’s where she LIVES!”

– Denise Boudreau Scott, Denise B. Scott, LLC Geriatric Consultant

“My aunt Elizabeth Santini had been living with me and my family for two years, until she fell and fractured her pelvis in three places. At the age of 92, it was unlikely that she would ever walk again. Four months later she is walking with a walker, able to get in and out of bed and chairs by herself. She is happy and calls Bishop Wicke her home. She has friends that she has meals and conversations with. The staff at Bishop Wicke was able to accomplish all of this despite my aunt’s age and the fact that she is forgetful and has dementia. My aunt is well cared for physically and emotionally by the entire staff at Bishop Wicke.

“My dad took care of my mom for three years until she passed away from breast cancer. Then he got sick and it was our turn to take care of him. He was lucky enough to go to Bishop Wicke after his hospital stays. The entire community – aides, nurses, dining staff, therapy and housekeeping worked hard with my dad each time to return him home so he could live out the rest of his life in the house that he lived in with his wife for fifty years and raised his four children. My dad is able to live and enjoy each day with his family around him because of the loving, caring and compassionate staff at Bishop Wicke. They worked their magic to return my dad to the only place he wants to be, at home. Although he won’t admit it, he misses his family at Bishop Wicke, who he owes his ability to walk again independently and take care of himself at home.

Thank you to the entire staff for giving us our dad back each time he was ill at Bishop Wicke. Every time he laughs, smiles, cracks a joke or tells us stories of the past, I think that if it weren’t for the hard work and dedicated team at Bishop Wicke, this would not be possible.”

–Danita Alberts, RN, MPA, Supervisor of Assisted Living Services at Spring Meadows

"I have been practicing in the area of Elder Law for the last 20 years. I am very familiar with the quality of care given at long term facilities. I have never heard of a complaint against the Wicke Methodist Home. My aunt, godmother and who I have always referred to as my second mother has been a resident for the past 4 and one- half years. I have witnessed the care first hand on a day in and day out basis. She is in the best hands I could have prayed for."

–Shawn Splan, Elder Law Attorney

"I am proud to have been on the medical staff at Bishop Wicke from 1999 to 2007, when time constraints made practicing at the nursing home no longer feasible for me. Despite not presently being at Bishop Wicke on a regular basis, I still maintain strong relationships with the many excellent nurses, administrators and staff at the facility and do not hesitate to recommend Bishop Wicke as my preferred choice when referring patients and families for both short term rehabilitation and long term care. The continuity and retention rate of the care team there and their dedication to doing the right thing in the right way for patients is most impressive. I consider Bishop Wicke to be the premier facility of its type in both the Greater Bridgeport and Naugatuck Valley areas. I would not hesitate to refer a family member in need to this facility."

– Dr. Domenic Casablanca