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Creekside
Convalescent
By Richard Paul Hinkle
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Convalescent care where both words countsT“Convalesce” is a pleasant word. It has a pleasing, partly sibilant, soothing sound, and the very idea of relaxing recovery offers some sense of lassitude, ease. But when you say “convalescent care,” those two words strike fear into anyone compromised in body or in spirit. If you’re honest with yourself, it conjures up the skanky smell of urine (or worse) and dungeon-like conditions of neglect, if not abuse. Thankfully, those images are increasingly old school, as thoughtful, caring, sharing folk join hands to make both words mean what they were intended to mean. If that sounds a little touchy-feely on the surface, closer examination takes you beyond that superficiality. Perhaps if I explain the origins of this story. I occasionally drop in on convalescent care homes—as a favor to social worker Nyla Blair—to play guitar and sing for the residents. One care home, the subject of this story, stood out for two reasons: One, it was clean and bright and had many home-like features; two one long-term resident, Don McGee, though bodily disabled, seemed to be able to mouth the words of every single song I sang, from Dylan to Creedence. (I got him once, though, by singing a song in Spanish. Don laughed heartily at that.) “We are constantly trying to think up new ways to make clients’ and residents’ stays here more normal,” says Creekside’s administrator Paul Duranczyk (duhr-ann-zick). He says that not by way of boast, but rather as job description. “We had a couple in their eighties, a few months ago, who asked to cohabitate, to share a room. We hashed it out with our staff and with their kids, and eventually decided to give them a shot at it. Is this unusual in a care facility? I suppose so, but it seemed to enhance their quality of life sufficiently to warrant the experiment. Do they have their days? Sure, just like any other couple, but so far it’s working out far better than any of us could have imagined.” Duranczyk is quick to point the credit to the staff of some 230 for their willingness to go out of their way to comfort and coddle clients and residents (clients being those in for short, rehab stints [both medical and mental], residents in for long-term, even rest-of-life care). “We have many people on staff who have been here for ten, fifteen, even twenty years, and all of them are committed to making things more livable. It is not uncommon for them to bring their pets or their kids here to mingle with the residents. It makes life here less institutional, a little bit more like a home.” The lobby was clearly redecorated with that in mind. One side is “living room,” with couches arranged for ease of conversation and mingling. The left side is set up as “game room,” where residents can play checkers, chess, cards, board games. In one corner is a good-sized aviary, with canaries and finches flitting about. The aviary is cared for by a volunteer professional, and is a source of continuing interest and amusement for residents and visitors. Then there’s Samantha, a fair-sized (and growing) Yellow Lab pup who roams the halls most days dispensing unconditional love and attention aimlessly and continuously. “Sam” belongs to director of nursing Traci Clark, who’s been at Creekside since 1998. “I used to work acute care at Memorial Hospital,” says Clark, decked out in practical pink scrubs. Sam is at her feet, then out into the lobby, where a patient tosses her a plastic toy. “I liked it at first—I was young, I liked the action—but then I began to realize that I wasn’t being appreciated for what I was doing. There wasn’t a positive outcome in the long run, and that left an emptiness in me. Patients and their families treated me like a servant. “Here, I really have a chance to make positive changes in everyone’s lives, the residents and their families alike. Rehab clients come in, and they can’t walk, and we get ‘em out of here on their feet. And they are so appreciative that they keep in contact, by mail, sending us updates. Or they come back, to thank us again. Everybody in this place works together as a team. The managers aren’t ‘up there.’ All of us have worked in the trenches, and know what it’s like. That’s why I wear scrubs, so I can pitch in when a little extra help is needed. Paul is always out walking the halls, ready to lend a hand, provide direction. And if he’s in his office, the door is always open. And not just to us, but to the residents as well. They line up outside his door to spend five or ten minutes with him—even an hour!—and he listens to them. And to us. It’s a big deal to the residents, makes ‘em feel important, tall, and I’ll tell you that it makes just as much of a difference to those of us who work with him. Heck, his home phone number is right there on his business card. He’s available to all of us. And it’s nice to be able to bring my dog. That sets a tone of normalcy for all of us, residents and staff alike. I bring my ten-year-old Black Lab sometimes, but she gets a little worn out with all the attention she draws. Sam can handle it, and come back for more.” Carole Gurrola is the assistant director of nursing. She’s been at Creekside 19 years, and her sister-in-law, Cindy Gurrola, the staff development coordinator, has been here 23 years! Carole is following up an example cited by Clark, about a rehab patient who was feeling somewhat at sea without his computer. “He did a lot of day-trading, so we asked if it would be okay for him to come into our office and use our computer when we weren’t busy,” says Carole. “When Paul okayed it, the guy just perked up, and he was here every day at two in the afternoon to check out the stock market. That’s the big change that Paul brought to us, the renewed focus on care and purpose. When patients are put into something that more closely approaches ‘normal,’ they really respond to that. They’re happier, and they work harder and more successfully at their rehab. We get ‘em better and we get ‘em home!” All are happy and quick to talk about Don McGee, who’s been a resident at Creekside for 30 years. “Don is amazing,” says Carole. “He has the best outlook on life. He’s always happy and ready to greet staff and resident alike with a hearty ‘Good morning.’ He has a better sense about life than anyone I’ve ever known. He knows us, he knows our kids, and he’s always there for us with compassion and understanding. I look at Don, and how he has reacted to his circumstance, and I think, What am I complaining about?” Almost wholly paralyzed, McGee is a big man, with a round, open Charlie Brown face and a deep, resonating voice. “I was born here in Santa Rosa, at Memorial, and graduated from Montgomery High in 1967,” he says, setting the background for me. “My father drove a truck and my mother worked as a bookkeeper at Exchange Bank. I went to the JC for two years, got my AA degree, then went to work for PG & E laying underground gas lines. I am also proud to have been a volunteer fireman for twenty years.” Those can be dangerous occupations, I note. I ask if that’s how he was injured. “They are dangerous if you don’t keep your cool,” he says with a wry smile. “I kept my cool.” No, the story of his injury is tragically ironic. A friend of his twin brother Ron, in a drug induced stupor, aimlessly fired off a .38 handgun. The bullet entered the back of Don’s head, exiting his right front temple. He has been bedridden ever since. He admits to occasional bouts of depression, but points to his Catholic faith as one means of retaining a zest for life that constantly inspires those around him. He also points to the vast improvements made at Creekside (formerly known as Driftwood) over the last couple of years. “This used to be a filthy place, and the food was terrible. Now it is open, airy, and so very clean. That comes from the top dog, Paul. He’s so nice to everybody, and he doesn’t have to be. There’s a whole difference in attitude since he’s come to us. Those on staff are so much more grounded, so much more here. Not up in the air, but down here with us. And the food service is so much better. We are served at table, with tablecloths and napkins, and the staff and administrators will sit down and dine with us—that’s how good it is. I especially like the battered fish. I look forward to Bingo, and I particularly enjoy the musical presentations. I do watch a lot of television, to pass the time, to keep up with events.” Santa Rosa Junior College Psych Tech (Psychiatric Technician) instructor Beverly J. Hinkle, RN, MS, has supervised her clinical students at Creekside for five years. “There have been noticeable changes here over the last couple of years,” she says. “Not only have physical appearances been improved, but attention has been paid to small details. They have created a warm and comfortable environment by introducing home-like touches: pet therapy, the presence of staffers’ children, the ‘mobility program’ that Traci incorporated that encourages residents to be more active—from getting up and walking the hallways to getting outside the facility for events like the County Fair.” Hinkle is particularly impressed by the administration’s willingness, even eagerness to have clinical students on site. “It is a bit of extra work for them to have the students there, to help guide and train them in the practical aspects of their incipient profession. On the other hand, it does take a little of the load off of the staff, and it certainly adds a certain lilt, a certain liveliness to the patients’ days. The most impressive thing, though, is that the residents here seem to be happy—in part because the staff treats them as family. I’ve seen staff bring personal items to share with the residents—shampoo, lotions, fingernail polish. They seem to have that wonderful sense of ‘ownership’—these are their residents. That’s pretty impressive.” Indeed, not only have the JC psych tech students been welcomed at Creekside for years, but the JC’s nursing assistant program just began its first clinical rotation there in November. Dr. Eran Matalon came to Santa Rosa in 1992, fresh from his residency at USC. Even as a young internist he felt drawn to geriatric and hospice care. “I like having a long term relationship with my patients,” he says. “I’ve been working at Creekside for about six years, and it’s great to see the turnaround, from one of the worst to one of the very best. The owners have given Paul and Traci the freedom to do their thing, and they have provided the leadership to allow the hands-on people to deliver the care. The mental health section is fantastic, the physical therapy and occupational therapy units are real gems for the whole community to take pride in. And you’re right about Don McGee. He’s the glue, the cohesive force that really raises the morale of both staff and residents, he is so friendly, so open, so positive. I can’t walk by his room without hearing his voice boom out, ‘Hi Matalon!’” Dr. Mana Hobson agrees about the positive changes that have occurred at Creekside. “You can really see the change in the last couple of years,” says the Santa Rosa gerontologist. “Just the basic cleanliness of the facility picks you up, and the staff morale is decidedly up, as is the level of care offered. I think they had some problems with funding some years ago, but now that seems to be behind them, and you see the implementation of programs like the Eden Alternative that focus on quality patient care.” The “Eden Alternative” is something that Duranczyk, a Michigan native, points to with pride: “Eight of us had gone to a conference, headed by Dr. William Thomas, whose Eden Alternative is all about reevaluating the experience of aging and disability. His thesis is that we need to see our environments as habitats for human beings, and not mere facilities for the frail and the elderly. He pointed to nature as an example of a vibrant, vigorous habitat, suggesting that companion animals bring variety and spontaneity to residents’ lives, which are often held captive to loneliness, helplessness and boredom. “That’s why Sam is so special here. We had a cat here once, but that didn’t work so well. Aside from having his tail run over by wheelchairs, I think the fact that he was past kittenhood didn’t give him the chance to adapt. Maybe if we brought in a kitten. The main thing is that a more vibrant community can do as much as medications to bring about healing. I think that is why Bingo is so incredibly popular to clients and residents alike. It’s the Holy Grail here, and it’s because it has no predictable outcome. It is truly a game of chance, and the results are entirely random. People really look forward to that. “But the animals really do change the habitat. Our activities coordinator has a Yorkie named Thor, who really lives up to his name—thinks he’s a hippo! And our business office manager has a huge English Mastiff, Kirby, who thinks he’s a lap dog. We have the aviary, as you have seen, and a couple of residents have their own birds in their rooms. Of course, the dogs are all trained appropriately, not to jump on laps, not to cage from dinner trays. The point is that it creates an environment that is more home-like, and that helps tremendously in recovery times and just in overall atmosphere.” When I comment on cleanliness and lack of institutional smell, Duranczyk fairly glows. “You’d be surprised what a few gallons of paint will do, for starters; and adding art work, paintings, in the hallway, adds another homey touch. The skylights bring in extra light, we use warm full-spectrum lighting [as opposed to the cold fluorescents of the past], and nearly all the rooms open to our patio and garden areas—some of the clients and residents actually have a little vegetable garden that they tend. Pay attention here in the halls, and you’ll see residents congregating at the skylights. As to the smell, that’s just a function of good care, good resident hydration, and great attention to cleanliness. We’ve gone ‘green,’ using only environmentally sound cleaning agents. And the residents really love the fact that we have a beauty/barber shop right here, on site. We even do the occasional blood drive here, so that residents have one more connection with the community.” I take a walk-through with Doug Buser, for nine years the owner-operator of two six-bed assisted living homes in Santa Rosa. “Look how nicely clothed and clean everyone is, how upbeat the staff is. Lots of smiles. It doesn’t take long to see how they relate to the residents and to the administration. I am impressed by Duranczyk’s zeal to participate in the regional disaster drill, and that he has disaster kits—emergency supplies—for staff, so that it will be easier for them to come here with their families and participate, in the drill, in a real emergency, without having to worry about what’s happening at home. “The dog [Sam] looks like she’s at home here, the way she ambles about, seemingly everywhere. The rooms are spacious, and there’s so much light. Light is a big thing in this environment, and when someone takes the time to change the light source, well, that speaks volumes, that sort of attention to detail. And the way they bring the residents into the activities.” We are watching Don McGee reiterate each Bingo call, in his deep, resonant voice. “Those are the ways that you make a place like this their home.” SIDEBAR |