Duane & Marlene Braham began their journey of caring for others in 1968 when they purchased the Conneautville Nursing Home, owned by Eldwood Heaster, in Conneautville, PA. This new endeavour began the Braham family's legacy of caring for the Elders in their community. In 1979, a beautiful new building was constructed on the 93 acre property.
Once the transition to the new home was complete, Duane Braham continued to work as the Administrator until his death in 1983. At that point, Marlene was prepared to take over in that role and obtained her Administrator license.
Duane and Marlene's family - daughters Cindy (Braham) Godfrey and Kim Braham-Moody and son, Douglas have all worked together in various capacities over the past 35 years to cultivate the landscape that has allowed Rolling Fields to grow and prosper.
By 1995, the Brahams were ready to begin the next phase of new growth for Rolling Fields. Plans were made to expand the facility by creating an addition featuring two new "streets". Joining the original Ash, Birch, Cherry and Dogwood Streets, Elm and Fig Streets allowed the capacity at Rolling Fields to grow from 120 to 181. Not only did this allow the Brahams to welcome a greater number of Elders into their home, it also gave them an opportunity to designate Elm Street as a secure setting for Elders with dementia-specific needs.
In July, 1996, another new feature on the Rolling Fields landscape had come to life. The "Young At Heart Child Care Center" opened its doors to the families of the community. This on-site daycare center serves as a benefit to both the employees and the Elders at Rolling Fields, providing an option for employee care partners with child care needs as well as fostering positive inter-generational relationships between the children and the Elders.
In 2001, Cindy and Kim attended an Eden Alternative workshop in Sharon, PA. They came back energized and knew that this philosophy of care was the right direction for their home.
By April of 2002, they had embarked on a journey that would change life in their home forever. It began by taking a hard look at their traditional medical model nursing home. Asking the question, "Is this Elder-centered?" about every decision made in the home.
The momentum grew and a complete culture change movement began. Aesthetic changes like removing the medical model nursing stations and making them into cozy common areas. Renovations to the bathrooms as they became warm, relaxing spas.
The management team transformed into a leadership team becoming "grandparents" to families.
Front line care partners and Elders are empowered to make decisions regarding Elder care, the result is Elder-centered care.
It has changed the way the entire home functions. The traditional business hierarchy has been flattened as empowered teams with the same ideals are putting Elders at the center of every decision on a daily basis. Even care partner schedules are designed around the Elder's preferences.
In 2007, the power of choice was taken to a whole new level. A snowstorm that kept many staff members from getting to work one day sparked another major change at Rolling Fields. Because they were short-handed, everyone available pitched in to get breakfast served that morning. As Kim helped to pass out meal trays to the elders, she realized how many of them them were still sleeping at that set hour or not yet ready to stop and enjoy their breakfast. That "ah-ha!" moment began a complete revolution of the food service and 24 hour dining concept at Rolling Fields.
Changing the way people dine changes everything. If you can at whenever you want to eat, then you can get up and go to activities when you want to, got to bed when you want to, take a nap...because you're not worried about missing breakfast, lunch or dinner at eight, noon and six.
Growing Into The Future
The journey for Rolling Fields continues into 2016 and looks forward to additional growth through their commitment to culture change in long term care.
Upgrading the information technology systems throughout the home is an important project to keep Rolling Fields at the top of their game. Plans for physical expansion to care for more Elders and provide more jobs in the community, are also in the works.
The future is bright at Rolling Fields and we invite you to our home to see for yourself how long term care can be different!
Rolling Fields was nationally recognized when they were selected for the 2009 Long Term Living Optima Award for Excellence for their 24-hour dining culture change. Below are excerpts from the magazine article published in September of 2009.
The program Rolling Fields presented for the 2009 OPTIMA Award is our 24-hour dining service known to us as “Jump Off The Cliff.” We began work on this program in March of 2007 and fully implemented the program in December of 2008.
In early 2007, as Kim Moody, our Administrator and part owner, was helping pass breakfast trays to the Elders in our home, she realized that she had to wake the majority of them up in order to let them know it was time to eat. After spending the previous several years advocating for Elder choices and educating our home on culture change, she had another light bulb moment as we have come to call them. In order to truly allow Elders that choose to dine in their rooms an option of sleeping in and picking their own meal times, we would have to completely get rid of the institutional tray service. This was huge. She approached the Leadership Team and described that she felt like she was on the edge of a cliff, and the only way to completely be free to let Elders choose when they got up, ate, and spent their day was to “JUMP OFF THE CLIFF” as we named it.
There were many months of planning and piloting the dining changes in different segments of the home. On December 16, 2008, we finally went whole house with our new dining program. To prepare for implementation, there were many areas that had to be addressed. One of our biggest, and most costly, obstacles was the fact that we had the perfect kitchen for making and serving large batches of institutional food. We did not have a kitchen that would work well for restaurant style service. Therefore, we had a company consult for a kitchen remodel. They helped us determine what equipment we needed, what equipment we currently had that we did not need, and what would be the best way to set up our kitchen. We included our Culinary Staff in this process. It was quite a change for many of them, as we have two cooks who have been with us for 30 years, and they have only done institutional cooking. However, we trained them over several weeks time prior to implementation. We also recognized that some of the training had to take place on the fly because you cannot predict what will happen when the orders start coming in. Training was accomplished with the help of several staff members who did have restaurant experience.
Menu development was also a lengthy process. This was done mostly by Allyson DeVantier, our Registered Dietitian at the time, Cindy Godfrey our Quality Assurance Director and part owner, and our Culinary Staff. Menu development started with Elder interviews. The jump team worked together to interview Elders and find out likes and dislikes. They asked specific yes/no questions, but they also asked open-ended questions e.g. are there items not on our current menu that you would like to have on the menu? Once the surveys were completed, a 24-hour menu was developed. This menu was also developed based on results from the pilot program. During the pilot, we kept track of what items were popular and what items were not. We also kept track of requests. In fact, the menu was modified as least twice during the pilot based on those results. When developing the 24-hour menu, ease of cooking, speed of cooking, and ease of holding were also considered. Like many homes we have struggled with how to offer a dignified dining experience for our Elders who require assistance with their meals. For many years, they were taken to the dining room, but we felt like we were feeding a herd of cattle. Then, we established "feeding areas" throughout our home and opened the dining room to only Elders where were independent with their meals. That ultimately ended up being no more dignified than taking them all to the dining room. Now that we had 24 hour dining, we realized that we could offer room service to our Elders who need assistance with meals. In doing this, our Elders are no longer rushed and they receive 1:1 dining assistance.
Our new 24-hour dining has had a huge impact on the lives of our Elders, staff and families. Quality of life for our Elders has been improved greatly because they now may choose exactly what and when they want to eat. There is no mad rush in the morning to get Elders up for their breakfast trays. Elders are sleeping in if they wish and we are able to allow them to maintain the same daily routine as they had at home. Our Elders’ physical health is also benefiting from this change. One of the most notable impacts has been a substantial decrease in the number of Elders on puree diets. We have typically had 20 to 30 Elders on puree. Because of the selection of food available and because there is more time for one on one interaction with dining, we only have seven Elders remaining on a puree diet. Another notable outcome has occurred with Elders with long standing pressure ulcers. Several Elders have been healed due to their increased intake now that they are able to choose the food they want to eat. We have seen many Elders at risk for weight loss now gaining weight due to the many choices available to them. Our use of supplements has decreased dramatically. Pain and behavioral issues are improving as we are now able to help an Elder who is up during the night by serving them a meal at their request, not just a typical snack item. Finally, Elder satisfaction with our home has been greatly impacted. Care plan meetings and resident council no longer revolve around the focus of food issues instead they are filled with compliments on the changes we have made. At our annual state survey in May, there were no Elder complaints about food. In fact, there were many glowing reviews about the food service not only from our Elders but also from the state surveyors, who ordered lunch each day of the survey. There have been no complaints about food temperatures as all meals are freshly made to order. Dining has become an event in our home and more Elders than ever are choosing to come out of their rooms and enjoy our dining room. Those that choose to eat in their rooms have commented on how much nicer our room service is than the institutional tray they used to receive.
Our staff members have also benefited from our new dining. Caregivers have more time to give Elders a positive dining experience which has increased job satisfaction. Many staff members have noted the positive impact the new dining has had on their Elders’ health and well being. Our staff members are also able to order a hot meal at an economical price, which is a great benefit in this economy.
CMS nursing home guidance is focusing on resident quality of life, environment and choice. One area to be reviewed during survey is looking for homes to de-institutionalize their meal service. Elder-centered care can truly not happen until this is accomplished. Our success proves that this can and should be done. Our Elders deserve nothing less. Our culture change journey can now flourish unimpeded with the boundaries of institutional food service.