Living Well Community & Care Home
From the outside, Living Well Care Home looks like a regular older home in the neighborhood. Even walking in, you’d never know it is a holistic, 15-room, Level III, residential care and assisted living facility for elders.
Located in Bristol, Vermont since 2004, Living Well emphasizes organic nutrition, whole life care and sustainability. They are the first nonprofit health care facility in the country to use Dynamic Governance (DG), a style of management based on co-creative input from all levels of the organization – including residents.
In just four years, they started receiving national and international recognition.
In 2008 they received the Governor’s Excellence Award as the state’s Program Champion, recognized as an “extraordinary role model for healthy aging” because of how well the residents are doing. Residents attended the awards ceremony with their drums, held at the Vermont State House and gave a musical performance, with Governor James Douglas drumming along.
Living Well also has done extremely well as a business. In that same year, they were able to buy the real estate from investors and they have been able consistently to take Medicare to cover the costs for 2/3 to 85% of their residents. This is unheard of in the industry where most facilities can take a maximum of 1/3 Medicare patients in order to be in the black.
In 2009, Dee DeLuca, administrator and co-founder, was honored with the VHCA Administrator of the Year Award. In 2010 they've received two awards from the Vermont Department of Vocational Rehabilitation - both the employer of the year award for hiring the disabled and an employee for the accomplishment of obtaining a good job.
How did all this happen?
A Little History
Co-Founder Paul Kervick reports, “In 2004 I received a call from Dee De Luca, a friend and community activist, who was trying to relocate the elders who lived in a residential-care home that after 20 years, was closing it’s doors. She wanted to know whether my wife and I would house one of them.” From that discussion, however, emerged the possibility of a community effort to continue running the facility - in a very new way.
“Elders are the story holders and wisdom keepers. I believe they are our county’s greatest underutilized resource. I had an existing 501-C3 nonprofit corporation and saw a tremendous opportunity. Plus, the timing was right.”
Just prior to this, Paul finished years of work on a much larger project. It was to create a sustainable model community within the City of Burlington, Vermont on the campus of a former private college. The vision included housing for the homeless, ecological renovation of several buildings, organic gardens, green energy, a holistic/integrative medical healthcare center, creative arts performance spaces and programs involving numerous organizations, both private and nonprofit. “The project went by the wayside but we ended up with a large network of like-minded people and relevant resources.”
In less than three weeks, Dee - a chief inspiration and investor in Living Well, gathered enough money from a small group of local community members in order to secure a loan from a local bank to buy the property. The investors set up a real estate company that rented the facility to Living Well until they purchased it in 2008. They operated it under the umbrella of Paul’s non-profit. “We became the first holistic residential care facility in the State of Vermont.”
It so happened that the International Sustainable Communities Conference was held in the area the following month and because Paul’s non-profit was one of the sponsors, his organization was able to offer a presentation.
During the conference, which had 600 attendees, “we described the new project, shared our holistic approach to aging and had John Buck introduce Dynamic Governance (DG). We did visioning, held Open Space meetings and gathered many creative ideas.”
Afterward, the Implementing Circle was established using DG principles, and others were invited to participate. Often facilitated by DG consultant John Buck, founding members met with architects, explored sustainability goals, created a vision, put together a business plan, established a strategic plan and operating protocols, and christened the venture Living Well Community Care Home (Living Well).
Knowing the residents would benefit tremendously from a holistic approach and DG, Paul and Dee were passionate (still are) about the project and thought their ideas would be easy to implement. “What we didn’t realize is that, in addition to asking the staff to change their well-established behaviors, we were asking them to make some major shifts in consciousness. It’s been humbling.”
An important aspect is that it be holistic, starting with the food. Living Well has an arrangement with a local CSA (Community Supported Agriculture) and a food coop and thus is able to provide organic, healthy meals at a good price. In addition, they established organic gardens in their backyard to help supply their own food in season.
Although people at the Dept. of Health and Human Services were impressed from the beginning, some of the Living Well staff actually reported the facility to the Dept. of Health anonymously for “depriving” residents of their Wonder Bread and candy. And they were slow to accept other changes.
Mysteriously, toxic cleaning products that had been removed would reappear. Finally one worker, “who chain-smoked and had the language of a sailor,” objected loudly. She claimed that after 30 years, she knew what “clean” was by the smell – of bleach. Paul comments, “They felt they weren’t able to do their job!”
Opportunities to Improve
Perhaps most challenging for staff to learn was the use of DG. They were used to giving or receiving orders, often with harshness, not sitting in circles with all levels of staff and residents making decisions together! The idea that everyone’s input is valued – in other words, that everyone is responsible for the whole - was met in the beginning with great suspicion and even disdain.
The consent process of DG, however, welcomes objections as opportunities to improve. As staff expressed doubt about the efficacy of fresh organic food, training programs were offered to expound the importance of healthy food for improved cognitive and physical functioning and described how toxic chemicals affect brain cells, for example. For the first several months staff also had to be reassured that they would not be fired if they offer new solutions - everyone’s ideas were repeatedly sought.
In the mean time, wonderful art were put on the walls, a feng shui specialist consulted, bright colors added and often music is heard – either from electronic players or from residents drumming, singing and/or playing the piano. And while there are plenty of “sweets” such as cakes and cookies on the healthy menu, virtually no refined or artificial sugar is used. The smell of homemade, 7-grain bread often fills the air. Everything possible is purchased locally.
Residents Show Improvements on all Levels
Within six months, many residents evidenced noticeable improvements. One woman who was thought to have severe dementia picked up the phone one day and had a lucid conversation with her family for the first time in years. Another woman, who mostly had sat in her room alone, got up and played the piano. No one knew she had been a piano teacher.
Living Well’s holistic healthcare approach (rather than disease care) involves having a naturopathic doctor visit once a month and she serves on the Board of Directors. Living Well has the first and only Integrative Medical approach to residential and assisted living in Vermont.
Early on the Naturopath indicated that the four residents diagnosed with a particular illness could be treated with a simple herbal tincture. one that costs $60 for a four-month supply – for all four people. This is compared to the chemical pharmaceutical costing $1000/month – for each.
Before long, all four residents were able to get off of the medication, plus they no longer needed the secondary prescription for side effects from the first one. Other residents also started to show visible improvements in the range of motion in their hands, arms, hips and even better blood pressure. And creativity is blossoming.
Paul comments, “Most residents are much more social and active in general. It’s as if they have come out of a sleep.”
Self-Determination & Contribution
One might think that people with dementia and various physical issues wouldn’t be interested in contributing or able to participate effectively, but they seem to thrive on it. The Resident Circle, for example, meets regularly and actively discusses whatever is important to them – whether it be the menu, how services are provided or what activities to pursue and how to measure success.
As a result of DG and their own decision-making, residents participate as desired in the daily routines and house chores, including meal preparation. One resident was leaving the refrigerator door open, however, resulting in food spoiling and energy wasted. This problem was solved when, during a Resident Circle meeting, another resident offered to check the door frequently – especially when that person, her friend, uses it.
The Resident Circle also elects one of their members to represent them in the Staff Circle. This representative checks with all of the elders every month and makes sure s/he understands their issues and concerns to be brought up in the Staff Circle. Resident input and daily participation is a vital part of the community.
Interfacing with the Larger Community
The music making started when some youth came by in 2006 and were allowed to camp in the back yard, in exchange for teaching art and drumming to residents. “We heard that the memory of people with dementia has been shown to improve from drumming. Residents really got into it, even those whose hands initially could barely curve around the edges of a tambourine,” says Paul.
After a few months, residents decided to create a band and began to write their own music; they would sing and chant along with the drumming, and it sounded good! Soon they started getting invitations to perform – including at the 4th of July parade in Bristol – during which they drummed for three hours while riding on a float, and at a recent Body-Mind-Spirit festival as well as other care facilities.
As arranged with a nearby high school, “at risk” youth do their community service hours at Living Well. Some students have maintained these relationships and continue to volunteer, valuing the friendship, support and wisdom from these elders. Girl Scout troops visit and play cards with the elders.
Another activity seen at Living Well is art. Citizens of Bristol can come in and take art classes and residents have had art exhibits locally. Paul states, “We focus on the beauty and wholeness of people. Our job is to build connections, connections to what each individual’s passion is about, with how to share it and how the community can support that. Everyone benefits.”
Going With the Flow
After about a year, the workers seemed to settle in with the new ways of doing things, including being part of a decision-making team that works in transparent, collaborative and supportive ways. Important innovations have resulted from both staff and residents. The idea that everyone’s input really is important has been learned experientially, over time.
A turning point in this was when the Management or General Circle decided to have the staff determine it’s own work schedule. Previously a point of contention, the schedule now is set up by workers themselves and includes swing shifts during busy times making it easier to cover the required 24/7 care. Staff attitude since has improved tremendously.
A few of the original workers left due to their own life changes, such as getting married, but none were fired. Interestingly, the new workers being drawn to Living Well are more open to the perspective and methods used. Paul reports that they have been much easier to train, in part because the existing staff helps considerably.
Many people, who become Direct Care Workers, come into this poor-paying field due to lack of education and challenging life circumstances. “We’re trying to support staff to live healthier – eat better food, exercise, etc., and to be empowered to create better futures.
“We have an arrangement with a local bank, for example, to give workers up to a $1000 loan, after being employed here in good standing for one year. Once the loan is paid off, if desired by the employee, the bank will continue to take out the same amount as the payment was each month, and help him or her apply it to an educational fund or savings account. The bank also helps the employee learn about good financial habits and empowering sound financial health.”
Paul explains, “The buzz word or phrase in the industry is ‘culture change’ but it’s more than that. We need to shift consciousness, to be aligned with universal principals, to move into collaborative coherence rather than ‘power-over’ control. We are a living system within interconnected living systems. We start with the heart and expand out.
“We’re bringing all of this together in a business and a community. Living Well is a vehicle through which we are manifesting these principles and sharing them with others. I’m a midwife. We all are. We’re here giving birth to ourselves, being present and sharing that with our community.”
After paying off investors in 2008, they were able to get excellent terms on a new loan from the VT Community Loan Fund. Now owning the property, they are in a better position to get grants for such things as having a community garden, solar, geothermal and other renovations. They also have two Direct Sales Marketing businesses, both of which benefit the health of those at Living Well first while also generating revenue.
One is Kangen water. Whether many of these machines are sold or not, having one dispensing “living water” to residents and staff is seen as vital to everyone’s health. The other business is Asea, a product that reportedly supplies “redox molecules” to protect, repair and replace other body cells as needed.
According to Paul, “Redox molecules are what signal the body’s immune system to activate. The problem is that most people in their 50’s and 60’s, produce just 10-15% of what they did when young. Without this redox communication, there is greatly reduced effectiveness in maintaining health – even with a healthy diet.”
A measurement of financial success is the overall expenses of the facility and resulting affordability for residents. Paul reports, ”To be financially sustainable, most assisted care facilities need to have a minimum of 2/3 of the residents be either private pay or have private medical insurance, and the rest can be low income or paid by Medicaid. We have reversed those numbers.”
Early in 2009 the Deputy Secretary for Vermont’s Health and Human Services Agency called and spoke with Paul and other State Officials for over an hour. Intrigued, he asked to visit the facility. He brought 10 people to Living Well and expressed great praise.
It turns out that the man was a Direct Care Worker himself many years before and he committed to helping Living Well connect with the appropriate University of VT and other state officials so as to get funding and volunteers to do research and document/prove what is happening at the home.
The founders at Living Well intend to document everything and to put forth a package of tools and model that others can follow to create similar facilities. They hope to inspire many in the state of Vermont, in other areas of the country and North America, and beyond.
Paul says, “We’re really midwifing a new social system’s approach for health and vital aging in community.” While that may seem like a big claim, I believe they actually are doing much more.
Beyond being a residential care facility, Living Well is a demonstration of living the universal principle of oneness - from communicating molecules within cells, to collaboration among staff, residents and the greater community, to cooperating with nature and benefiting global economics.
From it we can witness the truth of living systems interconnected with all other living systems. And we can experience the truth of a world of abundance, creativity, love, vitality and mutual support, on all levels. In other words, we experience a shift in consciousness.
I sincerely hope that the documentation and dollars flow for those at Living Well. I would love to see these practices implemented elsewhere – in other community settings, in Transition Town efforts, in more businesses and in civic government. We all deserve the benefits of Living Well.
Paul Kervick, MS, is a visionary, social architect, educator, minister, husband, father of four adult children and two grandchildren. He is co-founder/Director of Awakening Sanctuary, Inc. a non-profit 501(c) (3) educational and charitable organization and its major program, the Living Well Care Home, in Bristol, Vermont.
Paul left his family business in 1979 to move to Vermont and begin pursuing his love of creating new models of holistic health care and in 1977 cofounded and managed New Beginnings, Inc., the first birthing center in New England. He lives with his wife Julie in Shelburne, Vermont and can be reached by email: firstname.lastname@example.org or by calling 802-497-1249. For further information about Living Well, see: www.livingwellcarehome.org, email email@example.com or call 802-453-3946.
Gaya Erlandson, PhD is a psychologist specializing in relationship skills (is a Certified Imago Relationship Therapist) and a consultant for intentional living. She can be contacted via website: LivingNewStories.com or by calling her google voice phone: (828) 581-9036.
“It is possible that the next Buddha will not take the form of an individual. The next Buddha may take the form of a community, a community practicing understanding and loving kindness, a community practicing mindful living. This may be the most important thing we can do for the survival of the earth.” — Thich Nhat Hahn