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Offering a Beacon in the Darkness

A visit with Marilyn Rantz, Professor, Sinclair School of Nursing

By LuAnne Roth
Published: - Topics: nursinghome nursing eldercare collaboration
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In her twelve years as a nursing home director, Professor Marilyn Rantz says that she has never once met an individual who wanted to be in the facility. Most view the idea of entering a nursing home as a dreadful specter that they would be happy to avoid. As a professor in the Sinclair School of Nursing, Rantz has developed a collaborative project designed to change that attitude from dread into anticipation and even excitement.

Having watched the agony of my own grandmothers as they experienced being "stuck" in a nursing home, I was quite surprised upon walking into posh and hip TigerPlace for the first time. Opened in June 2004 and located at 2910 Bluff Creek Drive in Columbia, this cutting-edge teaching facility directed by Rantz was designed according to the concept of "aging in place"--the idea being that once you check in, you don’t ever have to leave (unless you choose to). "This is the only place in the state of Missouri where you’re not forced to move [to a nursing home] when your care needs are too high," Rantz observes. When a resident’s care needs increase, "we just increase the services," she explains matter-of-factly.

Calling the place posh isn’t exactly exaggerating. Since the tour occurred in December, TigerPlace showcased two 15-foot yuletide trees among other elegant holiday decorations. In the front entrance, a lovely sitting area nestles in front of a fireplace. Outside, a patio area and landscaped walkway wrap around the entire complex, encouraging fresh air and exercise. Community areas are replete with beautiful, polished woodwork. Details as small as the handrails, which run along the hallways of the entire building, resemble classic wood molding, and skylights in each hallway provide the therapeutic benefit of natural lighting. Artwork adorns the walls of several formal dining rooms, and there is even a grand piano available for use. Much of the décor involves Mizzou paraphernalia, including the columns (with faux cracks) in the dining room and hallways (a.k.a. "neighborhoods") given names such as "Flatbranch," "The Columns," and "North Village." There is a full-service beauty salon, a sports bar that comes alive during happy hour throughout each month, widespread internet access, a library area with a computer, a conference room, and a full-service pet care area (with veterinary service, boarding, and grooming).

In addition, TigerPlace offers a community kitchen, an exercise room with various kinds of equipment and an accessible whirlpool, and everyday exercise classes ranging from Tai Chi to aerobics. And those are just the shared areas of TigerPlace. Amenities in each apartment include a kitchen, a washer/dryer, a private screened-in patio with access to the outside, individualized heating and air conditioning controls, and extra tall ceilings. Of course, everything is fully ADA-accessible.

Besides being somewhere people would want to live, TigerPlace is also unique in the way it handles elder care. Rantz and her interdisciplinary team have designed a number of innovative care and safety features. Take the sensor system, for example, which will eventually be installed in the apartments of residents who volunteer. Developed by researchers from the University of Virginia, this technology provides a way of monitoring the functioning of residents in an unobtrusive manner--with motion sensors, a bed sensor to detect restlessness and breathing, a heat sensor on the stove in case it gets left on, and soon a gait monitor on the floor to detect when a fall may be imminent.

With these new interfaces, Rantz hopes to be able to detect an adverse event within seconds. When such an event occurs, staff will intervene immediately. But more importantly, explains Rantz, "I want to [be able to] intervene before people have a fall. I want to be able to predict when people are at risk and get them into Tai Chi…get them into physical therapy…get them into exercise classes (such as strength training) and delay the progress that results in people frequently falling." While there are sensors on all external doors to monitor the safety of residents who may develop cognitive impairment, there are also two-way speaker systems in the ceilings of the apartments so that residents will not have to be near a phone to seek help. Hence, there is always a "virtual nurse" on call from MU Sinclair Home Care, the Sinclair School of Nursing's home care agency that serves TigerPlace.

As we toured this remarkable facility, I kept finding myself repeatedly offering the same monosyllabic observation, "Wow!" By the time we left, I turned to my colleague, Jamie Stephens, and said something I would never have imagined myself saying: "I want to live here when I get old!" If my experience can be taken as representative, then it appears that Rantz is meeting her goal. She and her interdisciplinary team have managed to create a place where people would want to live, where they can stay--comfortably and happily--for the rest of their lives. If the perception of nursing homes as dreadful places to finish out one’s years still exists today, then TigerPlace has become a beacon in the darkness, one that will hopefully catch on and spread, so that a person's final years may be as easy, dignified, and enjoyable as possible.