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Long Term Care Conference
The Institute on Aging hosted the First Annual Conference on Long-Term Care
from July 8-11, 2001. Most of the participants were affiliated with the Center on
Ageing at the University of Hong Kong and were professionals involved with
providing services to Chinese elders. They traveled to Seattle after attending the
International Association of Gerontology Conference in Vancouver, B. C.
The state of Washington is an international leader in innovative models in long
term care housing, including adult family homes and assisted living residences.
Participants made site visits to Legacy House in the International District, Kin On
on Beacon Hill, Heritage House at the Pike Place Market (see article pg. 3), The
Summit at First Hill, University House in Wallingford, and Ida Culver House, both
Broadview and Ravenna sites. These facilities have developed solutions to caring
for elders with diverse health, social and cultural needs. The visits gave our guests
from Hong Kong valuable insights, but they report that a major problem for longterm
care planners in Hong Kong is space for building such facilities. Many
attendees commented on the benefits of long-term care in Seattle that provided a
range of housing with services. Yet these may not work in a city-state with very
little space for new construction.
Participants appreciated that experts in the field of designing and operating longterm
care facilities conducted the lectures. These included executive directors and
architects of local facilities, as well as national and local specialists in health
services and long-term care.
Planning for next year’s conference is already underway.
IoA Awarded CDC Grant
The IoA has been awarded a Federal
grant from the Centers for Disease
Control and Prevention to test a
community-based approach to oral
health promotion for older persons
and children. This intergenerational
study will aim to train elders as oral
health educators of children, and then
test their effectiveness in teaching
children these new skills.
Groups of Hispanic and non-Hispanic
elders in small Eastern Washington
farming communities will learn about
methods to improve their own oral
health and nutritional intake. They
will also learn about oral health and
dietary issues affecting children, then
teach these topics to 4th and 5th grade
children in these communities. The
use of elders as health educators is
hypothesized to help children improve
their oral health knowledge and
behaviors in a cost-effective manner,
because of greater time and role
modeling that they can provide. This
community-based research program
addresses several goals for elders and
children that were specified in
Healthy People 2010. Adults who are
age 60 and older and living independently
in the community will be
recruited from the Yakima Valley
Farmworkers’ Clinic, Grandview/
Mabton Parks and Recreation Centers,
and the RSVP Program at Yakima
Valley Community College. The
project, under the auspices of the NW
Prevention Effectiveness Center, will
continue for two years. Dr. Kiyak is
the Principal Investigator; Norma
Wells, BS, MPH, Associate Professor
in the UW Department of Dental
Public Health Sciences, is the Co-Investigator of this grant.
Sixth Edition of Hooyman and Kiyak
Textbook Now Available
The sixth edition of Social Gerontology: A Multidisciplinary
Perspective recently has been published by Allyn &
Bacon. This textbook is being used widely in gerontology
courses throughout the U.S. and Canada, and has been
adopted for the University of Hawaii’s telecourse in aging,
“Growing Old in a New Age.” Dr. Kiyak, Director the IoA,
and Dr. Nancy Hooyman, Professor and Dean Emeritus of
the School of Social Work at the UW, have revised the
book extensively, emphasizing successful aging in the 21st
century. Copies of the book are available from the UW
Bookstore.
Heritage House: A Model Assisted Living Residence
When Heritage House at the market opened its doors in
1990, it was a virtual pioneer in the area of long-term care.
And now, 11 years later, it is Washington state’s model
assisted living program for low-income frail elders. Prior
to 1990 nursing homes were almost the only housing
option for low to moderate-income elderly. Older persons
with more income had many more choices about where
they could live.
Guided by the vision of Chuck Hawley, Executive Director
of Providence Health System, to create a new model of
residential care that served a disenfranchised population
with nursing home needs, the mission of Heritage House
states that individuals who are aged, poor, cognitively
impaired, disabled or low income retain their basic rights
to choose where they live and how they want to receive
services. Its goal is to respect the dignity of the individual
by honoring their choices. Heritage House serves a diverse
population through a partnership between private and
public agencies that include: Providence Health System,
Seattle Housing Authority (SHA), Pike Place Market, City
of Seattle, Boeing Employees Good Neighbor Fund, and
the State of Washington. The building, with its panoramic
views of Elliott Bay and the Olympic Mountains, belongs
to the SHA.
Heritage House had been given a directive to develop a
social model of long-term care rather than a medical
model. The latter is based on the institution deciding
where, when and how treatment will be given. Whereas
this approach is efficient it is also quite expensive. A
social model addresses how services are delivered, emphasizing
residents’ inclusion in the decision-making. A
social model is structured for the dignity of the individual
rather than the convenience of the institution. Executive
Director Mark Williams says that residents often have to
have the ability to say no before they will say yes.
Mark states that what makes Heritage House different from
other assisted living communities is their care coordination.
The staff is able to utilize existing services in the
community to benefit residents, who actively participate in
negotiating their specific needs through informed choice,
rather than duplicating these services in-house. Skilled
nursing, physical therapy, mental health, adult day health,
hospice and transportation services are based on functional
capacity and choice, not diagnosis. Mark is extremely
proud that residents stay at Heritage House on average of
45 months—almost double the national average. He
believes this happens because staff aim to help people live
at Heritage House as long as possible. The care coordination
not only keeps people healthier but it supports their
dignity, choice and independence. Making choices means
that residents assume some responsibility for the consequences
of their choices; yet they benefit from this shared
responsibility by being able to control their quality of life.
Mark began working at Heritage House when it opened;
he was employed by the city’s Division on Aging as a
Service Coordinator. One year later he became the
Executive Director. Mark appreciates the challenge of
effectively utilizing Seattle’s numerous resources in
support of the elderly. He truly enjoys the process of
assessment, to discover the competencies of the residents.
This population has coped with loss, fear, wars, the
depression, raising families, children moving away, and
physical infirmities. The skills used to deal with these
events are often hidden by acute needs. Mark loves to
assist individuals in rediscovering these valuable life skills.
He sums up the residents’ level of satisfaction by quoting
Will, who moved in a year ago: “I’m glad you have a place
for me. I belong here.”
Mark lives in Richmond Beach and bikes to work. He has
participated in the 200 mile Seattle-Portland (STP) ride
seven times. He loves the creative process and enjoys
working with wood but his greatest passion is fishing. As
often as he can he is up before dawn and out on his boat
with his line in the Sound. Mark grew up in Florida on the
Gulf of Mexico where he and his father often fished daily.
Mark Williams, Executive Director, in Heritage House dining
room; mural created by residents.
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multidisciplinary
gerontology education (now by distance learning) 