Kendal’s Health Care Centers — What’s Up for the Future? And Why?

According to Charlotte Sibold, our Health
Services Administrator, the lifestyle and care
needs that were first envisioned for both the
Webster Center (assisted living) and the Borden
Center (skilled nursing care) have shifted since
each facility was built — Webster in 2000, Borden
in 2002. The largest cause of this shift is the
growing prevalence of dementia among both
Webster and Borden residents. (This increase is
in line with national and worldwide trends.

People are living longer, brains are wearing out.)
In addition, changes in hospital procedures have
affected the number and kind of short-term
residents who come to the Borden Center for
rehabilitation. Buttonhole and laser surgery, for
instance, require less rehab time than did the
more invasive procedures of fifteen years ago.
This need for change is reflected in Kendal’s
Master Plan. Borden and Webster will continue
to serve the greater Rockbridge community as
well as Kendal’s contract residents; this won’t
change. Within the next two to three years,
though, renovations to our health care centers
will make life brighter and more homelike for
their residents, while our wonderful staff will
have the workplace they deserve.

Residents with dementia now live in either
Webster or Borden, according to individual
need, and this arrangement will continue. Residents
who are in the early stages of dementia and who have few or no physical problems live in
Webster. For those who do have other conditions
as well, Borden is the answer. Both in Anderson Hall and sent up to the common
space adjacent to Webster’s kitchen. This will
be the procedure for all meals after the
renovation, although Webster residents who
prefer to eat in the main dining room may
continue to do so.

For the Borden Center, with its sixty beds and
its present large main dining room, the construction
needed to create the “neighborhood” pattern
will take place for the most part at the ends of
corridors, thus causing less disruption to residents.
Two neighborhoods (the present “400”
and “500” halls) will be designed for residents
with dementia, while the third (the present “600”
hall) will provide for short-term rehab patients.
Each of the long-term neighborhoods will have
24 residents, and each will have its own kitchen,
dining, and living spaces. The kitchens, like the

Webster and Borden are secure environments in
that, should a resident with dementia leave the
premises, the staff will be alerted. Residents
who do not have dementia and do not wear a
location device (perhaps a bracelet) may, of
course, come and go as they like.

Borden has had its monitoring system since it
was built, but Webster’s system was installed
only in the fall of 2015, along with the addition
of the glass doors in the corridor leading from
the Anderson lobby. As Charlotte points out,
caring for persons with dementia was not
considered a problem when the Webster Center
was designed. The assumption was that Webster
residents could easily mingle with Independent
Living residents, using the library and
other common spaces and taking meals in the
main dining room.

For some Webster residents
this scenario is still possible. But a person with
dementia lives in a different world. An unsupervised
person with dementia may wander into the
library, then into the lobby, then through the
front door, and then set out to walk a few blocks
to the home he or she remembers (perhaps in
Pennsylvania). The lesson is clear; for safety,
we need our monitoring system.
Again, having meals in the main dining room
is a pleasant occasion for a Webster resident who
does not have dementia. All the things
happening — people hurrying about, many
conversations going at once, sudden bursts of
laughter — add up to a sociable and jolly mix.
But for someone with dementia, who recognizes
nobody and does not remember having been in
this place before, this same dining room can be
bewildering and frightening.

Quiet, small-scale places to eat are a priority
for the renovations to both Borden and Webster.
Both centers will embrace a “neighborhood” or
“household” concept. For Webster, which has
only twenty residents at top capacity, the household
idea already has a good start. Residents
have always had a small and homelike community
kitchen which they can enter whenever
they like and which is capable of turning out a
good batch of fudge. Already, some meals —
breakfast every morning, and supper on Thursday
evenings — are prepared in the main kitchens, like the                                                                                                                                                                                                                                                             one in Webster, will be accessible to the residents.
Meals will be prepared in Anderson
Hall’s main kitchen and sent to the neighborhood
dining areas, but the kitchens can provide simple
snacks. “If somebody wants a grilled cheese
sandwich, we can make it right here,” Charlotte
says.

Borden’s corridors will be re-designed to have
as few as possible dead ends. Instead, residents
may walk in a loop pattern, and may often turn a
corner and discover something that interests
them.

“We want to encourage interactive wandering,”
Charlotte says. “There might be different
objects set up on a cart, for instance — maybe
kitchen gadgets to be sorted. Or fabrics to fold,
with different textures.” Wandering is typical
of dementia patients. They are trying to make
sense of the world they find themselves in, and
often they welcome finding something familiar
or something that sparks their interest.
Besides enjoying a variety of places to explore
indoors, Borden and Webster residents will
be able safely to go outdoors whenever they like.
Each neighborhood will have an enclosed
courtyard with paved footing, attractive plantings,
and comfortable seating. There is a
scientific as well as an esthetic reason for this
enhancement. “A lot of research has been done
on circadian rhythms,” Charlotte says. “It’s
been shown that natural sunlight can reset the
body clock. Residents who are exposed to
natural light during the day will be better able to
sleep without medication.”

Natural light will be plentiful indoors as well,
with an emphasis throughout Borden and Webster
on windows. The Borden Center is a step
ahead here. The beautiful Borden sunroom
already provides a light-filled place to gather and
is much appreciated by residents. The sunroom
was built in 2009, with the help of many generous
donors.

Borden’s “rehab” neighborhood will include
twelve rooms for short-stay residents, modeled
not so much on a permanent home as on a comfortable
hotel. There will be a small dining area,
although, Charlotte says, most rehab patients
prefer to have meals brought to their rooms.
“Socializing at mealtime is not a priority for
them,” Charlotte says. “They want to heal up
and go home.”

Many rehab patients will have already gone
home, straight from the hospital — a growing
trend. For these, Borden will offer expanded
outpatient facilities. Borden’s present rehab
room is across the hall from the present large
dining room. When the dining room disappears,
the rehab department can grow and will include
an amenity we don’t have at present — an outpatient
waiting room. Outpatients will also
have a direct entry from the parking lot and will
not need to negotiate Borden’s hallways.
At this point in time, it is not possible to give
an exact timetable for these improvements. But
stay tuned . . .

— Written by resident Jo McMurtry for the April 2017 Residents’ Newsletter