Philosophy
MISSION LODGE, unlike other facilities, does not have a special care unit or program. Rather, it is a totally dedicated, secured facility with a 100-year history of caring ONLY for those with dementia. On the Mission Lodge campus is an Adult Day Care, a Residential Care Facility for the Elderly (Assisted Living), and Independent Living and Skilled Nursing buildings. Our philosophy."caring makes the difference" reflects our commitment to provide each resident with outstanding, quality care that respects the dignity and self-worth of each individual.

Pre-admission Assessment
AT MISSION LODGE there is only ONE type of pre-admission assessment - that which is done to determine placement for persons with some form of dementia. This assessment includes determining the appropriate level of care placement, possible diagnosis and/or type and level of dementia; availability of medical information, advanced directives and preferred intensity of care; responsible party or legal representation (Power of Attorney, Guardian, Conservator, etc.); physical and nursing needs of the potential resident to determine the most suitable facility program/placement; and concerns of the person making the inquiry. An on-site home visit may be done. Leaving home is often a difficult change for a person with dementia and his or her family. MISSION LODGE invites and encourages family involvement several ways:

• Participation in the Support Groups.
• Participation in the resident care conferences offered immediately after admission and then on a quarterly basis with the interdisciplinary staff.
• Participation in Resident Council meetings and education seminars.
• Families are encouraged to come for frequent visits or phone the Charge nurse as often as needed to ease their and the resident's adjustment.
• During the admission process, the family history, daily routine, food preferences and other pertinent information is gathered and placed in the resident's file to help acquaint the staff with the new resident.

Assessment
A personal plan for the care of the person with dementia is designed. The interdisciplinary team members (physician, psychiatrist, nursing, social services, dietary, activities) are all involved in developing the plan of care, as is the family, responsible party and the resident themselves. Meetings to develop the plan of care take place quarterly. These care plans are individualized by utilizing input from all available appropriate sources and developing a comprehensive program for the resident. Family provides background and history for the plan, as well as supplying information of preferences that the resident may no longer be able to give us. Family concerns and expectations are addressed and realistic goals are then set for the resident. Every 90 days, as goals are reviewed during the care plan conference, the plan is revised.

Staff and Staffing Ratios
To meet the special care needs of the person and the need to feel secure, MISSION LODGE has always been different. Since MISSION LODGE is not a "unit" but a totally dedicated facility, all our staff are available to provide care and services to our residents. 85% of our staff are full time with 60% here for 8 years or more. Our total staff equals or is better than a 1 to 1 ratio per resident. Staff is made up of:

• DIRECT CARE STAFF - Consists of Nursing which is made up of a Nurse Practitioner, Registered Nurses (R.N.'s), Licensed Vocational Nurses (L.V.N.'s), Certified Nursing Assistants (C.N.A.'s) and Nurse Assistants; Activities, Social Services, and Dietary.
  
• SUPPORT STAFF - Consists of Medical Records, Housekeeping, Laundry, and Maintenance.

Staff Training
All facility staff - not just direct resident care staff - are in-serviced on a variety of topics by our Director of Staff Development, a licensed nurse. Training for staff includes topics from quality assurance and dementia care to validation theory. Training for everyone starts during the orientation process.

Physical Environment
MISSION LODGE was designed from the beginning to accommodate wandering residents, and was originally named the "Home for Wandering Ladies." We have three residential buildings on campus (and one day care building); Mission Lodge Assisted Living, Hunt Manor Skilled Nursing and Elizabeth’s Cottage Independent Living. All buildings are one story and designed to accommodate both male and females. The external parameters of the Assisted Living (ALF) and Skilled Nursing (SNF) buildings are not just "secured", but LOCKED with magnetic locks that allow wandering with safety. These locks are designed to release automatically in response to fire alarms. Each room and public area is equipped with smoke detectors and sprinklers. Mission Lodge building outlines a central courtyard, which allows wandering residents to ambulate through the halls and return to their starting place. For outdoor wandering, there are 5 enclosed patios and gardens with fountains to lift the spirit and provide a quiet spot for peaceful reflection.

Success Indicators
The success of our programs is determined by several indicators, including:

• A QUALITY ASSURANCE PROGRAM with protocols that manage all care given to residents.
• Resident status evaluations as documented in the weekly licensed nurse's summaries and the quarterly care plans.
• Daily monitoring with documentation by the nursing staff that indicates how residents are responding to nursing / activity / social service interventions.
• Resident comments made during the Resident Council Meetings.
• Family Surveys soliciting comments on our care and services. Surveys are sent to the responsible party 30 days after admission, on discharge, and during Care Plan meetings. We discharge 25 - 30% of our residents annually to home or lower level of care. This happens when the course of the dementia is other than Alzheimer - perhaps over medication or dehydration.