The Boston Home Growing and Changing With the Times - Interview

Nursing Homes, Oct, 2000

INTERVIEW WITH MARVA SEROTKIN, CHIEF EXECUTIVE OFFICER

In the past 120 years, The Boston Home has evolved from a home for "incurables" to a leading long-term care residence for people with multiple sclerosis and related neurologic diseases.

In 1881, Cordelia Harmon, a nurse at Massachusetts General Hospital, first opened the doors of The Boston Home for Incurables, which consisted of a small house in Brighton. During its first year, the Home admitted nine residents, turning away more than 100 applicants. Harmon began the Home in response to the needs of permanently disabled persons who could neither be cared for in their homes nor accommodated in area hospitals. One hundred and twenty years after its founding, The Boston Home continues to meet the long-term care needs of physically disabled adults, particularly residents with multiple sclerosis (MS) and related neurologic diseases.

Realizing the need was greater than Cordelia Harmon's initiative had responded to, in 1883 a group at Trinity Chapel formed "The Committee for the Establishment of The Boston Home for Incurables." In 1884, the Home purchased the Codman Farm in Dorchester, Mass. and renovated the farmhouse to accommodate disabled residents. An expansion of the building in 1887 increased the capacity to 65 beds.

That same year the Home received a $3,000 donation as the nucleus of a proposed $100,000 Permanent Fund, later known as the General Fund. An endowment was established as a result of the generosity of many people, including life member John Quincy Adams, and that endowment has steadily grown and kept pace with expenses.

At the turn of the century, the Home nearly supported itself by maintaining a large vegetable garden and raising chickens, pigs and a herd of cows. Many board members and neighbors donated bushels of apples, as well as cattle and land.

In 1924, the board took a step that was to guide the Home's destiny for nearly the remainder of the 20th century: It voted to no longer admit male residents, and three years later opened a new 56-bed building for women and young girls. After the board elected to close the children's ward of the Home in 1943 because of a lack of staff, the entire facility became a nursing home for women for the next 50 years.

In 1988, the board committed itself to remodeling and enlarging the facility, modeling it after Philadelphia's Inglis House. During a tour of that facility, board members were especially impressed by its use of assistive technology to improve residents' quality of life. This led to yet another new identity for The Boston Home. When the building project was completed in 1994, the Home decided to refocus its care upon individuals with MS and related neurologic diseases--and admission was once again open to men.

Most residents share two common characteristics: Their predominant diagnosis is MS, and most range in age from 30 to 60 years old. The Home's new mission statement best explains where the facility stands today: "The mission of the Boston Home is to meet the long-term healthcare and related service needs of the physically disabled adult population within an environment that fosters self-determination. To accomplish this basic purpose, The Boston Home develops innovative service models, which effectively address the health, psychosocial, recreational, vocational and spiritual needs of the individual."

The Boston Home has recently launched a strategic planning initiative, establishing the organization as a leader in research, training and innovative programs for adults with physical disabilities. The Home also actively seeks the most modern techniques in therapy and assistive technology.

Today, The Boston Home fosters a caring community through the modern values of diversity and the promotion of independence. Although the facility has been modernized and looks toward the future, it still takes guidance from its past. Recently, The Boston Home's Chief Executive Officer Marva Serotkin took the time to speak with Nursing Homes/Long Term Care Management about the Home's long evolution into a 21st-century, state-of-theart long-term care facility.

Since individuals with multiple sclerosis and related neurologic diseases require a high level of care, what are some of the services The Boston Home provides for its residents?

Serotkin: First of all, our residents require a high staff-to-resident ratio. The total hours per patient day, including nurses and CNAs, is 4.6. Also, our rehab services are quite extensive. We have speech therapy, and we conduct many group sessions with our speech pathologist. Many of our residents have significant swallowing problems, and the speech pathologist works closely with our dietary department.

For occupational therapy we have fine-motor groups. Also, our occupational therapist is involved in our assistive technology program. He is a specialist in adaptation, not only for computers, but also with all of the accessories that make life easier for residents who are disabled.

We have a seating specialist, as well, who works exclusively with wheelchairs and issues related to them. And our maintenance department assists in keeping the wheelchairs operational. We have very high-tech motorized chairs. Some of the chairs, for example, are activated by movement of the head. We also have a computerized system to localize the pressures when a resident sits in a chair. This enables us to structure both the chair and any cushions to minimize pressure on the resident.