Federal changes designed to make residents feel more at homeChanges, large and small, are pending over time for the Powell Valley Care Center.

The changes, largely environmental, are prompted by a federal push to make care centers more home-like.

Cheri Benander, vice president for residential services at Powell Valley Healthcare, told the Powell Valley Healthcare board last week that some of those changes are as simple as using cloth napkins at the dinner table instead of “clothing protectors,” which actually are adult-sized bibs.

Another would be eliminating set visiting hours, though the facility's exterior doors still would be locked at night, and restrictions could be imposed based on the residents' wishes and health needs.

But some of the recommended changes will require more time, work and expense.

Those include replacing medicine carts with wall-mounted medicine cabinets in residents' rooms, and eliminating music and announcements on overhead speakers and using a handheld paging system instead.

“It would drive you crazy if you had a loudspeaker in your home with announcements all the time,” Benander said on Thursday.

“I think these are wonderful changes. They're all about de-institutionalizing. People come here to live. They shouldn't feel like they're staying in a hospital for the rest of their life ... Really, it's about being like your own home.”

Still, many of the changes are expensive, she said. While most are not mandates now, Benander said they are recommended strongly and could eventually become federal mandates.

“We need to make progress, but they're not required all at once,” she said.

She said newer long-term-care facilities often are built without nursing stations. Instead, they have big living rooms and other gathering areas for residents.

Eventually, that could be a goal for the Powell Valley Care Center, she added.

But more immediate goals are to replace old, institutional-looking furniture in gathering areas and to remodel the dining room at the care center to make it more resident-friendly. She has turned information on the hoped-for project over to Diane Delozier of the Powell Medical Foundation, and Delozier is working to find grants to pay for the $55,000 project, Benander said.

When funding is available, the dining room will be redesigned to look more like a bistro, she said.

Between now and then, plans and blueprints must be drawn up and sent to the Wyoming Department of Health, where inspectors will determine whether they meet safety code and regulation requirements.

Meanwhile, residents are making more decisions about their surroundings and the food they are served, through a residents' council and a food committee, she said.

Benander noted that some of the recommended changes conflict with, or are complicated by, state and federal regulations.

For instance, a recommendation to reduce or eliminate signs in care centers conflicts with a regulation that all exits be clearly marked.

Replacing institutional-looking furniture also is a challenge, she said, because all furniture in the center must meet safety regulations, such as being fire retardant, and therefore generally is bought from commercial suppliers.

“You can't just go out and buy it,” she said.

A plan to replace curtains, which are all the same color and style, with more individualized ones, can be daunting,

Benander said. And that's after you consider the underlying code questions: Are these curtains fire retardant? Are they the right length to meet code?

“Just imagine having 100 people's bedrooms you're dealing with,” she said. “It can seem overwhelming to individualize those to 100 personalities.”

Hospital Trustee Kathy Bieke was enthusiastic about the pending changes.

“This is good stuff,” she said. “We've been trying to work toward this.”

Trustee Mark Kitchen agreed, but added he hoped that federal guidelines remain flexible and reasonable, especially in these challenging economic times.