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Mar 02, 2012 | Kathy Tellepsen

St. James' House Moves to Person-Centered Care

St. James HouseEveryone who is passionate about caring for elderly has a story. Mine began when I was young, growing up in a small town in Minnesota, sitting around the kitchen table with neighbors, young and old, telling stories. I was enriched by the time spent with these elders and learned from them. The stories about their lives taught me about hardship, courage, and how people lived through it. Those older than I were strong and they had faith that helped them overcome their challenges. Elders were a treasured part of my everyday life. They were my teachers and I have never forgotten the lessons they taught me.


Eventually, I grew up, married, moved to Houston, and joined St. Martin‘s Episcopal Church. Through my volunteer work, once again, I heard more stories from the elderly and I marveled at the experience and wisdom they were sharing. It brought back memories from my youth, with my neighbors and their valuable stories. I began to truly appreciate the concept of neighbors and neighborhoods.


As the years unfolded, I began working in nursing homes with all kinds of people challenged with issues of aging. A great deal of my experience was with individuals afflicted with memory loss and in some cases Alzheimer‘s disease. Issues of frailty and disease did not trouble me. I was deeply troubled by institutional nursing care. In fact, it is known that two-thirds of Americans would rather die than live in a nursing home, and that did trouble me.


I saw how the medical model determined when people would get up in the morning. I watched as light switches were flipped and people were told it is time to wake up: Get up and eat because now is when we can help you; rather than waking them up gently with the natural light of the day or a gentle rub on the shoulder. Most of the time it was five o‘clock in the morning! People were placed in wheelchairs and lined up to wait for breakfast, being objectified as the caregivers walked by them as though they were inanimate objects. Families didn‘t feel comfortable to come visit so the residents suffered more.


It was a cold medical culture. I was extremely disturbed and saddened with what I saw. I saw many people with no reason to live. I saw people being cared for 100% of the time and never ever being able to give back, an un-healthy and meaningless balance, different than their life experience.


During the years, I took the opportunity to train and work in assisted living, thinking it might be different. It was not. I then took on the role of being an ombudsman, thinking that would provide me the opportunity to change things, but again, it did not. I was troubled, and my passion to do something different was only fueled by the misguided care giving I was witnessing.


My role in the church continued to grow and I was asked to be the president of the board of directors at St. James’ House. I gladly accepted the responsibility, but really didn‘t understand yet how to drive the mission differently: All I understood in my stomach and in my head was that it was broken. I wanted to drive the mission in such a way that people would truly live with companionship, spontaneity, and purpose until they died.


My thinking was enhanced when I visited the Episcopal Homes of Minnesota and learned about something called person-centered care. I experienced something that felt really different and I experienced neighborhoods where the people who needed help living were valued. The caregivers were transformed and supported by a culture truly driven by the elders. It was a powerful moment in my own personal transformation. For the first time, I started to see how it could be different. There was energy in the neighborhoods that supported growth, no matter how frail a person was. These neighborhoods were about family loving family. It was a powerful moment for me, and I knew that I could never go back and support the old, medical model paradigm of care. I could never go back to supporting anything less than what our fellow Episcopalians had.


In March, 2010, I was privileged to attend a national conference on culture change or person-centered care, and visited a household model in North Carolina. I spent three days learning so much and saw transformation, not only in the way we support frailty, but also in how we support the caregivers. In spring of 2011, I was able to connect with a leader, Tom Zwicker, who shared my passion and vision for transformation. His journey in culture change started in 1995 and his story is different than mine. But we share the mission of changing the culture at St. James’ House.


One by one, members of the board have been embracing the new mission. The journey at times has been challenging but well worth the conversations that get us to alignment on the new mission of person-centered care. Probably the most powerful moment for me in my role as president came when the board voted to start training. Working with our grant writer, we will secure financial support; we will work to educate and enroll each individual in a new journey. Our training began on February 1 and is provided by an organization called Action Pact.


We are all Episcopalians but we don‘t all follow the same path that others have made. St. James’ is excited to be traveling a new path that serves the mind, body and spirit of the people who live together in community. We are new in our journey. This is our journey and we will learn as we go along. But, we will walk the walk and work hard to create a life worth living for everyone at St. James'.


Spread the word. We are alive and doing well. Come and see. 


Visit to learn more.


Click here to see a video interview with Tom Zwicker, executive director. Or click here to see a video interview with Kat Castro, activities director.