Katrina Mainetti: Director of Community Social Services at Terwilliger Plaza

Katrina Mainetti
Director of Community Social Services, Terwilliger Plaza

 

Tell us about your role at Terwilliger Plaza?

As the Director of Community Social Services, I am a member of the Health Services Team. My position has a specific expertise in working with Members as they navigate the complexities of aging, which may ultimately require the need for some form of assistance, or changes in lifestyle. I started here at Terwilliger this past October. I am a certified dementia practitioner with almost a decade of work in Alzheimer’s special care.

What type of changes are you talking about?

For instance, a Member may still be independent but might benefit from more in-home care to help maintain aging in place longer. Do they need some assistance within their apartment home? Perhaps the Member is a frequent fall risk and needs assistance with a shower. It could be a need for in-home physical therapy or medication management. We work with the Member to identify these needs and often coordinate with Ally In-Home Services to provide in-home care for Members so those who need just a little more assistance can maintain their independence.

There are also situations in which a Member begins to experience cognitive decline and may require that extra cognitive support that comes with assisted living.

Can you talk more about the transition to Assisted Living?

Within the Terwilliger Plaza campus, we have assisted care communities, located on four floors in The Terrace, and within The Metcalf, which is located on the 2nd floor of the Tower. This is also where we have our short stay area that Independent Living Members can utilize after surgery or for short-term needs.

My department is there for the Member, their spouse or family members to answer any questions or provide the resources they need as they prepare to move into Assisted Living. What are the changes they will experience in a higher level of care - emotionally, mentally, or specially addressing their healthcare needs? We work to cushion and support a Member’s transition, integrating the expertise of the nursing care and health care team, along with the Community Life team. This is their home, and we collaborate to create a cohesive experience and environment in which the Member will thrive. There are also instances where spouses who don’t have cognitive impairment move with their loved ones into assisted living apartment homes.

Are there situations in which Members need to leave Terwilliger Plaza for a Memory Care community?

We don’t have many of those circumstances at all. If we are communicating effectively and redirecting appropriately – using tools such as Wander Guard bracelets or making sure the front desk knows who should be coming and going from the Plaza. In my opinion, it is a better form of care than a locked door situation.

You host a mild cognitive impairment support group – is that open to all Members?

Yes, the name of the group is Exploring Cognitive Impairment. It is a beautiful combination of Independent Living and Assisted Living Members who have mild cognitive impairment, or friends, or spouses of people with cognitive impairment. It’s a safe space to share what that process is like for different walks of life, to know that they are not alone and that its okay to experience cognitive impairment.

We are currently reading a book written by a man with cognitive impairment. Our last book was written by a neurologist from OHSU who served Alzheimer’s patients for 30 years and then developed the disease himself. Her recently came and did a talk with us.

Can you talk more about this integrated approach between Health Services and Community Life?

My department works especially close with Life Enrichment. For example, when a Member does transition from Independent Living to Assistant Living, it is important to identify what engagement, including programs and classes Members can participate in to set them up for success.

In collaboration with Life Enrichment, we host a floor meeting every Monday for each floor of The Tower and The Metcalf – one each week. We also have an Assisted Living Resident Council once a month. I will share comments from the floor meetings with the department heads so that we have a collaborative approach to hearing concerns and suggestions from within the assisted care communities. Everyone’s opinion matters.

Is your focus only on Members in Assisted Living?

I have interaction and equal responsibility to all Members, whether they live in Independent Living or Assisted Living. I do have a particular focus, along with Life Enrichment, to assure that Assisted Living is equally integrated into activities and programs within Independent Living. From a psychological and emotional perspective, encouraging social engagement is an important perspective for those Members with cognitive impairment.

What drew you to work in this industry?

I was very close with my grandparents on my mom’s side. Had I known what I know now, I would have recognized the signs of Alzheimer’s in my Papa.  Experiencing someone that I loved dearly going through the process of entering a facility because he couldn’t maintain or sustain a quality of care at home was life changing for me. The very act of entrusting care into someone else, hoping they would maintain his routine and understand his preferences; watching the changes in his life, was an emotional journey.

I realized there was an entire population of people that I never thought to be connected to – and knew that in whatever capacity, I wanted to be there. I started as an Alzheimer care giver in Albuquerque, which is where I am from originally, and fell in love with it. It was the hardest job I ever had. The one thing though, – when I went home at the end of the day, I felt so empowered by the fact that I genuinely did good in the world.

What was it about Terwilliger Plaza in your decision to join the team?

Finding Terwilliger was an exciting moment for me because it is such a different structure. On my first interview, the involvement of the team in the interview process was energizing. You can feel that it’s different here. There is also an openness and willingness to talk about cognitive impairment and aging, and the rawness of that – an authentic acceptance about the realities of aging, it’s graceful and not scary. There is a respect for the aging process, with a person-centered focus on everyone.

You recently implemented the Life Assessment project during the transitioning to Assisted Living.

When people are moving from Independent Living to Assisted Living, because of their cognitive impairment, an individual may lose their ability to be an advocate for themselves. So, we implemented a new initiative, where, prior to transitioning we do a life story assessment either with the individual or with their families to better know them as a person to provide person-centered care. We want to know about their lives, who they are, what brings them happiness and what causes grief or pain so we can encourage or avoid certain interactions of circumstances.

Within Terwilliger Plaza there is a broad awareness of the community at large

Yes, I chair the Psychosocial Support Team, (PSST) which has a representative from those departments throughout Terwilliger that are relevant to our Member’s health and well-being. It’s a group that staff or Members can notify if they have a concern about the health of a particular Member. For example, if someone begins to show an increased level of confusion, or circumstances that arise that are out of the ordinary and cause a level of concern. If it is deemed urgent, we may reach out to that Member immediately. Or, we may decide, based on the concern, to just monitor the situation to determine if the issue has been resolved or it is indicative of a larger issue. It’s really a case-by-case situation to determine if the Member needs additional support or resources. Was it a one-time situation, or a reoccurring issue?

My hope is that Members and their family are comforted knowing that this care and attention is a cohesive and integrated approach from within Terwilliger. It is also a great opportunity for us to discuss the broader community. Perhaps there is a larger concern to address, or a missing element to the Member experience that we can provide. Essentially, it breaks down the silos and allows us to look at our community from a macro and micro perspective.

What do you enjoy most about your job?

Making an impact. Being an advocate for our Members. Allowing them the space to age gracefully, providing them resources and coming together as a team to support the best experience possible – always focused on dignity and respect.

 
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