Wartime and Women
The onset of World War II resulted in a severe staffing shortage as nurses joined the military or signed on for wartime industry jobs. In 1943, noting that other options existed for children, The Trustees sent the girls living at the Boston Home to other facilities and turned their focus to women. The Boston Home saw the war through with help from a nursing home group in Milton and the Dorchester Red Cross.
The annual reports of the 1950s are rich with accounts of residents who benefited profoundly from off-site surgery and physical therapy at the Home. This decade marked the new emphasis on giving the residents all that the outside world could offer them, realizing that their lives could be improved as much by independence as by protection and doting care. No longer a home for “incurables,” the facility officially became The Boston Home, Inc. in 1961.
Residents Breaking Stereotypes
The Boston Home embraced the philosophy that choice, self-determination, and independence were essential to supporting the best quality of life for residents. Residents could work if they wanted to. Many made full use of their skills and abilities in various endeavors, including selling crafts, sewing, typing, tutoring, and writing.
After a day’s work, residents relaxed and were entertained in a recreation room, with television, movies, musical and theater performances, and slide show travelogues. The Home received gifts of port and sherry enjoyed by the residents during the cocktail hour. Bird-feeding stations donated by the Audubon Society offered opportunities for quiet contemplation. Sightseeing tours in ambulances satisfied the residents’ need to connect with the greater community. All of their activities defied popular perceptions and stereotypes of what women with disabilities could do.
Throughout the 1960s and 1970s, the profile of the new resident was increasingly defined by serious physical disabilities, requiring bigger rooms and more skilled nursing care. By 1975, 70 percent of residents had a diagnosis of Multiple Sclerosis. They were typically in mid-life with an average age of 54, their careers cut short by increasing disability and living with families no longer able to meet their daily needs at home. At The Boston Home, the exceptional and compassionate staff worked with a single purpose to define the best clinical practices for their care. The body of knowledge the staff amassed over the next few decades offered great benefit to all The Boston Home residents, as well as the healthcare community at large. The needs of the residents with advanced neurological diseases inspired an increased priority of care: a focus on family-patient relations. The role of social work as part of The Boston Home’s mission was increased. A wellness and spirituality program was formalized to help residents deal with increasing loss, and to help them develop a life not defined by their disabilities.
In addition, The Boston Home was recently chosen as a site for Schwartz Center Rounds, rare for a nursing home. To make this changing population of residents as comfortable and safe as possible, certain equipment and facilities were needed. The Boston Home purchased a therapeutic whirlpool, electric beds, motorized wheelchairs, and the services of a psychiatrist, physical and occupational therapists, and an MS support group facilitator.
By the early 1980s residents enjoyed weekly visits from a hairdresser, bowled, had trivia contests, and played bridge, poker and cribbage. They attended book clubs, participated in an indoor gardening club, had sales at the resident-run “Corner Store,” and socialized at the in-house “Jake’s Bar.” Outings to attend parades, picnics, tours, harbor cruises, and more maintained the residents’ connections to the outside world. Candidates running for political office visited the residents who, as Dorchester residents, voted. In more recent years, residents have articulated their needs during MS Advocacy Day at the Massachusetts State House. By 1981, 87 full-time employees cared for 42 women residents—three to four times the minimum standard of nursing home care elsewhere.
Despite financial challenges, the Boston Home Trustees and staff did everything possible to maintain a family-oriented home rather than an institution.
When the original Codman mansion was demolished in 1965, paths were extended and paved, and an entire Activity Pavilion was built to offer additional space for recreation. But with a focus on residents who relied on large, customized electric wheelchairs, the facility needed additional improvements. The Board of Trustees considered several possible ways they could use The Boston Home’s facilities to best serve its residents. Renovations and expansions in 1985, 1993 and again in 2003 provided larger bathrooms and bedrooms, wider hallways, and more group activity spaces. The 1993 renovation increased the capacity from 42 to 84 residents and enabled the Home to become co-ed, as only women were living there at the time. Outfitted with state-of-the-art assistive technologies, the facility became a barrier-free, wheel-chair friendly environment with doors and elevators that automatically responded through wireless signals. There were advanced clinical resources unimaginable in Cordelia Harmon’s day. Residents gained new levels of independence, comfort, and dignity. The Boston Home had grown to accommodate 96 severely physically disabled adults. But The Boston Home was as large as it could grow and retain its close sense of community. Honoring Harmon’s original vision, it would remain first and foremost a home.
Resident life programs
Today, resident life programs at The Boston Home provide a structure of services that support the residents’ independence and creativity. The focus remains on enabling the body through assistive technologies; stimulating the mind with engaging activities; and nurturing the spirit in a combination of innovative and traditional ways including meditation, discussions, and diverse on-site religious services.
With years of hands-on experience, The Boston Home has become the standard in specialized residential care for adults with advanced MS, and received the designation of ‘Center for the Promotion of Excellence in Long-Term Care’ from the National Multiple Sclerosis society in 2007, a leardership designation that follows evaluation in areas including specialized programming, accreditation/licensure, expertise in MS, collaboration with the MS Society, and a commitment to MS care.
The Board of Trustees took stock of the experience and all the expertise gathered in decades of meeting the complex needs of its residents and asked: What more could be done? How could they expand their reach having narrowed their focus? The Boston Home is one of only a handful facilities of its kind in the nation. The burgeoning waiting list, again, reveals a desperate need. Straining the emotional, physical, and financial resources of willing families, hundreds of middle-aged adults severely disabled by progressive neurological diseases require highly skilled, specialized care in a residential setting. These adults in the prime of life often live in isolation or are assigned inappropriately to geriatric facilities not set up to meet their needs.
The Board of Trustees responded and expanded the Boston Home’s role with two innovative initiatives: the 2006 launching of The Boston Home day program B.Fit! and The Boston Home Institute for research and training marked The Boston Home’s banner 125th year.
The Boston Home Institute
Healthcare professionals from facilities around the nation now regularly join The Boston Home staff and experts in the field to define and share best practice standards for specialized residential care. They come for training in hopes of better meeting the needs of those they care for in clinics, hospitals, and through homecare services. The Institute also provides a platform for advocacy and public policy reform.
The Boston Home Outreach Services
B.Fit! , a unique socialization and wellness day program, offers outpatients access to The Boston Home’s services and recreational activities and, at the same time, enriches the residential community. More traditional physician-referred rehabilitation services are also offered.
A legacy built on early, generous support
In its first few decades, The Boston Home’s supporters created a fund that, carefully managed, and with occasional bequests, grew over the next century. This endowment allowed the Board of Trustees to best meet the needs of its residents with informed innovation, and it inspired a bold expansion of services.
The Boston Home Staff & Institute
While there is a national focus on funding for cure and treatment of diseases, there continue to be sparse resources for supporting and improving longterm care for those living with progressively debilitating diseases. The Boston Home brings generations of experience in caring for people with longterm, disabling conditions.
Today, members of The Boston Home Institute staff are formally sharing this experience with an eager audience of healthcare professionals from around the country who want to bring more independence and joy into the lives of their patients with advanced neurological diseases. For the first time in our history, outpatients are able to access key services such as specialized physical therapy, wheelchair customization, and social activities geared to their specific needs, including the most basic of human needs—to connect. Every day, residents of The Boston Home live full lives enhanced by the world around them. Here, they maintain a caring connection with one another, a connection forged by the experiences they share and strengthened by dignity.