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t is the lead story in The Dalhart Texan on a typical week in late November: Jordan Meador and Brandon Baca are among 21 outstanding 4-H members from the Texas Panhandle area honored at the 49th annual District l 4-H Gold Star Banquet at the Ministry Center of the First Baptist Church. Since 1902, this kind of story has appeared proudly and prominently in the Texan, the community newspaper serving the town of Dalhart (population 7,300 and located 85 miles from Amarillo). Dalhart, which claims bragging rights to the world’s largest free barbecue each August, is that kind of town—a place with a heritage and a heart. It is a place you may leave for a while but always take with you or come back to.
       That is what happened to Sharon “Shiny” Mallory, Director of Nursing (DON) at Dalhart’s 81-bed Coon Memorial Home. The Dalhart native (who picked up her nickname from her dad, because of her blonde hair) went elsewhere in the state for her education and other job opportunities. But no matter how far of a drive it was, she never left. In one case, she commuted 90 miles one way for four years. Then in the late 1980s, she caught on with Dalhart’s lone nursing home, an arm of the Dallam-Hartley Counties Hospital District, and rose through the ranks to take charge of nursing duties.
       So it was not exactly a homecoming for her, because she never really left. But it certainly was a reaffirmation that Dalhart was where she was destined to be. “We have a rural America setting here,” she says. “I like it.”
       The single-story Coon Memorial Home is named after R.S. “Uncle Dick” Coon, a wealthy businessman who owned the DeSoto Hotel in the 1930s. He became legendary for his generosity to depression-stricken farmers and cowboys. The nursing home offers residents a wide rage of activities, including games, arts and crafts, singing, and a variety of other events designed to be physically and mentally stimulating. Activities are specifically planned by staff to encourage participation according to the individual’s abilities and interests. The facility also offers three meals a day and snacks according to each resident’s dietary requirements.
       And the commitment of staff members like Mallory is clear. Last summer’s inspection of the 50-year-old facility by the Texas Department of Human Services rendered it a perfect 100% rating. What is even more notable is that in the past seven years, six inspections of the facility have been deficiency-free.
       “We do well on these surveys because of our wonderful employees,” says the facility’s administrator, Loree Elliott. “Our facility has been blessed by numerous employees that really care for each of these residents. The employees are proud of our facility and want to see it succeed.”

A Shifting Landscape

       Traditionally, Dalhart has been a farm town. In fact, it is also known as “The XIT City” after the legendary XIT Ranch. In its heyday in the 1880s, the XIT Ranch was the world’s largest ranch, with more than three million acres in 10 Texas counties that ran 150,000 head of cattle. Agriculture now fuels the economy in a new way that will bring big changes to all aspects of Dalhart, including the nursing home. Late in 2005, Texas Governor Rick Perry and Hilmar Cheese Company, the world’s largest single-site producer of cheese and whey products, jointly announced the company would build a new cheese and whey protein processing plant in Dalhart. The $190-million plant is a huge boost to the local economy. In fact, it represented the largest investment of enterprise fund dollars ever for a rural expansion in Texas. The new processing facility is being built in two phases, the first of which is expected to be completed this fall. It will increase the town’s population by an estimated 25% and provide about 120 jobs at the plant alone.
       Jobs ultimately lead to retirement, and the Coon Memorial Home is already looking down the road at what its needs will be. A year ago, it decided to modernize its anti-roam technology, installing a basic system (from manufacturer VeriChip Corp) that would allow it to expand in an orderly fashion as its needs increased. “It’s an easy system to use and required very little staff training,” says Mallory. And it is much easier to maintain. Like other facilities of its vintage, the Coon Memorial Home had added bit by bit of technology onto its evolving call system through the 1990s, until it finally became Babelesque and antiquated. “We had pieces in there from Radio Shack, everywhere,” says Mallory. “Getting all these pieces to talk to each other was a growing challenge, and finally we couldn’t get parts anymore.” Mallory is relieved that there is a modern, cohesive unit in place now that can be built upon later.
       The VeriChip system monitors 10 doors at the nursing home. That frees up appreciable staff time for other duties, such as spending time with residents. It all appeals to Mallory’s sense as a nurse: that letting residents move freely through their living quarters is infinitely superior to sedating them so they do not exit the facility and harm themselves. “No drugs or restraints appeal to me,” she says. “You can use a lot less medicine with residents when you have anti-roaming devices that keep people safe and you can depend on.” In fact, even though she is the head of nursing, she spends a lot of time out on the floor—interacting with residents and staff, talking, and training—rather than sitting at her desk keeping an eye on technology.
       This level of care is what makes community facilities like Coon Memorial Home attractive to prospective residents, says Jeannie Garrison, Director of Marketing for the Coon system (which includes an assisted living facility). “We don’t house as many residents as a big facility, but we can offer similar amenities, including those that keep residents mobile and safe,” she says.
       The nursing home has worked to creatively hide wires and other technological infrastructure that no one was anticipating when the structure was built in the 1960s. That is typical of smaller, well-established facilities that are already assimilated into neighborhoods. They are comfortable with their locations and would rather upgrade their systems and infrastructures than close their doors and move to the suburbs, says Kym Turco, a licensed physical therapy assistant and sales manager for senior living with Georgia-based Richardson Technology Systems.
       “Sometimes the way buildings were designed is a challenge for nursing homes,” says Turco, whose company has installed dozens of anti-wander units in residences across the United States. Indeed, multiple windows and doors are aesthetically pleasing, but every one of them needs to be secured if the facility has patients with dementia (which are becoming increasingly prevalent as facilities adopt more open and inclusive admission policies). Residents want a facility they can move into and call home rather than transferring from one place to another as their needs intensify.
       And that is leading the charge for anti-wander systems that are reliable, expandable, and as unobtrusive as possible. “People want their homes to look like their homes, not institutions,” says Turco. So installers work hard at hiding whatever technology support (eg, wires, alarms, and radio frequency devices) is required—which is another challenge for smaller, older facilities. Although modern wander-surveillance equipment is not cumbersome, it still requires some installation, and anyone who has worked on refurbishing older homes knows that sometimes new and old are not an easy fit. However, judging by Coon Memorial Home’s stellar ratings, it has figured out how to blend functionality, technology, and aesthetics quite successfully.

The Human Touch

       But despite breakthroughs in technology, when it comes to wander surveillance, there is no question that there is still no substitute for sharp-eyed staff. Staff members need to be engaged and responsive when the alarm is triggered by tagged residents near doors. Staff members must be aware of the patterns of problem residents so that they can anticipate movement and circumvent an unsafe situation; the VeriChip system can provide a history of a resident’s wander activity. And they need to educate well-meaning visitors who politely hold doors for residents and watch innocently as they walk off into a potentially dangerous environment, such as the street. “People are trying to be courteous, and it creates problems for staff,” says Mallory.
       And that small-town courtesy is one of Dalhart’s distinguishing features. As it moves into a new era, Mallory and her staff will be working hard to make sure municipal growth does not change their facility’s charm.