Sweetie greets everyone at the door, a cute little white dog, curious and affectionate and energetic. The residents love her. She's their mascot.
It's unusual to have a dog scurrying around in an elder-care place. But Braley Care Homes is not your usual elder-care place. For one thing, the main thing, it's the only free-standing dementia facility in the state.
For another thing, it's small, only 16 beds. And that's just the way owner-operator Chris Braley wants it. The intimacy. The interaction. It's everything.
The 40-year-old administrator inherited his interest in mental health care from his father, the late Dean Braley, a founder of Braley Thompson Inc., a trailblazing agency devoted to therapeutic foster care for kids from troubled homes.
The son started out treading in his father's footsteps, working with children and families in residential psychiatric settings. Eventually, they joined forces and applied the same home-like concept to geriatric clients struggling with dementia.
On his own now, he's the very hands-on boss at the Braley Care home just outside St. Albans on U.S. 60.
When he isn't taking care of business in his office, he's out there with the residents, chatting with them, listening patiently, immersing himself in whatever role he's expected to play.
It's working. He sees it in their serenity every day.
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"I GREW UP in St. Albans. My dad, Dean Braley, was in the mental health field. I was always around that. I wanted to go into counseling.
"He owned Braley and Thompson Inc., with Ray Thompson. They started it in 1979 and grew it through several states. It was a therapeutic foster care agency. They sold the company in 2000 to three employees.
"My dad started in mental health working with children in institutional psychiatric centers, and he ran a psychiatric center which is where he met Ray Thompson. At that time, in 1977-78, therapeutic foster care was virtually unknown.
"West Virginia was sending kids who didn't have a good home life to out-of-state psychiatric centers and paying a lot of money for that. My dad and Ray developed therapeutic foster care. It offered a variety of wraparound services, but they did it in a foster home setting with foster parents trained in mental health.
"I never got to meet the children my dad worked with, but I knew he was pretty good at it. I can remember being around town and people would come up to him and say, 'Mr. Braley, you saved my life.'
"Once I graduated from high school, I knew I wanted to do something in the mental health area. He advised me to go into social work because it would open up many more doors for me. I got my bachelor's at Concord.
"When I graduated, I moved to Roanoke and worked as a case manager for Braley and Thompson there. I was working with the children and their families and training the foster parents.
"I really wanted to get into therapy. I had to get a master's and my clinical license to do that. I got my master's in social work at Radford.
"Even now, I constantly want to learn. The same principles I learned about mental health and working with children and families apply to working with the elderly and people with dementia.
"You can reach children just by listening to them and letting them know you care about what they are going through, and I can reach my residents with dementia the same way.
"Whether you are working with children or the elderly, it comes down to basic respect. You can get all the training in the world, but what really matters is giving respect to that individual, listening to them, making eye contact with them, caring about what they have to say and then doing something about their needs.
"I graduated from Radford in 2001 and moved to Charlotte, N.C. My dad was selling Braley and Thompson. My girlfriend and I were getting a place and she was going to school in Charlotte, so I went to work for Youth Homes Inc., a therapeutic foster care agency, as a case manager for a couple of years.
"I still had this ambition to do counseling and work with children and families in that setting. There was an opportunity to go to a children's home in Charlotte, a residential center for children who could not sustain in their own home or a foster home or even a therapeutic foster home. It was more of a psychiatric center. They had a big rec program and their own school, and I was hired as a therapist.
"My dad and I had talked over the years about doing something together. He was boating full time. He would take the boat from Charleston through the entire river system into the Gulf of Mexico and back. He was down in Florida a lot, but he still had that itch to get involved in mental health in some capacity.
"He had a non-compete clause with Braley and Thompson, so we talked about what else we could do. The concept was the same as he had in therapeutic foster care, getting away from the institutional setting and going back to a more home-like atmosphere. It works for kids, and by golly, it works for the elderly, too.
"I left my job in North Carolina and came here full time to start Braley Care Homes.
"I realize the small home setting is good, but as we started seeing more residents with dementia that were physically healthy, they needed more space to walk around than just a house.
"We are the only free standing dementia facility in West Virginia. Others are a unit or a wing to a larger facility, more of an institutional component.
"So we built this. Part of it used to be a church. We like the open air feel. We added the hall for bedrooms and bathrooms. We created the half walls to give residents a sense of separation so they could freely walk to places that were interesting to them.
"We have different themes. We have a 1950s area with all authentic furniture from the 1950s. We have a sitting room where it's for peace and quiet to just sit and relax. We have a TV area and an activity area.
"We are licensed for 16 residents. I think of Braley Care Homes as the Goldilocks of assisted living. We aren't too big, but we aren't too small. We are just that right size for someone with dementia who is physically healthy but has the confusion and disorientation.
"I get out and interact with them. I wear many hats here. I want to be involved and hands on. The only way to understand what is going on is to be there.
"There are times at night when a resident is in crisis and may have become aggressive, and I will get called. Every single time, I have been able to help deescalate the situation and get them calm. That doesn't mean we load them up on medication or restrain them. We are a non-restraint facility.
"It just goes back to listening to what they are feeling. We do an in-depth social history so we know about their interests and hobbies what they did for a living, their home life, what they did growing up. All those things come into play in how we develop our activities program and how we relate to them.
"If it's a business leader, we are going to be using that terminology talking to them. One gentleman, we have briefcases for him and pictures that are familiar to him that he will carry around. He may pull out a picture and tell a story about it. He needs to have that, to feel important, needed, that people want to listen to what he has to say.
"We might have a homemaker, a woman who ran her home her entire life and cooked and cleaned and raised the children. We are going to be shucking corn and stringing green beans and doing cooking related activities with her.
"It goes back to residual memories. Things we have done for a long period of time, whether it's a person with a briefcase and doing meetings or a mother doing dishes and folding clothes, those skills are still there because they did them so much. We can tap into those with prompting and they can still do an activity like that through the course of the disease process.
"We recently lost a resident who was with us for six years. They become family. It's tough. But I tell my staff, think about what you are doing for them and making that difference because you have time to sit and talk to them and have the ability to be patient.
"One of the complaints I hear from staff coming from larger facilities is they wish they had more time to spend with the residents. Here, you get that time. I expect the staff to have that time. It's about that connection and interaction with our residents. You are going to see less aggression and agitation.
"I love doing the social histories. They are our elders, and that's how we learn, and I love learning. Just because they have dementia doesn't mean you can't learn from them. They are very wise people.
"I have a philosophy that we call stepping into their reality. Whatever they are thinking, that is what you do. If they think you are their brother, that is who you become. Role playing. It helps to keep their anxiety down. You can't change their reality, so you fit into wherever they are.
"This lady who recently passed away was a great gardener. I have a rosebush out in the courtyard. She was out there and she breaks off a piece of a rosebush and puts it in the ground. I asked her about it, and she says she is planting. I said, 'Oh, I can't wait to see what we grow!' In my mind, I think nothing will grow. Well, I now have the most beautiful rose bushes along the gazebo, all planted by this one resident. She knew exactly what she was doing. Those stories are why we do what we do.
"I'd like to grow my concept. This is absolutely where I want to be. Did I think in that first class at Concord that this is where I would be? No clue. I thought I would be working with children and families the rest of my life.
"I wouldn't change it for the world. I love doing this. The best part of my job is going out there and interacting with the residents, role playing and being involved with them.
"We try to have some silly themed dinner once a month. It's going after that smile, that laugh. If you can get a resident to laugh, that's gold. There's nothing more therapeutic than laughter. We try to do that daily, create a fun environment.
"People ask me all the time, 'Why don't you add on and put in some more beds?' The number 16 is ideal. If you start putting too many people with dementia together in one area, you lose what you are trying to do. Sure, I'd make more money. It's not about that. It's about having the right therapeutic approach."
Reach Sandy Wells at sandyw@wvgazette.com or 304-342-5027