This presentation was developed by the Texas Culture Change Coalition to serve as a tool to inform others about the background and principles of culture change in long term care.
Please feel free to use it as a whole or in part to inform others about the benefits of culture change.
12. Same Principles, Different Needs
Eden
Eden LifeLong Living
Alternative
Nursing Home Residential Home
Elders Non-Elders
CNAs DSPs
Shorter Term Longer Term
Full Life Life Interrupted
Person-Directed Person-Centered
13.
14. Person-Centeredness Continuum
Listen to these dining examples.
Where would they fit on the continuum?
Provider Staff Person Person
Directed Centered Centered Directed
Low High
Pioneer Network
15. What is the Goal?
Institutionalized Individualized
Care Care
16. Person-Centered Care
Know the Person
Individuality and
Uniqueness of
Every Person
Empowerment
Responsive,
Permeable Environment
Person Has Input About Wants
18. Artifacts of Change
Staff and residents are at
the center of the change process!
New Paint Staff recognition
Children Elimination of
call systems
Animals
Resident
Plants Recognition
19. How Do We Get There?
Empower
Have
Residents
Knowledge
and Staff
Incorporate
Create Artifacts of
Urgency
Change
Improve
Feedback
Care
Improve
Quality of
Life
20. Does Culture Change Work?
YES!
Research shows that
Culture Change
implementation
increases quality of
life and decreases
staff turnover.
21. The High Cost of Turnover
The direct cost of losing one direct
care employee is $2,500.
22. One Study Proves….
Nursing homes engaging in
culture change can not only
improve their residents'
quality of life, but can also
achieve better financial
returns.
E. Elliot, "Occupancy and Revenue Gains from Culture Change in Nursing Homes: A Win-Win
Innovation for a New Age of Long-Term Care," Seniors Housing & Care Journal, 2010 18(1):61–76.
25. The Bottom Line
Better Trained Less Increased Resident
Better More
and Turnover and
Care Referrals
Empowered Staff Family Satisfaction
Doing What’s Right is Good Business.
28. Culture Change
is NOT a quick fix
or a marketing
ploy.
It is the systematic change of
an organization in order to
provide a better place to live
and work.
29. What is the Key?
Complete Support
From Leadership!
31. Great Culture Change Literature
Old Age in a New Age: The Promise of Transformative Nursing Homes
by Beth Baker
What are Old People For? How Elders Will Save the World
by William H. Thomas, M.D.
The Journey of a Lifetime: Leadership Pathways to Culture Change in
Long Term Care
by Nancy Fox
Life Worth Living: How Someone You Love Can Still Enjoy Life in a
Nursing Home
by William H. Thomas, M.D.
The Silverado Story: A Memory-Care Culture Where Love is Greater
than Fear
by Loren Shook & Stephen Winner
32. Changing Aging Blogstream:
Keep Up with Culture http://www.changingaging.org
Change Happenings!
Pioneer Network:
Visit these websites for more http://www.pioneernetwork.net
information on culture change in
long term care, where it is
headed, and how you can be an
Eden Alternative:
agent of change! http://www.edenalt.org
Eden LifeLong Living:
http://edenlifelonglinving.org
Texas Culture Change Coalition:
http://www.txccc.net/
The Picker Institute, Long-Term Care
Improvement Guide:
http://pickerinstitute.org/wpcontent/uploads/2010/10/
LTC_Improvement_Guide.pdf
Editor's Notes
Provider Directed:Dining Meals are served at fixed times. Residents who are independent eat in a dining room and others who require assistance eat in their rooms. Meals are brought on trays from central kitchen. Residents who do not prefer meal may choose alternate meal. Staff Centered:Meals are served during fixed periods of the day (i.e., breakfast 7 to 9:30 am). Meals are prepared from a main kitchen and each meal offers residents two choices for a main meal, except for breakfast which is buffet style. Residents who are independent eat in a dining room and the others who require assistance eat in their rooms. Patient Centered:Residents have input on meal times and the menu. Residents are served freshly-prepared food from a rolling steam table. The food is not prepared in large industrial kitchen, but a smaller residential one. Aides serve the food to residents on dishes and not trays. The steam table is taken to residents who cannot come to the dining room. Resident Directed: Residents decide on the menu and where they want to eat and at what times. Meals are prepared in a residential kitchen near where the residents’ rooms are located. Meals are served family style, where serving bowls and platters are placed on the table and residents, who are able, can help themselves. Those who require assistance receive it from staff.
Audience Interaction: Ask the audience what simple pleasures they enjoy every day. Exercising? Having their coffee a certain way? What time do they get up? Do they shower in the evening or in the morning, etc.? What if these daily pleasures were taken away from you? Providing person-centered care means allowing individuals to enjoy the same daily pleasures that they would enjoy at home.