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138 In Pursuit of the Sunbeam: A Practical Guide to Transformation from Institution to Household things-are-done.
• Cross-training – Plan to offer cross-training to everyone. The more versatile workers you have the better. This training includes formal CNA training as well as dietary and activities training. Incentives should be offered to those willing to cross-train.
• Posting of household jobs – Decide the process for selection, and begin to form the communication method.
• Assignment to households – Decide the process for making permanent assignments to households. While the actual assignments should be made and instituted a bit later, this is the time to plan for who will work where, who will work together, who will work with which residents. Plan now for some resistance to permanent assignments. It will come from staff who believe that they will burn out caring for certain residents. Others will fear getting too attached to residents, concerned that they will be unable to survive the deep reoccurring losses from the passing of so many close relationships.
• Team meetings of future household staff – Start planning for these meetings now. Perhaps you will choose to implement temporary households on wings or floors of your current facility prior to move-in to the new households, or perhaps you will wait for the real move day, but as soon as possible, start meeting as a household team and planning for your future as a household.
• Assignment of residents to households – Start planning now for the high involvement of residents and their families regarding where they will live in the new households. Prepare yourself for some resistance, remember that the fear of the unknown is as present for families and residents as for staff.
Mr. Edwards, as a resident in a traditional facility, had lost the motivation to engage fully in life. He had been active in his church, community and profession prior to being admitted to the nursing home for an acute medical decline immediately following the death of his wife. Now, he was committed to logging the inadequacy of the facility’s response to his needs. When wheeled to the new construction site (while still in stud wall stage), he was able to select his own room. “This is the new nursing home?” he exclaimed. “If I have this room, I could put my desk right in front of the window and put a bird feeder in that tree. Life just might be good again!” Shortly after moving into the household, he set up