Page 4 - Tale of Transformation

Introduction
Creating more choice, privacy and opportunity for purpose in residents’ lives
More and more nursing homes are embracing culture change. The change of a culture from an institutional approach to provision of daily care for frail elders to one of staff, residents and their families working together in an organization to create an environment where each elder can live her life in a pleasant, satisfying and meaningful manner.
Through education, creative use of available resources and, in some cases, large financial investment in renovation and construction, the push is on to design these comfortable environments and eliminate practices that are institution focused rather than person- centered. Culture change represents both the true spirit of the laws regulating long-term care, and a genuine desire to improve the quality of life for residents and the quality of work life for the caregivers and all who work within long-term care.
Culture change in nursing homes means different things to different people. Many models have emerged, from the Eden AlternativeTM to the Service House; from neighborhoods to households to Green Houses. Each is a unique approach toward creating more choice, privacy and opportunity for purpose in residents’ lives. As such, there is limited consensus on what culture change is, and with clinical studies still underway, what health benefits each model may bring.
Nevertheless, many nursing homes want to sever the institutional past and join the movement, but they desperately need help getting started. Lack of a common definition and nomenclature for culture change continually begs the question: “Where do we stand and where do we go from here?”
Just as people’s personalities change at different life stages, nursing homes going through culture change will by necessity see innovative changes in core systems. There are push-pull forces affecting change in decision-making, staff roles, physical environment, organizational design and leadership. Attributes within these organizational dynamics are readily observable and often cluster at each stage of culture change progression.
Study of these attributes will lead any keen observer to identify areas where further work can be done. Always think team and high involvement. Avoid edicts. Encourage study, team decision-making and seeking direction from the residents, individually and in community. Work to build excitement, identity, community pride and a clear sense of mission. All will lead to excellence. Staff will have the satisfaction of knowing that they have created a climate where residents will experience joy, pleasure, meaning and purpose in their daily lives.
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