Page 5 - Tale of Transformation

What are the Four Stages of Culture Change and Why Do We Need Stages?
Take notes as you watch the video.
Stage One: Institutional Stage
Stage Two: Transformational Stage
Stage Three: Neighborhood Stage
Stage Four: Household Stage
Stage Five, Six and Beyond:
LESLIE A. GRANT, PhD, Associate Professor and Director of the Center for Aging Services Management, Carlson School of Management at the University of Minnesota
Stage One: We’re all familiar... with the traditional nursing home. Institutional. Departmentally
structured. Efficient, effective – but usually not the way elders want to live. A nursing home at this stage, the Traditional Stage, is prime for change.
Stage Two is the Transformational stage where everyone begins to work to create a more resident centered environment. Staff are growing personally and professionally, and residents are starting to gain control over their lives. Choices are increased in bathing and dining.
At Stage Three, the institution is broken into smaller functional areas often called neighborhoods. Staff consistently work in the same neighborhood and resident- centered dining is introduced. Staff and residents work together in teams to increase choices for residents and offer more opportunities for personal growth for staff.
After watching the Introductory section of the video, stop and pose one of the following questions to the team for discussion:
• What might the future hold for the frail and dependent of our society?
• How would you like to live when you’re old and frail? Or in need congregate living? (Consider your specific populations when shaping The household is an example of a Stage Four
these questions for your team – do you care for short term rehab, developmentally disabled or frail elders). • What do you want for your Mom and Dad?
It is often helpful to pose the question in the small group and then give people five minutes to sit by themselves, or walk away and reflect. Ask them to gather and then open for a discussion. Facilitator, pay attention to those who may be shy or uncomfortable about sharing. Ask them for their opinion: “Mary, what do you think?” But do not force anyone to share if they do not wish to. Be respectful and appreciative of all opinions expressed and gradually people will be more comfortable sharing into the circle. (See page 28 for more information on conducting learning circles)
environment. It is a self-contained living unit for a small number of residents, and requires major physical renovation or new construction. The goal is to create home, complete with kitchen, dining room, living room for each household. Self-led teams focus on resident- directed care. Authority and accountability is through the households rather than departments.
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