Page 63 - The Deep Seated Issue of Choice

THE DEEP SEATED ISSUE OF CHOICE
WHAT MAKES NEW IDEAS DIFFICULT?
The need for increased advocacy is evident through mindful consideration of our residents’ thoughts in “Hear Our Voice,” theme of the NCCNHR celebration of Residents’ Rights Week. How wonderful that so many residents and facilities contributed to the forum, “The Residents’ Voice.” But how sad that so many residents considered “a meeting to vote on what we want to do at our facility so that a decision may be the right one for all of us” as the response to how residents are involved in decision making in their facility. One resident boldly defined resident rights as “the right to be treated fairly and the right to say no!” Hopefully our increased focus on resident self-determination will grow and spread to the point that all of our elders soon understand their right to “have it my way.”
Education – An Opportunity for Increased Advocacy
Addressing the importance of research and education for all professions, Kantor noted, in Principles and Content of Culture Change:
If the culture change movement – and the philosophy and practice of person- directed care – are going to enter the mainstream and become the norm, it must be fully integrated into academic curricula, research agendas and training programs, for in truth, academia has been noticeable absent from the culture change movement... For the culture change movement to grow, we must assure that the principles of person-directed care are taught in training and education programs. For, while people may listen, and while they may believe in “aging with dignity” and consumer choice, this belief is not enough to extend the culture change movement, particularly into academia where we are training our future practitioners. For educators and researchers to be part of the culture change movement, for them to come to the table, culture change must demonstrate precisely – trough translational research, and education and training for the entire team – the efficacy, practicality, and validity of the culture change movement. Without this demonstration, we cannot fully change the culture of aging. With this demonstration, as our providers and educators learn more about culture change and witness person-directed care, they will themselves become change agents for aging with choice, dignity and self-determination. (Kantor, 2008)
As a provider who has personally witnessed the power of person-directed care, I believe this demonstration cannot come soon enough. While we wait, could we focus on just one consideration, the legal rights of the residents of long-term care facilities and current best practices that honor those rights? Our peers in developmental disabilities and in other countries have done so; we must also meet the challenge, and quickly.
Recommendation: National workgroup address the immediate inclusion of professional educational and competency requirements regarding resident rights, including the right of self-determination and the dignity of risk be included in all didactic programs, internship programs and continuing professional education requirements for all licensed, certified, and designated health professionals working with residents living in long-term care
settings.
Recommendation: AMDA develop and disseminate guidance for medical director
accountability that addresses proper training, competency assessment, and the medical
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