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Todd Shackelford
West Central Illinois
Area Agency on Aging
217-223-7904
Don’t Make Me Play Bingo For A Banana !
What is Culture Change?
Paradigm Shift in the Delivery of Care
Moving from Medical Model to Home Model
Decentralizes Decisions to the Resident(s)
Why Change the Culture in LTC?
Bette Davis speaking about Joan Crawford “She’s old. She’s tired. And she’s tired of being old”
Past models of care are not working Baby-boomers will not accept past models Industry practitioners are tired The industry must attract new workers The industry must have market survival Cant’ hove – LONELINESS, HELPLESSNESS AND BOREDOM ANY
LONGER !!!
Key Components of Culture Change
PERSON CENTERED/DIRECTED CARE
COMMUNITY DEVELOPMENT
CAREGIVER TEAMS
OPTIONS, OPTIONS, AND MORE
ACTIVITIES THAT ARE MEANINGFUL
KNOW EACH PERSON/ PERSON FIRST
Ombudsman Role #1
Problem SolversResident focused
Objectivity
See the big picture
Don’t have the “tapes”
Can provide guidance
Can provide solutions
Ombudsman Role #2
AdvocatesResident involvement
Family involvement
Facility involvement
Regulator involvement
Other advocates involvement
Ombudsman Role #3
Building or Supporting CoalitionsRegional coalition development
State coalition development
Building facility coalitions
In-service and public education
Media support and promotion
One Bite at a Time
Start using resident centered language
Start talking in terms of resident directed care
Never cookie cutter problems
Start problem solving systemically using culture change solutions
Encourage, build and support coalitions
But, But, But
“I don’t have enough time”That’s right - you don’t have enough time
Don’t give them fish. Teach how to fish
Work done now – saves time later
Sorts the men from the boys
“This culture change thing is just a trend”Look at the evidence around the nation
Would you want to live in the old culture?
Consumer expectations are changing
Is empty beds a trend?
“The focus of the Ombudsman must be on resident complaints”
True and in fact – OAA
Complaints can be the catalyst for systemic change – culture change approach
Efforts made now – may pay off in big dividends later
Real Case Scenarios
82 year old gentleman who constantly complains to administration, ombudsman, state regulators, legislators and the PUS. Has now discovered the power of the internet, distribution list e-mail and is gaining media coverage. Complaints are usually system problems in facility and not usually concerning his personal care.
Scenario #2
68 year old woman with mild dementia. Nursing staff frustrated as bathing has become a battle. Family members are demanding adequate hygiene for her. Dr. suggested a sedative be given or perhaps a mood elevator.