CULTURE CHANGE THROUGHOUT THE CONTINUUM
OF LIFE-LONG LIVING & LONG-TERM CARE
“After one has lived a life of meaning,
death may lose much of its terror,
for what we fear most is not really death,
but a meaningless and absurd life.”
~ Dr. Robert Butler (1927 – 2010)
Content Category Shortcuts:
5. THE
ELDERS (THE PEOPLE WITH & FOR WHOM WE’RE DOING THE DOING)
6. THE
STAFF (THE PEOPLE DOING THE DOING)
7. FROM,
FOR & ABOUT CAREGIVERS & CONSUMERS
15. HOME
& COMMUNITY-BASED SERVICES
21. ANIMALS,
INTERGENERATIONAL, PLANTS & ETC…
Three-Part DVD Series Provided to Every Nursing Home in
Georgia
“Many Paths to Person-Centered
Care: A Three-Part Introduction and Exploration of Culture Change” was introduced
this month. Featuring Carmen Bowman, the
series includes: What is Culture Change?, Artifacts of
Culture Change: An Organizational Readiness and Assessment Tool, and
Individualized Care Planning: Getting to Know the Person. The development of
these DVDs was a part of the grant we received from Healthcare Research, Inc.
Because of their generous support, this training series with handouts and
supporting material, has been provided to EVERY nursing home in the state
of
Culture Change Symposia to be Held in North and South Georgia
Changing the Culture of Long-Term Care is a symposium aimed at
promoting culture change in
A group of HUD colleagues from several states are working with members of
the Culture Change Network of Georgia on a new “instrument” to begin the
dialogue of Culture Change in Affordable Housing. “Instrumenting Culture Change in Affordable Housing”
will be available in September along with a webinar explaining the
project. Affordable housing members in
Categories being used to look at culture change in affordable housing
include:
1.
Values-Driven Leadership – vision; recognize it takes the
willingness to change policies, systems and practices; transfer of knowledge
into practice
2. Workplace Practices – practices
that affect a culture focusing on staff involvement, growth and retention
(continuous learning environment); quality of life, relationships and community
3. Community & Resident-Directed Life –
Ways to restore to elders as much control, choice and normalcy as possible to
live life in a true home-like setting; embrace and draw all staff and family
members (and others) into a shared partnership of supporting and caring for the
resident
4. Physical
Environment – create a meaningful relationship between the
person and her/his living environment
Stay tuned for more information coming soon.
Robert Butler, Aging Expert, Is Dead at 83
(Source: DOUGLAS
MARTIN, www.nytimes.com)
Dr. Robert N. Butler, a psychiatrist whose painful youthful realization that death is inevitable prompted him to challenge and ultimately reform the treatment of the elderly through research, public policy and a Pulitzer Prize-winning book, died Sunday in Manhattan. He was 83 and had worked until three days before his death… Dr. Butler’s influence was apparent in the widely used word he coined to describe discrimination against the elderly: “ageism.” He defended as healthy the way many old people slip into old memories — even giving it a name, “life review.”
In speech after speech, he pounded home the message that longevity in the United States had increased by 30 years in the 20th century — greater than the gain during the preceding 5,000 years of human history — and that this had led to profound changes in every aspect of society, employment and politics among them.
Dr. Christine Cassel, president of the American Board of Internal Medicine, said in an interview that Dr. Butler had in effect “created an entire field of medicine.” She said he had helped change attitudes so that aging could be perceived “a positive thing.”
Dr. Butler was the founding director of the National Institute on Aging at the National Institutes of Health and advocated for the aging before Congress and the United Nations. He helped start and led the American Association for Geriatric Psychiatry, the Alzheimer’s Disease Association and the International Longevity Center. President Bill Clinton named him chairman of the 1995 White House Conference on Aging. “He really put geriatrics on the map,” Dr. David B. Reuben, chief of the division of geriatrics at the University of California, Los Angeles, said in an interview.
Dr. Butler challenged long-held conceptions about aging, calling it “the neglected stepchild of the human life cycle.” He helped establish, for example, that senility is not inevitable with aging. When the Heinz Family Foundation presented him with an award in 2003, it called him “a prophetic visionary.” The most noted exposition of his vision was the 1975 book that earned him his Pulitzer, “Why Survive? Being Old in America.” It went from a bleak explication of the elderly’s condition to prescriptions to improve it.
“Human beings need the freedom to live with change, to invent and reinvent themselves a number of times through their lives,” Dr. Butler wrote. MORE
We Want Real Care Now
(Source: Dr. Bill
Thomas, changingaging.org)
I am excited to announce the launch of the Real Care Now social networking campaign to advance person-centered approaches to long term care at www.ChangingAging.org/RealCareNow. Real Care Now is a partnership between my blog, www.ChangingAging.org, and the Picker Institute, the leading foundation advancing person-centered health care, and the Erickson School of Aging Studies at UMBC, a first of its kind professional program integrating aging, management and policy.
Using social media tools such as blogging, Facebook and YouTube, we will introduce and popularize concepts of person-centered care. It's a simple message -- People want Real Care Now that responds to the needs of the individual, not to the needs of the health care system -- and we hope you will join us in spreading this message.
I've been working to reform nursing homes and long term care for over 20 years by promoting and creating new person-centered models of care. These include The Eden Alternative and The Green House Project, revolutionary alternatives to institutional nursing home care designed to provide person-centered care to older people.
We see person-centeredness as a social movement, and we’re fortunate to be doing this work when it's never been easier to communicate and coordinate using social media. These social networking tools help us connect with other people who share our vision of what high quality care should look like. Building off ChangingAging.org’s existing social media networks on Facebook, Twitter, YouTube and LinkedIn, we will post videos, social commentary and news updates related to person-centered health reforms.
The goal is to build support for transformational change in how the health care system takes care of older adults. Our healthcare system was designed to serve the need of younger people with acute conditions. But America faces a future where most of our healthcare resources will go to older populations with chronic health conditions.
We need Real
Care Now.
Please join us,
Dr. Bill Thomas
Connect with ChangingAging on:
Eden Alternative Appoints New CEO
(Source: www.ltlmagazine.com)
The Eden Alternative, an international not-for-profit organization dedicated to long-term care culture change, has appointed Christopher D. Perna as its CEO. The CEO position was recently created by the board of directors to help the Eden Alternative organization’s growth.
“Chris brings his passion for serving elders along with his outstanding leadership and business skills to this new role,” said Eden Alternative founder Bill Thomas. “We are excited to have him join the Eden team as we prepare for our fifth International Conference and the launch of The Path to Mastery later this month.”
“I met Bill Thomas several years ago and have watched the Eden Alternative grow as a driving force in the long-term care culture change movement,” Perna added. “It is an honor to be selected to lead an organization doing such important work and touching so many lives.”
Perna spent 25 years in the
insurance industry, most recently in long-term care insurance as president of MedAmerica Insurance Company. His tenure at MedAmerica was marked by the introduction of a new line of
long-term care insurance products. Perna has also
distinguished himself through his service to elders in the community of
National Movement Focuses on Choice, Independence for Elderly
(Source: Diana Nelson Jones, Pittsburgh Post-Gazette,
www.post-gazette.com)
At a recent training session for elder-care workers, Patricia Hillebrand asked the class of 15, all but one of them women, to imagine the anxiety of a person with Alzheimer's disease. "Remember the first time you were going to call a guy and ask him out?" Around the room of the Holiday Inn Express in Robinson, smiles acknowledged the fluttering fear and anxiety. "Imagine what it would be like to feel that way all the time," she said. Then she initiated a role-playing session designed to inspire trainees to walk in their clients' shoes.
Ms. Hillebrand is a training specialist for
Paraprofessional Healthcare Institute, a national organization that advocates a
shift away from traditional institutionalized elder care. PHI recently received
state grants totaling $500,000 to run a pilot program that Joe Angelelli, PHI
director for
Culture change is the term for a national movement that calls for a reversal of the traditional nursing home model -- re-education of care workers and a break-down of institutional housing. Increasingly, care is being taken to people where they live or in newly built enclaves designed to foster independence.
Foundations are spending millions to advance the idea. The Robert Wood Johnson Foundation has granted about $13 million. Ann Christiano, a spokeswoman for the foundation, said most of the money has been in support of the "Green House" model -- housing enclaves in which people who choose to be together can live individually but with communal spaces and support staff on site.
"People don't want to be in nursing homes," Mr. Angelelli said. "It's where they get sent. And the care they get is done by people who don't get the pay or support they need."
The grants from the Pennsylvania Department on Aging and the Department of Labor and Industry started a statewide re-education process for workers. It is heavy on role playing, such as walking across a room with eyes covered to give a worker an idea of the challenges blind people face. Most of the trainees are employers of people who do lifting, feeding, bathing and other elder-care support services. The state grants pay for their training and for the training that they take back to their employees.
Tiffany Richter, a master's student in social work at the
Nancy Mercer, a home companion service worker for From the Heart in Trafford, said an aspect of the training she appreciated was "practicing how to feed someone and encouraging nutrition, not just slapping a meal in front of them and walking out of the room."
Mr. Angelelli said the goal of the training is to build a more stable workforce and help workers bond with their clients so that the work will be more rewarding. Much of the industry's cost is in turnover. The rate ranges from 25 percent to 75 percent, he said. The lost time and retraining cost of losing a worker averages about $3,000, he said.
Language in the new federal health-care bill supports PHI's training model
and is based on recommendations from an
The culture change movement came out of the Omnibus Budget Reconciliation Act of 1987, which was in part a reaction to abuse scandals that rocked the nursing home industry, said Susan Feeney, a vice president of the American Health Care Association. She said the mission now goes beyond "person-centered" and seeks to have the elderly shape their own care.
Last year, amid massive budget cuts, one expansion of funding went to Medical Assistance to serve 2,000 people at home in the PDA Waiver program. These clients would have been eligible for government-funded nursing-home care, but similar care in their own homes cost the state less. The waiver program now serves more than 15,000 clients.
"Even institutions are starting to realize that this is what people
want, and from the market standpoint, it will all come down to this: What do
people want to pay for?" Mr. Angelelli said. "In
"I don't know of anyone who has balked at culture change," said Ms. Feeney, adding that nursing care for a more independent client has to balance the client's lifestyle desires with his medical needs.
Culture change adherents acknowledge that "there will always be a need
for nursing homes," said Mr. Angelelli, but the movement can reshape how
they are managed and run. MORE
WHAT’S IN A NAME? NASUA, AAHSA & NCCNHR CHANGE NAMES
NASUA (National Association of State
Units on Aging) Changes Name to National Association of States United for
Aging and Disabilities (NASUAD)
(Source: www.NASUA.org)
In keeping with its mission to design, improve, and sustain state systems delivering home and community based services and supports for the elderly and individuals with disabilities, the NASUA membership voted overwhelmingly in support of a proposal to change the name of the association to the National Association of States United for Aging and Disabilities, NASUAD.
The change was made, in part, to accurately reflect the evolving role of state aging agencies in the delivery and administration of long term services and supports, and to streamline the coordination and provision of these services across the continuum of care. Current NASUA President, and Commissioner of the Alabama Department of Senior Services, Irene Collins, applauds the members’ decision, “Through this meaningful step forward, the association welcomes the opportunity to build relationships and enhance the capacity of the state agencies to provide long-term services and supports to both older Americans and individuals with disabilities.”
When first established through the Older Americans Act (OAA), state units on aging were primarily responsible for the administration of OAA services within the aging network. Recently, federal legislation, increased reliance on additional funding sources, and the economic downturn have dramatically impacted and increased the scope of services states are called upon to provide, and their ability to do so. As the need for long-term services has expanded, so has the role of the state aging agency, with nearly 65 percent of the states serving both seniors and individuals with disabilities as of October, 2009. James Toews, NASUA Vice President and Assistant Director of the Oregon Department of Human Services, Seniors and People with Physical Disabilities, recognizes the significance of the name change, saying, “This is a pivotal time in our nation’s history. As an organization, we are looking forward to working with members of the aging and disability communities to emphasize the importance of a comprehensive long-term care system.” NASUA’s Executive Director, Martha Roherty, echoes these sentiments, “We welcome collaboration with our partners in the aging and disability communities as we work to further strengthen relationships at the national, state and local levels.”
This transition will be phased-in over the coming months. In the interim, please visit www.nasua.org for additional information.
National Association of State Units on Aging, founded
in 1964, represents the nation’s 56 officially designated state and territorial
agencies on aging. The Association’s principal mission is to support visionary
state leadership, advance state systems innovation and articulate a national
policy on home and community based services for older adults and individuals
with disabilities. More
AAHSA Board Approves New Name: LeadingAge
(Source:
www.mcknights.com)
The American Association of Homes and Services for the Aging's board has signed off on a new name for the organization: LeadingAge.
The organization for nonprofit eldercare providers has begun sending out e-mails to its 5,400 members. Each recipient has until July 30 to accept or reject the new moniker. But the vote is likely to be little more than a formality.
AAHSA originally planned to announce the new title at its November meeting in Los Angeles. But members were anxious to find out sooner, noted Lauren Shaham, vice president of communications. LeadingAge tested well with members early, and "really stood out as a strong candidate," she said.
The organization's new mission statement is also being changed, to "Expanding the world of possibilities for aging." A short video explaining the shift can be seen at www.youtube.com/aahsa.
The new name better reflects AAHSA's role and internal vibrancy, said Sharon Sullivan, the organization's vice president of marketing and conference services. Minneapolis-based Brand Tool Box was brought in to help with the rebranding effort. More
NCCNHR (The National Citizens’ Coalition for Nursing Home Reform) Changes Name to The National Consumer Voice for Quality Long-Term Care: The “Consumer Voice” For Short
(Source: Deane Beebe, PHI)
The National Citizens’ Coalition for Nursing Home Reform (NCCNHR) has changed its name, reorganized, and expanded its national advocacy priorities. NCCNHR is now The National Consumer Voice for Quality Long-Term Care — a modification of its tagline — or the “Consumer Voice” for short. The Consumer Voice has broadened its federal advocacy efforts to include addressing policy issues regarding at-home care and assisted living. The organization has been a force for improving the standard of care in nursing homes since its inception in 1975 as the National Citizens’ Coalition for Nursing Home Reform.
Among the ways that the Consumer Voice says it will carry out its revised mission — to represent the consumer voice at the national level as an advocate for quality long-term care, services, and supports — is to “promote the critical role of direct-care workers and best practices in quality-care delivery.”
The Critical Role of
the Direct-Care Workforce
Recognizing the value of direct-care workers to the care team and how these workers impact quality of care is not new to the organization. “No matter what laws and regulations are in place, no matter who or where the care is provided — the experience of the consumer is determined by his or her interactions with the direct-care worker,” said Consumer Voice Executive Director Sarah F. Wells. “I am confident that consumers and workers partnering together can advance quality in all care settings,” she continued. “This is an exciting time for The National Consumer Voice for Quality Long-Term Care and the people we represent.”
New Policy Agenda
The organization’s new policy agenda includes:
- the reauthorization of the Older Americans Act;
- implementation of long-term care provisions in the health care reform law, including nursing-home transparency, elder justice, and criminal background checks on workers;
- development of policy on non-nursing-home settings, including assisted living;
- promoting a high-quality and effective long-term care workforce;
- strengthening oversight and enforcement; and
- promoting long-term care quality initiatives.
The Consumer Voice’s expansion of priorities was the outcome of a seven-month strategic planning process (pdf) that was funded by The Atlantic Philanthropies and announced on June 14. The process brought together consumers, members, past and current leaders, donors, grant makers, long-term care experts, staff, and other stakeholders. More
Conversations with Carmen Webinar
July 16th Topic: Unlocking the Life
Within; The Key to Elder Wellness; Accentuating the
Positive
Guest: Glenn Blacklock, Action Pact Trainer and
Consultant, and LNHA
What is
wellness really? Even in the newest of buildings designed to be as close to
home as possible we are still discovering that something is missing. When
we peel back the oppressive layers of institutional living, we discover doors
elders themselves may have forgotten existed. Exploring wellness gives us the keys
we need to open those doors. This approach to wellness focuses on abilities and
ways to refuel the positive life force that each individual has within them.
Wellness applies to everyone - even the frailest of the frail. With Glenn, who
has researched and developed new training materials on wellness, this
conversation will explore wellness concepts, new ideas to try and how to get
the most out of the great things already happening in your home.
The
hour-long Conversations with Carmen webcast is an educational talk show where
you can join in the conversation by asking questions of Carmen and her guests.
Webcasts are held the third Friday of every month at
The $99
fee is per site, so get as many folks as you can together and be ready
to be inspired and informed! Click here to sign up now:
http://www.culturechangenow.com/webinar-carmen.html or you can call
our office: 414-258-3649.
Pioneer Network’s 10th National Conference
Sunday
Special! Arrive by 3:00 pm on Sunday, August 8th for This
I Believe -- an amazing opportunity to
learn how to engage our elders in writing their own This I Believe essay. This
I Believe is heard around the nation on public radio.
SAVE THE DATE!
October 14, 2010
3rd Annual Culture Change Network of Georgia Summit in Atlanta , Georgia
Remember to PROTECT October 14th for the 3rd Annual Georgia
Culture Change Summit to be held in
Understanding Care Partnership
(Source:
When we begin to focus on Elders as people who continue to "grow and become," we open to what they have to offer us. Seeing Elders as mentors with something to give helps us make the leap from caregiving... to care partnering. When those usually described as care receivers learn they have something to give - and there is always some way that they can, no matter how subtle -and those usually described as care givers deeply acknowledge the ways that they receive from care receivers, some amazing shifts occur in the care dynamic. They become Care Partners."
Instead of seeing the needs of 'caregivers' as separate from the needs of 'care receivers,' we need to focus on the well-being of the whole care partnership. At the Eden Alternative, we firmly believe that words make worlds. Like the term 'Elder,' the phrase 'Care Partner' is an excellent example of the transformative power of choosing our language carefully. As a concept, care partnership evens the playing field, as it is often easy to get trapped in a one-dimensional experience of care. With this in mind, teams must fully appreciate what it means to be a care partner team. The term "care partner" should never be used simply as a politically-correct replacement for the words "staff" or "aide" or "caregiver/care receiver." Care partnership encompasses so much more, both in nursing homes and out in the larger community.
By our definition, a care partner team is composed of the
following care partners: the Elder herself; those care partners who work
with her, whether they work in a nursing home or through home health
support; her family members, friends, volunteers, and any other health
professionals that collaborate with her. Care partnering implies a
balance of care, that opportunities to give as well as receive are abundant and
experienced by everyone involved in the care relationship in every
moment. To deepen the experience of care partnership, consider holding
Learning Circles on the subject that bring Elders and all of their care
partners together.
NIH Devotes Only 11% Funding Elderly Studies
(Source: New York Times)
The health needs of tens of millions of aging baby boomers threaten to overwhelm the nation's hospitals and caregivers within a decade or two, but the geriatric tidal wave does not appear to have been fully recognized at the National Institutes of Health.
The NIH, the main medical research center in the
Older Adults Enjoy Better Relationships with Family, Friends, Article Finds
(Source:
www.mcknights.com)
Say what you will about youth today, but a new article finds that people of all ages are willing to forgive and respect their elders.
Older adults typically report improved relationships, such as better
marriages, more supportive friendships and less conflict with siblings and
family members, according to
The perception of limited time, willingness to forgive, aging stereotypes and attitudes of respect are all factors in the treatment of the elderly. Still, it's about more than just how the young treat the old, it's about how all people interact, according to report author Karen Fingerman, professor of Gerontology, Developmental and Family Studies. The full article is available in this month's Current Directions in Psychological Science. Click here.
Turn 70. Act Your Grandchild’s Age
(Source: KATE ZERNIKE, www.nytimes.com)
Ringo Starr celebrated his 70th birthday last week by playing at Radio City Music Hall and saying his new hero is B. B. King, still jamming in his 80s. Joining Mr. Starr in his 70s next year will be the still-performing Bob Dylan (“May you stay forever young”) and Paul Simon (“How terribly strange to be 70”). Following soon after will be Roger Daltrey (“Hope I die before I get old”) and Mick Jagger, who is reported to have said, several grandchildren ago, “I’d rather be dead than singing ‘Satisfaction’ at 45.”
A rock ’n’ roll septuagenarian was someone the gerontologist Robert Butler
could have only dreamed of in 1968, when he coined the term “ageism” to
describe the way society discriminates against the old. Dr. Butler, a
psychiatrist, died, at age 83, a few days before Ringo’s
big bash. No one, his colleagues said, had done more to improve the image of
aging in
But as much as Dr. Butler would have cheered an aging Beatle onstage, his colleagues said he would have also cautioned against embracing the opposite stereotype — the idea that “aging successfully,” in his phrase, means that you have to be banging on drums in front of thousands — or still be acting like you did at 22 or 42. That stereotype is almost as enduring as ageism itself.
“The stories that we hear tend to pull us toward the extreme,” said Anne
Basting, the director of the Center on Age and
Community at the University
of Wisconsin at
(Source: Katie Cordrey, www.trendhunter.com)
Today
’s elders aren’t as
ready to be docile little old people as elders may have been in the past. They
certainly aren’t about to take any guff from would-be attackers, human or
beast. It’s all in the…
The Letter
(Source, Gary Tetz, www.ltlmagazine.com)
Every day except Sunday, I walk expectantly to the mailbox. Sometimes I'm accompanied by my adorable dog, Fizbo. Sometimes I go alone, just to maintain my alpha dominance. I do this out of lifelong habit, though I know it's become little more than a quaint and anachronistic holdover from a world that no longer exists. After returning home, I feel like I should meet a girl for a soda, help Pa shoe the horses, and listen to a radio broadcast of Fibber McGee.
Back in the good old days, the mail still held the promise of something. A long-awaited letter from the Bavarian beauty you met on the Orient Express was held reverently in your hand as you slid a trembling thumb under the seal. You knew the parchment inside would be soaked with either perfume or tears, and that in impeccable penmanship she would profess eternal love or announce its tortured end. Somehow, my cable bill never quite measures up.
That's the problem, of course. There's no intrigue or romance in the mail anymore. I can't remember the last time someone sent me something pleasant or meaningful via the United States Postal Service. It's all utility bills. One-time-only offers. Lingerie catalogs, and political leaflets-which are basically just lingerie catalogs with airbrushed adjectives instead of photographs.
Sometimes to fight these negative feelings, I like to remind myself how fantastic it is that we, as taxpayers, are given the opportunity to subsidize the daily delivery to our homes of things we don't want, along with the bonus privilege of having our identities stolen by mail thieves submitting credit card offers on our behalf. It's quite a privilege. As budget deficits soar, we should definitely keep funding this extraordinary service.
I only mention all this so you'll understand my state of mind as I made my customary trudge to get the mail one day last week. My expectations were low, my cynicism high. I had no reason to believe this trip would be unlike any other. Until I opened the box and there it was-The Letter…
I'd probably been subconsciously fearing this
moment for some time. I knew it was inevitable, like death, taxes, and another
season of Survivor. But still, I wasn't happy or emotionally prepared
when the envelope appeared-my official invitation to membership in the
AARP. MORE
(Source: www.latimes.com,
Thank you Karen Stobbe and Sonya Barsness)
Frail, elderly women started playing soccer
as a joke. Now they are running and competing on the field, leaving cultural
expectations in the dust.
5. THE ELDERS (THE PEOPLE WITH & FOR WHOM WE’RE DOING THE DOING)
Couple Survived Holocaust; Now Faces Separation at Nursing Home
(Source: Max Harrold,
Montreal
File photo: Francisc Basch
and his wife Elena in 2005. Photograph by: MARCOS TOWNSEND, GAZETTE
They survived the Holocaust, but now Elena and Francisc
Basch - married for 65 years - face the prospect of
being separated in the Côte de Neiges nursing home
where they live in adjacent rooms.
The case highlights the difficult choices faced by long term care facilities and the often disorienting consequences for frail residents. The couple's son says separating them - both his parents have Alzheimer's - would be too traumatic. The nursing home says it is legally entitled to do what it feels is best, based on each resident's needs.
The Baschs, both age 90, have different stages of the illness that impairs memory, thought, speech and can lead to complete helplessness. The Montreal Jewish Eldercare Centre says Elena must be moved to a different ward as soon as possible because she needs a more advanced level of care, her son Max Basch, 59, told The Gazette this week.
"They cannot survive without one another," explained Max, from his home in Tenafly, N.J. His mother's more advanced condition makes the familiarity of her surroundings critical and her husband in the next room is a big part of that, he said.
"They always hold hands," Max said. "They kiss each other. They're this incredible, great couple in theirs 90s. When he went to the hospital for a few days, she said 'Maybe I can go to the hospital and check in on him and cook for him.' She doesn't realize exactly where she is but she knows they are together." MORE
"Aging is no
accident. It is necessary to the human condition, intended by the soul. We
become more characteristic of who we are simply by
lasting into later years; the older we become, the more our true natures
emerge. Thus the final years have a very important purpose: the fulfillment and
confirmation ...of one’s character."
From James Hillman, THE FORCE OF CHARACTER THE LASTING LIFE, (Random
House, 1999).
Fair Pay for Caregivers: A Tribute to Evelyn Coke
(Source: http://www.phinational.org/fairpay)
Evelyn Coke died a year ago. She was a home care worker and, like many Americans, she worked hard -- often taking on 24-hour shifts and 70-hour work weeks. However, as a home care worker, Evelyn Coke was not protected by the federal minimum wage and overtime laws that cover most other Americans. She thought that was unfair and took her case all the way to the Supreme Court. Here are two things you can do to remember Evelyn Coke today:
Watch our video, Fair Pay for Caregivers: A Tribute to Evelyn Coke
Join our Facebook campaign calling for an end to the "companionship exemption"
Home Care Aides in Most States Hovering Near Poverty Line, Analysis Shows
(Source: www.mcknights.com)
More and more personal and home care aides (PHCA) are being paid wages that put them at risk of falling below the poverty line, according to a recent salary analysis.
Between 1999 and 2009, wages for PHCA rose from a national median of $7.50
an hour to $9.26 an hour, or roughly 26%. But after adjusting for inflation,
real wages were essentially unchanged, according to the updated
The PHI Chart Book tracks wages in all 50 states and the
A Story of Choice: Julia Ferrara, C.N.A., Tells a Story from the Field
(Source: Julia Ferrera - Palm
Garden of Ocala
Culture Change was and is a much needed progression in the day to day duties and care we give as healthcare professionals. Maintaining independence is more than just being able to dress, groom, and toilet yourself, but also being able to make choices about how, when, and how much. Empowering with choice is the key, but empowering to WHAT? Empower is defined as- "to invest with power or official authority." This is more of a reminder than a mantra. Our members are already the official authority for themselves, although sometimes they forget or become complacent with routine. Since our Administrator and Director of Nursing rolled out Culture Change, the results have been tremendous. I, as well as the rest of my team, noticed a difference overall in LTC population. They smile more, they are more relaxed, they eat better, they sleep better, they laugh more, and they have a feeling of warmth, security, and trust. All of these things our members experience, I believe, are a direct result of giving back the ability to make choices instead of telling them, "It's time to eat. It's time to sleep. It's your shower time. Get up now!" That's all very militant. When I am 90 years old, NOBODY BETTER TELL ME WHAT TO DO AND WHEN TO DO IT. In this story I'm going to tell you, it is evident how our change at Palm Garden of Ocala truly brings LTC out of the darkness and into the forefront of long-term living !
My name is Julia Ferrera, C.N.A,
Quality of Life Aide, and Neighborhood Leader. One day as I was walking from
room to room inviting members to enjoy the whirlpool in our day spa, I came
across Irene. Irene was face down in a newspaper. She was half asleep on the
over-the-bed table and drooling on herself. I said, "Irene, hi, how are you?" She mumbled nondescript words. I took the
table away, crouched down to make eye contact, and said, "Would you like
to come to the spa?" She replies, "No, I have to stay here with the
TV." I knew this was going to take some work I explained to her that it
was okay to leave the room, TV, and bed, because they would all be here when
she came back. She would not go. For 3 days, I asked Irene to come with me, and
each time she told me "No." She expressed, "What is the point of
it?" I told her to enjoy yourself. On the 4th
day, I tried something else. "good morning,
Irene," I said, "I wonder if you'll come look at something with me. I
want to show you something" She agreed and off we went to the Garden Spa. MORE
Strengthening the Direct Care Workforce: Preliminary Recommendations from a National Panel of Experts in Long-Term Care
(Source: www.directcareclearinghouse.org)
Abstract
This article outlines the preliminary recommendations made by a panel of
long-term care experts convened by the Benjamin Rose Institute on behalf of the
Author: Noelker, Linda S., et al.
Publication Date: Winter/Spring
2010
Published In: Public
Policy & Aging Report
Publisher: National
Academy on an Aging Society
How to Order This
Item: This article may be purchased at Public
Policy & Aging Report's website or here
Meeting Expectations: The Evolving Expectations of Consumers
(Source: James Davis, www.mcknights.com)
There may be no better reflection of how long-term care has changed in recent years than the continued proliferation of continuing care retirement communities and active adult communities across the country. While we in senior living view skilled nursing facilities and CCRCs at opposite ends of the continuum spectrum, the evolving expectations of consumers at each type of community show we may have to start sharing more traits in common than we typically think.
At Amsterdam Nursing Home in Manhattan, NY, I've certainly seen the attitudes and expectations of our residents and prospective residents change during the past 20 years. And many of the elements our nursing home residents are demanding are the very same things we highlight in marketing our organization's new CCRC, The Amsterdam at Harborside in Port Washington, NY, to a very different set of seniors.
The lesson may well be
that today's seniors don't accept that the experience at a skilled nursing
community should be anything less than what they receive when they lived
independently.
Let me give you three areas where CCRCs and skilled nursing now share common ground among consumer expectations:
- Care fosters independence
- Choice, customer service
- An extended family
As more seniors become familiar with the concept of CCRCs,
either as residents or knowing others who live there, those settings are
helping to reshape their views of what assisted living and skilled nursing
communities should offer. No matter what
end of the senior living continuum we work in, there are elements that are
becoming expected at every quality community. Looking at what each type of
community does right in exceeding those expectations will go a long way toward
making your community more appealing to a changing audience.
To read entire article go HERE.
Elderly Watch More TV than Younger People, Enjoy It Less
(Source: www.agingcare.com)
We usually scold our children and
teenagers for watching too much TV. It turns out that their grandmas and
grandpas spend even more of their time watching TV, and it is not good for them
either. FULL STORY
The ‘Other’ Activity Workers
(Source: Kathleen Mears, www.ltlmagazine.com)
After living here for a
few months, I discovered we had some wonderful volunteers. A retired gentleman
came every other weekday to read parts of the newspaper and hold discussions
with the residents. Afterward, he talked to us about things that happened to
him or distinctive stories he had heard. He always endeavored to bring up the
“good old days” so that the oldest residents could relate. While he was casting
his magic, I did not go in the dining room. I preferred to listen from outside
and watch him weave his spells.
We were also frequented by a woman who did Bible stories in the morning and a couple singers who came in at different times during the month.
The activity director at that time either had a great ability to get people to volunteer or was extremely lucky because most of them donated a lot of their time. She also had activity director and activity therapy students do their clinicals here. Since they were studying, they were much more interested in entertaining the residents. They gave a healthy boost to the activity department.
Most volunteers were affiliated with a church, so there were Sunday church services and two or three other church activities during the week.
I knew these seemingly irreplaceable volunteers would someday no longer be able to visit. I wondered how difficult it would be to find others who could fill their places with the same enthusiasm. A few months later, a new activity director came and she was not as gifted in locating volunteers. MORE
(Source: Al Power, www.changingaging.org)
Al Power delivers a powerful insight into the future of health care. This is a must read…
Ever since Professor Tom Kitwood coined the term “person-centred care” in the 1990s, it became a watchword of the culture change movement. Sometime after that, The Eden Alternative and others began to replace the term with “person-directed care”, which forces us to raise the bar beyond a paternalistic approach where we decide what elders need most, to actually asking them.
In recent years, many in the U.K. have moved on to a new concept: “relationship-centred care”. The rationale is that each person in a care home exists as part of a larger community where the well-being of all must be taken into consideration. A central concern raised with the older terminology is that focusing on an individual’s needs may actually infringe on the well-being of others in the community, which is also undesirable.
In actuality, that’s not just a nursing home issue. We all have to balance our autonomy with the needs of others in our environment. That’s why most of us still stop for red lights. But I’m not ready to abandon “person-directed care” yet. Here’s why: In the traditional nursing home, there is a much more powerful barrier to individual choice than the competing needs of others, and that is the institutional structure itself. What we choose to call our style of care is a moot point if we ultimately bow to the needs of this rigid system. My concern is that simply changing our semantics to “relationship-centred care” may fail our elders because it may not provide enough impetus for us to transform the care environment as well. This is where models like Eden reign supreme: they not only promote individualized care, but they provide a framework to realize it to the fullest extent by transforming operations, in order to remove those larger barriers.
We always have to consider the needs and desires of others in our residential care communities. But I think we will go a lot farther with individualized care if we keep the transformational process at the center of our model. Simply trying to create relationship without tearing down the institutional barriers falls short.
Free Comfort Care Guide
Encouraging Comfort Care: A Guide for Families of People with Dementia Living
in Care Facilities
(Source: Thank you to Dan Kuhn for sharing this information with us!)
The Alzheimer’s
Association-Greater Illinois Chapter is pleased offer this free online
resource, Encouraging Comfort Care: A Guide for Families
of People with Dementia Living in Care Facilities. This 21-page booklet
provides useful information to families and long-term care facilities personnel
about Alzheimer’s disease and related dementias,
particularly care issues related to the late and final stages.
For families, this guide will enable them to make informed choices about a variety of medical decisions they may face on behalf of loved ones with dementia living in nursing homes, assisted living facilities, and other types of care facilities. It will also equip families to ask good questions aimed at obtaining the best care for their loved ones, including a handy checklist of comfort care measures to be discussed with staff members of care facilities.
For staff members of long-term care facilities, the guide will serve as an important tool for those who wish to educate families and assist them in care planning. Individuals and organizations are encouraged to disseminate this booklet in electronic and print formats. Encouraging Comfort Care was made possible through a generous grant from the Retirement Research Foundation to the Alzheimer’s Association-Greater Illinois Chapter.
View and download the free guide by clicking below: (Please note: the comfort care guide may take up to several minutes to download due to the large file size.)
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The Power of Positive Language: Is it true?... Is it necessary?... Is it kind?...
(Source: Tom and Karen Brenner, Alzheimer's Reading Room)
Dr. Maria Montessori,
the first woman to become a physician in
“Instead of saying to a child, ‘Don’t be stupid, say, ‘Please be wise.’
Instead of saying, ‘Stop running!’ say, ‘Please
walk.’”
When we use positive language, this one seemingly simple change from negative to positive, can change everything in our lives. The use of positive language changes a parent or teacher from being a nag, or a scold into a mentor, a coach. The expected results are the same; we expect children to try and be wise, to walk in the house, to be good people. With positive language, we demonstrate that we believe that children can achieve these results.
As with many universal truths, what seems so simple and so obvious is also difficult and profound. It is not easy to turn our language patterns around. It takes a lot of thought and even more effort to break the habits of a life time, but if we can just try being conscious of using positive language, we will begin to see very real differences in our lives. This is especially true when caring for someone who is living with Alzheimer’s or other dementias. We use the Montessori Method as the foundation for the work we do with people who have Alzheimer’s.
Using positive language can make a huge difference in the lives of caregivers and the people they care for. When we work with someone who is living with dementia, we try to find the remaining strengths and spared abilities of that person. Building on these strengths and spared abilities, we can find ways to connect to that person, to reach people who sometimes seem unreachable.
Using positive language is a huge part of this program. We can turn “Oh, mom, you know you can’t drive anymore!” into, “Let’s go for a walk, mom.” We can tell the people we are caring for that we enjoyed being with them today or that we like the sound of their laughter. Positive language doesn’t mean patronizing language; compliments or encouraging words should be real and heartfelt. Even on the worst days, in the most difficult of circumstances, if we look deeply enough, if we try hard enough, there is always something positive that we can say to the person we care for.
Dr. Montessori never told people what to expect when they tried her method, she wisely knew that people have to experience the results for themselves. We encourage everyone reading this article to try the use of positive language in all of your relationships; and most especially when caring for someone living with Alzheimer’s. Before we pass judgment on others, before we lecture or scold, Dr. Montessori asked us to stop and answer these three questions about our own words:
“Is
it true? “
“Is
it necessary?”
“Is
it kind?”
Tom and Karen Brenner are
researchers, consultants, trainers and writers dedicated to working for culture
change in the field of aging. Tom is a gerontologist and has specialized in
creating and researching dementia specific training programs. Karen Brenner is
a Montessori educator and has specialized in working with children who are deaf
or communication disordered. They have been published in magazines and journals
both in the
Older African-Americans and Latinos with Cognitive Impairment Live Longer
than Whites;
Less Likely to be in Nursing Homes
Great need for culturally-appropriate
Alzheimer care resources & home-based services
(Source:
www.alz.org)
Honolulu, Hawaii; July 12, 2010 – Racially and ethnically diverse older adults are one of the fastest growing population segments in the United States and new research presented today at the Alzheimer's Association International Conference on Alzheimer's Disease 2010 (AAICAD 2010) in Honolulu reveals that older African-Americans and Latinos with significant cognitive impairment have a lower likelihood of nursing home placement and longer survival than White older adults in the study.
"These results have significant implications for caregiver burden and community resources," said Maria Carrillo, Ph.D., Alzheimer's Association's Senior Director of Medical and Scientific Relations. "If, as the study suggests, more African-American and Latino families are taking care of their loved ones with significant cognitive impairment in their homes for longer periods of time, there is a greater than anticipated need for culturally-appropriate dementia care resources and home and community- based services for these populations."
"These findings are particularly compelling since we found that African-Americans are about two times more likely and Latinos about one and one-half times more likely to develop Alzheimer's and dementia," Carrillo said. This was reported in March in the Alzheimer's Association's 2010 Alzheimer's Disease Facts and Figures report, a comprehensive compilation of national statistics and information on Alzheimer's disease and related dementias.
Another study reported today at AAICAD 2010 suggests that the bereavement process and mourning experience for Alzheimer caregivers after the death of their loved one varies greatly among different racial and ethnic groups. A third research report suggested that cultural and spiritual beliefs of African-Americans, American Indians and Whites greatly influence how long it takes for a family to seek a medical diagnosis of Alzheimer's.
"Alzheimer's leads so many families through unfamiliar territory. The need for education, information, supportive services is paramount," Carrillo said. "The more we learn about the similarities and differences that exist in how various groups perceive and experience Alzheimer's, the more effective we can be in developing culturally-appropriate information, services, and tools that are respectful of these perceptions and closely held values, and that contain authentic relevance that empowers families." MORE
Caregivers Get Training that Simulates Sensory and Memory Losses of Dementia
(Source: www.washingtonpost.com)
Left: Carolyn Young
looks through a pile of clothes while participating in an exercise designed to
simulate effects of dementia. Below, she looks at herself in a mirror through
goggles that limit vision. Bottom, she writes with hands restricted to mimic
effects of arthritis. (Photos
By Bill O'leary/the Washington
Put on a necktie. Buckle a belt. Write the names of my family members. And . . . what? I had five things to do in five minutes, but I couldn't seem to remember what they were.
This was largely because I couldn't feel, see or move as I usually do. I'd been gloved, goggled, headphoned and otherwise handicapped in an attempt to make me feel like an elderly person whose body and mind have begun to fail.
When I couldn't remember my tasks, I was nervous and embarrassed. I looked around, second-guessed myself. Seeing a pile of laundry, I started folding -- but was that one of my tasks? Is this what it feels like to have dementia?
"That was frustrating," said one of my classmates, Carolyn Young,
58, after she emerged from the simulation. "I didn't understand the
directions. . . . I was on my own, and I didn't know what to do." That's the idea. Along with 35 employees and
associates of the Sunrise Senior Living Community in
Stella Maris Uses Prayer to Spark Recognition in Dementia Patients
(Source: Priscila Moscoso Meiller, www.catholicreview.org)
TIMONIUM
– Many dementia patients can’t remember the names of their children or what
they did the previous day. Long after they have lost the capacity to formulate
a sentence, however, their spiritual memories often remain vibrant and alive.
“Folks that appear to be asleep, or not engaged or focused, when they begin to
hear a familiar prayer like ‘Our Father’ or the rosary, they’ve got every word
and are right there with you,” said Father Lawrence Johnson, director of
pastoral services at Stella Maris in Timonium, a long-term care facility that
includes dementia units.
Through a pastoral care program, Stella Maris leaders help patients with
dementia reconnect with their spiritual selves, using spiritual rituals as
memory triggers. “We are mind, body and spirit,” said Susan Anderson, a Stella
Maris chaplain. “The spiritual part of us doesn’t die,
it is always there and needs nurturing. It has its own history and recognition
of rituals.”
Sister of Mercy M. Karen McNally, chief administrative officer of Stella Maris,
added, “Often, when we need comfort and security, we go to prayer, we talk to
God. Prayer for our patients is a trigger that brings them a sense of peace. It
connects them with good experiences with prayer that were consoling, comforting
and enriching.”
Triggering the past is not the only goal of the pastoral care team. “We not
only want to connect them with the past, but we want to give them a present
experience of God’s love, care and presence,” said Gerry Cavanaugh, another
chaplain. “For them, we become channels of the presence of God and God’s love
right now.”
What distinguishes Stella Maris is its full-time
chaplains on staff. “The chaplains know what they are going to connect with
when they interact with one resident,” Father Johnson said. “What works with
one resident, might not work with the next one, but the chaplains, being on the
units on a daily basis, have learned what works with each individual.”
The pastoral care team has many success stories, of patients
whose dementia has progressed and no longer have the ability to form a sentence
or engage in a conversation of any duration, yet are able to say familiar prayers
and sing hymns, remembering every word. You can’t have a better feeling, in my
opinion, than knowing you make a difference in somebody’s life,” Cavanaugh
said. “It is highly motivating to come back, you know
somebody’s waiting for you.”
Chaplains often read short, easy to understand Gospel passages, and try to
engage the residents in conversation. They also do individual general
intercessions, asking residents who they would like to pray for that day. In
addition, they sing hymns or pray the rosary together and receive communion.
Families use the spiritual activities to structure their visits to loved ones,
coming to Sunday Mass and using time together in prayer, which is calming for
patients and brings them into the moment. More
Dining with FriendsTM:
An Innovative Approach to Dining for People with Dementia
(Source: www.alzheimersresourcecenter.org)
This person-centered program, developed by the Alzheimer’s Resource Center of Connecticut, offers innovative solutions to the adverse effects dementia has on nutrition, hydration and socialization. This program specifically addresses these obstacles and inspires dementia care providers to improve the lives of people with dementia. Their mission is to empower your organization to respond faster and more intuitively to the changing culture of dementia care.
A 4 minute Trailer and the full video can be viewed HERE.
(Source: www.alzheimersreadingroom.com)
A simple proposition, does touch (tactile communication) benefit patients suffering from Alzheimer's disease? Article
McClellan
to Forge New Foundation for CAST
(Source: Bob Gatty, www.ltlmagazine.com)
Mark McClellan, MD, PhD, the new chairman of the CAST Commission, will try to lay the foundation for a better understanding of how health IT and other technologies can be adopted effectively and lead to improved care for older adults. One of the top experts in healthcare policy, Mark McClellan, MD, PhD, has been named to chair the Center for Aging Services Technologies (CAST) Commission, an international coalition that is focused on developing, evaluating, and adopting emerging technologies for long-term care.
A former commissioner of
the Food and Drug Administration (FDA) and administrator of the Centers for
Medicare & Medicaid Services (CMS), McClellan is now director of the Engelberg Center for Health Care Reform and Leonard D.
Schaeffer Chair of Health Policy Studies at the Brookings Institution. In his
role at CAST, McClellan will help drive research and education around key
policy issues to advance aging services technologies, as well as support
efforts that educate healthcare professionals on how health information
technology (IT) can benefit older adults and their caregivers.
“Health IT has the potential to greatly
improve patient health and quality of life outcomes, but its success is far
from automatic,” McClellan said. “The CAST Commission will lay the foundation
for better understanding how health IT and other technologies can be adopted
effectively and lead to improved care for older adults-no matter where that
care is received.” MORE
The Generational Mobile Access Divide
(Source: Laurie Orlov,
Aging in Place Technology Watch)
New mobile wireless access survey by Pew -- overall usage is up. Get ready for some numbers -- but first, a definition. This new Mobile Access 2010 report from Pew defines mobile wireless access as a) Going online with a laptop using a wi-fi connection or mobile broadband card or b) Using the Internet, email or instant messaging on a cell phone. Given that definition, "59% of American adults now go online 'wirelessly' using a laptop or a cell phone, an increase over the 51% who did so at a similar point in 2009." And today, compared to a year ago, more cell phone users are taking pictures (76% versus 66%), sending text messages (72% versus 65%), and even accessing the Internet (38% versus 25%) from the 2009 survey.
Young adults -- it's all about the phone. Eighty-four percent of the 18-29 age group are wireless Internet users, up 11% in the past year, compared to 49% of the 50-64 age group, and only 20% of those 65+, with the older groups increasing only 5% and 3% respectively. And what are the younger folks doing? They're on the phone. The 18-29 age group are using their cell phones for taking pictures (95%), sending text messages (93%), sending pictures or videos to others (81%), accessing the Internet (65%) as well as playing music, games, or recording video. Okay, and I bet they are mostly talking to each other. Over at the other end of the age scale, not so much. Fifty-seven percent of those in the 50-64 age range are texting, but only 19% of the 65+ population text -- and everything else on the list, forget it.
So boomers and seniors want to stay connected to family -- but are they missing a medium?
The
mobile divide is widening.
New Leonard Florence Center for
Living Green House in Chelsea, MA Installs PEAC Customized Automation
Technology: Eliminates Helplessness for Residents with ALS
(NOTE: You all really need to watch
this video – amazing!)
(Source: William Crowe, Director of Business Development, PEAC)
PEAC's customized automation was recently installed at the
This video: http://www.youtube.com/watch?v=cc82w_0Kp2o shows the delight of Steve Saling, an ALS resident using the system. After installation Steve told us: "I cannot begin to tell you how awesome it is to have the freedom PEAC provides. Every time I show it off, jaws drop….You made it possible."
PEAC's automation technology can also be used by long term care facilities and vet community living centers working with persons with restricted motor function, e.g. neurological disorders like ALS, MS, MD and Parkinson's and severe injuries such as brain, spinal cord and stroke. William Crowe, Director of Business Development, says, “As our system greatly improves quality of life, choices and gives more independence and dignity, it will be helpful for SNFs to meet compliance issues under CMS regulations. And our system can be used in existing projects without any demolition required, as well as in new developments.”
For a brochure or for further inquiries, power point presentations or webinars contact William Crowe, Director of Business Development on 805.504.9740 ext 11 or 805 985-3520 or 808 226-9189 (cell).
Apple has Introduced Several New iPhone Apps to Help Caregivers
(Source: Caregiver Technology with Hat tip to Alzheimer’s Daily News)
Designed for "caregivers on the go," CareConnector includes: a Care Planner to store insurance, health care provider, and emergency contact information; a platform to track prescriptions and prescription history; a caregiver Message Board to talk with other caregivers and share stories and tips; and a Journal which gives caregivers the ability to take notes during doctor's appointments and write down questions. To learn more, visit strengthforcaring.com/careconnector. Free and operated by the Johnson & Johnson Care Initiative.
Elder 411 contains expert advice categorized into 10 eldercare topics.
Each section is organized by media type whether written, audio, or video, as well as an "
Elder 911 guides the user through the steps of a medical emergency, including what to do before a crisis occurs, while at the hospital, before leaving the hospital, and after leaving the hospital. The app also addresses recovery and quality of life issues. Each crisis page tells the user step-by-step what to watch out for. It also includes interactive checklists and supporting information where necessary. Elder 911 is available for $0.99 from the iTunes store. Go to full story: elderbrief.wordpress.com
Entrepreneurs:
Nine Technologies to Ease Pain of Getting Old
The baby boomer market is huge and
aging fast. Help is on the way.
(Source: Maureen Farrell, www.forbes.com)
The silver tsunami
is swelling. By 2025 the Earth will be home to 1.2 billion people aged 60 and
older, double the number in 2000. Laurie Orlov, principal analyst at Aging in
Place Technology Watch, a market research firm, estimates that the current
demand for "aging-at-home" products and services is $2 billion. By
2020 it will have ballooned to $20 billion. A slew of players are fixed on this
massive market (see our slideshow
of nine senior-friendly technologies and the brains behind them).
In April 2009 General Electric and Intel announced a 5-year, $250 million partnership to develop technology aimed at easing the transition to old age. Massachusetts Institute of Technology is on the case, too: In 1999 it formed AgeLab, a research center within the university's engineering school, to come up with new ideas for the next generation of seniors.
In
Pictures: Nine Technologies To Ease Pain Of Getting
Old
It's Good to be Home: Choosing Durable Yet Homelike Furniture for Smaller Long-Term Care Facilities
(Source: John Andrews, www.mcknights.com)
Green House and “neighborhood” communities are being built with increasing frequency in both the assisted living and skilled nursing sectors to give residents the feeling of truly being home. But with that laudable goal comes the responsibility of creating environments that convey the warmth, familiarity and comfort of a family home—not a larger long-term care institution.
Selecting the right furnishings is a major piece of that mission, and finding the appropriate pieces goes beyond ordering ordinary institutional stock. Furniture is the centerpiece of the décor and the personality of each room. It is also a key part of the infrastructure of dwellings like these.
The Green House Project Executive Director Robert Jenkens maintains that long-term care culture change brought on by new-phase housing is influencing the way furniture manufacturers develop their product lines. “In general, the long-term care industry is realizing that living in what looks and feels like a hospital isn't appealing to people,” he says. “Furniture manufacturers are responding to the overall emphasis by the industry to create a more residential environment, so furnishings are moving in that direction.
Choosey users
As a result of the new long-term care climate, Jenkens says furnishings
“have to be close to perfect because elders and their families are attuned to
the signals in their environment.” The style is crucial, he says, because “it
says either, ‘This is your home and you belong here'
or it doesn't. So the concept of just being ‘homelike' isn't really getting us
where we need to go. People have to feel like they are truly home and that they
belong.” MORE
World Health Organization (WHO) launches global network of age-friendly cities
Urban environments that allow older people
to remain active and healthy
USA: New York NY and Portland OR are only
cities in the US
(Source: http://www.who.int)
29 JUNE 2010 |
Positive contribution of older people
While the response to population ageing has often focussed
on the implications for governments of increasing demand for pensions and
health care, WHO tries to place more emphasis on the positive contributions
older people make to society. "Older people are a vital, and often
overlooked, resource for families and for society." said Dr John Beard.
Director of the Department of Ageing and Life Course at WHO " Their
contribution will only be fully realised if they
maintain their health and if the barriers that prevent them engaging in family
and community life are broken down".
MORE
Assisted Living Center Recognized for Energy Efficiency
(Source: Meredith Farley, www.retirementhomes.com)
Going green is typically thought of as something only
individual residences can do. However, an
The initiative has numerous benefits for the assisted living center that go
beyond just accolades, as the new amenities will result in lower energy costs
down the road and can improve the health of the residents. "Just breathing
the air here is healthier than in any commercial building because of our
filtration system," Academy Villas Executive Director Kent Prescott told
the source.
Having good air quality can relieve allergies, asthma and other breathing
problems and experts say that the health advantages could extend further.
Discovery.com reports that using environmentally friendly materials and paints
will not release harmful elements into one's indoor environment. More
Person Centered Care in Nursing Homes Enhanced by Consistent Assignment
Culture Change Demands Person Centered
Care
(Source: Carol Bradley Bursack, Editor-in-Chief, www.eldercarelink.com)
Culture change is the current buzz word for nursing home care advocates. The days of military style nursing homes set up for staff efficiency are beginning to wane as families demand better care for their loved ones, and boomers look at nursing homes and realize that one day they may live in one. This push from vocal advocates for vulnerable elders, with a little Boomer pride thrown in, is shaking up the industry. Not as fast as many of us would like, but nursing homes are, indeed, changing.
Enter the new age of person centered care. With person centered care, residents are no longer treated as just a generic elder in a string of elders. The staff in a good home these days will make a point of knowing something about what a person did for a living, what her interests are, where he grew up, where she lived, what he likes to eat and what food she hates…
Consistent Assignment of Aides is Important to Elder's Care
Nursing homes have 24-hour care and changing shifts, but it's still important to provide consistency of caregivers. During some of the time I had elders in nursing home care, the trend was cross-training, with the idea that everyone should get used to taking care of all of the residents. There is some validity in this thinking from the management's point of view, but my elders hated that approach and so did I.
Who's on First? Who's on Second?
I watched my elders' moods change according to their assigned caregiver. It was obvious to me that Mom was happier when Darleen was on duty and was assigned to Mom. Darleen knew what Mom would like for breakfast if Mom's appetite was lagging. She knew when Mom wanted to have her bath, how to keep Mom warm and how Mom liked her magazines arranged if things got out of place after I'd left from my daily visit…
Perfection Won't Happen but We Can Try
No matter how dedicated to person centered care and consistent assignment of the same aides to the people they match best, perfection isn't possible. No one can work every day. Our loved ones won't have their favorites all the time. However, it's heartening to know that in most of today's good nursing homes, the bar has been significantly raised. Our elders are looked at as individuals and given person centered care with consistently assigned aides. We should aim for no less.
Not all nursing homes have welcomed this enlighten way of caring and staffing. Some still over-drug their residents. In some areas, it's hard to find even one home that offers enlightened care. The Pioneer Network has been formed to focus on getting all care agencies and facilities to provide person centered care. They are making great headway, but unfortunately there's still a long way to go.
Boomers must use their clout to insist on higher standards of person centered care and consistent assignment in aging care. We need it for our elders and will want it for ourselves. If, one day, someone comes into my room at the care home to give me a bath, I'll quite likely want to know who this person is. More
Person-Centered Care in Assisted Living: An Informational Guide
(Source:
Center for Excellence in Assisted Living)
(NOTE: This paper is intended as a “what is” person-centered care informational
guide, rather than a “how-to implement” person-centered care guide. Please use
it as an opportunity to discuss and advance dialogue about person-centered
care. This paper was commissioned by the CEAL Board; however, the views and
opinions expressed are not necessarily reflective of every member organization
represented on the CEAL Board.)
To date, published information
about person-centered care in assisted living has been sparse. This paper
expands on a chapter entitled “Person-Centered Care in Assisted Living” in the
National Association of Boards of Examiners of Long Term Care Administrators’
(NAB) Residential Care/Assisted Living Administrators Exam Study Guide prepared
by this paper’s writer (Karen Love) and Mauro Hernandez1. This paper presents a
comprehensive framework about what is needed to support person-centered care
(PCC) outcomes based on evidence-based practices obtained through a broad
review of peer-reviewed and grey literature2. While there has been sparse
assisted living-specific research conducted about any elements of PCC, studies
conducted in other sectors such as nursing homes and the developmental disability
population, as relevant, are cited. In addition, the
paper draws on over 40 in-person and telephone interviews and discussions with
diverse PCC experts across the aging services network including leaders in the
culture change movement, long-term care practitioners and consumers.
While the paper’s focus is to detail PCC in assisted living, it is
important for the reader to understand that the national PCC movement (known by
many terms, see page 4) is not new and encompasses the wide spectrum of people
who are recipients of care and services (e.g., individuals of all ages who have
physical, developmental, intellectual, behavioral, cognitive and/or mental
health disabilities) and the providers that supply the care and services (e.g.,
hospitals, rehabilitation centers, primary care providers, nursing homes, group
homes, subacute centers, assisted living, adult day
care, home care). The general tenets and practices of PCC — honoring the person
— are the same across settings and populations wherever he or she lives.
The goal of this paper is two-fold. First, the paper proposes a
conceptual framework that can be tested and further refined through future
research. Although the literature and discussions with a range of stakeholders
indicate some degree of consensus around the key structural elements of PCC
described within, much work remains to be done to understand the
interrelationships and interconnectedness among these elements and to more
fully explore the most successful means of operationalizing
them. Second, it is hoped that this paper will inform current discussions of
PCC in assisted living settings. While there are some assisted living providers
that currently employ one or more of the elements needed to support PCC
outcomes, many providers have not evolved beyond the core values of a home
environment and improved service delivery (Utz,
2003). This paper is intended to help assisted living communities more fully
understand the structural framework that underpins PCC outcomes. MORE
Weinstein Center for Adult Day Services Introduces TimeSlips Storytelling
(Source: Georgia Gunter, Executive Director)
The
TimeSlips Story created by the Weinstein Center Men’s Club
The following story
was created after the participants viewed this picture of a Ford Fairlane.
Ford Fairlane
The car is a Ford Fairlane. Andrew Dice Clay, the comedian, owns
it. He drives it himself.
He’s currently in
Arizona or California or maybe even Alaska or Texas. You can tell by the
clouds and the sky.
The weather looks beautiful.
He may be from
He is going to
Nevada to pan for gold and to gamble. He’s not going alone – he’s going
with a girl.
It’s just the two
of them. She’s beautiful and has blonde
hair. Her name is Blondie.
The time period is
the 1950s, and it’s evening. They’re going to get married in
(Source: Interview by Karen Kahn, PHI)
Left: Peggy Powell
An interview with Peggy Powell, PHI Director of Curriculum and Workforce Development
Peggy Powell has been designing training programs for direct-care workers for over 25 years. Below she talks about how states can design quality personal and home care training programs that meet the learning needs of trainees, result in high levels of worker retention, and improve quality care for consumers.
One of things I
always hear you say, Peggy, is that you “need the right person for the job.”
The Personal and
PP: In working with home care agencies — and even individual consumers — we have always emphasized that direct-care is not for everybody. This may not be an occupation that requires a lot of formal education, but that does not mean that any person in need of a job, with the right training, will provide quality services and supports.
We recommend what we call “targeted recruitment.” That entails working with
agencies that serve low-income or ESL populations to identify potential pools
of workers. But we add to that a rigorous screening process for each candidate.
That might involve a process whereby a candidate must: MORE
See “Culture Change in Affordable Housing” Under Georgia News
Pain, Agitation Prevalent Among Dying Seniors in U.S. Hospitals
(Source: www.agingcare.com)
Despite end-of-life care accounting for 10%-12% of the U.S. health care budget and 27% of Medicare expenses, lifesaving treatments leave patients dying with distressing symptoms. FULL STORY »
What Happened to My Roommate? HIPAA and Death
(Source: Eleanor Feldman
Barbera, PhD, 
www.mybetternursinghome.blogspot.com, www.ltlmagazine.com)
The Health Insurance Portability and Accountability Act
(HIPAA) ensures that the personal information of our
nursing home residents stays personal, but sometimes it’s taken too far.
Well-meaning staff members, not wanting to violate HIPAA, are unsure whether or
not to share news of a resident’s death with that person’s friends in the
nursing home, so they err on the side of caution. This leaves other residents
wondering what happened and, if they suspect a death occurred, they’re left with
the unhappy knowledge that their own death could also pass unacknowledged.
Some members of Psychologists in Long Term Care recently discussed this and the consensus was that since someone’s death is a matter of public record, letting other residents know about it is not in violation of HIPAA. To follow up on this, I contacted the New York State Department of Health Nursing Home Hotline (888-201-4563) and they concurred: It’s okay to tell others that the person died, but not to give medical details.
Similarly, it’s within HIPAA guidelines to let a roommate know, for example, that their friend in the hospital should be returning to the nursing home soon, but not to discuss details of their health condition without the permission of the hospitalized resident or their family.
Part of creating more homelike nursing facilities is honoring the bonds created between residents. It’s important to share news, within the limits of HIPAA, of how friends and neighbors are faring, and it’s especially important to acknowledge the lives and deaths of those in our care.
Dr. Barbera is an
author and a licensed psychologist consulting in long-term care facilities in
the
(Source: ChangingAging.org)
The prestigious AHRQ has taken notice of the work Holy Cross hospital has done to improve emergency care for elders.
This is an important issue because…
* The population of seniors in the U.S. is growing rapidly, with growth expected to continue in coming decades, especially among those over 80. In Montgomery County, MD, for example, 70 percent of the anticipated population growth over the next 2 decades will be among people older than 65,1 and the number of residents age 65 and older not living in nursing homes is expected to double over a 30-year period, from roughly 92,000 in 2000 to 187,000 in 2030.2 Many seniors have chronic illnesses (e.g., diabetes, heart failure, osteoporosis, chronic obstructive pulmonary disease, dementia) that result in frequent ED visits.
* Stressful ED experience: Seniors often find the ED to be overwhelming due to factors such as loud noise, a lack of privacy, and the fast pace of interactions with staff. Poor hearing and neurological limitations often make it hard for seniors to understand what is occurring in the ED.
* Little followup, leading to
return visits: ED care traditionally focuses on treating patients’ immediate
health concerns and discharging them as quickly as possible so that additional
patients can be seen. Given the emphasis on speed, older patients often do not
receive or understand instructions on what they should do to address their
health issues once they return home. In addition, factors such as limited
transportation, unfamiliarity with technology, and difficulty dealing with
bureaucracy may prevent them from going to followup
doctor’s appointments and/or obtaining needed medications in a timely manner.
As a result, seniors have a high rate of return visits to the ED, leading to
high costs. MORE
Nurse Competencies for Culture Change
Released
(Source:
www.pioneernetwork.net)
The Pioneer Network announced that a two-year initiative with the Hartford Institute for Geriatric Nursing, in collaboration with the Coalition of Geriatric Nursing Organizations and the Pioneer Network, has ended with the release of “Nursing Competencies for Nursing Home Culture Change”. The document offers 10 competencies deemed most relevant and critical for creating and sustaining person-directed care. The initiative was supported by the Commonwealth Fund. To view the 10 competencies please go to http://www.pioneernetwork.net/Providers/ForNurses/
(Source:
Susan Misiorski, PHI)
Nursing and culture
change leaders at PHI training
National leaders in gerontological
nursing education and culture change participated in a two-day PHI Coaching SupervisionSM seminar in
PHI has been documenting and field-testing its Coaching Approach to Supervision with long-term care providers for the past four years, with funding from The John A. Hartford Foundation and The Atlantic Philanthropies. “It is a tribute to PHI and the work you have done that you were able to bring together such a distinguished group,” said Amy Berman, a program officer at The John A. Hartford Foundation who attended the program.
Spreading the PHI
Supervision Approach
Sara Joffe, PHI organizational and executive coach and director of the Center for Coaching Supervision and Leadership, and Susan Misiorski, national director of PHI Training & Organizational Development Services, taught the seminar with PHI Certified Coaching Trainers Anna Ortigara of the Green House Project and the Pioneer Network and Joanne Rader of Rader Consulting and the Pioneer Network.
Rader has supported PHI by bringing the PHI Coaching Approach to Supervision (pdf) to colleges of nursing. Ortigara has partnered with PHI to bring the PHI Coaching Approach as applied to three key areas — supervision, leadership, and clinical partnership — to the Green House Project.
Every Organizational
Level Would Benefit
“This coaching supervision class was remarkable,” Ortigara said. “These are the leaders who can bring coaching skills to undergraduate nursing students as well as long-term care provider sites. It can change the way nurses are engaged in empowering relationships with care teams.”
The seminar participants’ primary interest was in the application of coaching skills for nurses in the field. “The nurse’s role as supervisor of nursing assistants is critical to the delivery of high quality care, yet nurses receive little formal training in this non-clinical aspect of their role,” said Assistant Professor Elena Siegel of the Betty Irene Moore School of Nursing at the University of California, Davis. “It’s wonderful to see how PHI’s Coaching Supervision program is supporting nurses’ development in this area.”
There was also a high level of interest and excitement in the relevance of this approach for culture change efforts in nursing homes. “PHI has an exceptional approach to helping organizations on their culture change journey,” said Pioneer Network Executive Director Bonnie Kantor. She continued: One of the core values of culture change is that “relationship” is the fundamental building block of a transformed culture. I think that the skills, attitude, and knowledge gained through the training could assist care providers at all levels of the organizations in creating the kind of caring, effective, and efficient culture that we all desire.
The group of seasoned professionals also found the discussions, small group exercises, and skill practice sessions to be highly relevant to their own personal and professional lives. The PHI Coaching Approach draws upon the skills of active listening, self-awareness, self- management, and clear communication without blame and judgment. When practicing these skills in the classroom setting and back on the job, participants learn a dramatically different way to support individuals and teams than that offered by traditional supervisory approaches. More
Older People Mentor Troubled Teens in 'Granny Knows Best' Project
(Source: Martin Beckford, Telegraph.co.uk)
The elderly
are being encouraged to share their knowledge
More
than 50 “Grandmentors” will be assigned to young
people in London, providing them with support and advice. The aim is that the
retired volunteers will help the 14- to 19 year-olds in their care return to
education or find work, improving their career prospects and turning them away
from a life of crime.
Lord Freud, the Conservative peer who is now a junior minister for welfare
reform, proposed the idea to Community Service Volunteers. He said: “I think
there is huge, untapped resource of older and retired people who could
transform the lives of youngsters, many of whom don’t have someone independent
to talk to. I also think there’s huge potential in jumping a generation to help
tackle some of the serious problems facing young people in our society. I think
it’s much harder to grow up with so many competing pressures, but there are
many older people who could provide practical and emotional support.”
His project is being backed by Iain Duncan Smith, the new Work and Pensions
secretary, who said: "It's clear that older people have an important role to
play in building a Big Society, forging closer intergenerational links and
strengthening communities. I look forward to seeing the Grandmentors
programme in action and hope that it will encourage
key values such as respect, responsibility and civic awareness that are
essential to tackle social breakdown and help young people take control of
their lives and make the right choices for themselves and their families."
Lord Freud’s family charity, the JECDA Foundation, is funding the pilot scheme
together with Sir Harry Solomon, a retired businessman. It will see the Youth
Offending Service and Children’s Service in Islington, along with BSix College in neighbouring Hackney, refer up to 60 teenagers over the next three years
to trained and screening Grandmentors. The scheme
will then be independently evaluated by researchers from Manchester
Metropolitan University, led by Prof Chris Fox, and if deemed successful could
be expanded nationwide. More
Nonprofits + Older Volunteers = Great Return
(Source: www.ncoa.org)
Baby Boomers reaching retirement are ready to volunteer their talents to nonprofits—and the potential payoff is big. In three years of work with 60+ nonprofits, we’ve learned what it takes to turn the Baby Boom into a resource boom. On average, for every $1,000 invested in skilled older volunteers, nonprofits enjoyed a return of $8,000! Read more findings in our new report.
The Silver Generation: India's Seniors Come to the Forefront
(Source: news.rediff.com, first published in India Abroad)
When Hiren Mehta started managing a day care program for seniors
in Mumbai [ Images
], he had certain ideas about what older India [ Images
]ns wanted. "We used to have spiritual discourses and old movies here
originally," he says in his office next to a temple off a bustling side
street in
Harmony Foundation,
which runs the day care center does not even call them
seniors. It calls them Silvers. Every year they give out the Silver Awards for
exceptionally active seniors. Mehta showed me a calendar with the 2009
winners. Bhausaheb Thorat,
84, launched one of
That is taking some
adjusting all round. 80 million Indians are already
over 60. But they are just starting to understand the power of those numbers.
"We are not an organized sector," complains M R Parasuram
sitting in his air-conditioned office in 
A
ll of this
is new territory for India. Though the welfare of older citizens is written
into the Indian constitution, it is mostly on paper. For the lucky, old age was
about grandchildren and religious hymns. For the unlucky, it meant being
warehoused in one of the government's dreary homes for the aged or even cast
out on the streets. But now a growing number of India's seniors are starting to
take their future into their own hands. More
Elderly People 'Should Be Allowed to Keep Pets in Care Homes’
Elderly people should be allowed to keep their pets when they move into a care
home, preventing the needless destruction of thousands of animals every year,
MPs were told.
(Source: www.telegraph.co.uk)
Nigel Waterson, the shadow minister for older people, said his Care Homes and Sheltered Accommodation (Domestic Pets) Bill would ensure many elderly people would be able to keep their beloved animals when they have to leave their own properties. He told MPs some 38,000 pets were put down every year because their owners had been admitted into care in accommodation where animals were banned.
Mr Waterson, who
represents
He said: ''It is a staggering and very depressing fact that something like 38,000 healthy animals are put down every year simply because their owners are going into a care home or sheltered housing project and the rules do not allow them to take their pets with them.
''That's bad enough but it is also estimated that a further 100,000 pets have to be given up for adoption for the same reason and many of them become so distressed because of the feeling of being abandoned by their owners that they eventually have to be put down as well.
''I think this is totally unacceptable in a civilised country.'' He added: ''I'm not arguing for a blanket policy saying that every pet, from a python to a budgerigar, has to be admitted to a care home or sheltered housing. ''I'm simply arguing for a basic legal presumption that pets should be permitted subject to appropriate discussion about all the eventualities that can arise and provided they do not cause a nuisance to other residents.'' More