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CULTURE CHANGE THROUGHOUT THE CONTINUUM
OF LIFE-LONG LIVING & LONG-TERM CARE
“Real change happens when we shift our
perspective to adopt as our personal mantra:
"Up
Until Now." ~ Elaine Taylor-Klaus
1. GEORGIA
Georgia
Becky
Kurtz agreed to join AoA as the new Director of the Office of Long Term Care
Ombudsman Programs. Since 1994, Becky has served as the Georgia State
Long Term Care Ombudsman in
The
The
initial planning session for the pilot is scheduled for June 23, 2010 at the
offices of Aging Services of Georgia.
The
Advancing Excellence in
Every Nursing Home in Georgia Received a Free
Copy of Richard Taylor’s DVD,
“Be with me TODAY.”™
Due to the generous support of
Healthcare Research, Inc., EVERY nursing home in the state of Georgia
It is a remarkable documentation of Richard’s presentation, urging everyone to embrace the culture change philosophy of person-centered care and to recognize that “THERE IS A PERSON IN THERE!”
For
those of you who received one of the DVDs, we strongly encourage you to be a
CHANGE MAKER in your organization and in your community. Share Richard’s message with your staff,
families, residents and the greater community.
Make sure that everyone has an opportunity to learn the vital importance
of treating people who are living with dementia like PEOPLE, not a disease.
Ideas
to spread the word through the “Be with me TODAY”™ DVD: integrate it into your general training
opportunities; make it a part of new staff orientation; use it with support
groups or family councils; use it as an opportunity to start a group for people
who are living with dementia (newly diagnosed); create a “movie screening
event” and invite all staff, families, residents and the greater community to
come together. Be creative… And be a DIFFERENCE MAKER and a CHANGE AGENT! Thank You to
Healthcare Research Foundation! MORE
Atlanta
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ARC’s Lifelong Communities Initiative is one of eight projects
from around the world that received the Congress for New Urbanism’s 2010
Charter Award for Excellence in Urbanism. The award was presented May 22 during
the 18th Congress for New Urbanism (CNU) held in
Lifelong
Communities was chosen from among 90 entries fielded from around the world.
The award recognizes the initiative for collaboration among ARC, nonprofit
organizations, public partners and Duany Plater-Zyberk (DPZ) to examine ways in
which the region’s built environment poorly meets the needs of a
rapidly-growing elderly population. Using the knowledge gained over the course
of a nine-day charrette, DPZ created plans to turn major sites in six counties
into communities that better supports residents at every stage of their lives.
Elder Abuse Project Announced For Georgia County
(Source: Ctpost.com)
ATLANTA
(AP) — DeKalb County is teaming with Emory
Healthcare to offer a new program to investigate abuse of senior citizens and
find them temporary shelter — one of the first such programs in
the country. MORE
Check Out Of the Hospital - And Stay Out
Georgia Pilot Program Aims to Cut State Hospital Readmission Rate
Of 17.7 Percent
(Source: AARP
Bulletin)
·
Up to 40 percent of
hospital readmissions are preventable.
·
·
Medicare-funded pilot
program under way in Gwinnett, Rockdale and Newton counties.
·
·
In Georgia, 17.7 percent
of Medicare patients wind up back in the hospital within 30 days. MORE
Does Your Staff Have The Same Quality
Housing As The Residents You Serve?
Aging
Services of Georgia Works with Habitat for Humanity to Benefit Front-Line Staff
Aging
Services of GA members are committed to offering their residents the best
housing and services possible. You know
your residents enjoy quality, safe and affordable housing. But…do you know if all of your staff enjoy those same quality
standards in their own homes?
According
to a recent national report by the National Low Income Housing Coalition (Out of Reach 2009), rent has increased
in
Front Line Staff Could Benefit
from Affordable Homeownership through the Habitat for Humanity program. You can be the link by
connecting your staff members with the Habitat for Humanity affiliate in your
area and providing valuable information.
The benefits to your organization could be many…better staff retention
when employees are homeowners, thus adding value to their job, a more
financially stable staff, and staff possibly living closer to work, cutting
commute time and cost. You provide the
mentoring contact for your staff. They
will know that you care about the quality of their housing, too.
By
the way, there are more than 70 Habitat for Humanity affiliates across
2.
CULTURE CHANGE NEWS
CMS Official Honored For Work with Nursing Homes
Kudos To Karen
Schoeneman ~ THANK YOU For All That You Do!!!
Karen
Schoeneman, deputy director of the Division of Nursing Homes at the Centers for
Medicare & Medicaid Services, has received the 2010 Picker Institute Award
for Excellence. Schoeneman was recognized for her continuing efforts to
bring the culture change movement to nursing homes in the
Ground-breaking "Nurse Competencies for Nursing Home Culture
Change" Released
Hartford Institute for Geriatric Nursing
in Collaboration with the Coalition of Geriatric Nursing Organizations and
Pioneer Network Finalize Competencies Completed in a Two-Year Initiative of
Historic Proportion
Pioneer
Network Executive Director Bonnie Kantor announced that a two-year initiative
designed to develop nursing competencies specific to nursing home culture
change that brought together nursing and geriatric experts from across the
country is now complete. The resulting document, "Nursing Competencies for
Nursing Home Culture Change," offers ten competencies deemed most relevant
and critical for creating and sustaining person-directed care. The initiative
was supported by the Commonwealth Fund.
In
2008 Hartford Institute for Geriatric Nursing (HIGN) collaborated with
Coalition of Geriatric Nursing Organizations (CGNO) and Pioneer Network to
convene a panel of 31 nursing and other experts to explore opportunities and
barriers for nursing and culture change. The panel worked to answer the
question, "what is the role for nurses in achieving and sustaining this
change?"
"I'm
excited by these competencies because they are the first step in defining the
role nurses must play in this civil rights movement we call Culture
Change," notes Diane Carter, CEO of the American Association of Nurse
Assessment Coordinators (AANAC). It is just simply the right thing to
do." READ MORE
Pioneer Network Completes Year-Long Project Designed to Increase
Consumer Knowledge about Long Term Care and Culture Change (Georgia
Participated in Pilot)
Consumers Want to Know What Culture Change "Looks Like"
Pioneer
Network is pleased to announce the completion of a year-long project dedicated
to increasing consumer interest in long term care and culture change. In 2009, Pioneer Network received
a grant from The Picker Institute to develop the project, Changing the Culture of Aging:
Taking a First Step to Creating Knowledgeable Consumers. During the
year-long project discussion groups were hosted in private homes to discover
the most effective means of sharing information about culture change, and
determine consumer interest in learning more about person-centered care.
Findings
from the project were telling. The pilot study confirmed what we intuitively
know—that consumers' knowledge of long-term care comes from reactive
circumstances. That is, it is related to their personal experiences or a sudden
and immediate need.
In all, 502 consumers—over half of them Baby
Boomers—attended small-group discussion meetings in
Most important, a majority (78%) of consumers who participated wanted to
learn more about culture change. In particular, they wanted to
know what it "looks like" and how it would be affordable. The
outcomes of the pilot study reinforce the understanding Pioneer Network shares
with The Picker Institute—that this is the time to rally around the consumer
and fully engage the broader community in the culture change movement. MORE
Culture Change Close to Home
(Source: Provider Magazine)
Providers in most states can find
educational resources and training opportunities on culture change in their own
backyards. The Pioneer Network, a nonprofit
organization whose mission is to facilitate deep system change in long term
care, shares information and resources with national stakeholder organizations
and 30 state culture change coalitions to promote culture change and
person-centered care.
The primary purpose of the
coalitions is to advance culture change in their respective states through a
variety of activities, such as presenting educational programs and networking
meetings for providers; developing communication vehicles, including newsletters
and Web sites; and educating policy makers and regulators about culture change.
The table below contains
information about state-level culture change initiatives that are coordinated
by state survey agencies (SSAs) and/or state culture change coalitions. Among
the initiatives are a number of opportunities for providers to obtain technical
assistance, training, and even grant funds.
Click
here for Provider Extra News Online article, "Culture Change Close to Home
Dr. Richard Taylor Launches “Donate a Dollar to Dementia” Campaign
Funds Raised Will Support Awardees of the 2010 Carter Williams
Legacy Fund
The
Carter Williams Legacy Fund is a grant program to support the personal growth
of individuals involved in creating a new culture of elder care and aging. Last
year the Carter Williams Legacy Fund Honoree was Dr. Richard Taylor, a speaker,
author, blogger and retired psychologist. Dr. Taylor has launched a new
fund raising campaign, "Donate a Dollar to Dementia," which will
provide support for the 2010 Carter Williams Legacy Fund.
"We are not just a 'disease' that needs a
cure," says Dr. Taylor. "We are whole human beings who just happen to
have that diagnosis. People with dementia are whole people and should be
treated as whole people!"
The focus of this year's Carter Williams Legacy Fund awards will be on
individuals who are directly engaged in research and support of folks who have
been diagnosed with dementia-related illness and the caregivers who support
them. MORE…
More Retirees Find Facilities Speaking Their Language
Senior Centers, Nursing Homes Respond to Increased Diversity
(Source: The Washington
About
10 percent of Americans over age 65 are foreign born, according to the Pew
Research Center. AAHSA President and CEO Larry Minnix recently told The
Washington Post that as that number increases to 20 percent by
2050, more retirement communities will be looking for ways to attract foreign-born
residents and make them feel at home. Some AAHSA members have gotten a head
start in that effort.
"Everyone
is going to have to learn more about various ethnic and cultural sensitivities,
because the marketplace of aging is getting more diverse," said Larry
Minnix, president and chief executive of the American Association of Homes and
Services for the Aging. "I think, over the next five to 10 years, you're
going to see a lot of attention paid to this." MORE
Creating Home in the
Nursing Home II: A National Online Symposium on Culture Change and the Food and
Dining Requirements STILL AVAILABLE!
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Pioneer Network and the Centers for Medicare &
Medicaid Services (CMS) are collaborating to offer this special online
symposium to focus specifically on culture change and dining. (This is the
Symposium that was snowed out earlier this year...) Innovations in dining including liberalized
diets, buffet-style service and reductions in bib and supplement use have been
welcomed by providers, but they often struggle integrating new approaches with
the regulatory guidelines. The sessions offered below will address dining
initiatives and explore potential and perceived regulatory barriers so that
both innovators and regulators can come to a common understanding of responses
congruent with OBRA '87. (NOTE: Be sure to check out all of the background
papers!) More
It’s Never 2 Late/Pioneer Network Person-Centered Care 3 Minute Video Contest
Enter
to Win $500 and a Chance to Showcase your Organization's Initiative at the
Pioneer Network’s National Conference! Are you doing things in your community
that would blow away the rest of the country if they could only see it? It's
Never 2 Late and Pioneer Network have teamed up to sponsor a video contest!
First prize winners will receive $500 and will be highlighted during the
closing luncheon at the Annual Conference in August!
We
know that there are amazing initiatives are happening in your organizations
with technology and with dining. Can you capture person-centered care in your
community while the residents are using technology? Or show how your dining
program is person-centered? Submit a short video, no more than three minutes in
length in either the technology or dining category.
READ MORE
3.
CULTURE
CHANGE EVENTS
Conversations with Carmen
Webinar
June 18th Topic: Dementia Beyond Drugs - Changing The Culture of
Care
Guest: Dr. Al Power, MD, Board-certified Internist, Geriatrician,
Nursing Home Practitioner, Eden Alternative Mentor/Educator
Dr. Al
Power has recently contributed greatly to the culture change movement with his
new book Dementia Beyond Drugs: Changing
the Culture of Care. We are hoping this book will become a manual for
physicians, nurses, social workers, administrators, students and anyone on the
quest to create a relationship-rich and psychotropic drug-less culture
especially for those living with dementia. During this conversation, Dr. Power
will explain how to move away from the institutional model - viewing
individuals as patients defined by their dementia and using prescribed
medications to control their "troublesome" behaviors - to what he
calls an experiential model of care "dementia beyond drugs" in which
many people formerly sedated "awaken" from what Dr. Power describes
as their "calmatose" state with remarkable outcomes.
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! To register CLICK HERE or
for more info: or
you can call our office: 414-258-3649.
Building Intergenerational Relationships through an Eden
Perspective
Webinar June 23, 2010 from 2-3 pm EST
Imagine a place where a 98-year old is feeding an
infant, where an 87-year old is sharing her walker with a youngster who's just
learning to walk, and where a 4-year old suddenly discovers that her 78-year
old friend has to take out his teeth to brush them. Imagine a place where
people of all ages come together, interacting, exploring, and guiding. Imagine
a place where people build meaningful relationships
In the past, there was such a place - the family
home - where the job of raising young Children and caring for Elders occurred
under one roof. The current setting looks much different, The Macklin Intergenerational Institute.
A place that cares for the young and old in child care centers and nursing
homes.
Through this webinar, you will explore the Eden
Principles as they work to build intergenerational relationships among Elders
and Children. Discover the power that relationships among and between
Children and Elders have on each of the Ten Principles and recognize the true
transformation that takes place when these two groups are given the opportunity
to know each other. REGISTER
Pioneer Network’s 10th National Conference
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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.
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SAVE THE DATE! October 14,
2010
3rd Annual Culture Change Network of Georgia Summit in Atlanta, Georgia
4. ATTITUDES ABOUT AGING
Happiness May Come With Age, Study Says
(Source:
Nicholas Bakalar, www.nytimes.com)
It
is inevitable. The muscles weaken. Hearing and vision fade. We get wrinkled and
stooped. We can’t run, or even walk, as fast as we used to. We have aches and pains
in parts of our bodies we never even noticed before. We get old. It sounds miserable, but apparently it is
not. A large Gallup poll has found that by almost any measure, people get
happier as they get older, and researchers are not sure why.
“It
could be that there are environmental changes,” said Arthur A. Stone, the lead
author of a new study
based on the survey, “or it could be psychological changes about the way we
view the world, or it could even be biological — for example brain chemistry or
endocrine changes.” MORE
Believing What You Hear: The Impact of Aging
Stereotypes on the Old
The
authors of a new paper point out that ageism is different from other
"ism" stereotypes because all humans will become old if they live
long enough. They reviewed four theories of how stereotypes affect older
adults. The stereotype threat hypothesis suggests that since older people are
well aware of negative stereotypes about older people, they try to avoid
conforming to these beliefs and in doing so, become anxious and stressed. This
anxiety leads older adults to fulfill the stereotype by, for example,
performing poorly on a test of memory. MORE
The
first, most important and unbreakable rule is that men have no place offering
opinions on whether women should or should not "go gray." We live in
a culture that penalizes women for all of the normal signs of aging and... MORE
Read more at changingaging.org »
Elderspeak: New Program to Improve Communication with Elders Now
Available
Language, and our choice of language has a very
powerful effect on those around us. Elderspeak was developed by Daniel
Baer, MD, to heighten awareness regarding the impact of communication tone and
content with elders. LEARN MORE
Aged Care Residents 'Voiceless Citizens'
(Source: www.theage.com.au
)
Australia's
aged care residents have become "voiceless citizens" who are told
what time to get up and what to eat, an international dementia conference has
been told. Dr Stephen Judd, chief
executive officer of aged care provider HammondCare, was scathing of the aged
care industry in his address to the Eighth Biennial International Conference on
Dementia in
"Does
anyone seriously believe that an older citizen in residential aged care has not
had their rights eroded, however subtly, by being obliged to conform to a
regimented schedule?" he said. He
said schedules in aged care facilities were dictated by what best suited staff
and operational objectives, not what best suited residents. He said many older Australians were forced to
get up and be dressed by 8am every morning.
"Why can't they sleep in?" he said. MORE
(Source: Bob DeMarco,
Alzheimer's Front Row)
I can't
tell you how many times I either heard or read these words -- I can't take
him/her out because she eats with her hands. I know this -- it is a big problem
among Alzheimer's caregivers… The positive effects of socialization,
initiative, and motivation on the part of Alzheimer's sufferers and their
caregiver should not be overlooked. I believe these are as important as the
medication... MORE
5. THE ELDERS
(THE PEOPLE WITH & FOR WHOM WE’RE DOING THE DOING)
Elders in NY Enjoying New
Cottage-Style Homes
Joy
and Positive Results Including Less Depression, Increased Appetite, Improved
Mobility
(Source: Stacey Pensgen, WHAM 13)
Western
New York has its first cottage-style homes for the elderly. Four of the 20-room
Wegman Family Cottages have been built in
6. THE STAFF (THE PEOPLE
DOING THE DOING)
Be Proud: Omar Cain, the
Rapping CNA
(NOTE: Now THIS is an amazing description of what it
can be like to be a C.N.A. who loves
their job! Please make sure you watch
this… HATS OFF To OMAR!!! )
For
Omar, being a CNA is very meaningful work. “I love interacting with the
residents and listening to them spread their knowledge about life,” Omar
explained. Omar made the decision to be a CNA after his aunt, who is a director
of nursing, encouraged him to try it out. Although he was unsure about pursuing
this sort of career, he quickly realized that the reason it was right for him
was because his heart is in the work. “Being a CNA is not for everyone,” he
said. He believes that showing integrity and respect is the way to provide his
residents with excellent care. Besides the fact that Omar is consistently kind
and helpful, the residents and staff members at Golden LivingCenter, Stenton
love the fact that he writes and performs his own positive raps about the
residents and being a certified nursing assistant. Since he has always loved music,
he chooses to use it as a way to spread love, caring and positive thoughts. WATCH NOW
Nationally,
over 3 million certified nursing assistants and licensed nurses work in
long-term care (LTC). Of these 3 million providers, about 2.5 million are
certified nursing assistants (CNAs) and the remaining 500,000 licensed nurses
are evenly divided between licensed practical nurses (LPNs) and registered
nurses (RNs).1
With the aging of our
population, experts estimate that the demand for this workforce will double in
the coming decades, requiring up to 5 million direct care workers, 868,000 RNs,
and 231,000 LPNs nationally.2 The
article lists three “key challenges” that must be addressed to reverse that
trend…
(Source:
PHI)
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“Raising public awareness of what’s close to
our hearts is the overriding goal of Come
Care with Me,” Tracy Lawless and Allison Lee of
PHI told participants at an Iowa
CareGivers Association (ICA) training workshop recently. The program invites legislators and other
policymakers to experience firsthand what direct-care workers from residential
and community-based long-term care settings do as they go about their day. Not
just a quick photo-op, Come Care With Me
gives the legislator a chance to work next to a direct-care worker and
experience the difficulties and rewards of the job.
Come
Care with Me
was first launched in
“It’s
a great way for direct-care staff to get their word out,” said Julie Rossow, director of nursing at the Madrid Home,
“but the facility also needs to feel it’s in their best interest. It’s well
worth it and nice to realize we are important and to know the community is
interested in making our jobs better.” Come Care with Me is
an opportunity to bring direct-care workers, employers, consumers, family
members, and policymakers together to better understand the rewards and
challenges of the direct-care job. BE
SURE TO WATCH THE VIDEO
IFAS Issues Direct Care Worker Report Has
Overarching Strategy of Culture Change
The
Institute for the Future of Aging Services (IFAS) has issued a report entitled,
Direct Care Worker Retention: Strategies for Success. The report lists factors
that support direct-care worker retention including information on competitive
wages and health benefits and an overarching strategy of culture change. Read
IFAS report
WIN A STEP UP and NC NOVA
This
article describes North Carolina’s efforts to create quality care through
quality direct-care jobs since the early 1990s.
Aided by money provided through the Better
Jobs Better Care program,
…high turnover and vacancy rates
continue to be a major concern for states.
With the aging of the population and advances in medical care that help
people live longer lives, demand for well-Trained, quality direct care workers
will grow rapidly.
The
WIN A STEP UP program provides bonuses
and wage increases to direct-care workers who complete a certain amount of
training. It has been recognized by the U.S. Department of Health and Human
Services (HHS) as a proven method of reducing worker turnover.
Meanwhile,
the North Carolina New
Organizational Vision Award (NC NOVA) was established to recognize care
facilities that work especially hard to maintain a strong, well-trained staff
of direct-care workers.
7. FROM, FOR & ABOUT
CAREGIVERS & CONSUMERS
New Videos Provide Tips for Transitions in Care
While
caregivers face a range of challenges every day, few can generate as much concern
and uncertainty as trying to successfully manage a transition in care from the
hospital to the home setting. That’s why
the Centers for Medicare and Medicaid Services’ (CMS) Ask Medicare initiative has developed two
new videos to help caregivers and their loved ones successfully navigate the
process. The videos present practical, easy-to-follow tips and highlight
resources for additional support.
Tips
for Making a Hospital to Home Transition provides insights and expert guidance
on important issues caregivers need to plan for, and manage, when bringing a
loved one back home from the hospital. It offers advice on maintaining
effective dialogues with healthcare providers, preparing the home for new
equipment needs, planning for additional expenses, and more.
The
Planning for Your Discharge Guide offers a detailed checklist, developed by CMS
to help caregivers and their loved ones walk through a range of questions that
must be answered to ensure a successful and stress-free future of in-home care.
Visit
the Ask Medicare Web site at www.medicare.gov/caregivers
to view these and other helpful resources, including a free e-newsletter,
real caregiver stories, and targeted tips and tools. MORE
Women Are the Backbone
of American Caregiving
(Source: PHI)
Despite
significant changes over the last 30 years in women’s roles at home and in the
workplace,
New
research from Paraprofessional Healthcare Institute (PHI) shows that not only
are these workers female, but compared to the female workforce as a whole, our
caregiving system increasingly relies on older women to care for the very old.
In 2008, 22.1% of direct-care workers were reported to be
ages 55 and older, compared to 18%
of women in the civilian workforce overall. Personal-care workers were even
older, with nearly 30% being ages 55 and
older.
Direct
care is
Handing Over the Keys:
Consumer Empowerment and Aging Services
Who Knows What Consumers Want? They Do!
(Source: Sarah Mashburn,
futureAge)
From
the shopping mall to the service hotline, the challenge of finding out what consumers
want and figuring out how to provide it is an issue all providers (aging
services or not) face. So, what better way to get started than to ask a few
consumers themselves?
Join
the author as she hits the road to talk to seniors in her hometown, and looks
at how providers there and elsewhere are making responsiveness to consumers a
central element of their work. MORE Handing Over the Keys: Consumer
Empowerment and Aging Services
(Source: PHI)
The
Pioneer Network has completed a research
project exploring consumer knowledge of culture change in long-term care
facilities. The study — which consisted
of a series of discussion groups attended by consumers — found that nearly four
out of five consumers wanted to learn more about culture
change: what it looks like and how providers pay for it.
“A major finding of this project was the need to
educate consumers about options,” said Joanne Rader, the
project director. “Those who had been
exposed to the traditional model were unaware that things could be different.
Those who had little contact with nursing homes were surprised that there could
be such a lack of choice about basics such as when you decided to get up and go
to bed,” Rader said.
As
a result of the study, Caring
for the Ages, the monthly publication of the American Medical
Directors Association, has begun publishing a series of informational tear-outs
on culture change. The first installment, “Person-Centered
Care: What It Means to You and Your Family,” was published in the March
2010 issue.
“I
am really excited about this project,” said Susan
Misiorski, PHI National Director of Training and Organizational
Development. “As consumers become more knowledgeable
about what is possible to expect from the support systems available to them,
they will seek out only those organizations that embrace the principles and
practices of the culture change movement.”
MORE…
Female Caregivers Face A Heavier Toll: More Prone To Depression
than Men When Watching Over Ailing, Elderly Parents
(Source: HealthDay News)
A
new Canadian review finds that adult daughters suffer more than adult sons from
poor relationships with ailing and aging parents who need their care. "Adult daughters place greater emphasis
on their relationships with their parents, and when those relationships go
awry, it takes a worse toll on the adult daughters than the adult sons,"
said review author Marina Bastawrous, a graduate student at the University of
Toronto…
Why
do women get hit harder by strained relationships? "In terms of society's
norms, the responsibility to care for parents tends to fall on the women,"
Bastawrous said. "It almost becomes ingrained as their responsibility.
When they can't meet those expectations, the toll is worse on them than on sons
who aren't expected to take on that role."
Men, in contrast, may not see caring for parents as their primary
concern, she said. MORE
8. LIVING LIFE &
ACTIVITIES
Improve Operations With
Life Stories?
A comprehensive, consistent reminiscence
program may be right for your community IF your goals are to....
Read LifeBio’s Operations and
Reminiscence White Paper HERE
9. DEMENTIA
Helping Elders Live
With Dementia, Including Alzheimer’s
(Source: Doris Bersing, PhD, www.careminds.com)
The
Federal Interagency Forum on Aging-Related Statistics estimates that by 2030, 20
percent of the population will be 65 or older, compared with 13 percent in
2000. With this population explosion comes a growing concern about mental
health issues related to older Americans…
In
a society that values youth and productivity, many of these elderly have
limited access to mental health services; few receive the support they need to
alleviate symptoms. The emphasis in most
assisted living facilities is primarily on the physical needs of the residents—
have they eaten? taken their medications? been bathed? This, combined with
staffing shortages, and a growing trend whereby elders are being cared for at
home by inexperienced, albeit loving, family members, means that millions of
older adults’ needs for psychological support are not being met.
Issues
of depression, loneliness, forgetfulness, powerlessness, and communication
problems can be painful and difficult to deal with. Elders confronting these
challenges who have an outlet by which to express them are less likely to feel
isolated and overpowered by the accompanying emotions. Whether
institutionalized or not, seniors can benefit from art therapies and other
expressive arts. All humans are creative, but for those living with dementia,
that impulse may need to be supported and encouraged by others trained to
foster creative expression. ..
Mr.
Eddy, a wise client of mine, taught me that people with dementia are not
necessarily demented, and that if we make the effort to learn a different
language, we can communicate with our elders and understand the richness of
their experiences. First, we need to change our views of elders and recognize
that despite their diminishing mental abilities, they still possess a soul. MORE
Name That Tune: Alzheimer's Patients More Easily
Recall New Information When It Is Sung to Them
It
has been said that music has charms to soothe the savage beast. Now, research
shows it also may have the power to help Alzheimer's patients remember new
information. Researchers at the Boston University School of Medicine set out to
determine whether Alzheimer's patients would be better able to recall new
information if it was sung to them, as opposed to merely spoken. Alzheimer's
patients and older healthy control subjects were visually presented with the
lyrics to 40 songs. Half of the lyrics were presented along with the original
recordings. The other half was presented in a spoken format.
The
Alzheimer's patients could more easily recall the lyrics when they were
accompanied by the musical recording, according to the researchers.
Surprisingly, however, the healthy control group did not experience the same
memory benefit of the musical recording. This seems to indicate that the memory
encoding and retrieval process of musical information in Alzheimer's patients
is fundamentally different than in healthy seniors, according to the study. The
report appears online in the journal Neuropsychologia.
Senior
living communities, retirement communities, assisted living, skilled nursing,
adult day programs, and other organizations have a growing interest and need
to enhance or add memory care programs to their offerings. Here
are four tips to consider for your memory care program of the
future... MORE
10. DISABILITY COMMUNITY
A
recent U.S. Census Report estimates that cognitive disabilities (e.g., brain injury,
developmental, intellectual disabilities, mental illness, etc.) affect more
than 16 million Americans aged 15 and older. More than half of the
individuals have one or more disabilities that interfere with daily activities
throughout their lifespan.
Eden
LifeLong Living promotes the well-being of all members of the LifeLong Living
Community—residents and staff alike. When environments offer opportunities for
growth, and a sense of community, belonging and purpose, everyone thrives.
Everyone deserves the chance to live a meaningful life. By transforming
traditional custodial long-term care environments into vibrant LifeLong Living
communities, Eden LifeLong Living helps to create a better and brighter future
for people with cognitive challenges and the individuals who support them. MORE
11. TECHNOLOGY
For
families with hectic schedules, trying to attend Care Plan Meetings, which
occur during daytime work hours, can be a major challenge. Of course they don't
want to miss the opportunity to meet with the whole treatment team to provide
and gather information, and to advocate for their loved one. On the other hand,
taking time from work and other obligations may prevent even the most dedicated
family member from being able to show up for this very important meeting. Using
the free Skype or another video call option would allow family members to be
present from almost anywhere -- even halfway across the world.
For
nursing homes, offering families the option to Skype into Care Plan Meetings
shows their understanding of the challenges faced by family members and their
dedication to customer service. It highlights their commitment to providing the
best possible care for the residents, which includes facilitating the ability
of families to be part of the treatment team. And did I mention it's free? MORE
MA Nursing Home Uses Skype
to Bring Families Together
(Source: Meghan Foley,
The
Williamstown Commons can now bring family members face-to-face over thousands
of miles using their new Skype-ready computer… The first resident to use the
Skype was Mary Ann DiLego, 71. DiLego was injured in a car accident last
December. At the time, her daughter came out from
Alzheimer's and Caregivers Educational Event -- No Tech, Low Tech
(Source: Laurie Orlov, www.ageinplacetech.com)
Big conference, lots of empathy and caring. It's been a while since I attended an event exclusively focused on Alzheimer's -- I wondered if the curiosity about technology potential I encounter at so many other events would be duplicated. The 2010 Alzheimer's Educational Conference in West Palm Beach kicked off yesterday -- attended by professionals and caregivers, exhibit hall filled with senior housing offers (dementia units, respite), hospice and home care agencies, educational programs, local resellers, elder law services, and research programs…
I left
the event in a gloomy mood. There's no cure for Alzheimer's and most
Alzheimer's sufferers are cared for in the home -- it seems like there are
monitoring technologies that could give a caregiver respite, but none were
discussed. Yet caregivers are suffering terribly, especially as the disease
progresses -- an earlier session described them as mostly women, mostly older,
those with chronic disease having a 63% higher mortality rate. They are
committed to a task that becomes nearly impossible towards the end; and for
many caregivers, it is followed by their own collapse.
At
the end of the keynote presentation on the prospective new test for
Alzheimer's, the first question from the audience to this cheerful and
unsuspecting scientist was defiant: "What are you doing about those who
already have Alzheimer's today?" Why, nothing, he said, as I left the
room. Exactly. MORE
12. DESIGN & ARCHITECTURE
Housing Needs To Evolve For Aging Population
New
Book Calls For Design to Better Suit People’s Disabilities
One
major aspect missing from recent health care reform conversations is housing,
especially with regard to the aging population of the United States, according
to three University of Arkansas researchers who have collaborated on a new
book: Just Below the Line: Disability,
Housing, and Equity in the South. Problems
in housing will become increasingly evident as the first wave of baby-boomers
enters retirement over the next few years. In the
Post-World
War II housing no longer fits the current baby-boomer lifestyle. It was designed
for young, working families, not for an older population. Not only will those born in the surge
following World War II likely live longer than previous generations after
retirement, they’ll also demand more independent residential living than traditional
nursing homes or assisted living facilities.
Yet, the amount of government funds spent on health care versus housing
is a 15-to-1 ratio…
“We
need to be thinking about how we design housing to meet the variety of needs of
the current population,” Smith said.
Disability should be redefined “as a normal part of human existence,
that it exists along a continuum,” Williams said…
Nevertheless,
functioning is often determined not by the health or abilities of the
individual, but by design. Design can enable or disable daily functioning.
Out-of-date housing is one of those hurdles, particularly in the South, where
reverence for tradition makes change difficult and slow. MORE
Center for Health Design to Address LTC
Facilities in Upcoming Design Guidelines
Committee
work will begin shortly on the Facilities Guidelines Institute’s (FGI) 2014
Edition of the Guidelines for the Design and Construction of Health Care Facilities.
To help identify and provide comments for the long-term care chapters of the
guidelines, The Center for Health Design (CHD) is forming a workgroup of
industry experts. The workgroup project, which is being funded by the Hulda B.
and Maurice L. Rothschild Foundation, is scheduled to begin in June. A group of
15-20 individuals who are well versed in the current guidelines and regulations
are meeting to develop topic areas of focus and form sub-workgroups to prepare
comments over the next 3-4 months.
The
project’s primary goal is to articulate and finalize the sub-workgroup
participants’ comments on FGI’s proposed 2014 Guidelines by September 2010. The
comments will be collected and input as soon as FGI announces the opening of
the 2014 Guidelines public comment period. A secondary goal of the project is
to identify areas where additional research is needed to support design
strategies in long-term care and senior living facilities with evidence-based
design. “Research is one of the main drivers of change in the Guidelines,” said
CHD President and CEO Debra J. Levin. “But currently, there isn’t as much
research being done in long-term care and senior living facilities to connect
the design of the built environment with outcomes as there is in acute care.”
13. NURSING HOMES
Supporting
Culture Change: Working Toward Smarter State Nursing Home Regulation
(Source: The Commonwealth Fund)
The traditional nursing home regulatory approach, which uses survey
and enforcement to achieve performance improvement, has created tensions
between providers and surveyors. It has had limited success in improving
quality overall and not necessarily allowed innovation to flourish. This has
been the perception of many homes wanting to undergo transformative “culture
change” reforms. To move toward a new model of nursing home regulation, the
states and federal government must strike a balance between the traditional
regulatory approach to weed out substandard facilities and a partnership model
aimed at promoting high performance. This issue brief highlights the importance
of how such a model is structured, as well as the need to adequately train and
educate regulatory staff and providers about culture change. Regulators,
providers, consumer groups, residents, and their families also will need to
commit to the principles of person-centered care to ensure the success of the
new collaborative approach. MORE
Eight Projects to Get More
Than $160,000 to Improve Quality Of Life in
(Source:
“These grants will enable our
high quality nursing facilities to further enhance the nursing home residents’
everyday experiences,” Governor Douglas said. “I am pleased that we will be
able to help our elders live better, fuller lives.” Jim Beeler, President of
the Vermont Health Care Association said, “It took ten years to accumulate
enough money to make this grant process successful. That says something about
the high quality services our nursing facilities provide.” The grants were
funded by regulatory deficiency penalties collected from the state’s skilled
nursing facilities over the last decade. MORE
14. ASSISTED LIVING
The
National Center for
Assisted Living (NCAL) released a new report entitled “2010
Assisted Living State Regulatory Review,” (pdf) which provides a
state-by-state summary of assisted living regulations in 2009 for 21
categories. “Staff Education/Training,”
“Staff Training for Alzheimer’s Care,” and “Continuing Education Requirements”
for assisted living facilities are among the regulatory categories included in
the March 2010 report. The NCAL report notes that “at last eight states
increased or changed required staff training.”
“As
assisted living becomes a part of the full array of long-term care supports and
services in more states, it is good to see growing sophistication and
effectiveness of state training programs for direct-care staff,” said PHI
Midwest Director Hollis Turnham. Staff
Education/Training regulations vary widely state-by-state. In
The
report explains that there are federal laws that impact assisted living but
oversight of assisted living occurs primarily at the state level… At least
22 states reported making statutory, regulatory, or policy changes in 2009
impacting assisted living/residential care communities or assisted living
Medicaid coverage.
Yoga Can Improve Sleep among Assisted Living
Residents
Assisted
living residents would sleep at lot better at night if their communities
offered regular yoga classes, say researchers at Fooyin University in Taiwan.
During a six-month study, the researchers found that yoga practice helped
reduce the sleeping problems that residents of assisted living communities
commonly experience.
Those
sleeping problems were the topic of another study of assisted living residents
by researchers at the
On
average, they slept about six hours per night and for about one and a half
hours during the day. Researchers found
that residents’ poor sleeping habits were associated with lower health-related
quality of life, a need for more help with activities of daily living and more
symptoms of depression. Yoga classes helped participants in the
15. ADULT DAY
Adult Day Care for Alzheimer's Patients
(Source: Carol Bradley Bursack, Editor-in-Chief, ElderCarelink)
Caregivers
of folks with early on-set Alzheimer's face unique challenges, not unlike those
who care for parents or children who have suffered debilitating brain injuries.
These younger people often don't quite belong with the older generation found
in many adult day care settings… MORE
Adult Day Programs May Help Reduce Caregiver
Stress, Research Finds
According
to researchers at Penn State University, family caregivers with no formal
training who provide care to relatives with dementia are frequently overly
stressed. The study, published in Aging
& Mental Health, was conducted by Dr. Steven Zarit with a $3
million grant from the Institute on Aging. The focus was on how adult day care
impacts the stress levels of all individuals involved. Findings from the study
showed that participants experienced "radically different types and
amounts of stress." Read more about caregiver stress
16. HOME & COMMUNITY-BASED
SERVICES
When Culture Change Meets
Home and Community-Based Services
Several culture change models are well established in skilled
nursing, but how can they be adapted to home and community- based
services? Here is a look at how
providers are putting culture change to work for their clients, with a special
emphasis on building engagement and fighting isolation for clients still living
in their own homes…
(Source: Morgan Gable,
futureAge)
The
culture change movement is usually associated with modifying the environment of
nursing homes. Various culture change programs have emerged, including the
Pioneer Network, the Eden Alternative, Green Houses and the Planetree movement.
The Pioneer Network was developed in 1997 to change the way long-term care
services and supports are delivered throughout the country. The Planetree
movement dates back to 1978 and has been mostly associated with creating a
person-centered environment within an acute care setting. The Eden Alternative
also focuses on the transformation of nursing homes, and Green Houses have been
developed to downsize larger facilities to provide a more intimate caring
environment that has the atmosphere of a true home.
As
receiving care and services at home and in the community is becoming more
popular and desirable, culture change ideas are creeping into home and
community-based services (HCBS). Although we have become better at providing
care at home or in a community-based setting, there is still a danger that a
client may no longer feel like a valuable member of society if his or her days
are filled with receiving medical care, taking medicine and arranging doctor’s
visits, even if it is in his or her own home.
Providers
are asking, “How can we provide care and services for older adults in their own
homes and communities without creating ‘institutions’ within the walls they
call home or within the programs they attend?”
MORE When Culture Change Meets
Home and Community-Based Services
17. CONTINUING CARE RETIREMENT
COMMUNITIES
New Metrics to Define Value of Wellness in
Retirement Communities
(Source:
The
International Council on Active Aging (ICAA) and the ProMatura Group announced
the release of the ICAA/ProMatura Wellness Benchmarks. For the first time,
industry-wide metrics will capture the contribution and value of
wellness—lifestyle activities, fitness and recreation—to a retirement
property's mission and bottom line. "For the owners of retirement
communities, it has been challenging to determine how an investment in wellness
will return to the property," explains Colin Milner, CEO of
International Council on Active Aging. "Now, with these potentially
industry-changing metrics, organizations will have the ability to analyze the
contribution wellness has on their bottom-line, especially given the
current economic environment. This information is even more important for
advance planning, as owners decide not only what will attract residents 10
years from now, but what will keep them engaged." MORE Management section of the
ICAA website.
18. EDUCATION/UNIVERSITY
INVOLVEMENT
Timeslips Narrative Therapy at Penn
State College of Medicine
(Source: Danny George, www.themythofalzheimers.com)
_files/image010.jpg "Untitled-10 by dgeorge2844, on Flickr")
What is the power of story? Clearly, narrative is a critical unit of
understanding for human beings. We learn through stories, teach through
stories, and construct a meaningful reality by absorbing the stories of others
and creating our own narratives.
Because
storytelling is so essential to the human experience — even for persons with
dementia whose decline may compromise the ability to fully engage in narrative
— there has been a strong push to harness the power of stories in eldercare
environments. In the 1990s, Anne Basting, one of my mentors, developed an
innovative program called Timeslips, which is now used worldwide…
As
an undergrad, I wrote an independent study on Timeslips, and that’s why it was
particularly gratifying to incorporate the technique into a class I recently
taught at Penn State College of Medicine called “The Narratives of
Aging”. My 4th-year med students conducted four Timeslips sessions on the
locked dementia unit at a local residential home. The experience was an
all-around success; my students went above and beyond in their engagement with
residents, and the residential home will now be implementing Timeslips at all
of its sites in
Students at Penn State Give
Facelift to Nursing Home
(Source: Barb
Consiglio, WeAreCentralPA.com)
As his
last major school project before graduating from
19. MEDICAL COMMUNITY
Culture Change Is Encouraged To Find Balance
Between What Is Important To the Individual As Well As Their Health and Safety
(Source:
www.ncmedicaljournal.org)
Driven
in part by the aging baby boomers, the focus and definition of service quality is
changing. Culture change toward more person-centered practices is encouraged
through the service industries, as well as through the Department of Health and
Human Services and federal funding agencies. These changes promote finding a
balance between addressing what is important to individuals (as defined by the
individuals themselves) while also attending to a person’s health and safety.
It shifts staff focus from the person’s medical treatment or service needs to
how these needs can be met in the context of what is important to the
individual. Person-centered practices also support workplaces that are
attentive to staff needs, recognizing that promoting more satisfied staff will
result in more stable staff. MORE
Identifying Challenges and Opportunities for the
Long-Term Care Medical Practitioner
(Source: www.ncmedicaljournal.org)
Caring
for residents in skilled nursing facilities is often different than caring for
residents in the community or outpatient setting. Discussion and review of
goals of care between the patient and family and the interdisciplinary team are
crucial. In order to provide
person-centered care, one must understand the physical, medical, personal, and
even spiritual needs and expectations of a patient.
In
contrast with a more interventional disease driven model, caring for a resident
in a long-term care facility is frequently more about disease management and
how these processes affect the resident’s quality of life. It is important to
review and discuss expectations in order to facilitate and accommodate the
patients and their families’ needs.
In
the state of
Local
and coordinated community utilization of the MOST tool between facilities,
emergency medical services, hospital, and emergency rooms is important in
implementing this tool successfully. The admission process to a SNF is a good
opportunity to discuss and review goals of care with a resident and their
families when applicable. MORE
“Rum Raisin, Monkey Crunch, and Mocha Frappucino
Cherry with Gummy Bears on Top:” Striving for Personal Autonomy and Choice in
a Regulated Long-Term Care Environment
(Source: www.ncmedicaljournal.org)
The
title of this commentary comes from a metaphor often used to describe the
current generation of baby boomers who are now entering, and will continue to
enter in unprecedented numbers, America’s and North Carolina’s long-term care
facilities. The hugely profitable Ben and Jerry’s ice cream brand reputedly
owes its success to a wildly creative willingness to give consumers whatever
they want and to leap, not crawl, beyond the chocolate, vanilla, and strawberry
consumer choices of the past.
The
metaphor has been applied to describe
The
North Carolina Medical
Journal’s March/April
issue contains a suite of articles on long-term care, including two about
the state’s direct-care workforce. The
issue is entitled “Long-Term Care: Are We Ready to Meet Expected Needs and
Demand?” Several of the articles mention the expected care gap that
will emerge as the baby-boomer generation reaches retirement age.
“It’s
exciting to see a state-focused health care journal dedicate an entire issue to
the question of essentially whether the state is prepared to care for the
emerging long-term care needs of its citizens, and to underscore, in several
articles, the critical importance of building and supporting the direct-care
workforce,” said PHI director of policy research Dorie Seavey.
“In
addition, valuable information is presented about two leading initiatives in
(NOTE: I have included several of the articles in
this month’s Culture Change Connection, however it is worth checking out the
whole issue! The articles and information in this issue are applicable to all
of us, and include some excellent focus on culture change and person-centered
and person-directed care. What a
wonderful example and model for other states to use... Hats off to Matthew Ozga at PHI for
connecting to this!)
20. VOLUNTEERING
New Federal Report Shows Greatest Spike in
Volunteers Since 2003
Despite
difficult economic times, the number of Americans volunteering in their
communities jumped by 1.6 million last year, the largest increase in six years,
according to a report released today by the Corporation for National and
Community Service (the “Corporation.”)
The Corporation's annual Volunteering in
21. INTERNATIONAL
(Source: CalorieLab)
London
seniors are lining up to try the new equipment in the recently-built "Hyde
Park Senior Playground.” The play area includes low-impact fitness machines and
is designed to encourage exercise and socialization among seniors. MORE
Scotland's First Strategy for Dealing
with Dementia Being Launched
It
aims to put in place new national care standards and commits the Scottish
government to continuing support for dementia research. The strategy will lay out specific actions to
improve the care and treatment of people with dementia. It will focus particularly on getting better
hospital care, and giving more support after diagnosis…
The
strategy will commit the Scottish government to developing and implementing new
standards of care for people with dementia.
"These will be implemented across the board in both health and
social care and we want them to lead to a new era of respect, dignity and
self-determination for people with dementia."
Ms
Robison added: "People with
dementia must not only ensure the very best clinical care but must be treated
with respect and dignity at all times, and these standards will enshrine our
belief that this has to happen for every patient, every time."
Chief
executive Henry Simmons said: "This strategy is a strong start - now is
the time for real action on dementia.”We must ensure that health and social
care professionals, mainstream local services and communities across
22. PERSONAL TRANSFORMATION