CULTURE CHANGE THROUGHOUT
THE CONTINUUM
OF LIFE-LONG LIVING & LONG-TERM CARE
“Unless someone like
you cares a whole awful lot, Nothing is going to get better. It's not."
~
Dr. Seuss, from The Lorax
1. GEORGIA NEWS
CMP
Funds Spared In Georgia
(Source:
Coffey Break)
In the past we have
reported that Aging Services of Georgia had supported an effort to appropriate
“civil monetary penalty” (CMP) funds to programs supporting Culture
Change. These CMP dollars, which are collected as fines on nursing homes,
according to federal law must be spent to benefit residents of nursing
homes. The FY ’11 budget appropriated $1 million to the long term care
ombudsman program and $ 600,000 to Adult Protective Services to allay previous
reductions in these programs. The remaining funds were left in
alone. Aging Services will continue working with other
organizations/advocates to submit a plan to DCH on appropriate/effective ways
to use CMP to support the culture change work in
Culture
Change Network of Georgia Presents at “Thinking Outside The Box: Policy,
Service, and Research for Older Georgians in the New Decade" Conference
Left to
Right: Anne Hernandez, Dianne O’Donnell, Joan Carlson and Kim McRae
This conference was
co-sponsored by the University of Georgia Institute of Gerontology and the Georgia
Division of Aging Services, and took place on May3, 2010 in
Richard
Taylor, PhD Speaks at Georgia Institute on Aging’s Assisted Living Symposium
Assisted
Living: HOTEL or HOME? Humanizing Care
and Creating HOME in YOUR Organization
Richard Taylor’s
presentation, “I’m Still Here” --
Humanizing Care in Assisted Living, created some “Ah-Ha” moments for those
who heard him:
“Awesome! I am touched and I pray I will become
“humanized.” I believe his message
should be shared with all caregivers whether or not they work with residents
with dementia. It is a universal
message.”
“It
totally opened my eyes to how daily living for both resident and staff must
become the upmost reason to make every community a home. This program was a WOW moment!”
“I know
now people with Alzheimer’s are whole people, and are to be treated the way I
would like to be treated. Mr. Richard’s
speech was very interesting. I have
learned so much more today than I have learned in all the years that I have
been a C.N.A.”
“It
made me think differently about Dementia.
It made me think about ways that I can help my residents express
themselves or ask for things when they can no longer find the words. I want to see their light shine again.”
“We
need to include questions of “WHO” they are on our assessments. Not just their history and their illnesses
but WHO are they and how do they want us to help them continue to be
themselves.”
“Holy
Moly! This presentation changed my
entire perspective.”
Information about the April 29th Symposium
2. CULTURE CHANGE NEWS
CONGRATULATIONS KAREN
SCHOENEMAN !!!
CMS Official Honored For Work With Nursing Homes
(Source: McKnight’s)
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
The Picker Institute
award recognizes individuals who have spent their lives improving the lives of
people in long-term care. The nonprofit institute sponsors research into
improving the quality of life for people in institutions. More
Culture
Change Goes Mainstream
(Source:
Provider Magazine)
Bill
Thomas, MD, would like to clear up a misconception about his position on
nursing facilities: He doesn’t want to eradicate them; he wants to eliminate
the traditional,
institutional
model of care that was adopted by nursing facilities nearly 50 years ago. “I
want to abolish the practice of institutionalizing frail, older people,” he
says.
“The old model of the nursing homes needs to go away and be
replaced with new models.”
Although
he understands that doing away with institutionalization may take the rest of
his career—maybe even the rest of his life—Thomas is certain that it will
happen…
He
emphasizes that his plan is not “some kind of silly
turn-off-all-the-lights-and-walk-away idea.” No, he says, “that’s not what I
want—I want us to deliberately plan to outgrow the nursing homes. Let’s go
beyond something that was handed to us half a century ago; let’s embrace and
develop and implement new models of care.” …
Awareness
and adoption of some components of culture change have gained considerable
momentum in the past two decades and made even greater strides in the past
several years.
A
Commonwealth Fund survey of health care opinion leaders in 2008 found that 66
percent of respondents were familiar with the culture change movement, a
dramatic shift from a
2005
survey in which 73 percent of respondents were unfamiliar with the term.
In
a recent article in the journal Health Affairs, Commonwealth
Fund President Mary Jane Koren credits the Centers for Medicare & Medicaid
Services’ (CMS’) Eighth Scope of Work contract with the nation’s quality
improvement organizations as one reason why providers have become more aware of
culture change. However, the battle is not entirely won, Koren notes.
The
fund’s “2007 National Survey of Nursing Homes” found that only 5 percent of
directors of nursing said that their facilities completely met the description
of a nursing facility transformed through culture change, and only 10 percent
reported that they had initiated at least seven or more culture change
practices. “All told, about one-third reported adoption of some culture change
practices,” Koren writes, “and another third said that they were planning to
follow suit. But the rest of the respondents said that they were neither
practicing nor planning to commence culture change.”
The
difficulties of “operationalizing and maintaining culture change remain
daunting” but are not insurmountable, she says. Speculation about why more providers have not
adopted culture change on a wider scale typically centers on cost, access to
capital, and perceived barriers to implementation, such as regulations that
conflict with the person-centered approach that is so central to the movement.
Nonetheless,
culture change has become a part of the long term care lexicon. The basic
tenets of the movement—person-centered care, individualized treatment plans,
and resident choice and autonomy—have become the standard by which quality care
is measured.
‘It would be a mistake for any company
right now not to go down the path of culture change.’
Pioneer
Network Completes Year-Long Project Designed To Increase Consumer Knowledge
About Long-Term Care And Culture Change: Consumers Want To Know What Culture
Change "Looks Like"
(Source: Pioneer Network)
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.
"The Picker Consumer Project represents a major undertaking by our
organization to begin focusing on increasing consumer awareness and demand for
culture change." says Bonnie Kantor, Pioneer Network Executive Director.
"This project, directed by Joanne Rader, is also notable because it was
one of the first times that six major organizations came together to gauge
consumer awareness." These organizations and individuals included:
- Natasha Bryant, American Association of Homes
& Services for the Aging
- Marianna Kern Grachek,
- Chris Condeelis, American Health Care
Association
- Sarah Greene Burger, The Coalition of
Geriatric Nursing Organizations
- Jessica Brill and Sarah Wells, National
Consumer Voice for Quality Long-Term Care
A significant outcome from
the project is that Caring for the Ages, the American Medical Directors
Association monthly publication is now publishing a series of tear-outs
designed specifically for consumers and providing education about culture
change. The first of these columns, "Person-Centered Care: What It Means
to You and Your Family" can be accessed here.
Pioneer Network hopes
to pursue a Phase 2 of the project later this year, by reaching out to
consumers, educating them about culture change, and how they can advocate for
change. More
Richard
Taylor, PhD Promotes “Donate a Dollar to Dementia” Campaign For Pioneer
Network’s 2010 Carter Williams Legacy Fund
(Source:
www.RichardTaylorPhD.com)
Hello,
My name is Richard
Taylor and for the past several years I have been living with the symptoms and
diagnosis of dementia, probably of the Alzheimer’s type. Recently, I was
honored to be selected as the recipient of the 2009 Carter Williams Legacy
Award for the new purpose I have created for my life - bringing a voice to
people who are living with Alzheimer’s and dementia, and helping others see
persons with dementia as people – first. We are not just a “disease” that needs
a cure. 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 award I received is
given annually by Pioneer Network. With this personal award I want to take the
opportunity to shape the focus of the 2010 Carter Williams Legacy Fund. This is
a fund created and administered by Pioneer Network to financially support
opportunities for personal growth in those individuals who are quite literally
pioneers in the new frontier of aging, who are working every day to change the
culture of elder care and aging across
I have asked
that the 2010 awards be granted to individuals who are directly engaged in
research and support of folks who have been diagnosed with some form of
dementia and the wonderful caregivers who care for them. I believe there is a
grossly disproportionate emphasis on supporting research efforts into finding a
“cure” for dementia (primarily of the Alzheimer’s type), at the expense of
focusing on finding “cures” (or at least promising or best practices) to deal
with the real life, every day problems created by being forced to live with the
various symptoms of dementia. Unfortunately there is very little focus on how
to help those who are LIVING with dementia and the angels
currently caring for them… MORE...
The
Golden Rule Is Only Half-Right
(Source:
The Path to Home)
Blasphemy, right? Sure, the Golden Rule has served for a long
time as the go-to guidepost for how we should interact with others.
However, when it comes to Person-Centered Thinking, it’s only the beginning and
not something we should point to as a simple, straightforward philosophy for
achieving “person-centeredness”.
The “do unto others as
you would have them do unto you” way of thinking does set a certain tone for
developing empathy. That’s a good start towards determining how we relate
to others. Without empathy, we can’t develop connections and
relationships with other people. Empathy is what helps us seek out
commonalities and to find common ground. Without we can’t get far outside
of ourselves.
However, to believe
that others want to be treated as we would want to be treated leads to a
critical error in thinking, or a cognitive bias. Social sciences have a
name for this kind of error; it’s called a Projection Bias. In making
such an error, we are guilty of thinking that others share our same beliefs,
our culture, our values and so forth and we project our own way of thinking
onto others. In other words, we mistakenly believe that others are just
like us.
The Golden Rule
philosophy plays right into this mistaken idea-that of believing others want to
be treated the same as us. The problem is that they aren’t us!
Although we may all
have some common need for safety and security, for example, our views on what
constitutes “safe and secure” may be vastly different. For me, safety
might mean keeping my feet firmly planted on the ground; for the parachutist,
safety might mean checking one’s pack twice before taking the big leap.
There’s a vast difference between what each of us considers important.
To
attain true Person-Centered Thinking, we have to be cognizant of our
differences and understand how to assess the needs and desires of others,
without clouding the picture with our own beliefs and values. The Golden
Rule approach doesn’t take us far enough to do that and could lead to
unintentional conflict and misunderstanding, rather than to our intended
target.
We are guilty of
shortchanging the process, if we instruct our employees to adopt such an
approach to person-centeredness and we will fall short of attaining our
goal. Rather, we must encourage our employees to view Person-Centered
Thinking from the mindset of an investigator. That means learning how to
listen and to pay attention and how to develop critical thinking skills.
These are the tools that will bring us the evidence that tells us how others
want to be treated. More
What The
Long-Term Care World Needs Now
(Source:
McKnights)
The Centers for
Medicare & Medicaid Services' shift to a prospective payment system in 1998
sent shock waves through the industry and claimed the financial lives of many
prominent long-term care companies. The
current combination of recession, Medicare cuts, RUGS IV, MDS 3.0, state budget
crises, QIS, RAC, and the unknowable final shape of healthcare reform have
today's leaders feeling déjà vu. What do
long-term care companies need in order to avoid last decade's casualties? Here
are a few very important things:
Culture
An organization's
culture—its structure and values—is the single most important factor for
overcoming acute challenges and for transforming the industry one facility at a
time.
Centralization vs.
decentralization, Values and Creating new cultures
Empowering the field
and eliminating bloated bureaucracy is for many an impossible pill to swallow.
Yet, if you were to ask the dozens of beaten companies from the late 1990s if
they would try that medicine if given the chance, I bet they would.
Colorado
Culture Change Coalition VIDEO
(Source:
YouTube)
(Source:
Mature market Experts)
‘Participation’ vs. ‘Engagement’
Companies which provide
services to seniors will need to look beyond traditional approaches to aging,
Colin notes. “There is a difference between participation and engagement,” he
explains, pointing out that ‘engagement’ will become more important in the
years ahead. “The example I always use is my school career. While I was a
participant, I was not engaged and my grades suffered. Similarly, it’s not
enough for seniors to be enrolled in a health plan’s fitness plan or be just
living at a retirement community. People are looking to be fully engaged
because they understand that engagement is a key component to being healthy.
“Technology has already
changed how we are aging and we are just seeing the tip of the iceberg,” Colin
continues. “I think one of the most exciting possibilities rests in 3D
Holographic projection. Just like we used to see in the old Star Trek
adventures, soon your fitness instructor will be projected into your home to
work out with you. The technology is not that far off. Don’t believe me, just
check out what Musion
Systems Ltd. is doing!”
Effect On Companies
Colin believes that
companies which don’t adjust to the new expectations of people entering their
retirement years are likely to struggle. “Today’s mature market has very
different expectations for how they expect to age,” he says. “The dinosaurs of
the last generation — like outdated senior centers and retirement communities —
are a complete turnoff. In fact, just string the phase ‘senior center’ in front
of most boomers and you’ll see a clear reaction. For example, retirement
communities and golf destinations are being replaced by urban,
multi-generational settings with proximity to restaurants, shops, gyms and
theaters. Simply put, outdated products with obsolete names and terminology
must change … or face extinction.” More
3. CULTURE CHANGE EVENTS
A Day
Of Universal Design: The ABC’s of Universal Design and The Universal House
Tuesday, May 18, 2010 9 am –
4 pm Atlanta, GA
Conversations
with Carmen
Guest: Elizabeth Brawley, Environmental Design Consultant
May 21st Webinar Topic: Getting
Your Residents Outdoors
Residents all too often do not get outside. "Safety"
worries are often the reason why. Yet the benefits of being outdoors actually
mitigate many negative, "unsafe" outcomes. Elizabeth Brawley, a
leading environmental design consultant and author, will share tips on creating
as-safe-as-possible outdoor areas. Doses of sunshine contribute to maintaining
circadian rhythm, promoting better sleep and vitamin D synthesis for healthy
bones, all of which help to prevent falls. It is well known that being outdoors
prevents depression and reduces agitation. Sleep disorders, all too prevalent
in long term living environments, result in sleep medication and hypnotic use
which are strongly linked to falls and hip fractures. This conversation will
focus on ideas to woo residents outside with covered porches, raised gardens,
safe rockers and gliders, walkways for exercise and by holding group activities
outdoors.
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 noon Mountain time (11am Pacific, 1 pm
Central, 2pm Eastern). Certificates of participation will be available to
participants as well as handouts for each show. 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 or for more info: or you can call our office: 414-258-3649.
Creating Home in the
Nursing Home II: A National Online Symposium on Culture Change and the Food and
Dining Requirements is NOW AVAILABLE!
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...) More
The
Best Friends Approach™ Institute
2 Day
Train-the-Trainer Program for Alzheimer’s and Dementia Care
David Troxel and Virginia Bell
June 7 & 8, 2010
5th International Eden
Alternative Conference
The Art of Creating a Caring Community...Meeting the Challenges
June 13 - June 15, 2010
Pioneer Network’s 10th National Conference
NEW! Pioneer Network is
pleased to announce the confirmation of Kathy Greenlee, Assistant Secretary for
Aging of the U.S. Department of Health and Human Services (HHS) as one of the
plenary speakers.
Kathy Greenlee was appointed by President Barack Obama as the fourth Assistant
Secretary for Aging at the U.S. Department of Health and Human Services and
confirmed by the Senate in June 2009. Ms. Greenlee brings over 10 years of
experience advancing the health and independence of older persons and their
families, and Pioneer Network is pleased to be able to have her speak to our
conference attendees.
NEW! We
know change is hard work and it takes a team approach to make it happen.
So, we are introducing our Culture Change Team Special which includes both the
full conference and a full day intensive. You and your organization qualify if
there will be four or more registrants from the same address. Give your
interdisciplinary teams an opportunity to experience the engagement and
excitement that our conferences are known to provide!
SAVE
THE DATE! October 14, 2010
3rd
Annual Culture Change Network of Georgia Summit
Getting to Know All About YOU
Tracks
featuring national experts LaVrene Norton and David Troxel
4. ATTITUDES ABOUT AGING
Those
People
(Source:
Alzheimer's Reading Room)
We were
working in a memory support center one day when we noticed two women crying at
a table. We went over to them to ask if there was something we could to do to
help. One woman exclaimed, “We drove fifty miles to come and visit our
friend who is living here now. We have known each other all of our lives; we
grew up together and raised our families together. Now, she doesn’t want to
visit with us. She wants to be with those people.” MORE…
Saturday
Night Live Tasked With Fighting Ageism
(Source:
ALFA)
The nation’s leading senior
living organization reached out to producers of Saturday Night Live, in
anticipation of actress Betty White’s appearance as host.
The 88-year-old actress and comedian hosted NBC’s Saturday Night Live as
part of a viral social media promotion that allowed Facebook users to select
her as host. Prior to the live show on Saturday, the Assisted Living Federation
of America issued a press release and sent correspondence to the Lorne
Michaels, producer of Saturday Night Live, calling on the show to avoid
“negative stereotypical portrayals of the very old.”
White’s appearance did include many references to her age. However, at least a
couple of those references helped illustrate just how “vibrant and active”
seniors in their 80s can be, a point ALFA Richard Grimes made in his letter to
Michaels. The New York Times
called White’s performance on Saturday Night Live, “one of the strongest
outings of the season. All it took to reinvigorate a 35-year-old comedy show
was the presence of an 88-year-old woman.”
MORE…
5. THE ELDERS (THE PEOPLE
WITH & FOR WHOM WE’RE DOING THE DOING)
Meeting
In The Middle: True Stories Of Presence From The Bridge
Once a
Teacher, Always a Teacher
(Source: Memory Bridge
Although Sue and I
enjoyed getting to know one another, her lack of interest in group-based
cognitive activities persisted. A home visit was arranged, allowing me to
connect with Sue on a more personal level in her home environment, where we
played games and perused her photos and books. Sue sustained interest and
actively participated without signs of apathy or frustration. She especially
cottoned to reading aloud and assuming the role of teacher—having been a
first-grade teacher for many years—while I assumed the role of student. This visit
reinforced for me the magic that happens when activities and facilitators
resonate with individuals' unique abilities and emotional needs.
For my next visit at the respite program, I brought a copy of A Light in the
Attic by Shel Silverstein, dubious that Sue would feel comfortable reading the
poems aloud to a group. To everyone's surprise, Sue prompted me to lean closer
so that together we could flip through the pages. “Would you like to read one
of these poems?” I asked. Noticing Silverstein’s amusing illustration, Sue
responded with a laugh and an “oh my golly,” then slowly began to enunciate
with relative ease and no further encouragement from me the following…
MORE…
6. THE STAFF (THE PEOPLE
DOING THE DOING)
A
Graying Population, a Graying Work Force
(Source: NYTimes.com)
In an aging population,
the elderly are increasingly being taken care of by the elderly. Professional
caregivers — almost all of them women — are one of the fastest-growing segments
of the American work force, and also one of the grayest.
A recent study by PHI National,
a nonprofit organization that advocates on behalf of caregivers, found that in
2008, 28 percent of home care aides were over age 55, compared with 18 percent of
women in the overall work force. The
organization projects that from 2008 to 2018, the number of direct care
workers, which includes those in nursing homes,
will grow to 4.3 million from 3.2 million. The percentage of older caregivers
is projected to grow to 30 percent from 22 percent.
The average caregiver in
“The older ones came to
us after being family caregivers, so they understood the stresses that families
were under,” Ms. Topp said. “They came with respect for age. They didn’t see
age as a disability.” MORE…
Why Is
One Of The Most In-Demand Jobs So Low Paid?
(Source:
msmagazine.com)
Those who care for our
elders continue to be stuck at
the bottom as far as wages and respect [PDF], despite rapidly growing need
for their services. No matter the setting in which they work—nursing homes,
assisted living, individual homes—direct care workers are low-paid, often
without health insurance and confronted with back-breaking labor and
challenging clients with complex medical needs. And, no surprise, nearly
9 out of 10 direct-care workers are women, 28 percent are African-American and
23 percent are immigrants [PDF].
These caregivers
provide the most intimate care imaginable to frail and vulnerable people. We
depend on them to give competent, compassionate attention to our
grandparents—and to us as we age. Their clients’ lives are literally in
their hands. “What we do is important,” says Tracy Dudzinski, a direct-care
worker in
According to the Bureau
of Labor Statistics Occupational Outlook Handbook, the elder care field is
among the fastest-growing in the nation, with 50 percent growth from 2008 to
2018 predicted for home-care workers. But we’re doing little to attract people
to these critical jobs. We reward women like
Now, direct care
workers are taking matters into their own hands and speaking out. “People
misunderstand us,” says
Among DCA’s most
successful projects is the Voices
Institute, a week-long retreat and intensive training session for
direct-care workers to become advocates for their profession. When I asked
(NOTE: Be
sure to read the comments section!)
Fostering
Therapeutic Nurse-Patient Relationships
(Source:
journals.lww.com/nursingmadeincrediblyeasy)
A therapeutic nurse-patient
relationship is defined as a helping relationship that's based on mutual trust
and respect, the nurturing of faith and hope, being sensitive to self and
others, and assisting with the gratification of your patient's physical,
emotional, and spiritual needs through your knowledge and skill. This caring
relationship develops when you and your patient come together in the moment,
which results in harmony and healing.1
Effective verbal and nonverbal communication is an important part of the
nurse-patient interaction, as well as providing care in a manner that enables
your patient to be an equal partner in achieving wellness… MORE…
(Source: The Path to Home)
Did you happen to catch
the recent
news story about the young
Of course it’s sobering
to imagine being trapped in your body for all that time, unable to communicate
or tell anyone what you were thinking. But I can’t help but wonder, how
did the people who cared for him treat him during those twenty-three
years? Did they treat him as a person or an object? How does the
information that he can hear and comprehend change their approach to
caregiving?
Hopefully, his
caregivers have no regrets, now that they know he was cognizant all
along. I think there’s a lesson here for all of us-those we provide
care for may realize a lot more than we think they do, in spite of disease and
infirmity, and our interactions with them should always respect their
personhood. More
7. FROM, FOR & ABOUT
CAREGIVERS & CONSUMERS
The
Empowered Elder Advocate: We Won't Be Brushed Aside
(Source:
Carol Bradley Bursack)
Many of us are old
enough to remember the accepted thought that the doctor was always right. We
were trained to bow to the superior knowledge of the doctor, because after all,
why would you go to the doctor if you already knew all of the answers? We still
see doctors because of their expertise, of course, but we are learning to be a
partner in health care. In my opinion, a good doctor will welcome our input
because the more they know about us or the person we are advocating for, the
better they can be at helping us.
Since, with some
notable exceptions, most of us on OurAlzheimer's are here because we have a
loved one with dementia, it often falls to us to be the advocate for our loved
one's health. This is particularly true as dementia symptoms increase. Whether
we are our own health advocate or are advocating for a loved one, a recent
survey shows people are, as a group, getting more involved in health care.
Chris Schroeder, CEO of
HealthCentral, and James Burroughs, Associate Professor of Commerce at
the
The
New Face of Caregiving: Male Caregivers
(Source:
AARP Bulletin Today)
When his wife, Chris,
was diagnosed with breast cancer on their 19th wedding anniversary, Dave Balch
suddenly found himself with two full-time jobs: running his home-based software
business and taking care of her. “I don’t know how I managed everything,” says
the 60-year-old from
Each year, more
Americans are finding themselves in a similar situation—and challenging
preconceived ideas about men and caregiving.
“People think that male
caregiving means that the guy calls home from the job and asks his wife how his
mom is doing,” says Donna Wagner, professor of gerontology at
Aging
As A Women’s Issue
(Facebook
- IAHSA)
Women are
disproportionately affected by ageing. Daughters care for mothers and
mothers-in-law. Women are more likely to be paid caregivers in the home and in
facilities. And women live longer than men.
Today I went to a panel discussion hosted by IAHSA member, Volunteers of
America. They conducted a study
on ageing in the United States. They found that only 11% of caregivers are
paid for their work, but “82% of baby
boomers expect to be providing care for a loved one.”
It’s time we all look
for ways to help caregivers and the older adults the care for. What is your
facility doing to help caregivers? MORE…
A
ROUSING SUCCESS...
(Source:
www.qualityhealth.com)
Early-morning sun
warmed the stillness inside the Cafe as I gazed around the silent space
that, last night, had been filled with rousing cheers from the many Cafe
friends and family members of loved ones with Alzheimer's who had
participated in the AA Action Summit 2010 in Washington, DC. with so many other
family advocates from across the country.
Their Summit included
many, many Congressional visits on Capitol Hill to share their
personal stories and lend their impassioned voices to a collective
force urging understanding, enhanced awareness, and most importantly,
legislative action to assist families living with this devastating illness.
Last night, they were
cheering a major victory for tens of thousands of Americans living with
early-onset Alzheimer's disease. The Social Security Administration (SSA)
announced it will streamline the application process and wait time for
providing benefits for loved ones with this devastating condition.
Not everyone can travel
to our nation's Capitol for such a
On
this quiet sunny morn, seeing last night's cheering friends in my
mind's eye, I smile and say into the stillness: TOGETHER WE CAN! Caringly, Jackie More
Research
By The Hartford And ComPsych Finds Baby Boomers' Caregiving Duties Impact Jobs
And Health
Stressed-out Sandwich Generation Needs Help, Says Insurer's Expert At
Conference
(Source:
thehartford.com)
SIMSBURY, Conn., Apr 22,
2010 (BUSINESS WIRE) -- The demands of balancing a full-time job and caring for
an injured or ill family member is a major source of stress for many Baby
Boomers and is impacting their productivity and their health, according to new
research by The Hartford Financial Services Group, Inc. (NYSE: HIG) and
ComPsych Corporation.
The
A
majority of Baby Boomers said they are stressed out about caregiving and, at
the same time, are worried about how their caregiving is impacting their job,
according to The Hartford's survey of Americans born between 1946 and 1964 who
accessed ComPsych's Employee Assistance Program (EAP). Conducted in February
2010, the joint survey by The Hartford and ComPsych found younger Baby Boomers,
ages 45 to 54, are carrying the largest burden of family care responsibilities,
with more than half saying they've taken time off from work to due to their
caregiving responsibilities. MORE…
(Source:
Alzheimer’s Reading Room)
Family members who provide care to relatives with
dementia, but do not have formal training, frequently experience overwhelming
stress that sometimes leads to breakdowns or depression..... MORE…
8. LIVING LIFE &
ACTIVITIES
Playing
Ball at Pennybyrn at Maryfield
(Source:
Culture Change Now Newsletter)
All
over the country, the baseball season is now in full swing (pun intended), but
at Pennybyrn at Maryfield in
All agree the baseball game is a highlight in the Pennybyrn community. But,
there was one game that almost didn't happen. The game was scheduled during the
week the survey team was at Pennybyrn to conduct the annual survey and this
gave Administrator Vonda Hollingsworth pause:
"On the way to work that morning, I thought to myself, 'Jeez, I wonder
what they will think?' When we play, it is loud and crazy with everybody
running this way and that, trying to steal bases, and residents being pushed in
wheelchairs or running arm in arm with staff round the bases. Would the
surveyors think we are putting our residents' safety at risk? I knew the
surveyors would be right in the middle of it since they were working out of a
room in our town square.
Then I thought-what am I doing? Whose choice is it to take a risk? I am
"taking chances" right now-driving my car. Individuals should be able
to decide themselves what risk they want to take. Our residents are LIVING and
living life is all about little risks everyday. If they want to play ball,
my apprehension should not stop them. I thought there might be a real
chance the surveyors would not like our game - but that was a risk I was
willing to take. To my delight, several of the surveyors stop working to watch
our game. They laughed and even cheered. It turned out they thought it was
wonderful! I am so glad that I didn't allow my hesitation to limit our
residents' ability to choose their life that day.
LaVrene Norton witnessed a game on a visit and was delighted to witness some
serious living going on when she saw a resident being whizzed around the bases
in her wheelchair - legs straight out in front of her with a look on her face
that was wide-eyed exhilaration. That's how you play ball! More
9. DEMENTIA
Clear
Evidence Showing That The Reasons For Treating Alzheimer's Patients With
Respect And Dignity Go Beyond Simple Human Morals
(Source: University of Iowa
"What this research suggests is that we need to start setting a
scientifically informed standard of care for patients with memory disorders. Here
is clear evidence showing that the reasons for treating Alzheimer's
patients with respect and dignity go beyond simple human morals."
Informed
Caregivers Can Improve Quality Of Life Of Alzheimer's Residents
(Source:
McKnight’s)
Why are people who are
diagnosed with Alzheimer's, the seventh leading cause of death in the
Alzheimer's disease
(AD) is a silent killer that gradually destroys a person's memory, ability to
learn and communicate, and the ability to carry out daily activities. As AD
progresses, individuals can experience other weakening side effects, including
anxiety, irritation, and possible hallucinations. AD patients experience side
effects that ultimately impact their quality of life, which is defined as being
in a state of complete physical, mental and social well-being.
The question that
lingered throughout this research study was whether the implementation of a
training model for caregivers positively impacts the quality of life of older
adults who have been diagnosed with AD and reside in a nursing home. To test
this question, a training model was designed to promote a positive change in
the caregiver, while also increasing the knowledge of the caregiver and
improving the clinical application of care to the resident with dementia…
Once the research was
completed and analyzed, the team determined that the quality of life for
Alzheimer's residents had improved, and was directly related to the caregiver
and resident relationship… This study also proved that the previously assumed
notion that individuals with AD were not able to rate their own quality of life
was incorrect. These individuals were able to rate their own quality of life
well into the progression of the disease…
The resident's quality
of life is about more than the resident participating in activities. Rather, it
is about being in a state of complete physical, mental and social
well-being… MORE…
Dementia
Should Be No Barrier To A Good Quality Of Life
(Source: Medical News Today)
Only 13
per cent of people believe a person with dementia
can have a good quality of life at all stages of their condition according to
Alzheimer's Society research released today (Thursday, 15 April). However a new
report by the charity found a better quality of life is possible for people
with a dementia diagnosis. It highlights simple things such as having someone
to talk to or being able to practice a faith that can have a huge impact.
My
Name is Not Dementia, draws on the views of people with dementia including
author Sir Terry Pratchett who has written a foreword for the report. It aims
to break down misconceptions by showing a person's identity does not disappear
because of a dementia diagnosis.
Research also shows more than half (54%) of people think a diagnosis of
dementia would have a bigger impact on their quality of life in later life than
cancer (19%) or a physical disability (16%). Over
half of people (52%) believe dementia has a stigma attached to it.
Award winning author Sir Terry Pratchett who has posterior cortical atrophy, a
rare form of dementia, said, 'Dementia is undoubtedly a cruel and debilitating
condition. However a diagnosis does not strip a person of their identity. That
person still has a voice and they deserve to be heard. Dementia requires not
just care but also understanding. There is an opportunity here to give the lie
to some of the clichés of care. We have to learn to be good at it.'
Ruth Sutherland, Acting Chief Executive of Alzheimer's Society, said, 'All too
often dementia is seen as an insurmountable barrier and a diagnosis is seen as
a death sentence. This doesn't have to be the case. By listening to people
living with the condition, as this report does, we can better understand what
is important to them and how they would like to live their lives. We need to
learn to see the person not just the dementia.'
MORE…
More
With Dementia Wander From Home
(Source:
NY Times)
“It started with five words — ‘I
want to go home’ — even though this is her home,” said Ms. Machett’s husband,
John, a retired engineer who now cares for his wife full time near
Close your eyes for a
moment and imagine spending the rest of your life surrounded by a thick,
towering glass wall. You can see the people around you but you can’t understand
what their saying. You try to speak out and tell them you’re scared and feel
like you’re going crazy but you can’t remember the words even though you still
feel the emotional pain. Months and even years go by and nothing has
changed except the people outside no longer bother to look at you. Even your
children give you an emotionless stare implying you’re probably already dead
but your body just doesn’t know it yet.
Can you think of
anything more horrifying? Can you imagine anyone living such a hopeless and
frightening existence? There are thousands living this nightmare everyday –
they’re severely-impaired
dementia patients! They have lost their ability to communicate,
but they still hear us, they just can’t answer back. How many times do you
think a dementia patient has heard, “Don’t worry your mother doesn’t understand
a darn thing we’re saying.” “There is no one home upstairs.” Then they look
over at mother and she is trembling and crying uncontrollably. She wants to
tell them she is aware but her brain won’t allow her to.
Judy Berry lived this
experience when her mother was stricken with dementia. Judy’s mother was
labeled as an “aggressive-behavior” patient because she would trip caregivers
and patients when they walked by. In 7 years her mom was thrown out of 12
separate facilities because of her behavior. She spent her last year of life
tied up to a chair and drugged into oblivion to keep her compliant. During this
period of time, Judy wasn’t able to find a facility that could make a positive
difference in her mother’s life because they all thought her mom was
irretrievably lost to her illness, and they would only provide custodial care
to keep her clean and fed.
At 55 years of age Judy
Berry gave up a successful career and made a lifelong commitment to change the
Face of Dementia Care in our society and to be an advocate for all seniors with
dementia in a quest to maintain their Basic Human Rights to Dignity, Choice and
Quality of Life until death. With a handful of skillfully trained and
experienced health care workers and a modest savings account, Judy took the
first step in fulfilling her promise and opened Lakeview Ranch for Specialized Dementia Care.
These are Judy’s words,
“With the help of 15
seasoned health care workers I started this project 8 years ago. The Lakeview
Ranch Model of Specialized Dementia Care has proven that these unspoken and unmet needs are the
underlying cause of most challenging and aggressive behavior and the #1 reason for all the
rampant unnecessary hospitalizations and overmedication that has sent
healthcare costs spiraling out of control to say nothing of robbing our seniors
of the dignity and quality of life they so deserve.”
The Lakeview Ranch Model of Specialized Dementia Care gives her residents the tender-loving care she wished for her mother. Right now there are 80 caregivers for 30 dementia care residents. The care is intensive, very personal and immediate. With the appropriate care, and attention from the caregivers the aggressive behavior begins to fade away because ALL of the resident’s needs are being met, especially the emotional ones. “These patients are really scared and confused because they don’t know what is wrong with them. Once we gain their trust and develop a bonding relationship they begin to respond to us positively in a lot of ways,” said Judy Berry. MORE…
To learn more about
Judy Berry’s work please Lakeview
Ranch. You may also learn more about their foundation, the Dementia Care Foundation. More
Hoping
Skills: Why Alzheimer's Disease Is Not The End
THE DEVIL MADE ME DO
IT!
(Source:
Memory Bridge
When a
person with dementia does something that might be annoying to you but isn't
hurting anyone, we call that "so what behavior.” So what if it happens, it's not the end of
the world.
At 5:30 in the morning the nurse came into the neighborhood to pass out the
morning medication. She hadn't been there long when she got called away. Before
leaving she pushed her cart into the nurses station and locked the gate.
"What are you doing,
Oh brother, I thought. What do I do now? I needed to distract her. MORE…
(Source:
Changing Aging)
More of Al Power’s interview on his new book, Dementia Beyond Drugs: Changing
the Culture of Care
Q:
How has our society’s view of aging created the institutional model of care and
what can we do to change it?
A: Society views aging as decline because we are overly
preoccupied with what adults can and cannot “do.” We fail to recognize that
elderhood is a separate developmental stage, in which the assimilation of experience
and perspective into wisdom
replaces
the busy workday world of younger adults. As a result of our skewed
perspective, we have created institutions that merely try to mitigate decline
by medicalizing the aging process and creating a stifling environment that we
label “protective.” We do not see the rich tapestry that elders continue to
weave, despite illness or frailty. By seeing elders with “new eyes,” we can
begin to celebrate and cultivate their gifts rather than simply disempower,
isolate, and overmedicate them.
Q:
How can we provide care that is more “humanistic” and “enlightened”?
A: There are many examples, as I apply the framework of my model
to a variety of care scenarios. But a central humanistic tenet follows Tom
Kitwood’s charge that we acknowledge the personhood of each individual and their capacity
for growth and engagement through all stages of life, and all stages of
dementia. Here’s an example of how we can be more enlightened: When people in
the nursing home “wander,” we used to restrain them, but now we use wander
alerts, create circular pathways, use signs on doors and better lighting to
create a safer place. We think we have become more enlightened. We haven’t.
I encourage care partners to replace the term “wandering”
(suggesting purposeless activity) with “searching,” and then ask, “What are
they searching for?” Often it’s some connection, some relationship, something
that has personal meaning in an environment that offers none. So by providing
the stop signs, circular paths, fenced-in courtyards and alarmed doors, we have
merely created a safe place for the person to be lost and searching for the
rest of their lives. We’ve missed the larger need. More
10. DISABILITY COMMUNITY
Young
Nursing Home Residents: Person-Centered Culture Change Must Include Them
(Source:
hospiceandnursinghomes.blogspot.com)
As quiet
as it’s kept, young residents are often found in nursing homes. They are a
growing population that many overlook when they think of nursing homes as “old
people’s homes.” In many ways, traditional nursing homes are not designed
with needs of young residents in mind…
Another
young resident was one of several roommates who shared a room with my patient.
Many of my hospice patients had multiple roommates. Imagine dying while living
on a daily basis in a room with three other people with various illnesses,
including dementia…
But
there was a sadness about these young people and some others I have seen in
nursing homes. These residents, particularly those severely challenged, didn’t
appear to have much scheduled to enrich them creatively other than watching
television and observing what was going on around them. Sure, there were
overlapping activities in which all ages could participate. But ages twenty
through one hundred have unique requirements. Young people often craved
attention and clearly needed more engaging activities focused on their age
groups. Their needs must be addressed if nursing homes are to become
person-centered in providing quality of life for all residents. MORE…
11. TECHNOLOGY
Boomers,
Barriers, And Myths
(Source:
Laurie Orlov)
Assumptions,
aspirations, and realism. In
recent here-there-everywhere travels, I was often intrigued by assumptions that
were cited as fact. I heard about barriers to adoption, narrow-cast
definitions of broader opportunities, and sweeping generalizations about
markets too broad to characterize. That last, of course, is the so-called baby
boomer market -- discussed all day at a well-run event in
Enough boomer
demographic data to confound any marketer. In keeping with the theory that
boomers are a market, the conference presenters
generally began their talks (as all, including yours truly, do) with stats to
help make their case -- baby boomers are wealthier, tech-savvy, own iPhones,
are entrepreneurial, self re-inventing, chronic-disease plagued, interested in
franchising, traveling, dating, volunteering, etc. It was a fascinating day,
inspiration for attendees to learn more, start and run new businesses. My
favorite segment was a presentation by 23-year old Alex Chamberland about
In tough times,
boomers create their own opportunity. In other recent and related news, you may have
noticed this intriguing observation from the
Kaufman Foundation: more than 80% of all tech startups in 2008 were by
people over 40, that the number of people age 55-64 starting tech businesses
grew 36% in 2008, and that the 20-34 age bracket had the lowest startup rate.
And most entrepreneurs that I speak with tell me that they are not venture
capital backed -- a good thing if they are woman-owned -- see today's NY Times on the dearth of Silicon
Valley investment in women-run businesses. The more common practice: take
an idea, bootstrap it yourself,
augment with angel investors to grow quickly or (my favorite) grow it slowly,
gaining market insights and forging partnerships along the way.
Okay, now for
this week's rants. So
now that we're on the topic of tech, let's mull some myth-like barriers to tech
adoption, reinforced in my talks and travels this past week: MORE…
Technology
for Caregiving and Aging in Place - Updated 2010 Market Overview Report
Highlights New Vendor Entrants
(Source:
PRWeb)
Port St. Lucie, FL
(PRWEB) April 8, 2010 -- The growing marketplace for technology to assist aging
adults is attracting a steady stream of new vendors to a market that will
exceed $20 billion by 2020, according to the newly updated 2010 report by Aging
in Place Technology Watch. The emergence of caregiving as a concern to baby
boomers is driving new entrants into the market, according to Laurie M. Orlov,
founder of the market research firm.
"At a time when we
are seeing so many business opportunities shrinking, this market is poised for
steady growth," said Orlov. "With the slowdown in the housing market,
growing elder caregiving responsibilities, and emerging technology awareness of
service providers means that more people will look for solutions that help
older family members. This is a catalyst for innovation and opportunity for
both new entrepreneurs and new business opportunities for existing companies.
The industry
projections are part of the updated market overview report, 2010 Technology
Market Overview from Aging in Place Technology Watch. The document updates
which technologies matter to inform caregiving and enable aging in place,
including categories for communication and engagement, safety and security,
health and wellness, and learning and contribution. The report explains how
these tighten the connections between families, caregivers, service providers,
and care recipients. MORE…
No
Impact For Seniors: Paper books, Health IT, FCC And Other Goals
(Source:
Laurie Orlov)
Excuses
everywhere as to why not this and can't do that. If you're trying to make sense
out of lack of progress in terms of Internet adoption and seniors, look no
further than Friday's Senate hearing, with its
overreaching title: "Aging in Place: The National Broadband Plan and
Bringing Health Care Technology Home." Read and absorb a veritable laundry
list of reasons why we need to buckle down and get a plan in place to get
health technologies into the home -- maybe by 2020.
Is lack of
broadband access the real problem? Never have so many heard so much about
insurmountable barriers to stem rising healthcare costs of an aging population.
Let's skip most of the barriers -- they are for others to debate -- and just
focus on one noted by Mohit Kaushal, digital healthcare director, Federal
Communications Commission, about connectivity: "Broadband is either
missing or too expensive." MORE…
12. DESIGN & ARCHITECTURE
Virginian
Launching Portable Housing For Aging Relatives: The
Granny Pod
(Source:
Washington
What it
might look like here:
For complete
story:
13. NURSING HOMES
Website
Allows Providers to Measure Culture Change
(Source:
PHI Blog)
The Pioneer Network has
launched an online version of its popular Artifacts of Culture Change
tool. The web-based evaluation tool
allows long-term care providers to measure how successfully they have
implemented culture change in their facilities.
The tool helps providers determine whether they have introduced culture
change in a sustainable way, as well as how far along they have already
progressed in their culture-change journey.
"The artifacts
tool is not only a wonderful way to measure change progress, it also offers
ideas about opportunities for change an organization may not have been aware
of," said Susan
Misiorski, PHI National Director of Training and Organizational
Development.
Scoring Points
for Culture Change
The web-based tool
measures a facility's culture-change progress in six categories:
- Care Practice Artifacts — What are the facility's
policies on person-directed dining, bathing practices, etc.?
- Environment Artifacts — Do residents have ample
space and privacy? Does the facility include amenities such as Internet
access and outdoor areas? Does it reflect "home"?
- Family and Community
Artifacts
— What is the facility's visiting policy? How are families involved and
welcomed?
- Leadership Artifacts — Are residents given the
opportunity to voice their opinions to staff members?
- Workplace Practice
Artifacts
— Are CNAs allowed to set their own schedules and work consistently with
the same residents? Are they given the opportunity for advancement via a
career ladder?
- Staffing Outcomes and
Occupancy
— How long do workers remain with the facility? What is the staff turnover
rate over the last 12 months?
At the end of the
evaluation, facilities are awarded a point total based on their responses, with
a maximum score of 580 points. Providers
can use the evaluation tool as often as they want, free of charge. The Pioneer
Network recommends quarterly "tune-ups," but stresses, "It's
your choice."
Updating the Evaluation Tool
The new online
evaluation tool is an update of the paper-based Artifacts of Culture Change,
which the Pioneer Network debuted in 2006. The Web-based version incorporates interpretive
guidelines issued in 2009 by the Centers for Medicare & Medicaid
Services (CMS). According to the Pioneer
Network, the evaluation tool "represents the first national database of
implementation activities ever collected."
The Pioneer Network used funding from The Commonwealth Fund to build the
online version of Artifacts of Culture Change.
More
Changes
In Nursing Homes To Benefit Residents, Families, Staff
(Source:
K-State Perspective)
While surveying older
patients about breaking a hip, researchers in the British Medical Journal found
80 percent of respondents would rather
be dead than in a nursing home. But according to Gayle Doll, director of
the gerontology program at
Previously, nursing homes
focused on the medical side of long-term care. Now the trend is to look at the
person and their various needs, rather than just their medical needs. The focus
on person-centered care includes more consistent staffing, Doll said. In the
past, workers would go anywhere in the care center they were needed, while
trying to remember the needs of many patients. Now, the same staff works with
the same group of residents.
"It's all about
creating relationships," Doll said. In the future, she said there may even
be universal staff members who will tend to all of a resident's needs,
including housekeeping.
Choice is another
focus. This includes choices on eating, what to eat and when; activities;
bedtimes; and bathing.
Private rooms are
becoming more common as well. Doll expects that in the next 15 years, all rooms
will be private in nursing homes.
Doll said it's easy to
tell if a nursing home is focusing on culture change -- visiting one at about 6
a.m. will show if all of the residents are being awakened or if they can choose
to get up when they wish. "You also can view the interaction between staff
and residents," she said. "See if they talk over their heads or to
the residents."
This culture change is partially
due to the ever-expanding options for the aging, Doll said. Now, older adults
can consider home health, which allows the person to stay in his or her own
home. Another option is assisted living, which provides supervision but a lot
of independence for residents who can take care of most of their own needs.
It's like a "very small apartment but with help nearby," Doll said.
Yet another of many options available today includes "green houses,"
which are like boarding houses with only eight to 10 residents.
"Everyone's trying
to make it more homelike," Doll said.
The gerontology program
at K-State focuses on long-term care issues. Doll and other K-Staters are
studying how culture change is affecting residents. In addition, researchers
have written about
More information about
K-State's gerontology program is available at: http://www.k-state.edu/gerontology/
Photos: (Top) The
front doors of the healthcare households at Meadowlark Hills Retirement
Community,
14. ASSISTED LIVING
Poor
Sleep Is Common Among Elderly People Who Live In Assisted
Living Facilities, A New Study Found
(Source: HealthDay News)
This lack of sleep is associated with declining quality of life and increased depression. Many older
adults move into an assisted living facility
(ALF) when they're no longer able to live independently but do not require the
level of care provided in a nursing home. ALFs typically provide meals,
housekeeping and personal care assistance.
In this study,
Poor sleep was
associated with lower health-related quality of life,
the need for more help with basic daily tasks (such as dressing, grooming and
bathing), and symptoms of depression. MORE…
15. ADULT DAY
Grants for Social Model
Day Programs Available
(Source:
The Brookdale Foundation)
The Brookdale
Foundation will be making grants
available to qualified organizations for the development of new
dementia-specific, social model day programs. The 2010 RFP for the start-up of
social model "Group Respite" or "Early Memory Loss"
programs for people with Alzheimer's disease and their family caregivers is now
available.
16. HOME & COMMUNITY-BASED
SERVICES
Home
Care Businesses Fill Void As Alzheimer’s Care Units Decline
(Source:
PRWeb)
Home care is growing as
a result of the increasing incidence of Alzheimer’s and other dementias, said
Paul Hogan, Co-Founder and CEO of the Home
Instead Senior Care network, the world’s largest provider of non-medical
in-home care and companionship services for senors. One in eight people aged 65
and older (13 percent) have Alzheimer’s disease, according to the Alzheimer’s
Association 2010 Alzheimer’s Disease Facts and Figures report.
“In the past, care
communities have been the only options for seniors suffering from Alzheimer’s
disease,” Hogan said. “But with more seniors wanting to stay at home – about 86
percent in our surveys – and fewer nursing beds available, the strain will
continue to increase on the nation’s family caregivers. These caregivers often
need assistance with their loved ones as the disease progresses.”
The total number of
nursing facility beds (in dedicated special care units) in the
This national trend
could confirm a growing need for more resources, and a growing market for senior care businesses. “Since
almost half of nursing home residents in the U.S. have Alzheimer’s or other
dementia, and only 5 percent of nursing home beds are in Alzheimer’s special
care units, it is clear that the great majority of nursing home residents with
Alzheimer’s and other dementias are not in Alzheimer’s special care units,”
according to the Alzheimer’s Association’s 2009 Alzheimer’s Disease Facts and
Figures report.
As a result, family
caregivers are stretched thin and feeling the crunch. More than 40 percent of
family and other unpaid caregivers of people with Alzheimer’s and other
dementia rate the emotional stress of caregiving as high or very high, compared
with 28 percent of caregivers of other older people, according to the
Alzheimer’s Association’s 2010 Alzheimer’s Disease Facts and Figures report.
About one-third of family caregivers of people with Alzheimer’s and other
dementia also have symptoms of depression, the report noted.
“That’s why developing
resources to help these families should be our top priority,” Hogan said, “and
why Home Instead Senior Care is working to address the changing needs of our
growing senior population.” MORE…
Emotional
Stress Is Higher With Dementia Care
(Source:
High Beam Research)
[Editor's note: This is
the second of a two-part article that discusses best practices for the care of patients
with dementia. Last month, we looked at an overview of the challenges presented
by dementia patients and techniques that improve care. This month, we look at
additional tips to increase patient compliance and ways for home health workers
to handle the stress of dementia care.]
It is not uncommon for
a home health patient to have dementia in addition to the medical diagnosis
that is the reason for admission to home health. Being able to recognize and
overcome the challenges presented by dementia is important to being able to
ensure a good outcome for the patient, according to sources interviewed by
Hospital Home Health.
Taking
care of home health staff members who care for patients with dementia is as
important as taking care of the patients themselves, suggests Elizabeth Gould,
MSW, director of quality care programs at the Alzheimer's Association. At least
this is part of the input received from members of the task force that worked
on the Alzheimer's Association's Dementia Care Practice Recommendations for
Professionals Working in A Home Setting.
"Although the best
practices suggested by the task force working on the recommendations focused on
care for patients with dementia, several suggestions were made to include care
for the home health provider," says Gould. Caring for a patient with
dementia can be more challenging than most home health patients, so it is
important to provide support to prevent home health provider burnout, she
explains.
"I found it
interesting that a number of people who reviewed the recommendations suggested
inclusion of a section on provider self-care," says Gould. "Being
aware of the stressful effects of caring for a patient with dementia is
especially important for home care providers, because there are fewer
boundaries between personal and professional relationships," she
says. MORE…
Program
For Elderly Will Be Expanded: Counseling
Can Ensure Home Care
(Source:
www.boston.com)
Bowing to pressure from
lawmakers and advocates, the Patrick administration said yesterday it will
expand a pilot program that tries to keep frail senior citizens out of nursing
homes by providing free counseling about alternative care.
The action comes a week
after legislators demanded that the administration explain why it had failed to
follow a directive in the state budget that required the state to expand the
program, which the administration’s own analysis showed kept more than 300
people living at home in one year.
“We have waited three
and a half years to get this done and we are ready to help bring elders home,’’
said Al Norman, executive director of Mass Home Care, an association of
nonprofit agencies that had lobbied for action…
MORE…
How Will Healthcare Reform Impact HCBS
Providers?
On March 23, President
Obama signed the healthcare reform bill into law. This historic moment owes a
lot to AAHSA members who have been advocating for its passage for a very long
time. AAHSA's Health Reform Hub has been updated and is ready to give you the
latest on how healthcare reform will impact you. The site features specifics
(on the right-hand side under "Get Smart") on how healthcare reform
will impact adult day programs, home health agencies, and hospice
programs. (See AAHSA website)
17. CONTINUING CARE RETIREMENT
COMMUNITIES
CCRC's Are Expanding
Their Home And Community-Based Services Offerings
(Source:
Coffey Break)
Preliminary findings
from the 2010 AAHSA Zeigler 100 show that more than 75 percent of the largest
25 multi-site not-for-profit senior living organizations offer HCBS; in 2009,
two of these organizations expanded their services. Of the largest 10 organizations,
80 percent offer HCBS, with one expanding its services. None reduced the
services offered. (In last year's publication, more than 70 percent had either
kept their HCBS services level or expanded, but 26 percent had reduced their
services). See Ziegler's
Z-News. Also, read the
report of AAHSA's HCBS Cabinet to learn about developing or expanding HCBS
in your organization.
18. END-OF-LIFE & HOSPICE
The Importance Of Memorial Services In Long-Term Care Facilities
(Source:
fullcirclecare.wordpress.com)
Death is such a taboo
subject in our society, but for long-term care residents (those living in nursing
homes and assisted living facilities) often it is even more of a forbidden
subject. Why should the right to grieve and express emotions over the
loss of a friend stop upon entry into a long-term care facility? In most
facilities when a resident dies, the resident is taken out through the back
door once all the other residents are secured in their rooms with the doors
closed.
There is a national
effort to guide facilities toward person-centered care or culture change.
Efforts to change the approach of dealing with death and dying in long-term
care facilities can have a tremendous impact on this culture change movement –
and on the mental outlook of someone facing the end of life.
So many are affected by
the death of a resident - family and friends, facility staff, and other
residents. How the facility responds to death sends a message to the
remaining residents. Facilities that celebrate a resident’s life with a
memorial service are amazed at how much everyone appreciates the opportunity to
honor the person. Some facilities invite residents and staff members to
share stories, poems or songs about the deceased resident. More
|
|
It
is the hope of long-term care advocates that more facilities will embrace the
idea and begin holding memorial services. What a
compassionate and caring gift to give residents and family members. |
19. EDUCATION
Culture
Change Close To Home
(Source:
Provider April 2010 Extra News Online)
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. MORE…
Caring
For Our Elders: Nursing Education Is Changing To Meet The Needs Of An Aging
Population
(Source:
Star Tribune)
According to the
Administration on Aging (www.aoa.gov), people
65 years and older numbered 38.9 million in 2008 - or about 12 percent of the
population. By 2030, nearly 20 percent of the
Nursing
Challenge
An aging population
poses a challenge for healthcare - especially nursing. That's because older
adults receive the highest percentage of healthcare services, and registered
nurses play an essential role in their care.
More
Elderly
Dementia Patients And “At-Risk” Students Create Friendships
"Beautiful Circle of Knowledge"
(Source: There Is A
Bridge)
The Memory Bridge Initiative was featured on the front
page of the Chicago Tribune on April 14, 2010. Pulitzer-prize winning
journalist Ted Gregory followed a
As
the school bus lumbered to a stop outside the
These students attended one of Chicago's most troubled high schools — Bowen
Environmental Studies Team — where only 7 percent of students passed state
competency exams in 2008 and where more than 95 percent live in poverty. Last
year, five teens were killed in the gang-ravaged
That rainy Monday in October, each of the students was about to meet a retiree
with dementia as part of a 12-week class called
Read
the online version of the Chicago Tribune article on Memory
Bridge
Eastern
Michigan University Offering Dementia Studies Certificate
(Source:
WLNS.com)
The university says the
graduate level certificate program is aimed at people who work in hospitals,
home health care, research centers, veterans' services, businesses and
substance abuse centers. It says the multidisciplinary program deals both with
theory and applied subjects related to deterioration of brain function.
20. MEDICAL COMMUNITY
Culture
Change Movement Is Becoming Mainstream: A Person-Centered
Approach Is Critical
AMDA
Seeks To Help Physicians Understand Culture Change And Their Role in it
(Source: AMDA, www.caringfortheages/current)
A
growing number of facilities, communities, and practitioners have embraced the
movement that long-term care advocates call culture change. The Centers for
Medicare & Medicaid Services has expressed support for the efforts, and
research is demonstrating the clinical and operational effects on long-term
care. For those practitioners and
facilities that have not yet embraced culture change, the message from others
appears to be: Dispel the myths. Stop the excuses. Seek ways to embrace and
implement change that is culture deep and part of everyday work and life. “This kind of caring should be what elders
expect in whatever place they call home,” said Pioneer Network Executive
Director Bonnie Kantor, ScD. “We're moving from adoption to widespread
implementation.”
There
are many terms that people associate with culture change: person-centered care,
person-directed care, patient-centered care, patient-directed care,
resident-centered care, and resident-directed care. The name game can be
confusing, but it's important that facility leaders not get hung up on
terminology, said Dr. Kantor. “We are very big on knowing your audience and
using what terminology works for them.”
Joanne
Rader, one of the Pioneer Network's founders, said, “There is no national
consensus on terminology. But in any given setting, people need to make a
conscious [decision] about what term they will use. Then everyone needs to have
a common understanding what culture change means and how they are involved. …
They need to understand that each person they care for is at the center of this.
They must understand that their job is to be in service to the people they care
for.” MORE…
Person-Centered
Care: What It Means to You and Your Family
(Source: AMDA, Caring For The Ages)
You
may have heard about the culture change movement in long-term care. This is a
shift in philosophy and practice that is all about meaningful relationships and
service. Staff, caregivers, and practitioners really know their long-term care
residents/patients and make sure they have choices about their daily care.
Person-centered care is one term used to describe this type of care.
Person-centered
care is based on ongoing relationship building and reflects the person's needs,
values, and choices. Everyone—including family and friends—works as a team to
provide comfort, care, support, and joy for the resident/patient. Everyone
shares a focus on the person's best interests and personal goals. All
residents/patients can benefit from person-centered care, even if they have
dementia such as Alzheimer's.
Understanding
person-centered care will help you decide how you can help your family
member/friend. It will make sure that everyone else involved in your family
member/friend's care knows what he/she wants, likes, and believes, allowing for
respect of their choices. SEE ▸
Questions
to Ask Your Physician and ▸ What You Can Do…
What Culture
Change Means to Physicians
(Source: AMDA, Caring For The Ages)
Nevertheless,
when advocates of culture change use the word “overmedicalized,” what they
generally mean is that the facility is too much like a hospital and too little
like a home. But I have never met a resident who complained that every time
they had a medical complaint they were seen by their doctor. Families don't
worry that there is too much medical presence in the facility, that doctors
come too frequently or communicate too much with the family and each other, or
that consultants are too available. Quite the contrary.
Thoughtful,
evidence-based, geriatric care should still be a goal for facilities undergoing
the most radical of culture change. It remains a highly desired feature of care
for virtually every resident.
Education of your medical staff regarding many of the above issues, such as liberalizing diets and simplifying drug regimens, can occur regardless of whether the rest of the facility is changing its culture. Advancing good geriatric care is always consistent with culture change and remains your goal as the medical director. MORE…
21. INTERNATIONAL
Taking
Seniors To A Higher Plane
(Source: rediff.com)
India
Home, now in its third year, stands out from many facilities for seniors from
India in the New York tri-state area. First, it offers easy access to activity
sites thanks to a minibus donated by the Leena Doshi family. Second, it aims to
have its own living facility for seniors and help those with dementia. Apart
from yoga and meditation classes, birthday events, outdoor trips, it is also
empowering seniors, teaching them English, and through organizations like the
South Asian Council for Social Services, it also gets seniors to know their
legal rights and various resources New York city offers them.
The organization owes its existence to three daughters who also are doctors,
and the plight of their parents. "Towards the end of his life, my father
Vangapandu Lakshmi Naidu, a Sanskrit scholar, suffered from vascular
dementia," said Dr Vasundhara Kalasapudi, a geriatric psychiatrist and
president, India Home.
Two weeks ago, Kalasapudi received an award for community service from SACSS
during the latter's 10th anniversary celebrations in
She and her friends
realized that if Indian senior citizens had a place of their own where they
could not only reminisce about their Indian roots but also forge new
friendships and receive active counseling, they would be less miserable.
"In fact, anyone who attends our events feels very positive and
empowered," Kalasapudi said. 'We are no prisoners in our homes, watching
TV all the day, and longing to meet our friends face-to-face,' is a common
affirmation you hear from many seniors. MORE…
International
Developments in Self-Directed Care
(Source:
IAHSA - The Global Ageing Network)
We are seeing an
increasing number of studies and articles about who is in charge of health care
decisions for individuals. Called by a number of different names
[personalisation; patient-directed care; person-centered care; self-directed
care] they all mean the same thing – Who Decides?
The Commonwealth Fund’s
recent study entitled International
Developments in Self-Directed Care gives evidence of an
international trend toward self-directed care focused on an unlikely group of
patients – the frail, old, disabled and mentally ill. The enabling factor is the
use of personal budgets, a cash payment made to people eligible for services
with few strings attached, empowering the individual make their own decision
about who will care for them how.
The implications are
huge. As noted by John Goodman in Health
Affairs, “The advantage of empowering patients and families in
this way are straightforward: lower costs, higher quality care and higher
patient satisfaction.”
See link for last weeks
post on implications of ‘personalisation’ – a study by The
Third Sector Research Centre in England.
More
Global
Alzheimer’s Disease Charter
We Are Facing A Public Health And Social Care
Emergency And Immediate Action Is Needed!
(Source:
www.globalcharter.org)
Alzheimer’s
disease is the most common cause of dementia and accounts for 60-70% of all
cases. Alzheimer’s disease and other dementias are progressive, degenerative
illnesses that attack the brain.
They affect people’s abilities, impacting on all aspects of their life and upon
others in their lives, particularly those who care for them day by day…
Lack
of awareness and understanding has resulted in insufficient resources to
address this crisis. Worldwide, attention to this rapidly growing problem is so
small that most of those affected continue to suffer without help, or hope.
This must change! The quality of life of people with Alzheimer’s disease and
other dementias can be transformed. Too often, they, their families and carers
lack the support that they need and deserve.
We,
the members of Alzheimer’s Disease International (ADI), representing 77
associations around the world, urgently call upon all governments and
stakeholders to act now.
Within the limits of the
resources available to different countries, an eleven-point action plan
consistent with the
Fiona Phillips
Helps Get Mobile Dementia Therapy Bus On Road
(Source:
Belfast
Former GMTV presenter
Fiona Phillips, whose parents were both diagnosed with dementia, was at Belfast
City Hall yesterday to launch a new mobile therapy unit to support people with
the disease. The first of its kind in
Fiona
Phillips was at Belfast City Hall yesterday to officially unveil the
initiative, which has been named the Fold Brain Bus.
Ms
Phillips has been vocal about her experiences in caring for her father with
dementia
The eye-catching pink and
purple bus contains a range of interactive equipment and computer software
which stimulates people with dementia, ultimately reducing depression and
agitation. The TV personality, who used
to share a couch with Ulsterman Eamonn Holmes, has championed dementia issues since
her parents were struck by the illness…
“The people of
Read
more:
22. ANIMALS, INTERGENERATIONAL,
PLANTS & ETC…
Cat’s
Scan – Feline Has An Uncanny Knack For Helping Patients At The Lighthouse
Nursing Home
(Source:
Revere
On the
staff directory in the foyer of the Lighthouse Nursing home, there is one
picture in the bottom corner that bears quite a tale.
It’s not a picture of
one of the nurses or even of one of the social workers there, it’s a picture of
a strange looking cat named Rocky – and while he’s listed as director of cat
services, he has a number of talents that he spreads throughout the halls of the
home’s Dementia Unit. MORE…