CONNECTION ™
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Produced by the Culture Change Network of Georgia March/April
2011
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CULTURE CHANGE THROUGHOUT THE
CONTINUUM
OF LIFE-LONG LIVING & LONG-TERM CARE
“A society's quality and durability can
best be measured by the respect and care given to its elder citizens." ~ John F. Kennedy
Content Category Shortcuts:
Federal Register Publishes
Final Rule on Civil Money Penalties:
Funds Must Benefit Nursing Home Residents
(Source: PHI)
The Centers for Medicare and Medicaid Services' (CMS) final rule on Medicare and Medicaid Programs, Civil Money Penalties (CMP) for Nursing Homes was published in the Federal Register on March 18. These regulations, implementing provisions of the Affordable Care Act, establish new ways to spend CMPs collected by CMS. According to the Federal Register notice (pdf), there is some flexibility on how the money can be spent, but some of the CMP funds must be applied directly to promote quality care in nursing homes and the well-being of nursing home residents. As of March 23, CMS is responsible for authorizing how all CMP funds garnered from nursing home penalties imposed by CMS and states can be used. Funds Must Benefit Nursing Home Residents. READ FULL ARTICLE HERE
Person-Centered Care Creates Home-Like Environment for Residents
(Source: Chicago Tribune)
(NOTE THIS IS IN THE “MASS MEDIA” FOR ALL
CONSUMERS TO SEE!)
The common living room at Lutheran Home in Arlington Heights.
Christine Casey believes that personal care has probably extended
the life of her 93-year-old mother, Jane Olson. Olson lives at Three Crowns
Park, a retirement community in Evanston. At first, Olson lived in her own
apartment. But Olson moved into the nursing care wing of the building when
she became frail. The wing was recently remodeled and the staff uses an
approach called person-centered care. The wing has several sections, each with
about 17 residents. Each section or neighborhood has private rooms clustered
around a common area that seems more like a private home than a nursing
facility.
Olson's room is right across the hall from the neighborhood's dining area.
Going to breakfast doesn't involve a walk down a long corridor, or an elevator
ride. Olson can stop by for a snack when she wants. The comfortable common
living room is right outside Olson's room. Best of all, the staff knows Olson
and what she likes. The same nurses treat Olson day to day. They build
relationships together. "It's a very personal approach," says Casey.
"We feel so fortunate."
Dignified living The kind of person-centered care that
Olson receives is growing in popularity. Person-centered care is a recognition
that resident choice and autonomy should be the primary aim of resident care in
nursing homes and assisted living facilities. Residents should be able to get
up when they want, or eat when they want, instead of being tied to a
task-oriented nursing schedule. Residents should decide whether they'd prefer a
bath or a shower. Consistent staffing lets residents and nurses alike get to
know each other.
"Person-centered care is something so simple" says Karen Love,
president of the Center for Excellence in Assisted Living, Falls Church, Va.
"It's treating residents with dignity."
The shift towards person-centered care started in the early '90s. It is
sometimes referred to as "culture change." The Pioneer movement and
the Eden Alternative are both examples of person-centered care models. The
Illinois Pioneer Coalition is a non-profit group that promotes person-centered
care through community outreach programs and education. The Coalition also
seeks to inform the public that the philosophy of care at a nursing home does
matter. "Many Chicago-area buildings practice person-centered care,
but the goal is to expand that network," says Stephanie Buck, executive
director of the Illinois Pioneer Coalition.
Relationships matter The staff at person-centered care
buildings must be trained in the approach. Employees are taught how to build
the daily activities around the individual needs of the residents instead of
focusing on a list of tasks that must be completed. Person-centered care is
practiced at the five Chicago area facilities owned by Lutheran Life
Communities. "The key is for the staff to build a relationship with the
resident and the resident's family," says Amy Iacch, corporate director of
clinical services at Lutheran Life in Arlington Heights. Forming a personal
attachment results in fewer complaints from residents. It also helps to reduce
staff turnover because they are personally involved in their work.
One of the most notable examples of person-centered care is the Green House
Project. The project creates small, intentional communities for groups of
elders and staff. Each Green House is designed for six to 10 elders. The senior
has his or her own room. The house has a shared living room, and an open
kitchen and dining area. The Green House encourages elders to make themselves
at home. Residents can decorate their private rooms and baths with their own
belongings. They have easy access to all areas of the house, including the
kitchen, laundry, outdoor garden and patio. They are free from schedules and
can eat, sleep and entertain themselves when and where they choose. Meals are
prepared in the open kitchen and served at a large dining table where all
residents can socialize.
A small staff manages resident care. This helps create a family-like
environment and allows residents and staff members to build relationships.
"Activities are very spontaneous," says Bill Keane, manager of the
Green House project, Alexandria, Va…
"The idea is catching on," says Robyn O'Neill, the long-term care ombudsman for suburban Cook County. In her work advocating for nursing home residents, O'Neill says residents of buildings with a person-centered approach tend to be happier than those in other types of homes. Person-centered homes are the subject of fewer complaints too. When seeking nursing care, O'Neill advises: "People should ask about it." READ FULL ARTICLE HERE
The Impact of a Regulatory Intervention on Resident-Centered Nursing Home Care: Rhode Island’s Individualized Care Pilot
(Source: By
David
G. Stevenson
and David
R. Gifford,
The Commonwealth Fund)
Abstract:
In an effort to use the annual nursing home survey process to promote resident-centered
care practices, the Rhode Island Department of Health implemented the
Individualized Care Pilot from November 1, 2007, to April 30, 2008. The
initiative promoted resident-centered care primarily through activities integrated
with the annual recertification inspection. In addition to enhancing existing
survey processes, the pilot incorporarated a visit from the state Quality
Improvement Organization into the survey process itself. This study assessed
the impact of that pilot on resident-centered care practices. Online surveys
were sent to administrators at all
Bringing Culture Change to the Regulatory Process
(Source: by Patricia Sheehan,
Editor-in-Chief, Long-Term Living Magazine)
I checked into the requisite regulatory session at the EFA conference this morning with a bit of trepidation, thinking it would be a snoozefest and so over my head that it would be a waste of my conference coverage time. Instead, I was immediately drawn into the engaging and compelling program by presenters Gaius Nelson of Nelson-Tremain Partners, and Skip Gregory of Health Facility Consulting.
The two expert consultants used gentle humor backed by solid facts to build a case for sensible and research-based reform of redundant, inflexible, and outdated life safety and design codes that perpetuate antiquated models and create barriers to person-centered care for nursing homes. They identified the myriad challenges reformers face, including dealing with entities that are working off a 10-15 year cycle on codes; for example, federal enforcers still adhere to the 2000 edition of Life Safety Codes when a newer edition has been in existence since 2004.
“Design codes are based on an outdated institutional model, created for the caregivers, not the residents and without any real thought to it,” charged Gregory, citing a California nursing home standard that still permits four beds per room. “Why do we put up with this?”
Nelson and Gregory identified current regulatory reform efforts and offered guidance on how to influence and support regulatory reform. They encouraged attendees to learn the code revision cycles and work with their state provider associations to affect change. “There are enlightened regulators,” said Nelson. LINK HERE
The Continuum of Care – What Does It Mean for Culture Change?
(Source: By Laura Beck,
Learning & Development Guide, The Eden Alternative)
Culture change in our industry was born in the halls of the nursing home. For many years now, we have witnessed exciting developments regarding how we can transform the nursing homes of yesterday into the warm, welcoming homes of today. We have had the opportunity to benefit from a body of work that has been years in the making. When we talk about the “whole continuum of care,” we are referring to the undeniable fact that care doesn’t stop inside the walls of the nursing home. It reaches beyond those walls into the neighborhood streets and communities that make up our towns and cities. It reaches into the faith-based communities, the senior centers, the adult day centers, the assisted living and independent living communities, the hospitals, and the home health networks that support the needs of Elders in those towns and cities.
And in each of these environments, care does not live in a vacuum. The care experienced in the nursing home is connected to the care offered in the hospital or at home or in assisted living. Each impacts and influences the other. This is why culture change must reach across the entire continuum of care to be truly effective. We can’t push hard for change in nursing homes and simply ignore how the institutional model impacts care in someone’s home. When the general public is educated about culture change and person-directed care, we raise the bar of expectation. No one drives change better than a motivated consumer! But it is more than just teaching the public about what to demand from care at any level. It is also about empowering the public to own their role in changing the culture of care. How do they live these concepts in their own lives, in their own interactions, in their own care relationships? Quality care begins at the grassroots level. We are all part of the solution.
Two weeks ago, members of the Culture Change Network of Georgia came together to acknowledge their varied roles on the continuum of care at Eden at Home Trainer Certification in Atlanta, Georgia. This particular culture change coalition is committed to addressing care as a continuum, and given their creativity and enthusiasm, we have no doubt they will achieve great things. May their commitment be a reminder – it can be different, no matter where Elders live!
Eden at Home™ is an initiative of the Eden Alternative® focused on applying Eden’s Ten Principles to home and community-based care.
Florida Nursing Home Watchdogs: The Truth Has To Be Told
(Source: By Bill Thomas,
Changing Aging)
This will not end well. The state Department of Elder Affairs also has notified Florida’s 400 mostly volunteer ombudsmen, instructing them not to speak to the media without alerting a district manager about the conversation and detailing the questions asked.
“My biggest concern is that we can still speak for residents, still do yearly assessments of the facilities, still handle residents’ complaints and not be muzzled by the industry or the governor or anyone else,” said Lynn Dos Santos, chairwoman of the State Long Term Care Ombudsman Council and a volunteer herself. “Under the new policy, I shouldn’t be talking now. But the truth has to be told.” Someone must speak for those who, literally, cannot speak for themselves.
Full story
here. Background on the situation in Florida here.
Consumer Voice Statement on Florida Ombudsman Resignation
The independence and effectiveness of the Florida long-term care ombudsman program were dealt a severe blow last week by the forced resignation of state ombudsman Brian Lee. The Consumer Voice is shocked that Gov. Rick Scott forced out the ombudsman, who represents some of the state's most vulnerable residents, on the recommendation of nursing home and assisted living operators who are the subject of the ombudsman program's oversight. The ombudsman is mandated under the Older Americans Act to be an independent voice for residents and free of conflicts of interest. Ombudsmen investigate resident complaints and serve as advocates to ensure that residents in nursing homes and assisted living facilities are protected under the law.
"Brian was recognized by his colleagues in Florida and nationally for his commitment to protecting the rights of long-term care residents and working with residents, families and providers to improve care," said Sarah F. Wells, Consumer Voice executive director. Wells said the office must be independent and free of political interference to perform its statutory functions.
Lee was asked to resign after he asked the state's nursing homes for names of companies and individuals with an ownership and operational interest in their facilities. State ombudsmen were given authority to request the information from Medicare and Medicaid-funded nursing homes in transparency provisions in the health care reform law. The law was the subject of congressional hearings in which witnesses testified that it is often impossible to hold nursing homes accountable for quality because of complex ownership and operating structures. In a recent report, the Government Accountability Office said, "To determine the effect of ownership on nursing home quality of care, it is necessary to have complete and accurate ownership information that provides a clear understanding of the relationship of each owner to the nursing home and any other owners."
Ombudsmen in some states report that nursing homes routinely provide the information when it is requested. In 2012, a summary of the ownership data will be reported on the federal government's Nursing Home Compare website, which is designed to help families choose a nursing home. "We are very concerned that the governor of Florida has yielded to industry demands to dismiss an effective advocate for residents in a state that so many elderly Americans choose as their retirement home," said Wells. "As a national voice for long-term care residents, we strongly urge the governor to follow the law and allow the ombudsman program to operate without interference."
Planetree's
Heidi Gil and Dr. Bill Thomas Discuss the Long-Term Care Improvement Guide (The Guide Is a “MUST READ”)
(Source: By Bill Thomas,
Changing Aging)
Safety Surplus: The Upside to Risk
(Source: The GREEN HOUSE®
Project)
"Risk." This word conjures up feelings of negativity and fear. But Dr. Bill Thomas gives us a fresh perspective on this daunting term. Risk is "the outcome of an action [that] may result in something unexpected." Upside risk is the possibility that something good can come out of taking risks. At the 2010 Green House Project Meeting, Dr. Bill Thomas describes the danger of creating "too safe" of an environment, where individuals are not allowed the opportunity to take risks that allow them to grow and thrive. Watch Dr. Thomas speak about how upside risk can help elders thrive! WATCH HERE:
Traditional Business Models in the Skilled Nursing Care Sector are About to Undergo Massive Change, Panel Predicts
Larry Minnix, CEO of LeadingAge, insisted that many operators will need to focus on culture change that supports the best possible care delivery. He again warned that substandard facilities will not survive into the future. CLICK HERE.
Alzheimer’s Advocate Tom DeBaggio Dies
(Source: NPR)
Melissa
Block wrote: Tom DeBaggio died Monday at the age of 69. He was 57 when he
was diagnosed with early onset Alzheimer's disease, and quite fearlessly shared
his experience with NPR over the years - first with Noah Adams and later with
me.
DeBaggio
lived for plants and the garden. He started out selling tomato plants in
Styrofoam cups from his driveway in
When
DeBaggio was diagnosed with early onset Alzheimer's, he set to work, writing
two books about living with the disease. He described with remarkable candor
the frightening progression of his illness.
"This
is an unfinished story of a man dying in slow motion," he wrote in the
first book, which he titled, with his typical brutal honesty, Losing My Mind.
Go to full story:. You will also be able to
listen to all the interviews with Tom DeBaggio there.
Creating Eden in Georgia
Eden at Home Trainer
Certification Workshop A Tremendous Success!
The Culture Change Network of Georgia (CCNG) is proud to be the first state coalition to host an Eden at Home workshop. The three-day Eden at Home Trainer Certification Workshop: Creating Quality of Life for Care Partner Teams Living with Dementia took place March 7 – 9th in Atlanta at Aging Services of Georgia’s Center for Positive Aging and was a tremendous success! There were 25 participants from throughout the continuum, including six representatives from Augusta. Our Educator was Laura Beck, Learning & Development Guide for The Eden Alternative. Laura actually developed the curriculum for Eden at Home, and we were very fortunate to be able to “experience” the transformational workshop with her - she did a fabulous job!
Eden at Home (EAH) applies the Eden Alternative’s Ten-Principle
Philosophy to improving quality of life for Elders living at home (or
participating in any kind of “non-nursing home” community supports and
services) and their care partners. A
community-based approach to person-centered care, EAH focuses on building
collaborative care partner teams that include the active participation of the
Elder themselves. Working together,
empowered care partner teams help to ensure the independence, dignity, and
continued growth and development of our Elder care partners and each
other. After the three-day training,
participants became Certified Trainers and are equipped to inspire care
partners both within their own organizations and out in the community. READ FULL
STORY HERE
Georgia Eden at Home Trainer Certification Workshop Graduates 2011
Culture Change: Making it Happen One Home at a Time
(Source: Carolyn Roper, GMCF
Quality Advisor, Patient Safety Pulse)
Culture Change is going full steam in many nursing homes in Georgia! We at GMCF (Georgia’s qio) had the opportunity to visit a home that had taken the next step in the culture change journey. Michael Ostro, Administrator of Rosemont Nursing Home, spoke with us recently and related that all clinical measures at Rosemont have improved since they opened their ice cream shop, “Sweet Delights.” This is huge! Can you imagine NO weight loss? And improved high risk pressure ulcer rates? Can you imagine happy residents moving around the home with a purpose and a smile because they know a snack is waiting at the drive thru any time of the day or night? Why, it’s just like being at home!
If you’re wondering how to start changing your dining program, here are some questions you can ask your resident council: READ THE REST OF THE ARTICLE HERE
Rosemont Nursing Home – A Real Home in
Every Sense ““We knew we could create something like an
old-fashioned storefront that they could relate to, and then give them choices
in a snack, and give them some place to go.” The stand, which is staffed,
also features a “drive-thru,” complete with wheelchair rails, so that
residents in wheelchairs can just approach the stand from the opposite side
of the walk-up front and order their own frozen treats. “The first time we opened the store,” Ostro said, “we
brought a resident in who had never spoken a word. We handed her an ice
cream cone and she said ‘ice cream.’ I guess that’s what you’d call a ‘grace
moment.’” There have been many more moments like that. “The staff
is seeing some amazing reactions in the residents,” added Ostro. ~
Administrator Mike Ostro
All the residents enjoy Rosemont’s new ice cream stand and often “line up” in the afternoon for their frozen treats.
Georgia Bill Proposes Official Designation for Assisted Living Facilities
(Source: by Deane Beebe, PHI)
A bill that would make it possible for residents of Georgia’s assisted living facilities to continue living in these settings — even if they needed help with medications or were not ambulatory — cleared the Georgia State Senate on March 14. The state’s House Health and Human Services Committee passed a similar bill on March 7.
Currently, Georgia licenses only two types of long-term care facilities — nursing homes and personal care homes. In Georgia, assisted living facilities are designated as personal care homes. This means they can provide services such as meals; 24-hour supervision; help with bathing, dressing, and other daily activities; and supervision of self-administered medication. They cannot, however, provide medical or nursing services, which include assistance with taking medications. When assisted living residents need help administering their medications or are deemed to be too immobile to manage in an emergency, they are required to move out — which usually means to a nursing home. (In some cases, a state waiver can be obtained, but reports say such waivers are rare.)
“We have heard from our members that residents in assisted living want the choice to age in place,” said Kathy Floyd, associate director for advocacy at AARP Georgia, a proponent of the bill. “This legislation will give that choice and protect residents’ safety.”
Assisted Living Facilities Could Employ Medication Aides
Should the proposed bill become law, assisted living facilities will be permitted to employ medication aides who could administer certain medications to the residents, in accordance with the Georgia Department of Community Health (GDCH) regulations. “We’ve seen the medication aide position work well in other states and think that these aides could be a big help in Georgia,” Floyd said. The bill lists numerous requirements for medication aides — for example, it states that they must be certified nurse aides. It also says that the aides must have successfully completed a state-approved medication aide training program, the training requirements for which are outlined in the bill. GDCH must establish and maintain a medication aide registry should the bill become law.
To comply with the proposed law, the assisted living facilities must also have adequate staff to help residents with mobility problems manage in an emergency situation.
Advocates, including AARP Georgia and the Georgia Long-Term Care Ombudsman, have been working for the past 16 years to get the state to designate assisted living facilities as a licensed care level of their own. According to reports, the nursing home trade association supports the current bill but originally opposed it, saying they feared that it would pose a safety risk to residents who needed care. Should the bill become law, assisted living facilities with at least 25 beds could become licensed long-term care facilities with a designation of their own. Georgia would join 22 other states that license assisted living facilities. Advocates say they expect Governor Nathan Deal (R) to sign the bill into law. LINK HERE
Law that Pushes Elderly into Nursing Homes Being Reviewed at Capitol: Current rules can force residents out of assisted living facilities
(Source: By Carrie Teegardin,
The Atlanta Journal-Constitution)
Jeff Herman wants his 92-year-old mother to keep living at the Sunrise assisted living home in Buckhead. His mother wants to stay. Sunrise wants to keep her too. But even though no public money is involved, the state of Georgia also has a say in the matter. The state believes that Myrtle Herman isn’t mobile enough to stay at Sunrise and it is trying to force her to leave, an action that would push her into a nursing home.
For 16 years, advocates for elderly Georgians have said the state needs to change the law that makes elderly people move against their will. But every year, state lawmakers, under pressure from a powerful nursing home lobby, have refused. That might change this year.
A bill that would for the first time create an official “assisted living” designation in state law appears to have momentum at the Capitol. The outcome of this year’s debate on the issue has implications for every Georgian whose spouse or parent is becoming frail as well as for an entire baby boom generation that is entering retirement. For Jeff Herman and others who want their family members to stay in the facilities that have become their homes, a change can’t come soon enough. “They’re not only doing a disservice to the elderly people, but to all the families of the elderly people,” Herman said. “I have stayed awake at night wondering if today is going to be the day that the state is going to come in and force Mom out.”
Unlike many other states, Georgia law does not recognize assisted living facilities. They are licensed as personal care homes. That designation was created years ago, before the concept of assisted living was widespread. Personal care home rules were set up to regulate small facilities that usually cared for just a handful of elderly or disabled people in a homelike setting. While nursing homes are authorized under state law to deliver a range of heavy-duty medical and personal services, personal care homes aren’t allowed to do much. Unless the state grants a waiver, residents must be able to take their own medications and be mobile enough to get around in an emergency. Getting a waiver is far from a sure thing. A Department of Community Health review of waiver requests from 2009 found that the state approved about a third of the requests that were related to a resident’s condition.
Under bills approved by committees in both the House and the Senate, Georgia would create the new assisted living designation for facilities with 25 beds or more. While those facilities wouldn’t be allowed to do as much as nursing homes could, they could have medication aides on staff who could give residents pills and insulin shots, which isn’t allowed today. And the rules would permit residents to stay even if they need some assistance getting around, as long as the facility has enough staff to keep its residents safe during a fire or other kind of emergency. The legislation (HB 405 and SB 178) is not a done deal. But both versions of the bill have cleared committees. The Senate is expected to pass its version during a vote scheduled for Monday. Even the nursing home lobby has given its blessing. “We are finally catching up with other Southern states in allowing Georgians the choice to age in place,” said Kathy Floyd, a veteran lobbyist for the AARP who has personally pleaded with legislators for years to give Georgians this alternative. READ MORE
Georgia Work Group Takes on the Issue of Mental Illness in Affordable Housing
(Source: by Alisha Sanders
On a recent visit to Atlanta, I had the opportunity to tag along with Aging Services of Georgia CEO Walter Coffey to work group the recently formed with several other organizations to look at mental health issues in affordable senior housing in the state.
The
work group’s members include the local Area Agency on Aging, the Emory
University Fuqua Center for Late Life Depression, the
Alzheimer’s Association and the state’s Department of Community Affairs,
Council on Aging, and Division of Aging Services. Their goal is to define the
housing and service needs of older persons with mental illness in
Affordable housing members regularly contact me about the growing challenges they face in supporting residents with mental health issues. This is area that taxes affordable housing staff in their personal ability to address residents’ mental health issues effectively, control their impact on the community and identify resources to support them and meet their needs. This work group is an important milestone in Aging Services of Georgia’s work to help affordable housing members achieve these goals.
The association’s other programs include staff training for the early detection and screening of depression and other mental illnesses as well as incorporating the PEARLS program into affordable housing settings. PEARLS is an evidenced-based treatment program designed to reduce depression in physically impaired and socially isolated older adults. Staff receives an initial training and ongoing support from PEARLS in managing data, tracking residents’ progress and evaluating program results.
I encourage other states to follow Georgia’s lead and make mental health screening and treatment a priority for their members and the people they serve. LINK HERE
RossWoods Adult Day Services Blessing of the Hands
One morning in early January, Dwight Wilson, Hospice Chaplain, Michael Jones, Hospice Chaplain/Bereavement Coordinator and Angela Compton, LMSW, all from Amedisys Hospice, made a special visit to RossWoods to ‘Bless the Hands’ of the RossWoods’ caregivers.
“We wanted to start the New Year with a great anointing for those who give loving care to our family members who are in need of day services,” stated Chaplain Wilson. “The caregivers’ hands have the daily honor to touch, assist, entertain, support and love those who can no longer be left alone at home. Our community is blessed to have so many kindhearted professional caregivers who give of themselves on a daily basis to make sure that life is sweeter for those in their care.”
April 15, 2011 at the Coastal Georgia Center, Savannah, GA
(If you have not “experienced” Teepa Snow then this is a MUST – I think that she explains dementia better than anyone I have ever seen!)
This is sponsored by the Alzheimer’s Association. REGISTRATION FLYER AVAILABLE HERE
FREE Three-Part Webinar Series: Changing the Culture of Long-Term Care
April 14, April 21 & April 28th 11:45 – 1:00 pm
The webinars are based on the “Changing the Culture of Long-Term Care Symposa” that took place in Georgia in 2010 (in Athens and Valdosta). This series is an opportunity to explore the Culture Change movement, which is based on person-centered values and practices, where the voices of elders and those working with them always come first.
The FREE webinars are April 14th, 21st and 28th from 11:45 a.m. to 1:00 p.m. We hope you will join us! If you missed the symposia, be sure to tune in! Please share with your networks. CEUs are available.
Session 1: April 14th presentation by Rose Marie Fagan
Session 2: April 21st presentation by Karen Nichols
Session 3: April 28th presentation by Kim McRae
Please see the flyer for more information such as learning objectives, schedule of events, speaker biographies, sponsor information, resources, and registration links. Note that you need to register for each webinar individually.
Conversations with Carmen Monthly Web Talk Show
The shows are produced by Action Pact and hosted by
For $99.00 per site, as many people can watch as you can get around
a computer monitor or in a room to see a projection of the show. Many teams tell us that having their whole
team hear the same up-to-date, innovative information in an encouraging
conversation format helps them dive into what fits their community.
Date: Friday, April 15, 2011
Guest: Linda
Roberts, Pioneer Network Liaison, Dietetics in Health Care Communities a
dietary practice group of the American Dietetic Association
Conversation
Topic: The American Dietetic Association's 2010 latest position paper:
Individualized Nutrition Approaches for Older Adults in Health Care Communities
The American Dietetic Association first came out in support of liberalizing restricted diets in 2002. Even the CMS guidance to the Nutrition Tag F325 refers to it. If that wasn't impressive enough, ADA recently issued an updated 2010 position paper entitled Individualized Nutrition Approaches for Older Adults in Health Care Communities. Join the conversation about it with content advisor to the paper and consultant dietitian, Linda Roberts, involved in both the culture change movement and ADA. If the dietitians are leading the cause to support self-directed living, and eating, why wouldn't we join them?
Next month's guests and topic are:
Date: Friday, May 20, 2011
Conversation Topic: Nurse
Competencies in LTC Culture Change
Guests: Joanne Rader and
Polly Youngren
In 2010, the Pioneer Network and the Hartford Institute for Geriatric Nursing together developed ten competencies for nurses to support changing culture in long term care settings. Our two guests who were involved in the development of the ten competencies will explain each competency as well as their history, use and future.
OPEN HOUSE the Center for Assistive Technology and Environmental Access (CATEA) at Georgia Tech
APRIL 21, 2011 from 6:00 PM -
9 PM
490 TENTH STREET, NW ATLANTA, GA 30332
Join us on April 21st from 6pm-9pm as the staff and students at the Center for Assistive Technology and Environmental Access (CATEA) at Georgia Tech present their latest research and design projects on accessible education, enabling environments, accessible workplaces and rehabilitation engineering. The Open House will feature cutting edge research on design and technology to promote the health, active lifestyles, and societal participation of people of all ages and abilities. Find out about our 3-D virtual learning environments utilizing creative avatars, the accessible aquarium project, social networking to help students with disabilities to succeed in STEM programs, universal design solutions, and new products to enhance the independence of older adults living at home.
That same night, our neighbors across 10th St., the Aware Home and Ellen Do's Happy Home class and those across Hemphill, the Wireless RERC, will also be having open houses, so please visit us on the NW corner of Tech's campus across from Rocky Mt. for this multi-location, inter-laboratory Über Event. Parking is available off 10th Street in the W32 lots adjacent to CATEA off Hemphill and behind CATEA off 10th. Refreshments will be served.
Please RSVP by April 11, 2011 : For more information contact Susan Perlman
MAY 10 & 11th ~ “BEST FRIENDS TELL STORIES” – A Two-Day Workshop on Humanizing Dementia Care
Atlanta, GA
David Troxel will teach us how to integrate the Best Friends Approach® into our organizations and how to build a Best Friends Staff.
Karen Stobbe will share how to use the Time Slips creative storytelling method with people with dementia.
These two national speakers will help change the way we “do what we do” to improve the quality of life of our friends who are living with dementia.
We have a limited number of scholarships available for friends of the Culture Change Network of Georgia – Pay for 1 Registration & bring a Direct-Caregiver FREE!
Register now for this fabulous workshop – for the CCNG Scholarship, write in the name of the Direct-Caregiver you will bring for free on your form: Click here for registration form.
The Best Friends™ Approach Institute Master Trainer Conference
Join authors David Troxel and Virginia Bell June 6 and 7, 2011
The Horton Grand Hotel in San Diego,
California
To receive additional information as it
becomes available, please
sign-up here:
Eden Alternative Webinars ~
Spring 2011
Practices for Staff Stability: What You Do Matters
Wednesday, April 27th, 2011, 3:00 – 4:00 p.m. ET
Click here to
register for this webinar
Take This Job & Love It! Finding Inspiration at Work No Matter What
You Are Doing...
Wednesday, May 4th, 2011, 3:00 – 4:00 p.m. ET
Click here to
register for this webinar
The How of
Change: What You Do Matters
Wednesday, May 18th, 2011, 3:00 – 4:00 p.m. ET
Click here to
register for this webinar
For a listing of recorded ON-DEMAND webinar events available for purchase, click here.
EDRA42 Chicago: Person-Centered Design in Healthcare: Building Connections
Wednesday, May 25, 8:30 am–4:30 pm, Palmer House Hilton, Chicago, IL
There has been a dramatic shift over the past several decades to include patients/residents/families as active partners in care, across the full continuum of care. However, insufficient attention has been directed at the important role and positive impact of patient/family/person-centered care, especially with respect to the design and built environment of healthcare settings. This intensive, held at the 42nd Annual Conference of the Environmental Design Research Association, will highlight some of the ways in which patient/family/person-centered care is being translated throughout the creative design process across acute and long-term healthcare settings to create very positive outcomes.
To register or to view the entire program
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Pioneer Network Conferences
August 2 – 4, 2011 in St.
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(near Seattle
Ageism in America
(Source: www.msnbc.msn.com)
As boomers age, bias against the elderly becomes hot topic
Erdman Palmore, 74, challenges the stereotypes of aging by skydiving, whitewater rafting and flying a hot-air balloon.
Greeting-card and novelty companies call them “Over the Hill” products: the 50th Birthday Coffin Gift Boxes featuring prune juice and anti-aging soap; the “Old Coot” and “Old Biddy” bobblehead dolls; the birthday cards mocking the mobility, intellect and sex drive of the no-longer-young. Many Americans chuckle at such humor. Others see it as offensive, as one more sign of pervasive ageism in America.
It’s a bias some also see in substandard conditions at nursing homes, in pension-plan cutbacks by employers, in the relative invisibility of the elderly on television shows and in advertisements.
“Daily we are witness to, or even unwitting participants in, cruel imagery, jokes, language, and attitudes directed at older people,” contends Dr. Robert Butler, president the International Longevity Center-USA and the person who coined the term “ageism” 35 years ago. READ MORE
I’ll Be Out There Again
(Source: Bill Thomas, ChangingAging)
If you haven’t heard about the Life in a Day video project you should take a look at the teaser embedded below. It caught my attention because the interviewee is a man who has confronted death and in doing so has pierced the veil of imagined immortality. He is visibly moved by the care and compassion that the staff show him and it is clear, as he speaks to us from his hospital bed, that he will return to the world “out there” as a changed man.
This is both moving and intriguing because, through him, we glimpse a “fast forward” entry into elderhood. Elders are the same people they were when they were young, they still do “crazy things” but, as decades pass, they increasingly center their lives and their actions in the realm of belonging. All of our “adultish” readers (myself included) should heed this man’s words. Life is about gratitude. It is about the people we love and the people who love us. It is about kindness. It is about being true to ourselves. Elderhood is rich because it is the time and place where the knowledge of one’s own encroaching mortality enables us to see the world as it is.
Nobody Gets Out of Here Alive
You
can deny the inevitable but not defy it—still there are a few compensations to
growing old
(Source: by JOSEPH EPSTEIN, Wall Street
Journal)
Illustration by Arnold Roth
We are all born with a serious and unalterable defect: We grow old—at least the lucky among us do—and then we die. Some attribute this to the decisive side-effect of the poor judgment Eve showed in the Garden of Eden; some to the breakdown in the plot of evolution, which appears to have creaked to a halt before finishing the job and rendering human beings both perfect and immortal. Whichever the case, we are left with the appalling inconveniences of aging and the unavoidable fact of death. Aided by careful diet, nearly constant exercise, serene thoughts and relentless medical discovery, there are those who attempt to deny death. They are counting on longevity without surcease. These people and their optimistic thinking are the targets of Susan Jacoby's "Never Say Die: The Myth and Marketing of the New Old Age." (Pantheon, 332 pages, $27.95)
Ms. Jacoby is herself 65 years old, and thus at the older end of the generation known as baby boomers, who, she feels, are especially loath to admit to growing older, let alone to dying. Not a generation, the boomers, to heed Homer, who advised, "Best not to be born, or to die young"; or for that matter Xenophon's Socrates, who submits to death tranquilly because he thinks it preferable to old age (which Trotsky, before meeting with death through assassination by ice pick, called "the most unexpected thing of all that happens to man").
Boomers and other death-deniers find succor in all the heartening health news—and every television station and newspaper now has an editor or reporter or two purveying it—that brings hopeful new cures for old diseases and successful longevity experiments on mice and other critters. They gobble up stories in the New York Times of a 90-year-old woman tossing javelins, Elliott Carter composing music at 100 and other elderly folks who, after putting down half a carafe of red wine, enjoy a good smoke and perhaps a robust bonk. Death they've heard of but don't quite believe in, not really, at least not for themselves. For them "old" is a psychologically, if not politically, incorrect word, and one expunged from their vocabulary.
In her book, Ms. Jacoby serves as a reality instructor. Bad news flows from her as profanity from a rap group. And bad news is what she has for all who believe that, because longevity has doubled since the middle of the 19th century—this owing chiefly to improved sanitary and environmental conditions—there is no good reason for its not continuing to climb upward, ever upward. She reports, for example, that of all who attain the stately age of 85, fully half will have that stateliness snuffed out by Alzheimer's; and, more wretched news, there is a strong chance they will also end up in a nursing home with some other dread medical affliction or other. LINK TO ARTICLE HERE:
ChangingAging.org and Anna
Ortigara shared a link.
Book Review - Never Say Die - By Susan Jacoby
What of the neighborhoods that have banded together to deliver services to the old old who wish to stay in their homes? Or the many innovative group-living arrangements — like the “Green House” model, which puts 6 to 12 older adults in homes integrated into the surrounding community — that stress co...
ChangingAging.org
USA Today is Running a Fantastic Series on the Boomers: Take the “Generation Quiz”
(Source: ChangingAging.org)
The latest content includes a “Generation Quiz” that looks like it could have been designed BY/FOR the Changing Aging crowd. Which generation do you belong to? The generation you belong to isn't just about the year of your birth, but about your cultural experiences. Take this quiz and pick which fashion trends, news events, movies, tv shows or toys you remember from your formative years. Then we'll match you up with your generation. LINK HERE
Report Provides Updated Statistics on
Older Americans
Older Americans 2010: Key Indicators of Well-Being
(Source:
www.agingstats.gov)
A recent report produced by the Federal Interagency Forum on Aging-Related
Statistics provides data on the status of the US population aged 65 and
older. The report includes 37 indicators, grouped into five sections,
including population, economics, health status, health risks and behaviors, and
health care. The older population in the US is expected to double from an
estimated 35 million aged 65 and older in 2000 to 72 million in 2030, which
will be almost 20% of the US population. The percentage of people aged 65
and over who are obese increased since 1988-1994 from 22% to 32% of the
population in 2007-2008. Health care costs for older Americans
experienced a dramatic upsurge, from $9,224 in 1992 to $15,081 in 2006.
Increased health care costs also drove out-of-pocket spending for health care,
which grew from 12% in 1977 to 28% in 2006. For more information, visit: Federal
Interagency Forum on Aging-Related Statistics: "Older Americans 2010: Key
Indicators of Well-Being" LINK HERE
A Day in the Life of a Nursing Home Charge Nurse
(Source: By Tony Sexton, senioradvocacy@yahoo.com)
Well the day starts innocent enough, receiving report from Charge Nurse from previous shift. As I begin with accu-checks (checking blood glucose levels) and tube feeding, phone rings and on the way to answer the phone (which turns out to be one of my CNA’s running late) another of my CNA’s asks if I can come take a look at a Resident who is not acting right. While in assessing Resident bath aide asks if I can come to whirlpool room and look at what appears to be a new bruise. Upon finishing assessing resident I head out to assess resident with new bruise and am stopped by another resident at their room door asking if I can help find her TV remote. I tell resident I will be happy to if she will give me a few minutes, while at the same time I am being paged for a phone call (which turns out to be same CNA telling me she will not be in at all… leaving us one short on the hall.) On way to whirlpool room alarm on resident chair sounds (an alarm btw I soon find out that was D/c while I was off.) Take a look at the clock and find I still have eight accu-checks and nowhere close to being finished, but have to be in dining room for breakfast very soon. READ MORE HERE
The National Association of Health Care Assistants (NAHCA) Announces the Release of the NAHCA VIRTUAL CAMPUS of CARE
This on-line program is a
significant step beyond the compliance driven on-line training currently
available in the marketplace
(Source: www.hancacares.org)
"The most important difference is the coach, the actual people who serve as mentors and guides" says Lori Porter, founder and CEO of NAHCA.
"NAHCA coaches have a strong history of interactive involvement in the success of direct care workers, and NAHCA's VIRTUAL CAMPUS of CARE, (NVCC) on-line educational experience is no exception." Lori continues, "It is not enough to have an on-line experience without the personal mentoring and guidance of successful peers." According to Porter, the education involved to produce true quality of care must be "peer driven and experienced based." Only then do all the stakeholders fully realize a meaningful education."
NVCC draws from a 15 year history and over 100,000 documented field hours working directly with Certified Nursing Assistants, their immediate supervisors, and administrators… LINK HERE
Consumer Voice Releases New Guide for Consumers
New
Guide Helps Consumers Navigate Long-Term Care System as Affordable Care Act
Reaches its First Anniversary
(Source: The National
Consumer Voice for Quality Long-Term Care)
March 23, 2011 - Today, on the first anniversary of the Affordable Care Act (ACA), the National Consumer Voice for Quality Long-Term Care (formerly NCCNHR), announces the launch of its new guide Piecing Together Quality Long-Term Care: A Consumer's Guide to Choices and Advocacy, which is intended to educate people with disabilities and older adults about their options for long-term services and supports and empower them to be self-advocates for quality long-term care. The guide also provides information and resources to assist people currently living in nursing homes to move back into the community.
The Consumer Voice has developed a website for the guide, which features Piecing Together Quality Long-Term Care in different formats, including an HTML version, a PDF version and audio portions of the guide. The website also includes three state-specific guides funded by the Consumer Voice and written by citizen advocacy groups in Kansas, North Carolina and Virginia. These state guides are designed to assist older adults and persons with disabilities in making informed decisions when choosing long-term care services. A hardcopy of the 80-page, professional bound guide is available for $20 and can be purchased online.
"While older adults and individuals with disabilities may have different needs, they all deserve a choice of quality long-term care services," said Consumer Voice Executive Director Sarah F. Wells. "Many consumers face the daunting and overwhelming task of trying to navigate a long-term care system that is fragmented and complicated. This project aims to build a bridge between the aging and the disability communities and create a strong, unified long-term care consumer voice.
"We are launching the guide at this time because the Affordable Care Act is increasing opportunities for the elderly and persons with disabilities to receive care in their own homes."
The publication of this new resource coincides with the one-year anniversary of the signing of the ACA, which created some of the most significant improvements and changes in long-term care in a generation. Through the ACA, consumers will see increased transparency of nursing home operations and quality; improved safety for people receiving care in long-term care facilities and their homes; strengthening of agencies that investigate neglect and abuse of the elderly, including the long-term care ombudsman program, state survey agencies and Adult Protective Services; and new programs that provide incentives to states to provide more Medicaid home and community-based services.
This guide was funded by the Milbank Foundation for Rehabilitation. For more information on this project and on health care reform, visit HERE.
(Source: Carol
Bradley Bursack)
Many of us are caregivers for parents of the opposite gender. This can create significant problems when we take our loved one out in public and they need to use a bathroom. Men can't take their mothers into the ladies room. Women can't take their dads into the women's room.
“Live a Good Life Wherever You Call Home: How
Long-Term Care is Changing to Meet Your Needs”
A Webinar for Consumers, Sponsored by
Pioneer Network & AARP
Now Available for FREE 24/7 ~ This free webinar offers consumers exciting information about how long-term care is changing, and how you can find and advocate for care that focuses on your, or your loved one's individual interests and needs. Get practical tips on how to assess whether potential care settings such as assisted living residences or nursing homes will help you live the life you want. Whether you're helping a loved one now or planning for the future, this webinar offers insights to change the way you look at long-term care. Live a Good Life Wherever You Call Home: How Long-Term Care is Changing to Meet Your Needs is a free webinar that will offer insights to consumers to change the way we look at long-term care. Featured presenters are Rose Marie Fagan, co-founder of Pioneer Network, and Karen Stobbe, Pioneer Network conference chair. The webinar is moderated by Susan Lutz, Project Manager at AARP Education and Outreach. CLICK HERE TO JOIN THE WEBINAR
Consistent Assignment of
Caregivers Is A Huge Plus For Elders
(Source: By Carol Bradley Bursack,
www.mindingoureldersblogs.com)
Think of it this way. A person comes to your door or into your room if you are living in a care facility. You’ve never met this person, but he or she announces that it’s time for a bath. The person proceeds to help you get ready for your bath, while you remain confused and frightened. Who is this person? Why do they want to give you a bath? What would you do? Likely have the “fight or flight” response which is wired into human brains, right? The modern approach of consistent assignment, which means that the person needing care is assigned a specific caregiver, is a big step forward in this regard. A care receiver is much more likely to respond well to a person they know and like. LINK TO POST HERE in ElderCareLink
Long-Term Care is Newest Topic on NIH Senior Health Site
(Source:
National Institutes of Health – National Institute on Aging)
What is long-term care and will I need it? If I do need long-term care services, where can I find them? Are there things I should be doing now to plan ahead?
Older adults and their loved ones can find easy-to-understand answers to these and other questions by visiting "Long-Term Care," (http://www.nihseniorhealth.gov/longtermcare/toc.html) the newest topic on NIH Senior Health, the health and wellness website for older adults from the National Institutes of Health.
"Long-Term Care" is the 50th topic to appear on NIH Senior Health (www.nihseniorhealth.gov), joining an impressive roster of research-based health topics of interest to older adults, including exercise and physical activity, safe use of medicines and management of diseases such as stroke, diabetes, osteoporosis and Alzheimer's disease. A joint effort of the National Institute on Aging (NIA) and the National Library of Medicine (NLM), both components of NIH, NIH Senior Health is designed to be senior friendly and is tailored to the cognitive and visual needs of older adults. The short, easy-to-read segments of information, large print, opened captioned videos and speech function make the information on the site easy for older adults to see, understand and navigate.
Alzheimer's and The Invisible Siblings: If you’re burdened by a family member who is missing-in-action, what do you do?...
(Source: By Pamela R. Kelley,
Alzheimer's Reading Room)
Buried in the comments to Bob’ s article, In the Bunkhouse, Random Thoughts Edition, and in reference to the growing number of Alzheimer's caregivers (almost 15 million), I noticed this exchange:
Carol Wright: "What I'd really like stats on, are those who have a close relative with Alzheimer's ... and they refuse to help. I want a stat on the deadbeats so they can see themselves officially identified. Right now they are invisible".
Nancy: “ Hear, Hear!!! I totally agree!! If everyone who identified themselves as a primary caregiver also indicated how many siblings they have who do not help … well, my conservative estimate is another 15 million!!!”
Many of us who are the One have experienced intense disappointment, hurt, and anger when we feel like we've been abandoned to our mission by those with an equal stake in our loved one’ s care. Reading the above exchange made me wonder about those invisible siblings and adult children. How can they blithely carry on without realizing how important and meaningful a small act in support of the caring mission would be? Then, I began to identify all of the assumptions I made when I formulated the question. READ ARTICLE HERE
ABC World News Launches Series on Caring for Aging Relatives
Families on the Brink: What to
Do about Mom & Dad?
Staying at Home: Should caregivers keep elderly in their homes or in care facilities?
Prescription Problems: How to prevent medication complications with elderly.
Family Tension: Experts discuss how caregivers can cope with stress.
Families and Providers Need to Prepare for a New Elder Care World
(Source: By Howard Gleckman, Caring for Our Parents)
As if we needed it, this week has provided yet more evidence that the world of both medical and long-term care services for seniors is changing in profound ways. It is complicated and hard to follow, but the bottom line is this: There will be increasingly less government support for the services frail seniors and their families need. And senior services providers and communities must begin to find new ways to work together to make up for those declining government dollars.
Yesterday, Congress disclosed details of last weekend’s budget agreement–the one that averted a last-minute government shutdown. The news could have been worse for seniors’ programs, but it still was not good. Some examples: Compared to last year, funding for senior meals programs was frozen, block grants that fund local non-profits were cut by $20 million, low-income energy assistance was cut by $400 million, the community service program for seniors was cut by $375 million, and on and on.
And those cuts were just a down payment. In a period of severe budget constraints and tremendous pressure from the tea party movement, both Congress and President Obama are moving to cut trillions of dollars more from the federal budget. And many of those cuts will hit the frail elderly and their families. Obama’s speech today was evidence of where the debate is going. House Republicans want to cut $800 billion from Medicaid over the next 10 years. Obama vows to fight them, but he’s proposed to cut $100 billion. Republicans want to abolish Medicare and replace it with private insurance and government vouchers. Again Obama says he’ll oppose this, but he’s responded with his own plan to cut Medicare by $340 billion over 10 years. The way Washington works, a final agreement (reached probably after the 2012 elections) will split the difference on many of these cuts.
Advocates will lobby hard to block these changes, but as hard as they try, they will not succeed in saving today’s funding levels. It simply won’t be possible. So my advice is for providers and communities to think about new ways to deliver services. Work together to build volunteer networks to provide rides and meals to homebound seniors. In my book, Caring for Our Parents, I describe some of these alternatives–senior villages, intentional communities, non-profit caregiver training programs, and many more.
Some senior living providers are beginning to reach into their communities to help organize volunteers. Hospitals and nursing homes are building relationships with local churches and synagogues. There are lots of creative people looking for new models of care.
Of course, volunteers can’t do everything. Nursing facilities as well as home care nurses and aides have to be paid with real money, and finding ways to replace Medicaid funding won’t be easy. Programs like the CLASS Act are a small start in that direction. But there is much that communities can do for those seniors who need help. There isn’t much time, we need to start now to build these alternatives. LINK HERE
Finer With Age: Person-Centered Care
Thanks to Rhonda Rotterman and the
Western New York Alliance for Person-Centered Care, and to Cathy Lieblich of the
Pioneer Network for sharing this great video moderated by Beverley
Laubert. Beverly is the Ohio long-term
care ombudsman, chairperson of the Ohio Person-centered Care Coalition, and a
member of the steering committee for the Advancing Excellence campaign (who now
gets to work with Bonnie Kantor). Here’s the excerpt from the WNYAPCC
e-newsletter.
A Great Video for You and Your
Staff
Check out this great video from the Ohio Department of Aging:
In the first segment, Vicky Bartlett, the
president and CEO of Sunset Retirement Communities in
What Alzheimer's Can't Take
(Source: By Mary
Barry-Lipman, Washington Post)
Stillness welcomes me home - though home will never be the same. It has only been four hours since we lost Dad to Alzheimer's, but we had been losing him slowly, piece by piece, for a decade. The chill in the air elicits a thousand memories that lie, one over the other, like rings of a tree, or striations of rock that fuse and in their entirety become an object or a lifetime.
Standing in the doorway of our home, for a moment it is as though everything is as it was, as if he might be in there. I strain to hear the dishwasher and wish that if I stood still a minute longer, I could hear his voice saying "Okay, I am going up."
Before we knew, out loud, what was happening to Dad, there were fissures in the surface, minute changes that appeared a decade ago that we have come to understand as the beginning.
From my earliest memory, when Dad was on his way to sleep he would lock the doors, turn on the dishwasher and announce, "Okay, I'm going up," as he went upstairs. As the disease progressed, he began "going up" earlier and earlier in the evening. READ MORE
Webinar: Dining with Friends: An innovative approach to dining for people
with dementia
The
"Dining with Friends" program, developed by the Alzheimer's Resource Center
of Connecticut
(Source: Advance for Long-Term Care Management)
"Dining with Friends" is an approach that focuses on dignified dining for residents with dementia. The "Dining with Friends" program, developed by the Alzheimer's Resource Center of Connecticut, used person-centered care to offer the opportunity for conversation, socialization, fun, hydration and nutrition. This Webinar describes specific dining needs and the challenges of meeting those needs, for the person with Alzheimer's disease. Details about food choices, place settings, dignity, appealing food choices and the overall dining environment are shared. WATCH HERE
Clearing the Fog in Nursing Homes
(Source: By PAULA
SPAN, The New York Times)
The
woman, who was in her 90s, had lived for several years at the Ecumen Sunrise
nursing home in Two Harbors, Minn., where the staff had grown accustomed to her
grimaces and wordless cries. She took a potent cocktail of three psychotropic
drugs: Ativan for anxiety and the antipsychotic Risperdal to calm her, plus an
antidepressant. In all the time she’d lived at
Belinda Day Saylor Eva Lanigan, right, director of nursing at the Ecumen nursing home in Two Harbors, Minn., with a resident, Marjorie Labrie, 94.
The
Two Harbors home happened to be where Ecumen, which operates 16 nonprofit
“What’s people’s biggest fear? Being a ‘zombie’ in a nursing home,” said Laurel Baxter, the Awakenings project manager.
Any visitor can see what she means. Even in quality nursing homes, some residents sit impassively in wheelchairs or nod off in front of televisions, apparently unable to interact with others or to summon much interest in their lives. Nursing home reformers and regulators have long believed that this disengagement results in part from the overuse of psychotropic medication to quell the troublesome behaviors that can accompany dementia — yelling, wandering, aggression, resisting care. For nearly 25 years, federal law has required that psychotropic drugs (which critics call “chemical restraints”) be used only when necessary to ensure the safety of a resident or those around her.
The drugs can cause serious side effects. Since 2008, the Food and Drug Administration has required a so-called black box warnings on their packaging, cautioning that they pose an increased mortality risk for elderly patients. Nevertheless, a national survey reported that in 2004 about a quarter of nursing home residents were receiving antipsychotic drugs. (Among the antipsychotic drugs most commonly used in nursing homes are Risperdal, Seroquel and Zyprexa.)
Though
they may be prescribed less frequently following the F.D.A.’s warnings, these
drugs are still overused in long-term care, said Dr. Mark Lachs, chief of geriatrics
at
“If a place is understaffed, if it takes particularly unruly patients, you can see how it happens,” Dr. Lachs added. “Behavioral interventions are far more time-consuming than giving a pill.”
Nevertheless, Ecumen’s Awakenings project emphasizes nondrug responses. “Medications have a place, but that shouldn’t be the first thing you try,” said Eva Lanigan, director of nursing at the Two Harbors facility. MORE
NAPA (The National Alzheimer
Project Act) - Will the Tzar/Emperor
really know about Alzheimer’s disease?
(Source: The Myth of Alzheimer’s)
According to the Alzheimer Association The National Alzheimer’s Project Act will create a coordinated national plan to overcome the Alzheimer crisis and will ensure the coordination and evaluation of all national efforts in Alzheimer research, clinical care, institutional, and home- and community-based programs and their outcomes.” A senior academic leader reportedly said he almost danced on a table and sang when he heard the news of President Obama signing the bill. He (I am refraining from using real names to protect both the innocent and guilty) is quite the Empire Enthusiast as he also called for a pregnancy-type test for Alzheimer’s in a film which featured the zombie theme floating in the dark night-time air of dementia. Part of the plan apparently includes appointing an Alzheimer’s tzar (since tzar or csar refers to a supreme leader in Russian and nearby regions and is translated from the Latin for emperor, I will use the more generic term). Our featured academic leader expressed his hope publicly that this person “really knows about Alzheimer’s.” Well I do too but then I wondered what that meant. What is real knowledge about Alzheimer’s? Can he/she tell us what it really is? Does this mean knowing biology, drug development, clinical care, and/or health services? We are told that finding a cure depends on the will of the American people which I supposes translates into their money. Just today Francis Collins announced that he wants the government to spend billions to develop drugs for conditions like Alzheimer’s because drug companies have not been able to solve the problem . Please could we not have a little humility about what we can accomplish by spending money, appointing emperors, and promoting reductionist solutions to complex human problems. LINK HERE
Engaged and Transformed: St. Leonard finds success with Alzheimer's therapy program
(Source: by Julie Thompson,
Long-Term Living Magazine)
Caregiver Laura Spain is able to spend one-on-one time with a resident while two other residents enjoy viewing a DVD together.
Step inside the 600 Hall at St. Leonard Franciscan Living Community in Dayton, Ohio, and you'll witness a scene like no other. The hall, which is dedicated to the care of 18 residents with Alzheimer's and dementia, is often quiet and the demeanor of its residents is rather calm. All around the community sit residents actively engaged in their own individualized activity: One is wearing headphones and listening to music reminiscent of his or her past while another is flipping through a worn hobby book with a visiting family member.
This wasn't always the picture. Just a year ago St. Leonard was faced with the same challenges that all continuing care retirement communities have when it comes to Alzheimer's and dementia care. The disease's unpredictable patterns were causing patients to become easily agitated and caregivers mentally and physically exhausted. READ FULL ARTICLE HERE
People with Alzheimer's from Around the World Speak Out at Unique Forum in Toronto March 26, 2011
(Source: Canada NewsWire)
People with dementia will break the silence and talk candidly about the fear, stigma, challenges and triumphs of living with memory loss at a special interactive forum being held in conjunction with the 26th Annual Conference of Alzheimer's Disease International in Toronto from March 26 to 29. A Changing Melody brings together people with early stage dementia, their families, friends, health care professionals and other care partners in a safe space to share and learn with and from each other. The forum, which takes place March 26, provides resources and support for making informed decisions about how to better live with dementia. Session topics will include: Coping with stigma and fear; Adapting to change so as to enhance well-being; Enabling persons with dementia; Creating strong partnerships in dementia care.
"Seeing how people respond to what they hear and learn from others is incredibly satisfying," said Lynn Jackson, a planning committee member who is living with dementia. "In the past some have decided to become advocates themselves for the cause. This is so inspirational - a true testament to what a person can do even with a diagnosis of early dementia."
A Changing Melody is hosted by the Murray Alzheimer Research and Education Program (MAREP) at the University of Waterloo in partnership with the Alzheimer Society of Canada, the Alzheimer Societies in Ontario, and the Dementia Advocacy and Support Network International. "People with dementia, family members and professionals experience personal transformations by interacting together at the forum. It is that powerful," said Sherry Dupuis, director of MAREP. "We are all changed people when we leave the event."
This is the first time A Changing Melody has involved presenters and participants from across Canada and around the globe, including Australia, Scotland, Trinidad and Tobago, and Finland. Featured speakers at the day-long event include Australian author Christine Bryden, who was just 46 and a single mother of three when she was diagnosed with dementia. She will share her insights about the 16-year roller coaster of her life since diagnosis and her continuing struggle to live well with the disease.
Also on the day's agenda is a theatre performance, titled "You Say Goodbye and I Say Hello," that addresses the negative stereotypes about the disease and recasts the long goodbye of Alzheimer's as the long hello of profound and new understandings. Based on the real life Alzheimer's story of author Cathie Borrie and her mother, the presentation will feature Cathie and Canadian actress Patricia Bower as Cathie's mother. A Changing Melody will be broadcast live for people who can't attend. To learn more or to register for the forum or broadcast, visit here. LINK TO ARTICLE HERE
Free E-Newsletter for People
with Early-Stage Dementia
(Source: Lisa Snyder, University
of California San Diego ’s
Shirley-Marcos Alzheimer’s Disease
Research Center
"Perspectives-
A Newsletter for Individuals with Alzheimer's or a Related Disorder" is a
free international quarterly publication written for people with early-stage
dementia. Each issue features essays or reflections from people with dementia,
updates in research and resources, and articles on relevant early-stage issues,
programs, and coping tips. Perspectives is published by the
To get a free e-subscription, email Lisa Snyder at lsnyder@ucsd.edu with your
request. To see sample recent back issues click here and scroll
down to Perspectives.
10. DISABILITY COMMUNITY
12. DESIGN & ARCHITECTURE
Traditional Business Models in the Skilled Nursing Care Sector are About to Undergo Massive Change, Panel Predicts
Larry Minnix, CEO of LeadingAge, insisted that many operators will need to focus on culture change that supports the best possible care delivery. He again warned that substandard facilities will not survive into the future. CLICK HERE
Advancing Excellence Quality Improvement Tools and Resources: Be Sure To Check These Out!
(Source: Advancing
Excellence)
|
Quality Improvement monitoring tools are now available for six of the Advancing Excellence Goals: Staff Turnover, Consistent Assignment, Restraints, Pressure Ulcers, Pain, and Advance Care Planning. We have also made suggestions for the other two goals: Resident and Staff Satisfaction. Use these tools as part of your internal QI programs. They provide you with appropriate summary and feedback information for your management teams, QA committees, and others interested in your QI activities. Feedback from nursing homes using them indicates the tools help implementation move forward. CLICK HERE FOR TOOLS |
For 3 years we have worked to find the perfect message to describe the Campaign. Making Nursing Homes a Better Place to Live, Work and Visit! This says it all for our residents, staff, and consumers.
Kentucky Governor Presents
$800,000 in Grant Funding for Hospice Assisted Living Project
(Source: By Misty Maynard, www.maysville-online.com)
Gov. Steve Beshear joined state and local officials in Maysville Friday for the presentation of $800,000 in Community Development Block Grant funding for Hospice of Hope's planned 48,230-square-foot assisted living facility and separate Hospice inpatient facility, known as Kenton Pointe Assisted Living. "This is something to celebrate, ladies and gentlemen," Beshear said of the Hospice project. Beshear said harsh economic times and the state's budget woes eroding its ability to provide basic services should not and are not excuses for "doing nothing." "Instead, we have taken the opposite attitude here in Kentucky, we have become more aggressive in making things happen," he said. LINK HERE
Imy Higbie on Her Roommate's Passing
Imy Higbie shared this eye-opening story several years back at the Pioneer Network conference… Please take the time to watch this and think about what she shares. We miss Imy and are so thankful that we still have access to her wisdom through youtube.
Americans Voice Concerns About Hospice and End-Life Care
(Source: Alzheimer's
Foundation of America e-Newsletter)
An overwhelming majority of Americans agree that health and life issues, including hospice care, palliative care and end-of-life care, should become a top priority for the U.S. healthcare system, according to a poll, "Living Well at the End of Life: A National Conversation," released by the National Journal and The Regence Foundation.
In addition, 97 percent of the 1,000 adults who participated in the phone survey believe that individuals and their families should be educated about palliative care and end-of-life options along with curative treatment; more than 80 percent feel that private health insurance or Medicare should fully cover palliative care and end-of-life care treatment options; and 86 percent note that a public dialogue about these issues will help inform individuals and their families about their treatment options.
More than 60 percent of respondents had an experience with palliative care, end-of-life care or hospice care either for themselves or a family member, and nearly half were somewhat or very unprepared for that experience.
READ MORE HERE and LINK TO POLL
More Hospices Providing
Alternative Therapies
(Source: www.mcknights.com)
Approximately
42% of
Researchers point out that while these alternative therapies aren't usually covered by insurance, they significantly contribute to the patient's quality of life while calming their anxieties and improving their moods. The CDC study was published in Wednesday's edition of National Health Statistics Report. LINK HERE
Unnecessary End-Stage
Dementia Treatments Increase Medicare Costs, Researchers Say
(Source: www.mcknights.com)
A significant portion of Medicare expenditures for dementia residents in nursing homes is spent on aggressive treatments that could have little clinical benefit, according to a new study conducted by the Institute for Aging Research. Researchers reviewed Medicare expenditures for 323 advanced dementia patients in Boston-area nursing homes and found that Medicare expenditures grew by 65% in the four quarters preceding death. They found that 30.2% of Medicare expenditures were for hospitalizations and 45.6% were for hospice. End-stage dementia patients are often needlessly subjected to hospital stays, believes lead researcher, Dr. Susan Mitchell. She said many treatments could be adequately handled in a nursing-home setting because hospital stays can be traumatic for dementia patients.
“Our study demonstrates that a large proportion of Medicare expenditures in advanced dementia are attributable to acute and sub-acute services that may be avoidable [as many as 75%] and may not improve clinical outcomes,” Mitchell said. The study was published Jan. 10 in the online version of the Archives of Internal Medicine. LINK HERE
21. MEDICAL COMMUNITY
Finding the Right Level of Posthospital Care: “We Didn't Realize There Was Any Other Option for Him”
(Source: By Robert L. Kane, MD, jama.ama-assn.org)
Abstract: Many families considering posthospital care options are ill-prepared and in need of guidance. They may not know the range of available options, the relative benefits of each, or have considered their therapeutic goals. Physicians should be informants, advocates, and facilitators of this big leap for their patients. Making a good long-term care decision requires information and structure, but such decisions are often made under great time pressure as part of a hospital discharge. Professional intervention and guidance by an informed but disinterested facilitator may be needed, but hospital discharge planners may not be well suited for this role because their mandate is a rapid discharge. Physicians have 2 crucial roles in these transitions: to ensure the seamless delivery of primary care and to advocate for and facilitate, however possible, better decision making. Physicians need at least a rudimentary knowledge of the array of options and the implications of each. Even if the physician cannot serve as the planning facilitator, the physician should ensure that this task is done well. This review describes the range of options and the implications of each option for long-term care in the United States. It suggests the need for evaluating each patient's care goals, family circumstances and resources, and clinical status to determine if more aggressive medical care might improve an individual's clinical trajectory. LINK HERE
Baccalaureate Nursing Education
Recommended
Baccalaureate Competencies and Curricular Guidelines for the Nursing Care of
Older Adults (2010)
(Source: Hartford Institute for
Geriatric Nursing)
AACN
and the Hartford Institute worked collaboratively with an expert panel to
develop these competencies and curricular guidelines to serve as a supplement
to the 2008 AACN Essentials of Baccalaureate Education for Professional Nursing
Practice . The purpose of this
document is to assist nurse educators in incorporating geriatric-focused
nursing content and learning opportunities into the baccalaureate nursing
curriculum, including both the didactic and clinical experiences to ensure that
nursing students are able to provide the necessary geriatric care for the
nation’s aging population. This project was generously funded by the John
A. Hartford Foundation Click here to learn more about this resource
Nursing Homes
as Clinical Placement Sites Modules: Resources for Clinical Faculty
These online learning modules, developed by the Hartford
Institute and the American Association of Colleges of Nursing, are designed to
help faculty select and use nursing homes for undergraduate student clinical
placement, with a special focus on nursing homes involved in resident-directed
care and culture change. Introduced by an Overview module, the six modules
cover the following topics:
Overview of
Project
Module
1. Nursing Homes, the Basics
Module 2.
Nursing Practice in Nursing Homes
Module 3.
Resident Directed Care and Culture Change in Nursing HomesConsultGeriRN.org/uploads/File/NHModule/sftp://root@ConsultGeriRN.org/var/www/apps/cgrn/production/shared/public/uploads/File/NHModule/Module6_Nursing_Home_Prep.ppt
Module 4.
Structuring Student Placements in Nursing Homes
Module 5.
Introducing Resident-directed Care and Nursing Home Culture Change: A Case
Study
Module 6.
Nursing Home (NH) Preparation/Readiness as a Clinical Site
GNEC- Geriatric Nursing Education Consortium
Faculty
Development Project: Enhancing Gerontology in Senior-level Undergraduate
Courses
GNEC is a national initiative of AACN with generous
funding from the John A. Hartford Foundation to enhance geriatric content in
senior-level undergraduate nursing courses. Administered by AACN in
collaboration with the Hartford Institute for Geriatric Nursing, faculty at a
majority of the baccalaureate schools of nursing across the country have been
educated in the fundamentals of geriatric nursing and the use of geriatric
curriculum resources.
Learn
more about this resource..
LGBT Elders Raise Serious Fears About Long Term Care Facilities
(Source: National Senior
Citizens Law Center, PRNewswire - USNewswire)
A majority of lesbian, gay, bisexual, and transgender (LGBT) older adults
who answered a national online survey believe that staff of long-term care
facilities would discriminate against an LGBT elder who was open about his or
her sexual orientation, and more than half believe that staff or other
residents would abuse or neglect an LGBT elder. Released today, the groundbreaking report-LGBT Older Adults in
Long-Term Care Facilities: Stories from the Field-utilizes survey results
for the first glimpse into some of the issues faced by LGBT older adults in
long-term care facilities. Of the 769 individuals who completed the
survey, 328 people reported 853 instances of mistreatment in such facilities.
The survey, conducted from October 2009 through June 2010 did not use a
representative or scientific sample, but includes hundreds of personal comments
offered by the respondents, ranging from reports of staff harassment to staff
refusals to provide basic services or care.
Of the 769 individuals
who completed the survey, 284 identified themselves as LGBT older adults.
Others said they were family members, friends, social service providers,
legal services providers, or other interested individuals. "Our hope
is that this report provokes thought, raises critical questions, and compels
future systematic research that can be used to dive deeper into the issues
raised by these findings and the many personal stories we received," says
National Senior Citizens Law Center Executive Director Paul Nathanson.
Some of the comments
point to possible violations of federal nursing home law, while others signify
that far more training and awareness by staff is needed in addition to enhanced
consumer awareness . The report also points to a wide array of policy remedies
that could be enacted to support LGBT elders better and improve the facilities where
they reside. The report's recommendations are directed toward
policymakers as well as long-term care providers.
The survey, website
and the report were prepared by the National
Senior Citizens Law Center in collaboration with Lambda Legal, National Center for
Lesbian Rights, National Center for
Transgender Equality, National Gay and
Lesbian Task Force and Services &
Advocacy for GLBT Elders (SAGE). Survey results, comments and personal
videos from LGBT older adults can be found as well as profiles of the authors
can be found HERE.
23.
VOLUNTEERING
24.
INTERNATIONAL
Disaster is Heavy Burden to
Bear for Japan's Elderly
(Source: By Grace Wong for CNN)
Japanese families eat dinner at a shelter on March 16, 2011 in Kesennuma, located in the northeast of Miyagi prefecture.
Hiromitsu Shinkawa, a 60-year-old from Minamisoma, was rescued at sea two days after seeing his wife and house swept away by a tidal wave. A 70-year-old woman in Iwate prefecture who, along with her house, was carried away by the tsunami, but managed to survive the ordeal. An 83-year-old Japanese woman escaped the tsunami by jumping on her bicycle Video and riding to safe ground. In Japan, where nearly a quarter of the population is aged 65 and older and where women hold the world record for longest life expectancy, many of the faces of the disaster have been elderly. The 9.0-magnitude quake that hit the northeastern coast last Friday wiped out rural villages and towns -- areas which "tend to be older because young people have left for the cities," according to Richard Jackson, head of the Global Aging Initiative at the Washington-based Center for Strategic and International Studies. Sarah Harper, director of the Oxford Institute of Population Aging, said: "In many rural areas, there's a rural-out migration and you have communities that have high percentages of independent self-sufficient older people in their 80s and 90s." The quake and its ensuing tsunami have killed more than 5,000, as of Thursday, and almost 10,000 still remain missing, according to the National Police Agency. Japan has mobilized the largest call-up of its Self-Defense Forces since World War II to deal with the catastrophe, which in addition to causing billions of dollars of damage, has unleashed a nuclear crisis that is still unfolding. Richard Blewitt, CEO of HelpAge International, a global non-profit that helps disadvantaged older people, said Japan's large older population could be among the hardest hit by the disaster. FULL STORY HERE
China Trying to Force Children to Visit Aging Parents
(Source: by Tralee Pearce, Globe and Mail)
Come visit me or I’ll sue you. That’s the substance of a new law being pitched in China to encourage people to visit their aging parents. Under the proposed legislation, an amendment to a 1996 law, pensioners who are ignored by their children could take them to court with the threat of fines or jail time. News that the Chinese tradition of respecting and caring for elders may need a tune-up comes at the same time as a debate rages about similar practices among North Americans of Chinese descent.
Canadians Know Way Too Little
about Dementia, Survey Finds
(Source: by Andre Picard,
Public Health Reporter, Globe and Mail)
Advocates are renewing calls for a national dementia strategy as evidence emerges that Canadians are woefully uninformed about the basics of the devastating condition whose numbers are soaring. “We’re not really prepared for what’s coming – on an individual or societal level,” said Mary Schulz, director of education at the Alzheimer Society of Canada.
With more than 500,000 Canadians living with Alzheimer’s and related dementias, and that number expected to double within 20 years, Ms. Schulz said education should be the key component of a strategy. She said it is essential that everyone know the risk factors, the early warning signs and how dementia progresses because dealing with the condition is going to be a daily reality for many baby boomers and their offspring. Yet, according to a new survey commissioned by the Alzheimer Society, Canadians have surprisingly little knowledge of even the basics of dementia. For example, one in four people surveyed could not name a single symptom of the degenerative brain illness, while only one in two identified memory loss as a key warning sign. Far fewer respondents could identify other common symptoms such as disorientation, repetitive behaviour and wandering.
“What we see in the survey results is a lot of naiveté,” Ms. Schulz said. “You can put in a teacup what a lot of people know.” Ms. Schulz said what surprised her most was that those surveyed – 1,006 respondents aged 45-65 – appeared unprepared to deal with Alzheimer’s even though many in that demographic will be called on to be caregivers. In fact, more than one-third of the randomly polled said they have been personally touched by Alzheimer’s. But, in the survey questions, that group proved to be only slightly more informed.
Initiative Helps Dementia Carers Train In Empathy
A new training initiative is
helping dementia carers empathise with those they look after
(Source: by Anna-Marie Lever,
Health Reporter, BBC News)
Trying dementia: a workshop of blindfolds and fast eating
Goggles that distort vision, gloves that reduce the sense of touch, and loud white noise - just three things which create a sense of frustration, confusion and loss of control. By evoking the feelings of what it might be like to have dementia, those at the workshop are able to reflect on how best to care for people with the condition.
Maizie Mears-Owen, a mental health nurse and drama therapist, developed the training: "I find I learn much better if I can experience something rather than sitting and taking notes. I absorb it and it stays with me longer. "From the beginning of the workshop I create confusion and frustration and get the staff to really understand and walk in the shoes of those who have dementia. "We provide good dementia care in our homes but we wanted to take it to the next level and build on what we already do."
Care UK, a health and social care services provider, has piloted this scheme in nine of its care homes. They hope to roll out the training across the UK in the future.
Learning through play
Communication overload - the training uses games which make it hard to concentrate
The workshop starts with communication games, where staff are constantly asked questions and distracted by loud noises while trying to read a newspaper. The training then simulates a meal time. To give the sense of older age, the carer wears gloves to restrict mobility, and goggles to mimic a visual impairment. They are then fed cereal very fast by a colleague. The situation is taken to the extreme so the carer experiences loss of control and what it might be like to be supported.
One carer who has undertaken the workshop is Jeni Beck, home manager
at Appleby House in Surrey. She said:
"It made me feel sick and I didn't really want to eat. Because it was fast
I didn't know when the spoon was coming, it was quite frightening. It gives you much greater awareness of what
someone with dementia has to battle with on a daily basis and a better
understanding of how to approach somebody.
It reinforces that you need to communicate all the time and slowly,
always telling the resident what you are doing - making sure your sentences are
clear and that you are talking to the individual and not over them." Continue reading the main story
25. ANIMALS,
INTERGENERATIONAL, PLANTS & ETC…
Alzheimer's Patients Benefiting From Fostering Kittens: Tehachapi
Manor Residents With Alzheimer's Are Fostering Kittens
(Source: Kimberly Foley- 23ABC Mountain Reporter,
www.turnto23.com)
Fostering animals is a common thing to volunteer to do, but a Tehachapi assisted living home has turned fostering kittens into a therapeutic activity for their residents. Tehachapi Manor is fostering kittens from Have a Heart Humane Society. It's an idea that has everyone involved benefiting, especially the three residents staying at the manor, all of whom have Alzheimer's.
WATCH THE VIDEO CLIP and READ THE REST HERE:
Finding Peace in a Slice of
Pie
Why
would an assisted living community care about teaching children?
(Source: prnewswire.com)
Silverado Senior Living, a memory-impairment assisted living, at home and hospice company has tapped the energy and resources of Derek Munson, author of the award-winning book, Enemy Pie, to conduct a series of presentations on January 26, 2011, to bridge the gap between young children and frail elderly, and validate the importance of both age groups…
From its founding, Silverado Senior Living has dedicated its purpose to improving the lives of the memory impaired with a simple philosophy that "Love is greater than fear." This means including children in various ways at each of its twenty assisted living communities. Co-founder, Steve Winner says, "We recognize that our children will be the shepherds of our aging population in the years to come and at Silverado we hope to prepare them in any way we can." LINK HERE
Pets Can Be Therapeutic For the Aging Population
(Source: by Carol Bradley Bursack, Editor-in-Chief,
ElderCare Link)
Numerous studies have shown that pets can increase the quality of life for our aging population. The unconditional love of a dog or the soft purring of a snuggly cat can be helpful for many people, even in later stages of dementia. Many nursing homes, notably those based on The Eden Alternative, have found animals including dogs, cats and birds, along with plants and other natural surroundings, to be soothing and beneficial to people in nursing homes. My personal experience with several of my elders showed me that pets can make a difference.
Studies showing the positive effect on aging people abound. One site, Pets For the Elderly, is packed with studies showing the wonderful effect that pets can have on elders. My own research includes my neighbor, Joe.
I became Joe's default caregiver during the last five years of his life. Joe was a lonely eighty-year-old widower, deaf since his 30s. He loved to feed the birds outside, to the extent that he was able to convince a few Blue Jays to winter over in our far north location. After spending significant time as Joe's daily visitor and caregiver, I one day said, "Joe, let's go get a bird for you." He loved the idea, so we gathered up my boys, I got out the car, and we drove to the mall. Joe picked out a pretty turquoise parakeet he named Nuts.
Nuts, or "Nutsie" as we called the bird, became an incredibly important part of Joe's life. Joe could remember only one tune from the days when his ears worked. It happened to be "The Sweetheart of Sigma Chi." He didn't know why he remembered that particular tune, as he was not in the Sigma Chi fraternity when he was young and in college, but the song had a popular run and the tune stuck with Joe. He'd sit at in a chair next to Nutsie's cage by the hour, often squawking out his unique version of "The Sweetheart of Sigma Chi." The bird would chirp along, though Joe couldn't hear it.
Lost Pet Devastates Elder
One day, after cleaning the bird's cage, Joe forgot to close the cage door. When he returned to the cage Nuts was gone. Joe apparently had been sitting and moping, with the aid of some vodka, until I came for my morning visit. I could even see signs of shed tears as he told me, "Nutsie's gone. He's lost."
I ripped through the house, praying that I'd find that bird and get it safely back in the cage. Joe was consumed by grief. Just about the time I was giving up, I heard a chirp. Sure enough, Nutsie had gotten up on a curtain rod and snuggled smugly into the folds of the drapes. I finally caught the bird and put him in his cage. Joe was ecstatic and life was once again worth living.
We had a few other adventures of that sort. Once I had to fish the bird out from behind Joe's refrigerator. But we always rescued Nutsie. When Joe broke his hip and had to move to a nursing home, I asked the administrator if Nutsie could join Joe. I told them I'd take complete responsibility for the care of the bird. They graciously said yes, and Nutsie was with Joe until the day Joe died. My kids and I then took Joe to our home. READ MORE HERE
The Amazing Skidboot
26. PERSONAL TRANSFORMATION
Be the Change Maker and Bring the Change That You Want to See In This World
(Source: Sailesh
Mishra)
WATCH
THIS: Be the change that you want to see in this world
(Source: Seth Godin’s Blog)
A friend sent me a copy of a new book about basketball coach Don Meyer. Don was one of the most successful college basketball coaches of all time, apparently. It's quite a sad book—sad because of his tragic accident, but also sad because it's a vivid story about a misguided management technique. Meyer's belief was that he could become an external compass and taskmaster to his players. By yelling louder, pushing harder and relentlessly riding his players, his plan was to generate excellence by bullying them. The hope was that over time, people would start pushing themselves, incorporating Don's voice inside their head, but in fact, this often turns out to be untrue. People can be pushed, but the minute you stop, they stop. If the habit you've taught is to achieve in order to avoid getting chewed out, once the chewing out stops, so does the achievement.
It might win basketball games, but it doesn't scale and it doesn't last. When Don left the room (or the players graduated), the team stopped winning.
A second way to manage people is to create competition. Pit people against one another and many of them will respond. Post all the grades on a test, with names, and watch people try to outdo each other next time. Promise a group of six managers that one of them will get promoted in six months and watch the energy level rise. Want to see little league players raise their game? Just let them know the playoffs are in two weeks and they're one game out of contention.
Again, there's human nature at work here, and this can work in the short run. The problem, of course, is that in every competition most competitors lose. Some people use that losing to try harder next time, but others merely give up. Worse, it's hard to create the cooperative environment that fosters creativity when everyone in the room knows that someone else is out to defeat them.
Both the first message (the bully with the heart of gold) and the second (creating scarce prizes) are based on a factory model, one of scarcity. It's my factory, my basketball, my gallery and I'm going to manipulate whatever I need to do to get the results I need. If there's only room for one winner, it seems these approaches make sense.
The third method, the one that I prefer, is to open the door.give people a platform, not a ceiling. Set expectations, not to manipulate but to encourage. And then get out of the way, helping when asked but not yelling from the back of the bus.
When people learn to embrace achievement, they get hooked on it. Take a look at the incredible achievements the alumni of some organizations achieve after they move on. When adults (and kids) see the power of self-direction and realize the benefits of mutual support, they tend to seek it out over and over again.
In a non-factory mindset, one where many people have the opportunity to use the platform (I count the web and most of the arts in this category), there are always achievers eager to take the opportunity. No, most people can't manage themselves well enough to excel in the way you need them to, certainly not immediately. But those that can (or those that can learn to) are able to produce amazing results, far better than we ever could have bullied them into. They turn into linchpins, solving problems you didn't even realize you had. A new generation of leaders is created...
And it lasts a lifetime. LINK HERE
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October/November/December 2010