Participatory Action Research for Culture Change

by JOHN DAVY

The culture change movement brought a much-needed emphasis on the dignity and humanity of those receiving long-term care. Research has identified many outcomes of culture change—reduction in over-medication, more home-like environments in LTC, improved social life for residents, and many other targeted benefits. However, as an article in the most recent Gerontologist notes, “little evidence suggests that elders them­selves have participated in the identification of areas in need of improvement within their LTC communities and in the development of culture change initiatives.” (Shura et al 2011). This article presents a study that involved older adult residents directly as experts and participants in implementing culture change in LTC.
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Occupancy and Revenue Gains from Culture Change in Nursing Homes

by Saher Selod

Long-term care communities are undergoing innovative changes in order to improve the quality of life of their residents. “Culture change” is an example of a new practice being implemented in many of the communities around the United States. One of the ways long-term care communities are changing is by moving from a “provider-directed” model (focusing on the institution) to a “person-centered” model where the residents are able to participate in the majority of their daily decisions.
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Ten Competencies Report: Nurse Involvement in Culture Change

In 2008, the Hartford Institute for Geriatric Nursing, in collaboration with the Coalition of Geriatric Nursing Organizations and Pioneer Network, convened an interdisciplinary Expert Panel of leaders in culture change and in gerontological nursing to explore and make recommendations about the role of nurses with regard to nursing home culture change. An issue paper, Nurses Involvement in Nursing Home Culture Change: Overcoming Barriers, Advancing Opportunities (www.hartfordign.org/policy/position_papers_briefs), provided several recommendations, one of which was to develop a set of competencies for licensed nurses in nursing homes to promote and facilitate person-directed care and culture change in their organizations. This recommendation recognizes the important role nurses play in an organization’s nursing home culture change transformation and ensuring high quality care and life for residents.

A core group of nurses with expertise in nursing home culture change were charged to address this recommendation. The group reviewed existing competencies for nurses and other disciplines in long-term care and care of older adults. They consulted with nurse experts, actively engaged in the work of culture change and considered role models, to identify the competencies. Ten competencies were finalized after extensive input from nurses throughout the country via a survey that proposed 39 competencies. The 10 competencies are those deemed most relevant and critical for nurses to be successful in creating and sustaining person-directed care.

The 10 competencies are specific to nursing home culture change. There are existing geriatric nursing competencies that were developed and shared in 2000 by the Hartford Institute for Geriatric Nursing and the American Association of Colleges in Nursing (AACN). The 10 competencies build on this body of knowledge.

The competencies do not specify the role of the nurse or the level of education of the licensed nurse. Some competencies will be more applicable to nurses in administrative positions and registered nurses, while others are applicable to all levels of licensed nurses.

The 10 competencies, in total, are necessary for the entire licensed nursing team. As such,a nursing team well grounded in these competencies, would be an invaluable part of the interdisciplinary team, recognizing that is a team effort.

May 27, 2010
Nurse Competencies for
Nursing Home Culture Change
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Related Resources from Amazon.com:
Bringing culture change into better focus: what are the real ingredients of culture change in nursing facilities?
(coverfeature): An article from: Nursing Homes



Tracking environmental enhancements: a North Carolina study investigates, 'how much change in culture change?'.

(CULTURE CHANGE): An article from: Long-Term LivingThe death of culture change? One of the leaders synonymous with this movement tells how to prevent its demise.(featurearticle): An article from: Nursing Homes

Culture change: its lapses, anomalies--and achievements.(MOVING TOWARD evidence-based)(Company overview): An article from: Nursing Homes

The Pinnacle of Culture Change | ChangingAging.org

by Peg LaPort
UPDATE: Please continue this conversation on the newly-created LinkedIn Changing Aging Network.
Now that the snail mail has delivered hard copies of this month’s outstanding issue of Provider Magazine, I’d like to revisit highlights of the cover story: “Culture Change Goes Main Stream.”

• In 2005, nearly three-quarters of health care opinion leaders surveyed by the Commonwealth Fund were unfamiliar with the concept of “culture change,” despite nearly 20 years of advocacy within the movement.
• Three years later in 2008, 66 percent of respondents reported they were familiar with the culture change movement — a dramatic turnaround.
• A 2007 National Survey of Nursing Homes reported one-third of nursing homes had adopted some culture change practices and another one-third were planning to follow suit.

What’s driving the change in attitudes? Certainly, decades of work by advocates in the culture change movement pushing for more person-centered approaches to long term care, such as Dr. Bill’s Eden Alternative philosophy and Green House Project, labeled by Provider as the “peak” of the culture change movement. As of this year, 79 Green House homes have opened in 14 states, and another 132 homes are either in development or under construction in another 12 states.
But the biggest indicator of a sea-change in attitudes towards culture is the conversion of big for-profit facilities:
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TIME GOES BY | The Cultural Perception of Aging

by Ronni Bennett

When Time Goes By was barely a glimmer in the back of my mind in 2003, I had been researching aging for about seven or eight years during which time I had amassed a hefty library of books on the subject along with hundreds of pages of popular, medical and research reports. After all that study, the only message I could find was that getting old is entirely about debility, decline and disease. No one had anything good to say about it.

My refusal to believe that was the genesis of this blog which would investigate, think out loud and write about what getting old is “really like.” I would not avoid the normal changes that come with advancing years, but I would also seek to correct to some degree the prevailing zeitgeist in both popular and scholarly circles that there are no positive aspects to aging, that it is all about being unwell.

Back in those years before TGB, the potential consequences of the aging of the gigantic baby boomer generation was confined, mostly, to researchers concerned with statistics and demographics. It had not trickled down yet to advertisers, politicians, self-help gurus, cosmetic surgeons, pharmaceutical manufacturers, book publishers and the popular media. That changed in 2006, when the oldest boomers began turning 60 – a nice round number to take advantage of – revealing a huge, new potential for profit-taking.

And so they all jumped on the boomer bandwagon headlining stories in newspapers, magazines and on television for that generation creating a new market for products and services aimed at them. Internet sites with the word “boomer” in the name multiplied like bunny rabbits although most of them failed. (I can tell you why, but that's for another day.) The marketing to boomers, however, continues to grow.

But a funny thing has happened with that: the boomer-targeted media is still about how awful it is to get old. Superficially, it doesn't always look that way with the bright, shining faces of handsome people in their slim, trim bodies riding bicycles whose only concession to age is (professionally styled) gray hair - lots of it.
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Announcing the 2010 New Culture of Aging Services Webcast | ChangingAging.org

There is an immediate and pressing need for education around the issue of culture transformation in aging services. There is also extraordinary pressure on training and travel budgets.

To support this growing demand for culture change, Dr. Bill Thomas is announcing a 12-month online video education series beginning in January 2010 designed for aging services facilities:

The 2010 New Culture of Aging Services Webcast Series

This online video series will provide an abundance of low-cost, high quality education and information for those caring for elders. Featuring easy-to-use webcasting technologies, the series will help aging services facilities build the foundation for transformative culture change. Participants will interact with Dr Thomas via streaming video without travelling or special equipment. There will be opportunities to ask questions, live-chat, poll participants on major issues and some participants will even join him on video to share their stories and challenges.

In bimonthly sessions spanning 24 hours of livestreaming video, Dr Thomas will share sensible, proven methods and tactics to help facilities around the country create new cultures of care for their organizations. The streaming video webcasts will be viewable at www.changingaging.org with no special equipment or downloads. All you’ll need is a broadband internet connection and web browser.

Visit www.ChangingAging.org/culture-change/ to register your facility today.
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