Section VMental Health and Social

Service NeedsUnit 2: Culture Change

What is a Culture Change?

The purpose of culture change philosophy is to promote a new way of thinking relating to people living in nursing facilities. The “old” culture was task-oriented and schedule driven, and the new culture is focused on the person living in the facility and building relationships between that person and the people working in the facility. It is a change of perspective from viewing the nursing home as a work site controlled by nursing facility employees to viewing it as the residence of people with disabilities, regardless of age, living in their own home.

Cultural Influence on Residents’ Needs:

- Culture is the customs, beliefs, social practices, and traits of a racial, religious or social group.

- Culture is not a basic human need, but has a strong influence on needs.

- Know and respect the cultural background of residents.

- Talk to residents and/or family about their cultural background and practices and support the resident as appropriate.

- Report special needs verbalized by the resident to the nurse so they can be included in the care plan.

What are some things that you already know about cultural differences that

would affect a resident?

Major Characteristics of Culture Change include:

- An environment of home and community within long-term care facilities;

- A vision of leadership committed to cultivating living environments that nurture, inspire and create a home-like setting and ambiance for the people who live there;

- A paradigm of person-centered and person-directed care practices;

- Emphasis on the dignity and worth of an individual’s preferences related to routine tasks (e.g., bathing times, set bed-time hours, flexible dining choices);

Major Characteristics of Culture Change include:

- Consideration of the voices of people with disabilities regardless of age, medical condition or limitations; and

- The empowerment and support of direct care workers.

Purpose of Culture Change (changing routines and organizational

approaches in an effort to individualize and de-institutionalize care)

Person-Directed Care

- Care is directed by and centered on the person receiving care.

- Meaningful relationships for those who live and work in the facility as well as involving families and friends to create a community.

Person-Directed Care Values

- Dignity

- Respect

- Purposeful living, self-determination

- Freedom to make informed choices about daily life and health care

- Meaningful relationships for those who live and work in the facility

Residents Control Their Schedule for:

- Walking

- Bathing

- Going to bed

- Eating - what and when they eat

●Residents can create living spaces that are more private, comfortable, and personalized.

●Residents have a say about the environment of common areas in the facility.

●Meaningful involvement of the residents’ family, friends and the greater community outside the facility walls.

●Quality of life as well as quality of care are equally important.

Long-Term Care and Culture Change

- The same staff take care of the same resident

- Good relationships develop between staff and the residents- Motivates staff to provide better quality of care

- The residents feel more secure, content and happy

- Lower staff turnover

- Formation of “neighborhoods”- Smaller groups of residents

- Consistent staff assignments

Language

Patronizing Language

- What is it?

Patronizing Language

The words we use and how they affect the relationship- How do you think elderly people react to

patronizing language?- How do you think the elderly regard those who

use it?

Language That Bothers Some People

- High pitched voice

- Loud voice

- Slow talk

- One-sided conversation

- Calling someone “dear”, “sweety”, etc.

- Using first name

- and finally,...

Language That Bothers Some People

- Saying, “it’s time for our…”

- Using “we” or “our” when speaking to an older person

- It confuses the difference between you and me and implies that the person cannot make independent decisions