Todd Shackelford

West Central Illinois

Area Agency on Aging

217-223-7904

Don’t Make Me Play Bingo For A Banana !

What is Culture Change?

Paradigm Shift in the Delivery of Care

Moving from Medical Model to Home Model

Decentralizes Decisions to the Resident(s)

Why Change the Culture in LTC?

Bette Davis speaking about Joan Crawford “She’s old. She’s tired. And she’s tired of being old”

Past models of care are not working Baby-boomers will not accept past models Industry practitioners are tired The industry must attract new workers The industry must have market survival Cant’ hove – LONELINESS, HELPLESSNESS AND BOREDOM ANY

LONGER !!!

Key Components of Culture Change

PERSON CENTERED/DIRECTED CARE

COMMUNITY DEVELOPMENT

CAREGIVER TEAMS

OPTIONS, OPTIONS, AND MORE

ACTIVITIES THAT ARE MEANINGFUL

KNOW EACH PERSON/ PERSON FIRST

The Ombudsman’s Role in Culture Change

Ombudsman

CNAs

Nursing

Administration

Ombudsman Role #1

Problem SolversResident focused

Objectivity

See the big picture

Don’t have the “tapes”

Can provide guidance

Can provide solutions

Ombudsman Role #2

AdvocatesResident involvement

Family involvement

Facility involvement

Regulator involvement

Other advocates involvement

Ombudsman Role #3

Building or Supporting CoalitionsRegional coalition development

State coalition development

Building facility coalitions

In-service and public education

Media support and promotion

How do you eat an elephant?

One Bite at a Time

Start using resident centered language

Start talking in terms of resident directed care

Never cookie cutter problems

Start problem solving systemically using culture change solutions

Encourage, build and support coalitions

But, But, But

“I don’t have enough time”That’s right - you don’t have enough time

Don’t give them fish. Teach how to fish

Work done now – saves time later

Sorts the men from the boys

“This culture change thing is just a trend”Look at the evidence around the nation

Would you want to live in the old culture?

Consumer expectations are changing

Is empty beds a trend?

“The focus of the Ombudsman must be on resident complaints”

True and in fact – OAA

Complaints can be the catalyst for systemic change – culture change approach

Efforts made now – may pay off in big dividends later

What’s it like to be a resident

(AKA – person who lives in a facility)

Personal Exercise

Real Case Scenarios

82 year old gentleman who constantly complains to administration, ombudsman, state regulators, legislators and the PUS. Has now discovered the power of the internet, distribution list e-mail and is gaining media coverage. Complaints are usually system problems in facility and not usually concerning his personal care.

Scenario #2

68 year old woman with mild dementia. Nursing staff frustrated as bathing has become a battle. Family members are demanding adequate hygiene for her. Dr. suggested a sedative be given or perhaps a mood elevator.

Be the Champion of Change!!!