Welcome to the Culture Change Connection.  You will receive this monthly email communication from the Culture Change Network of Georgia the middle of each month!  In the meantime, please visit www.culturechangega.org and be a part of the growing Culture Change movement in Georgia.

A BIG THANKS to Healthcare Research, Inc. for supporting the Culture Change Network of Georgia with a grant for the continued coordination and development of culture change work in Georgia!  You will begin to notice changes in the website that provides you with timely, significant information as well as resources (like the new FREE webinar series mentioned below), and promising practices from providers throughout Georgia.  The grant also provides funding for training via scholarships to the 3^rd Annual Georgia Culture Change Summit.  Several new webinars will be developed to provide you with information to help you implement culture change in your organization.  Lastly, the grant will fund 500 of Richard Taylor’s first DVD, “Be with me TODAY.”  Every nursing home in Georgia will receive one of these DVDs this spring!

This webinar series provides a summary of each of the three tracks presented at the 2^nd Annual Culture Change Network of Georgia Summit, and an overview of the culture change movement.  Session 1: Overview of Culture Change and Person-Centered Care by Kim McRae; Session 2: Dementia and Communication by Karen Stobbe; Session 3: Vision and Leadership by Steve Shields; and Session 4: Implementation, “How To…” and Celebrating Success by Karen Nichols.  Support for the series was generously provided by Healthcare Research, Inc. Recordings of these complementary webinars are available 24/7 so that everyone in your organization can have access to this wonderful information.  Available on the web site (www.culturechangega.org). 

We applaud each of you for your commitment to quality improvement by signing up for the Advancing Excellence Campaign. Georgia is one of only a few states where 100% of our nursing facilities are taking part in this great work! Over 6000 U.S. nursing homes have signed on to participate.  The national average of participation was 38.8%. 

Advancing Excellence in America’s Nursing Homes is a national campaign to encourage, assist and empower nursing homes to improve the quality of care and life for residents.  Comprised of long term care providers, medical professionals, consumers, employees, and state and federal agencies, AE is the largest and first coalition of its kind to measure quality by setting clinical and organizational goals for nursing homes. 

LANEs (Local Area Networks of Excellence) are the statewide coalitions of stakeholders.  The LANE is the central organization within a state to support participating nursing homes in achieving their clinical and organizational goals and help the Campaign succeed.  The LANE is comprised of a wide spectrum of long-term care stakeholders including representatives of the nursing home associations, state survey agency, ombudsman office and quality improvement organization as well as consumer advocacy organizations.

When asked why the Georgia LANE is so active in promoting nursing home enrollment in Advancing Excellence, LANE co-convener Linda Kluge noted that, “The Campaign provides the framework for nursing homes to be able to improve the quality they offer their residents. Participating nursing homes, through involvement in the Campaign and use of its technical assistance resources, can position themselves to provide better care, have better surveys, and get better satisfaction results.”

The coalition stimulates quality improvements by providing nursing homes with free, current and practical evidence-based resources, empowering residents and their families with education, and helping participants reach their targets. Homes can compare their progress with state and national averages.

The eight goals included in the campaign are: Goal 1 – Staff Turnover; Goal 2 – Consistent Assignment; Goal 3 – Restraints; Goal 4 – Pressure Ulcers; Goal 5 – Pain; Goal 6 – Advance Care Planning; Goal 7 – Resident/Family Satisfaction; Goal 8 – Staff Satisfaction.  The ranking of goals selected by nursing homes in Georgia can be found here:  Congratulations to you all as you begin this very important work.

Pioneer Network and the state culture change coalitions have been working hard to create places where elders are happy to live and workers are proud to work.  In addition, they support the need to create more options and choices for elders and others who need assistance and want to stay in their own homes.

Providers and organizations are changing, and now it is time to educate and inform consumers that things (aging and long-term care) can be different. Read more.

In addition to having the ability to deliver and expand programs, successful nonprofits and NGOs also have "adaptive capacity," which can take them from "Just Another Organization" to "Community Change Agent."

17 Hallmarks of Community Change Agents:

(1) They are always innovating and looking for opportunities that will improve their communities.

(2) They are on the "leading edge" of change and are sought out as experts.

(3) They are responsive and modify existing programs as needed to meet changing needs.

(4) They don't seek perfection but they do seek excellence, so the bar is always set high.

(5) They value team, and they have an understanding that attracting, retaining, and supporting a strong team is essential to delivering high quality services.

READ FULL ARTICLE

Culture change and person-directed care have received national attention in US News & World Report and on MSN online! The first article is in US News & World Report and is titled “These Nursing Homes Care About Their Elderly Charges: At new-culture facilities, the emphasis is on respect for residents and a homelike setting.”  The article also has links to US News & World Report’s list of what they describe as the best nursing homes in each state. The list uses the 5-Star rankings, survey results, staffing levels, and quality members to create their list.

The second article is titled "America's Best Nursing Homes." and is currently on MSN online. These articles represent an enormous opportunity to share the real possibilities of culture change and person-directed care as we work to educate consumers and caregivers.  Please take a moment to read both articles, and make sure to pass them on to your friends and colleagues, so that we can continue to share the good news that culture change is gaining momentum!

ElderHealth NW has been working in the greater Seattle area community for over 25 years and was among the first adult day health providers in the country. Over time, ElderHealth has expanded to offer a variety of services in accordance with its holistic mission statement.

ElderHealth supports elders through four Adult Day Health sites, an Adult Day Care Program, two Supported Living sites, In-Home Services, a Volunteer Companionship program, Mental Health Services and Care Consultations.  MORE

For long-term-care providers, changing the culture in nursing homes can also mean changing an operation's bottom line.  

While the term “culture change” is hardly new for the skilled-nursing industry—it began as a grass-roots movement in the U.S. about 15 years ago—it has gained traction lately as studies have shown both qualitative and quantitative results, and the CMS incorporated culture-change concepts when it enhanced guidelines for surveyors of nursing facilities this summer.

Culture change, it seems, not only addresses quality and workforce issues, but it can also improve occupancy rates, operational costs and competitive position in the marketplace—all of which can improve a facility's bottom line.

“The reality of it is: Whether we think it’s true or we don’t, whether we see it or we don’t see it, the nursing home market is shrinking,” Shields says.  “And those that survive are going to be the ones that adapt to this new model.”  MORE

Pioneer Network will offer this three part series which will explore outdoor environmental design and green spaces to benefit older adults.  The webinars will take place on three Tuesdays in March -- the 2nd, 9th and 16th from 1:00pm to 2:00 p.m. EST.  Whether you are a Nursing Home, Assisted Living or Independent Living professional, Pioneer Network’s Creating Home-- Access to Nature Webinar Series will demonstrate the importance of having people, policies, and programs that support outdoor usage.

“Creating Home in the Nursing Home II: A National Symposium on Culture Change and the Food and Dining Requirements” was cancelled due to crazy winter weather.  However, CMS and the Pioneer Network are working to develop a “Plan B” and news will be shared as it becomes available.  Georgia was going to have 22 people in attendance!

In the meantime, the pre-symposium background paper by Carmen Bowman, “The Food and Dining Side of the Culture Change Movement: Identifying Barriers and Potential Solutions to furthering Innovation in Nursing Homes” is filled with fabulous information and is now available on the Pioneer Network website.  Take the opportunity to “whet your appetite” and talk about how your organization is looking at the experience of food and dining for the elders that you serve. 
Download Background Paper

The traditional nursing home regulatory approach, which uses survey and enforcement to achieve performance improvement, has created tensions between providers and surveyors. It has had limited success in improving quality overall and not necessarily allowed innovation to flourish. This has been the perception of many homes wanting to undergo transformative “culture change” reforms. To move toward a new model of nurs­ing home regulation, the states and federal government must strike a balance between the traditional regulatory approach to weed out substandard facilities and a partnership model aimed at promoting high performance. This issue brief highlights the importance of how such a model is structured, as well as the need to adequately train and educate regulatory staff and providers about culture change. Regulators, providers, consumer groups, resi­dents, and their families also will need to commit to the principles of person-centered care to ensure the success of the new collaborative approach.   MORE

Advocates want to make nursing homes more comfortable and humane, with home-like amenities and resident-centered care. And they're looking to National Fire Protection Association (NFPA) for leadership on the code changes that can help make it happen.
One size does not fit all. That's the message of a movement called "culture change," which aims to individualize the care and well being of nursing home residents across the country.

Instead of two or more people to a room, with each room furnished almost identically, culture-change supporters seek rooms that are as individual as their inhabitants, with personal belongings treated not as threats to efficiency and care, but as key elements of residents' health and happiness.

Rather than a single large dining area that serves uniform, institutional food, culture-change advocates envision smaller, more home-like eating and kitchen areas serving a greater variety of food, and that may even involve residents in the food preparation. Even the term "nursing home" is subject to a phase out in favor of names like care community or life center. Advocacy groups such as Pioneer Network and Society for the Advancement of Gerontological Environments (SAGE) hope to push culture change beyond the early adopters and into the mainstream, essentially reshaping the landscape of nursing home care. Read more.

For the next 20 years, an average 10,000 baby boomers are retiring daily and many people in their 50s, 60s and 70s are asking the question, "Where will I be living?"

Before 2001, few people were familiar with the concept of "intentional communities" until the first one was formed in Boston. Beacon Hill Village was the first intentional community and there are now communities in California, Colorado, Connecticut, District of Columbia, Florida, Hawaii, Illinois, Indiana, Maryland, Massachusetts, Minnesota, Nebraska, New Jersey, New York, Oregon, Pennsylvania, Tennessee, Virginia, Washington, Wisconsin and the first International Community in Australia.

Intentional communities are membership organizations in which dues are paid for services, services that allow people to continue to live in their neighborhood close to friends and in their home. As members in intentional communities age, the community organizes and develops programs and services that allow them to lead safe, healthy and productive lives in their own home.  MORE

Technology links Sacramento-area first-graders, retirees ... It didn't take long for Bobbi Donovan's first-grade students to shed their hesitation and greet their new pen pals.  Within minutes of meeting, kids from Kohler Elementary School in North Highlands were climbing into the laps of residents at Eskaton Village, a retirement community in Carmichael.  In October, each of Donovan's 26 students was assigned a resident in the assisted living unit at Eskaton. The kids now call them "buddies." 

The kids met with their buddies at Eskaton in December and over the course of the school year have used Skype, an Internet video calling service, to stay in touch.  "I think it's a great program," said Betty MacKinnon, 92, who has two buddies in Donovan's class. "All my grandchildren are grown, so I love it."  Besides forging relationships, the program has been a teaching tool for Donovan and Adam Hill, Eskaton's assisted living activity coordinator.  The children practice their reading and writing by sending letters, e-mails and Christmas cards – and by reading books – to the Eskaton residents. Eskaton residents, meanwhile, are learning to use computers…

Thanks to some good advice at the right time and some positive reinforcement I soon started learning there was "more there".....

In his article, "I Remember Better When I Paint", Max Wallack stopped me dead in my tracks when I read these two words -- "more there." He managed to give me a new perspective on something I have been thinking about and trying to do for years.

I consider myself fortunate because I learned early on to let my mother do every thing she could do. More importantly, to stop doing everything for her. Frankly, doing it for her was easier. This was important advice -- let her do it.

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