Todd Shackelford West Central Illinois Area Agency on Aging 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 Solvers Resident focused Objectivity See the big picture Don’t have the “tapes” Can provide guidance Can provide solutions

Ombudsman Role #2 Advocates Resident involvement Family involvement Facility involvement Regulator involvement Other advocates involvement

Ombudsman Role #3 Building or Supporting Coalitions Regional 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 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!!!