THE PIONEER EXCHANGE

Common Ground
for a New Culture
of Aging










Cultural Change: Getting Residents Out of Wheelchairs

Diaries
by maryharroun
Posted on Tue Feb 27, 2007 at 01:46:09 PM EST

Getting residents out of wheelchairs and up and walking and when rest is required to provide real chairs for them to sit in.  As many facilities have a great fear instilled in staff that residents must not fall, they have preferred to keep them in wheelchairs, with alarms and lap restraints to keep them seated.  This practice is not meeting the goals of real cultural change.  Read on.....

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JCAHO Resident Identifier Regulations

Diaries
by Bill Graves
Posted on Wed Jan 03, 2007 at 08:56:08 AM EST

--from the diaries -- lots of good discussion in the comment section -- joe

To band, or not to band....

We recently had a JCAHO survey, and the issue of resident identifiers came up.  According to JCAHO regulations, there needs to be 2 identifiers available to nursing staff to ensure that they are dispensing medications, treatments, etc. to the appropriate resident.  In the past we had a photo of the resident in our MAR, and the residents wore name bands - just like in a hospital.  As part of our Culture Change journey, we've eliminated the wrist bands.  We felt that our Consistent Assignments were enough to satisfy the regulation.  In addition, we have the resident's name outside the door to their room, and their name is on the footboard as well.  Our JCAHO survey didn't feel that either the consistent assignments or the resident names were enough to meet their requirement, and although I think our surveyor understood the intent of Resident directed care, she still felt that in order to comply with the reg, we needed to reinstitute the name bands.  Obviously, we don't want to do that, and I wanted to ask other facilities if they've experienced the same type of issue, and how did you handle it?

(5 comments) Click Here to Read and Leave Comments >>

Looking Back......and Forward

Diaries
by Bill Graves
Posted on Tue Oct 24, 2006 at 09:47:51 AM EST

I am posting the following piece written by one of our resident's wives.  She has a way of translating her emoitions into words that is truly a gift.  She is, of her own admission, "living in the dark ages," and uncomfortable with computers.  She has given my permission to post this piece here for other's to see.

The realization that one year has quickly gone by since my husband, Bob, entered St. Camillus Health Center last October awakens deep thoughts and emotions within me.  They are reminders that letting go is still a struggle at times.  Visits, to spend time with Bob, have been numerous.  As I pass through the front door, I note the cozy sitting area, complete with fireplace, and hot coffee.  The familiar ritual begins with several warm greetings exchanged with staff and residents I meet along my way, revealing a sense of belonging that has invited many tender moments.  Everyone is acknowledged. Relationships have formed as they do in every family.

October marks another milestone - our 45th wedding anniversary:  Fr. Jack will help us celebrate this occasion during mass, as he has with other couples.  Feelings of gratitude deepen, when I ponder the opportunity to pray the Rosary and receive Holy Eucharist daily.  It adds great meaning to life at St. Camillus and provides comfort and richness to those able to participate, especially during difficult times.

I don't know how to fully capture the various ways joy touches my heart. It's in the many people who help our loved ones.  Their kind gestures are observed over and over, as they join together to meet every need.  Joy also permeates the atmosphere, whether it is at the friendly pot luck suppers in the mansion, the carefree patio cookouts or just gathering on the sunshine bridge sharing stories and soaking in the rays.  I often remind myself that these events-and so many others- are happening at a long term care facility! Beyond this reality, there's a great knowing that St. Camillus is also a warm home where shared values reflect one family, and where life and love make people feel at home.  The evidence is apparent on the walls filled with happy family pictures and large canvases of bright vivid colors.  It's evindent in the garden that flourished with a variety of flowers and vegetables around an inviting patio. The wonder of watching plants grow was ongoing all summer and the harvest was plenty.  The fresh basil added a delicious taste to scrambled eggs!

The St. Camillus staff deserves praise for their commitment to paving the way for the best in family living.  It's a sign of hope and full of promise for things to come as "culture change" goes forward.  Complimentary comments, from so many others, are heard all the time.  We deeply appreciate the excellence you have earned and that you stand for.  

An enormous thank you to all the special people, Bob and I have come to know and respect.  Some stand out in an extraordinary way by pouring out their best into every day.  Their hard work and positive gentle spirits touch our hearts.  In this season of Thanksgiving, it's a perfect time to say how grateful we are to the dedicated St. Camillus staff.


Rose Gallagher
October 2006

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Ohio's second annual person centered care conference

Diaries
by pkmurray
Posted on Thu Sep 21, 2006 at 08:27:04 AM EST

from the diaries -- joe

The Ohio Person Centered Care Coalition is finalizing plans for its second annual conference in March, 2006.  We are soliciting speakers for the conference until the end of September.  For information about our conference please go to our web site: Ohio Person Centered Care Coalition.

Our first statewide conference was held in February of this year and was attended by more than 250 people.  It was highly successful as an educational, networking, and motivating conference.

Our coalition's present work includes:

  1. Planning the second annual Person-Centered Care Conference for March 2007 in Columbus, Ohio.
  2. Developing a mentor home program that would enable providers opportunities to visit a home that is further along on the culture change journey.
  3. Developing a resource to be shared with long-term care providers that will clarify regulations that apply to person-centered care.  The purpose of this is to support providers as they discuss their changed organizational culture with state surveyors.
  4. Developing an organizational brochure that was initially used at an exhibit at the AOPHA annual conference September 19 and 20th.

These projects give a sense of the direction of our coalition and our committment to bring a genuine nursing home culture change to Ohio.

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Article

Diaries
by joe angelelli
Posted on Tue Sep 19, 2006 at 03:06:19 PM EST

There was a good article on the Household Model over the weekend in Florida's Herald Tribune.

In his book, Shields notes that he learned that the first household was moving to a 24-hour dining schedule just days before it was implemented, as well as the staff's plan to do away with three eight-hour shift scheduling with flex work times. A team leader told him about it in passing.

"I don't remember much about the rest of the conversation because my head was swirling," Shields wrote. "I admit my first reaction was to feel a little stung because I didn't know anything about either issue. And then I thought, 'Well, what have you been wanting for all this time, big boy?'"

Since the staff works with the same residents in the households, they build a bond rarely seen in traditional nursing home settings. Workers know residents' needs, both physical and emotional, more intimately.

And residents know about the staff's personal lives, improving trust and communication.

When I give talks these days I talk about setting up two different news aggregators on Google News, one just using the words "nursing home" and another with "nursing home culture change" as key words.  Everyday I get an e-mail with links to 10 or 15 mostly "bad news" articles about nursing homes from around the country, and once a week or so I get an e-mail with one link to one news article covering some aspect of culture change.  This was one of those links.

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