THE PIONEER EXCHANGE
Common Ground
for a New Culture
of Aging
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Regulations & Culture Change
News
by joe angelelli
Posted on Wed Mar 07, 2007 at 05:52:16 AM EST
There's a tremendous amount of education happening on the topic of regulations and culture change around the country. Action Pact has new "Featured Stories" up on their website that include some great insights from Pat Maben and Glenna Massey, as well as a review of the NHRegsPlus website out of the University of Minnesota.
And in Kansas, the Kansas Association of Homes & Services for the Aging recently helped to sponsor trainings that featured regulators, providers and ombudspeople in the same room exploring culture change scenarios:
Nearly 600 Kansas long term care professionals, state survey agency personnel and ombudspeople recently participated in full-day trainings on person-centered care and regulatory compliance. (Not bad considering there are 340 nursing homes in the state.)
Nationally-recognized culture change educator/consultant Carmen Bowman guided participants through the historical context for nursing home regulation, and discussion about ways specific long-term care regulations support culture change practices. Providers and survey agency folks alike were challenged to view the regulatory construct as tool to rethink current practices and expectations, and to allow for more person-centered approaches to care.
Joint long-term care provider and surveyor training has been a tradition in Kansas since 2000, when provider and agency stakeholders came together to identify ways for regulators and the regulated community to gain a common understanding on deficient as well as best practices. Trainings are held in two locations twice a year, and while they generally have focused on clinical care, the first culture change-related joint training was held in 2002.
Carmen will be speaking at the
Ohio Person-Centered Care Coalition's 2nd annual conference in Columbus on March 20th (sold out) and I will be there to live blog it. There has a been a fascinating exchange on the Ohio coalition's listserv recently about the survey process concerning call bells -- it has proven to be a great education for all involved.
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New Arkansas Use of CMP Funds
News
by joe angelelli
Posted on Tue Mar 06, 2007 at 04:57:33 AM EST
Arkansas Governor Beebe signed two bills into law that are designed to promote nursing homes with home-like settings. One bill would allow money from civil penalties paid by nursing homes in violation of state or federal law to go into a trust fund for the so-called "Green House" nursing homes. The other would set higher staffing standards for nursing homes....A spokeswoman for AARP of Arkansas says the bills represent a change in culture because they promote not only quality care but also quality of life. 
More about the bill passing the Arkansas House & Senate here:
"the bill, which passed 96-0 and goes to the Senate, gives the state Office of Long-Term Care authority to establish staffing standards for nursing home facilities certified as Eden Alternative or Green House projects."
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As California Goes....
News
by joe angelelli
Posted on Thu Feb 22, 2007 at 08:20:23 AM EST
The California Culture Change Coalition is off to an exciting start in 2007, having incorporated as a 501(c)(3) on February 1. I attended the coalition's meeting in Sacremento on February 2 and spent the day talking with a diverse group of coalition partners. I came away hoping that the old adage, "As California goes, so goes the rest of the country" holds up in this case, because they really do have all the stakeholders around the table and are poised to do great work.
California is fortunate to have involved in its coalition several folks with a tremendous amount of experience implementing person-directed care practices and building community across the long-term care spectrum, including David Farrell. They also have founding Pioneers Barry and Debby Barkan.
I was lucky enough to be able to spend some quality time with the Barkans while staying in their Berkeley home. Barry shared with me an article he wrote for Aging back in 1981. It's based on a talk he gave at a UC Berkeley conference the year before, and he said it was carried around by Carter Williams for several years before she ever met Barry. It very much captures the spirit of OBRA 87!
Reading the paper for the first time on the plane ride home, I thought about how it's truly a foundational document in the culture change movement -- something everybody should read because it captures the essence of what this work is all about.
I highly recommend downloading it (opens as a .pdf) and sharing it with others. Hold a learning circle in your organization and discuss it, or honor Barry and Debby by making it the topic of a community meeting!
(1 comment)
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More Trading Places
News
by joe angelelli
Posted on Tue Feb 20, 2007 at 06:26:20 AM EST
The NBC Nightly News "Trading Places" series continues this week. They are sharing stories from viewers and exploring elder care issues in more depth.
On Monday night they ran a wonderful
story about Rakhma Homes in Minnesota. Several Pioneer Network board members and staff visited Rakhma while in Minnesota a few weeks ago for a board meeting (thanks to the Minnesota Health & Housing Alliance for helping to arrange the visit).
The piece about Rakhma ended with a comment that residents are "not in a home, they are at home." It would be great if NBC were to explore that concept more and show how a small but growing number of nursing homes are doing truly remarkable work individualizing care and de-institutionalizing services -- and also share how some nursing homes with more resources are transforming themselves into households and neighborhoods.
It's really important to raise awareness about nursing home alternatives as that will spur innovation in all areas. But we can't lose sight of the fact that we have 15,000+ nursing homes and approaching this as a zero sum game (home & community-based care VS. nursing home care) is not useful. In many communities, the nursing homes that are undergoing a transformation represent an incredible resource for educating the broader community about the need to invest in a direct care workforce, one that can serve individuals with chronic care needs across the long-term care spectrum. Think of what the Green Houses are doing in the communities where they're being built -- they are nursing homes undergoing a deep transformation, and there are many other nursing homes adopting other approaches to creating households (for example, over 200
Household Matters Toolkits have been distributed). The stories of those organizations deserve to be heard too.
Last night's program featured Dr. Marie Bernard, The Donald W. Reynolds Chair in Geriatric Medicine at the University of Oklahoma. You can read her blog here.
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Trading Places
News
by joe angelelli
Posted on Wed Feb 14, 2007 at 11:41:29 AM EST
NBC Nightly News is running a series called,
Trading Places: Caring for Your Parents.
It's generating lots of comments and viewer stories on the The
Daily Nightly, the NBC Nightly News blog:
Life may offer you a guidebook, but the pages are blank -- you have to fill them out as you go. With that in mind, we are featuring stories this week about the challenges of caring for our aging parents and it's hitting closer to home than I ever imagined. I just returned to Washington, D.C., after a week in Redmond, Wash., a suburb of Seattle. I'd gone out there to help my 81-year-old Dad through a tough surgery and I only had a few days to get him home from the hospital and make sure he was safe and comfortable before I had to take the cross-country trip back. While at the hospital, in the grocery checkout, or in line at the pharmacy, I saw others just like me ?- adult children or other caretakers doing what they could to help out an aging parent. Assisting a frail parent walk, leaning in to hear a dry whisper of a voice, chuckling over some shared family memory -- these are scenes repeated hundreds if not thousands of times each day in this country.
Update [2007-2-15 11:28:59 by joe angelelli]: Tonight's installment looks really good. Ann Curry tells the story of her father, Bob. On the Daily Nightly blog, the producer Clare Duffy shares what it was like to work with Ann and her father on the piece (after her own father passed away two years ago):
We arrived in Oregon last Thursday to follow Bob around, capturing everything this extraordinarily active man does. The camera crew and I were hard pressed to keep up with him. Ann joined us on Saturday for our interview. We squeezed around the dining room table and settled in for a conversation. Ann and her father have the kind of relationship where it seems they've never stopped talking. They discussed everything: love, loss, learning, what it's like getting older, and how to keep one's zest for life.
If there's one thing I'd like to see people take away from this series of reports, it's this: Do what Ann did. Sit down with your parent or parents, set up a video camera and start talking. Don't do it around a holiday, when there are presents or other distractions. Do it for no other reason than to get them on the record - both the stories you've heard a thousand times, and the things they'll tell you that will surprise you. It might feel strange, but eventually you'll all forget the camera is there. And don't wait.
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