THE PIONEER EXCHANGE

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Family participation in Culture Change

Diaries
by kate ricks
Posted on Wed Mar 15, 2006 at 02:42:48 AM EST

bumped back up to the top of the page, to draw attention to Kate's work in the comment section -- joe

I've been a quiet promoter of Culture Change for a number of years.  Recently I've participated in several Almost Home events including the Senate luncheon on Capital Hill. This movement brings a real hope for genuine improvements in long-term care.  There is one aspect of this movement, however, that I find increasingly troubling and that is that there is no recognizable place in it for family members and most particularly for family councils.  

 We are perhaps the biggest supporters and promoters of Culture Change.  To continue that support, we need an equal place at the table.  Not only do we also have legitimate needs that must be recognized and addressed, we bring a point of view to any deliberations of this sort that is both necessary for a successful outcome and is not available elsewhere. We are, when all is said and done, the folks who make the ultimate decision as to just where our loved ones will reside.  If we are not welcomed as equal partners into the unfolding culture change "journey", the probability is high that we'll get off the train.

Our schools faced this issue of "what do we do with families?" years ago.  In schools we generally call them Parents.  There was a time when no Parent ever entered a classroom during the school day.  The very thought was terrifying to both administration and staff. Parent Groups were viewed with suspicion.  Now, not only do we welcome parents in our classrooms, we even like them.  We know that the more parent involvement in a school, the better the school.   In long-term care facilities, we often call these same folks Responsible Persons.  The time for long-term care facilities to follow the path our schools followed regarding Responsible Persons and Responsible Person Groups is now.   The reason is the success or failure of this very promising new direction. This time, let's walk together.

< Changing Titles of Management & Leadership Staff | Hoping for a Brighter Future >



Family Participation in Culture Change (4.00 / 1)

I really appreciate your comments Kate. I think you are exactly right about family participation. There are several spects that need to be explored. Families need to know there is "something different." Providers struggle with how, when and what to involve and engage families with in general and in their culture change process. In my experience it is importnat for staff to begin the personal transfromation and have some information and comfort in expressing the new vision etc. before involving families so that they can answer questions, and be a part of true dialogue. What you suggest is a new culture of family involvement which is exactly what providers need to explore. Other stakeholders also need to explore this - surveyors, advocates and community based services.
In true culture change - deep transformational organizational change, families are very involved and their engagement increases throughout the journey. Families are engaged in strategic change events helping to ground the vision, in action teams working on solutions and innovations to accomplish the vision and in communites of elders and staff working togwether to create the climate each day for self direction to occur.

by Megan on Mon Mar 06, 2006 at 08:01:46 AM EST
Family involvement (4.00 / 1)

Kate - We need you on the train! The Pioneer Network is evolving and growing as is the whole arena of LTC. You say you have been a quiet promoter of Culture Change.  We need more  families as active,vocal participants. As Megan's comment states, having families and family councils present at the table is essential to transformation.

How do you see yourself being at the table? I can think of several avenues. One is to become part of the state coaltitions that are forming to help transform the care systems. Another is to work with a particular facility and be on a committee that is guiding the change. We need more family members to attend conferences, join committees and  bring comments and concerns to the blog as you have.
My experience is that often family members have limited energy and time while they are the primary support person for someone in a facility. My hope is that even after the person dies, that in some way families will remain involved in the transformation process. Then they have more time, support and insights to share on a larger level. Plus one thing I think is happening is that as "baby boomers" watch their parents enter the systems, they become very clear that there is a need to create something different for themselves also. this takes us way beyond the borders of nursing homes which is exactly where this movement needs to go. It is time for some very creative thinking at all levels of care and for very active consumer participation.

So I very much welcome you to the table and recognize the important and multifaceted knowledge that you and other family members bring.


by Joanne Rader on Tue Mar 07, 2006 at 04:35:39 PM EST
Family Participation (4.00 / 1)

I totally agree with Kate's point about the need for a role for families and a process for providers and workers to incorporate this role. In our journey at Lakewood Healthcare (Milw, WI) we found help from the Live Oak Institute (Debby & Barry Barkan)and their teachings involving community gatherings. The Barkans share their knowledge at Pioneer conferences or through consultative arrangements.

Tom Zwicker


by Tzwicker on Wed Mar 08, 2006 at 10:06:58 AM EST
Family Members experiences needed (4.00 / 1)

Thanks for all the worderful comments on family involvement in Culture Change.  It gives me great hope that this may really happen.  Here in Maryland, we are planning a series of conferences on Culture Change.  Our focus will be, in part, how families and family councils can play a significant role in the process as equal and valued participants from the beginning phases through the problems and processes to the final outcomes. We are looking for individual family members and members of family councils who have been involved as an integral part of a Culture Change project in their facilities to give us descriptions of how this was accomplished.  We'd really love to have a coordinated description given by both a family council and the administrator of a facility.

by kate ricks on Tue Mar 14, 2006 at 08:15:10 PM EST
Culture Change Conference, Elkton (none / 0)

Being in Delaware, I don't know the name/tele. number of the fire hall in Elkton, but it is easy to get to and has good parking and a large room.  It would be a good place for the conference.   I could help with set-up, etc.  I have also asked AARP-DE again about partnering.

Ah, where did all the other comments go?


by nurse2 on Sun May 14, 2006 at 01:03:52 PM EST
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