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CULTURE CHANGE:
THE ART OF ACCEPTING THAT 1 + 1 DOES NOT ALWAYS EQUAL 2!




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                                                 OR
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                   Mary Ann Johnson, MA, Program Director
            The Alzheimer’s Association Greater Richmond Chapter

                          Bonnie M. Cauthorn, IIDA
                              Design Source
Goals and Objectives

            Define culture change



    State the reality and debunk the myths



List steps to begin to make the effective change


2
Why Culture Change?




3
Number of Americans 65 or older (in millions)
100
 90                                                   90
 80
 70
 60
                                  72
 50
 40            50
 30
 20
 10
  0

             2020               2030              2045



      Three million of today’s babyboomers will reach age 100.



 4
65 years
             9 out of 10 will deal with
at least one chronic health condition

                     Projected Population Change in the US
                              (by age): 2000-2050
                                     percentage
                                                                389%


                                                      114%
             46%         32%      26%        49%

             ..0-4      ..5-19   ..20-44   ..45-64    ..65-84   ..85+

      5
By 2050, someone
                              will develop AD every
                                    33 seconds.
                                                      By 2010, there will be
                                                       almost a half million
           Every 70 seconds                            NEW cases of AD a
           someone develops                            year, and by 2050,
                  AD                                  there will be almost a
                                                        million cases each
                                                                year.




  10 million baby
                                 CALL                              The number of
                                                                 persons with Young
boomers will develop
        AD
                                  TO                             onset AD (under 65)
                                                                     is growing
                                ACTION


       6
What is culture?
        collective beliefs that, in turn, shape
        behavior.

        based in part on experiences of the
        geographic location and culture that a
        person lives in and the social encounters
        that a person has with others.

        based on a foundation of historical
        continuity.




 7
What is CULTURE CHANGE?
      The new “buzz” word in aging services



      A common name for the transformation of services,
      based on person-directed and person-centered
      values and practices.

      Focuses on the social and cultural decision factors
      and the way in which these interrelate with
      elements such as access to and availability of
      information or financial options or incentives facing
      individuals to drive behavior.



 8
Culture change is……..
                                    …the focus on
                                    respecting the
                                     differences in
 …the way in      …the manner
                                     each person
which services      in which
                                    and provides a
 are provided     services are
                                        culturally
   that are          offered
                                        sensitive
  centered in    determined by
                                    environment of
    person       residents, staff
                                     care for both
directed care.    and families.
                                      employees
                                         and the
                                       residents.


   9
The 8 Myths of Culture Change
           • Culture change = change in program for providing quality care to
MYTH 1:
             residents in communities.

           • The goal of culture change is to move from the current medical model to
MYTH 2:
             the social model.

MYTH 3: • Culture change and patient centered care is too costly.


MYTH 4: • Culture change applies only to long term care skilled nursing
          communities.

MYTH 5: • Patient centered care is the job of nurses.


MYTH 6: • The administrator or executive director need to be “on board” before
          these principles are initiated.

MYTH 7: • It takes several years before the value of culture change can be seen and
          evaluated.

MYTH 8: • One specific model of culture change fits all.


      10
Myth #1
                                       MYTH:
                                       Culture change is a change in
                                       program for providing quality
                                       care to residents in
                                       communities.




  REALITY:
  • Culture change is a process by which
    change occurs in the way care is
    provided.
  • Culture change focuses on respect for
    staff, residents, and their families.



  11
Myth #2
                                                  MYTH:
                                                  The goal of culture change is to
                                                  move fully from the current
                                                  medical model to the social
                                                  model.




 REALITY:
 • Culture change promotes the person centered
   care model and is more holistic in nature.
 • The goal is quality medical care and quality of life.
   -- David Farrell, MSW, LNHA, Director, Care Contium




    12
Myth #3
                                                   MYTH:
                                                   Culture change and patient centered
                                                   care is too costly.




REALITY:
• “Culture change is about attitude, kindness, respect, compassion
  and empathy, all of which are free.”
• “Providing this type of care does not require hiring more staff but
  rather optimizing the interactions between residents, families and
  staff on all levels.”
• Research shows that involving the staff, residents and families
  in the care actually takes less time and provides better quality
  care. (Cornelia Beck) --2008 by Planetree and Picker Institute.



      13
Myth #4
                                               MYTH:
                                               Culture change applies only to
                                               long term care skilled nursing
                                               communities.




 REALITY:
 • Culture change can occur wherever there is a
   community of people.
 • Culture change is needed in all aspects of care, for
   both long term and short term care residents, in both
   skilled nursing and health care communities as well
   as assisted living communities.



    14
Myth #5

                                MYTH:
                                Patient centered care is the job of nurses.




  REALITY:
  • Patient centered care is the job of
    all staff and involves all levels of
    staff, including administration.
  • Families and the resident should
    also be a part of this process.


  15
Myth #6
                                                      MYTH:
                                                      One specific model of
                                                      culture change fits all.




REALITY:
• Just as everyone who has a dementia disease is an
  individual, so are the residential communities.
• There are many different culture change models.: LEAP,
  Eden Alternative, HATCH. All have good points and
  similar principles.
• Organizational change should consider the principles of
  each model and design it to fit the individual community.



     16
Myth #7
                                  MYTH:
                                  It takes several years before the value of
                                  culture change can be seen and evaluated.




  REALITY:
  • Positive results are seen within the
    first 6 months.
  • The longer the principles are in
    place and used by the community,
    the greater the value will be.


  17
Myth #8
                                           MYTH:
                                           The administrator or executive director
                                           need to be “on board” before these
                                           principles are initiated.




REALITY:
• Change can be difficult for all staff members but it
  only takes a few leaders on staff as role models,
  showing courtesy, respect and developing care
  plans to fit individual needs to spark a change,
• Often it takes time for administrators to see the shift
  in care. --David Farrell, MSW, LNHA, Director, Care
  Continuum



     18
“Change does not necessarily
bring improvement. But there
can be no improvement
without change.”

“The 21st Century Hospital Innovative Care for Older People Conference 20-21”,
2/03, A Consumer Perspective- Nancy Pierce




   19
Questions? Call……




        800-272-3900




20                     20
Resources
• Patient Centered Care, Improvement Guide, 2008, Planetree and Picker
  Institute, www.pickerinstitute.org
• Myths and Misconceptions of Culture Change, David Farrell, MSW, LNHA,
  Director, Care Continuum, www.ccerap.org
• Pioneer Network web site, www.pioneernetwork.net
• www.culturechangega.org


  This program was compiled by Mary Ann Johnson, MA.
  Program Director, Alzheimer’s Association Greater
  Richmond Chapter. Program may be used only with
  permission from the Alzheimer’s Association, Greater
  Richmond.


     21

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Culture change 1+1

  • 1. CULTURE CHANGE: THE ART OF ACCEPTING THAT 1 + 1 DOES NOT ALWAYS EQUAL 2! 1 2 OR 102 1 Mary Ann Johnson, MA, Program Director The Alzheimer’s Association Greater Richmond Chapter Bonnie M. Cauthorn, IIDA Design Source
  • 2. Goals and Objectives Define culture change State the reality and debunk the myths List steps to begin to make the effective change 2
  • 4. Number of Americans 65 or older (in millions) 100 90 90 80 70 60 72 50 40 50 30 20 10 0 2020 2030 2045 Three million of today’s babyboomers will reach age 100. 4
  • 5. 65 years 9 out of 10 will deal with at least one chronic health condition Projected Population Change in the US (by age): 2000-2050 percentage 389% 114% 46% 32% 26% 49% ..0-4 ..5-19 ..20-44 ..45-64 ..65-84 ..85+ 5
  • 6. By 2050, someone will develop AD every 33 seconds. By 2010, there will be almost a half million Every 70 seconds NEW cases of AD a someone develops year, and by 2050, AD there will be almost a million cases each year. 10 million baby CALL The number of persons with Young boomers will develop AD TO onset AD (under 65) is growing ACTION 6
  • 7. What is culture? collective beliefs that, in turn, shape behavior. based in part on experiences of the geographic location and culture that a person lives in and the social encounters that a person has with others. based on a foundation of historical continuity. 7
  • 8. What is CULTURE CHANGE? The new “buzz” word in aging services A common name for the transformation of services, based on person-directed and person-centered values and practices. Focuses on the social and cultural decision factors and the way in which these interrelate with elements such as access to and availability of information or financial options or incentives facing individuals to drive behavior. 8
  • 9. Culture change is…….. …the focus on respecting the differences in …the way in …the manner each person which services in which and provides a are provided services are culturally that are offered sensitive centered in determined by environment of person residents, staff care for both directed care. and families. employees and the residents. 9
  • 10. The 8 Myths of Culture Change • Culture change = change in program for providing quality care to MYTH 1: residents in communities. • The goal of culture change is to move from the current medical model to MYTH 2: the social model. MYTH 3: • Culture change and patient centered care is too costly. MYTH 4: • Culture change applies only to long term care skilled nursing communities. MYTH 5: • Patient centered care is the job of nurses. MYTH 6: • The administrator or executive director need to be “on board” before these principles are initiated. MYTH 7: • It takes several years before the value of culture change can be seen and evaluated. MYTH 8: • One specific model of culture change fits all. 10
  • 11. Myth #1 MYTH: Culture change is a change in program for providing quality care to residents in communities. REALITY: • Culture change is a process by which change occurs in the way care is provided. • Culture change focuses on respect for staff, residents, and their families. 11
  • 12. Myth #2 MYTH: The goal of culture change is to move fully from the current medical model to the social model. REALITY: • Culture change promotes the person centered care model and is more holistic in nature. • The goal is quality medical care and quality of life. -- David Farrell, MSW, LNHA, Director, Care Contium 12
  • 13. Myth #3 MYTH: Culture change and patient centered care is too costly. REALITY: • “Culture change is about attitude, kindness, respect, compassion and empathy, all of which are free.” • “Providing this type of care does not require hiring more staff but rather optimizing the interactions between residents, families and staff on all levels.” • Research shows that involving the staff, residents and families in the care actually takes less time and provides better quality care. (Cornelia Beck) --2008 by Planetree and Picker Institute. 13
  • 14. Myth #4 MYTH: Culture change applies only to long term care skilled nursing communities. REALITY: • Culture change can occur wherever there is a community of people. • Culture change is needed in all aspects of care, for both long term and short term care residents, in both skilled nursing and health care communities as well as assisted living communities. 14
  • 15. Myth #5 MYTH: Patient centered care is the job of nurses. REALITY: • Patient centered care is the job of all staff and involves all levels of staff, including administration. • Families and the resident should also be a part of this process. 15
  • 16. Myth #6 MYTH: One specific model of culture change fits all. REALITY: • Just as everyone who has a dementia disease is an individual, so are the residential communities. • There are many different culture change models.: LEAP, Eden Alternative, HATCH. All have good points and similar principles. • Organizational change should consider the principles of each model and design it to fit the individual community. 16
  • 17. Myth #7 MYTH: It takes several years before the value of culture change can be seen and evaluated. REALITY: • Positive results are seen within the first 6 months. • The longer the principles are in place and used by the community, the greater the value will be. 17
  • 18. Myth #8 MYTH: The administrator or executive director need to be “on board” before these principles are initiated. REALITY: • Change can be difficult for all staff members but it only takes a few leaders on staff as role models, showing courtesy, respect and developing care plans to fit individual needs to spark a change, • Often it takes time for administrators to see the shift in care. --David Farrell, MSW, LNHA, Director, Care Continuum 18
  • 19. “Change does not necessarily bring improvement. But there can be no improvement without change.” “The 21st Century Hospital Innovative Care for Older People Conference 20-21”, 2/03, A Consumer Perspective- Nancy Pierce 19
  • 20. Questions? Call…… 800-272-3900 20 20
  • 21. Resources • Patient Centered Care, Improvement Guide, 2008, Planetree and Picker Institute, www.pickerinstitute.org • Myths and Misconceptions of Culture Change, David Farrell, MSW, LNHA, Director, Care Continuum, www.ccerap.org • Pioneer Network web site, www.pioneernetwork.net • www.culturechangega.org This program was compiled by Mary Ann Johnson, MA. Program Director, Alzheimer’s Association Greater Richmond Chapter. Program may be used only with permission from the Alzheimer’s Association, Greater Richmond. 21