Team Presents for OKAHSA in May

Focus of Day-Long Conference will be Person-Centered Care

Oklahoma City, OK –The Oklahoma Association of Homes and Services for the Aging (OKAHSA) recently chose the Institute for Caregiver Education to be their sole provider of Person-Centered Care Education for their Annual Spring Conference on May 8, 2008. The symposium will offer training on a variety of person-centered care practices that are designed and proven to elevate the quality of life and the quality of care for residents in nursing home settings.

The Institute team will facilitate four sessions including: An Introduction to Person-Centered Care; The First Year of Implementation; Retention, Work Force Development and HR Practices; and Making the Business Case. The first session, An Introduction to Person-Centered Care will include an in-depth look at how we de-value our elders by the nature of our own society’s perceptions of aging, and how this affects our work in long term care.

The First Year of Implementation will focus on initiatives designed to educate the entire nursing home community, including resident interviews, employee orientation, buddy-systems and how to communicate new concepts to families.

Retention, Workforce Development and HR Practices is a two-part session in which attendees will discover fundamental principles necessary to move from a traditional model of workforce development that is top-down oriented, to a model that embraces a flattened hierarchical structure that encourages empowered decision-making.

The final session, Making the Business Case, is designed to answer questions including “Why should we adopt this change?” “How much can it cost?” “How will it affect the bottom line clinically and operationally?” “Will the state and Federal surveyors support it?” and finally, “How will it affect our presence in the market?”

The Oklahoma Association of Homes and Services for the Aging (OKAHSA), organized in 1993, represents over 100 not-for-profit, private, fraternal, religious, and government-sponsored nursing facilities, assisted living, retirement communities, housing, and adult day service centers. OKAHSA members serve more than 8,000 persons in facility-based settings. Association members employ over 85,000 people and involve countless volunteers.

The Institute for Caregiver Education is a nationally-recognized leader in Culture Change education. For more than 15 years the organization has provided quality caregiver education to nursing homes from California to Maine. Over the last seven years the IfCE team has educated hundreds of long-term care professionals on a myriad of Culture Change topics at such national conferences as ASA, NADONA, AAHSA, AHCA, ACHCA, The Pioneer Network, the VA Summit and numerous state associations. The Institute for Caregiver Education is currently a leading Culture Change educator for a number of state QIO organizations as they work with the 8th Scope of Work and CMS.

For more information about this event, or to request a speaker, please contact Allison Lantieri, Director of Communications at 702-567-2769 or e-mail her at alantieri@caregivereducation.org.

Community Life Part II

So the questions regarding the instance in the previous post in which the Bookkeeper ran a craft group included:

1. Well, who gives the bookkeeper PERMISSION to leave her office twice a week?
2. Does she have to CLOCK OUT?
3. Is she PAID EXTRA for that time?

First, I have to say that though valid, these questions come from a medical model perspective that has been conditioned to be focused on a top-down management style. First, why does the Bookkeeper need permission? I she wants to bring life and spontaneity and creativity and enjoyment to the elders that live in the home, shouldn't we instead say "Wow! How can we support her in doing that, and get other individuals to want to behave similarly?"

Secondly, why should she HAVE to clock out? If it is only two hours a week, let's afford her the opportunity to step outside her job silo and PARTICIPATE in the community. I would ask of course, that she assure us that she can complete her job responsibilities, and that if a crisis comes up, she be able to get some back-up for leading her group.

And third, the issue of being paid extra: if you have employees that are only willing to go above and beyond their job description if they are paid extra, then you have two deeply systemic problems. 1) You don't encourage a work environment where folks feel free to step outside of their job description and 2) If they will only do something extra for the money, they are not the right people to support a change to person-centered care. PERIOD.

If we can start to think about Community Life as an opportunity to build on the practices of Therapeutic Recreation and create a wider focus that embraces both the needs of the residents and the gifts of the staff, we are taking an important step toward building true community.

--Allison Lantieri

From "Activities" to Community Life

Our organization has been fortunate to have had an opportunity to drive some of the system changes taking place in eldercare that transform communities from a medical model of care to a social model. Included in that transformation is an effort to move from a traditional "Therapeutic Activities" model to one of "Community Life." I was consulting recently in a home that is undergoing such a change, and I wanted to share some thoughts about the experience with you.

The whole idea about Community Life focuses on the fact that an organization whose teams are caring for elders has more than just a duty to those that they serve. In fact, such organizations need to focus equally on their residents and their "staff." Community Life is a great example of how a system-change whose goal is to move from a medical to a social model of care can benefit teams and residents EQUALLY.

For example; one of our biggest ideological shifts concerning a traditional Activities model is that rather than serving the largest number of residents at a time (which is most convenient for the staff and THEIR schedule); i.e. Bingo at 10am and an outside entertainer at 2pm; instead we focus on meeting the needs of the residents on an individual and/or small group basis.

We know that elders don't do as well in large groups. And that is not to say that they might not occasionally enjoy being in a large group, but rather that every day twice a day in that environment is not usually in their best interest. Nor does it mirror for most of them how they lived their lives prior to coming to the nursing home.

One of the initiatives that we have been advocating for is taking a look at the hobbies/interests/backgrounds of the team members that work in our homes. Sure, in some cases we know how many kids they have, where they might worship, if they have a favorite type of ethnic food, but usually we don't know if they coach a team, know a second language, are an expert woodworker, or if they love reading novels.

Do you see where I am headed with this line of thought?

If we took the time to really get to know the individuals who work in our homes, then we could integrate their talents (the ones OUTSIDE of their traditional work silos) into the LIFE of the home. I'll give you an example.

A home that we work with in Western Massachusetts has a bookkeeper who seldom had a reason to "come out" of her office and interact with the residents. However, when the Community Life (formerly known as the Activities Director) was looking for a combination activity and fundraiser, she thought about the bookkeeper, who happened to be a seasoned seamstress/knitter/crocheter. She asked this individual if she could spare an hour a couple of times a week to instruct residents on different craft projects, that they could later put up for sale. The Bookkeeper said yes, and from that day forward, the home has had a twice weekly craft group and an annual craft sale, of which all proceeds benefit the Community Life program.

Whenever I offer that story up during my consultations, I get the same questions:

1. Well, who gives the bookkeeper PERMISSION to leave her office twice a week?
2. Does she have to CLOCK OUT?
3. Is she PAID EXTRA for that time?

I'll answer those questions in the next post!

--Allison Lantieri

Aging and Wisdom

I fell in love with this quote about aging recently:

Sara Paddison, The Hidden Power of the Heart

"You only hurt yourself when you're not expanding and growing. Many people can't stand the thought of aging, but it's the crystallized thought patterns and inflexible mind-sets that age people before their time. You can break through and challenge your crystallized patterns and mind-sets. That's what evolution and the expansion of love are really about."

-Allison Lantieri, Director of Communications