Dont Make Me Play Bingo For A Banana

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Dont Make Me Play Bingo For A Banana !
Todd Shackelford West Central Illinois Area
Agency on Aging 217-223-7904
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What is Culture Change?

• ?Paradigm Shift in the Delivery of Care
• ?Moving from Medical Model to Home Model
• ?Decentralizes Decisions to the Resident(s)

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Why Change the Culture in LTC?

• Bette Davis speaking about Joan Crawford Shes
  old. Shes tired. And shes tired of being old
• Past models of care are not working
• Baby-boomers will not accept past models
• Industry practitioners are tired
• The industry must attract new workers
• The industry must have market survival
• Cant hove LONELINESS, HELPLESSNESS AND BOREDOM
  ANY LONGER !!!

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Key Components of Culture Change

• PERSON CENTERED/DIRECTED CARE
• COMMUNITY DEVELOPMENT
• CAREGIVER TEAMS
• OPTIONS, OPTIONS, AND MORE
• ACTIVITIES THAT ARE MEANINGFUL
• KNOW EACH PERSON/ PERSON FIRST

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The Ombudsmans Role in Culture Change
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Ombudsman
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CNAs
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Nursing
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Administration
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Ombudsman Role 1

• Problem Solvers
• Resident focused
• Objectivity
• See the big picture
• Dont have the tapes
• Can provide guidance
• Can provide solutions

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Ombudsman Role 2

• Advocates
• Resident involvement
• Family involvement
• Facility involvement
• Regulator involvement
• Other advocates involvement

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Ombudsman Role 3

• Building or Supporting Coalitions
• Regional coalition development
• State coalition development
• Building facility coalitions
• In-service and public education
• Media support and promotion

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How do you eat an elephant?
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One Bite at a Time

• Start using resident centered language
• Start talking in terms of resident directed care
• Never cookie cutter problems
• Start problem solving systemically using culture
  change solutions
• Encourage, build and support coalitions

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But, But, But

• I dont have enough time
• Thats right - you dont have enough time
• Dont give them fish. Teach how to fish
• Work done now saves time later
• Sorts the men from the boys

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• This culture change thing is just a trend
• Look at the evidence around the nation
• Would you want to live in the old culture?
• Consumer expectations are changing
• Is empty beds a trend?

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• The focus of the Ombudsman must be on resident
  complaints
• True and in fact OAA
• Complaints can be the catalyst for systemic
  change culture change approach
• Efforts made now may pay off in big dividends
  later

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Whats it like to be a resident

• (AKA person who lives in a facility)
• Personal Exercise

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Real Case Scenarios

• 82 year old gentleman who constantly complains to
  administration, ombudsman, state regulators,
  legislators and the PUS. Has now discovered the
  power of the internet, distribution list e-mail
  and is gaining media coverage. Complaints are
  usually system problems in facility and not
  usually concerning his personal care.

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Scenario 2

• 68 year old woman with mild dementia. Nursing
  staff frustrated as bathing has become a battle.
  Family members are demanding adequate hygiene for
  her. Dr. suggested a sedative be given or
  perhaps a mood elevator.

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Be the Champion of Change!!!