Person Centered Culture Change In Adult Day Services - PowerPoint PPT Presentation

1 / 30
About This Presentation
Title:

Person Centered Culture Change In Adult Day Services

Description:

Person Centered Care is driving the change in facilities that ... Are we too busy filling out forms to learn the essence of this person? What are their hopes? ... – PowerPoint PPT presentation

Number of Views:34
Avg rating:3.0/5.0

less

Transcript and Presenter's Notes

Title: Person Centered Culture Change In Adult Day Services


1
Person Centered Culture Change In Adult
Day Services
  • National Adult Day Services Association Annual
    Conference 2008
  • Presented by
  • LaDonna Jensen, RN
  • Marilyn Hartle, MSW, LCSW

2
What is organizational culture?
  • Belief systems
  • Rules - both formal and informal
  • Norms

3
What is culture change?
  • Understand culture change is a persistent,
    subtle ingenious substitution of one way of being
    by another. Thomas Kitwood

4
What is culture change?
  • Widespread movement within the field of aging and
    care for persons with dementia
  • Movement to profoundly change systems and to
    transform care organizations to be driven by the
    choices and needs of the people they serve
  • Person Centered Care is driving the change in
    facilities that care for people with Alzheimers
    disease

5
What is Person Centered Care?
  • Person Centered Care is a combination of
    theories based on ethics and values - as well as
    care techniques - that guide care practices. It
    is based on the belief in the inherent value of
    an individual. PCC takes the perspective of the
    person with dementia and creates a social
    psychology of care that supports
    well-being. Jentle Harts Consulting

6
Person Centered Care
  • Person Centered Care is an ongoing process of
    compassion, education, modeling, evaluation and
    monitoring engaged in for the purpose of
    improving the health and well-being of all
    persons involved in the giving and receiving of
    care. Luther Manor Adult Day
    Services

7
Elements of Old Culture
  • Environment
  • Ring of recliners around a television
  • Bathrooms partially used as storage rooms
  • Staff specific badges that emphasize position/job
    title
  • Organization
  • Hierarchal staff structure
  • Decision making occurs from top down
  • Outcome measurements
  • Focus on physical outcomes of care, i.e. falls,
    weight , skin breakdowns, nutritional intake
  • Emphasis on medical monitoring

8
Elements of Old Culture, cont.
  • Program
  • Herd mentality-everyone must do the same thing
    at the same time in the same place
  • Unchanging, repetitive calendar
  • Staff lead all activities
  • Limited access to outdoors
  • Little or no participant input into program
    choices
  • Therapeutic fibbing as an unquestioned approach
    for people with dementia

9
Why Change?
  • Consumer demand
  • Third party reimbursement expectations
  • Upgraded expectations of services by the baby
    boomers
  • Accrediting bodies have changed expectations
  • What once was standard of practice is now
    considered deficient practice
  • It is the moral and ethical thing to do

10
Change in Language
11
Change in Language, cont.
12
Assessments for Care Planning
13
Care Plans
14
Why I statement Care Plans?
  • Strives to put the person back in charge of their
    own life
  • Supports documents our efforts to advance
    person centered care/individualized care planning

15
How do we facilitate I Care Plans
  • Is the participant consulted?
  • Is their involvement facilitated regardless of
    their level of impairment (physical, cognitive or
    mental)?
  • Are we too busy filling out forms to learn the
    essence of this person?
  • What are their hopes?
  • What brings them joy?
  • What are their dreams?
  • What do they worry about?

16
Examples of things to ask
  • Name of choice. Is this name appropriate for all
    staff to use?
  • Preference in group dynamics
  • Likes to be in the center of things
  • Reflectiveprefers to watch
  • Prefers small, quiet groups
  • Likes large groups with lots of noise and
    activity
  • Example from
  • Luther Manor Adult Day
  • Wauwatosa, WI

17
If they were writing their own care plan, what
would it look like?
  • People (staff) remember the details of stories
    more than statistics or lists of tasks
  • When staff know something about the people they
    interact with, they can move beyond being task
    focused
  • My Personal Care Plan

18
Person centered outcome measurements
  • Quality of life indicators
  • Dementia care mapping
  • Attempts to take the perspective of the person
    with dementia
  • Evidence based, observational process
  • Can be used in several ways for quality
    improvement processes as well as individual care
    planning

19
Recruiting Staff Who Get It
  • Flexible
  • Kind
  • Empathetic
  • Comfortable with participants
  • Participant choice drives the program

20
Typical Program Assistant Job Descriptions
  • Lists skills competencies needed with
    corresponding responsibilities
  • Participate in assessment/care planning
  • Assist in developing the activity plan
  • Carry out plan of care
  • Carry out recreation activities
  • Observe and report observations
  • National Adult Day Services Association
  • Training the Program Assistant in Adult Day
    Services, 2004

21
Observe Report Observations
  • Current standards require observation at minimum
    of
  • Skin tone
  • Strength
  • Flexibility
  • Signs of physical discomfort
  • Changes in abilities, behaviors, appearance
  • Program Assistants should be able to conduct calm
    observation report detail in times of crisis,
    reporting only what is seen, heard done
  • National Adult Day Services
    Association
  • Training the Program Assistant in Adult Day
    Services,
  • 2004
  • Is This Good Enough?

22
Potential Additions to Job Description to Support
Person Centered Care
  • A primary responsibility is to get acquainted
    with the participant and work on establishing a
    relationship with him/her their family
  • Observe for evidence that a person experiences
    particular pleasure in a specific activity
    report that during care plan meeting
  • Observe report signs of emotional discomfort
    whenever they occur with a participant

23
Program Assistant Job Descriptions
24
Performance Expectations
  • When person centered care is embedded in an
    organization, the primary performance expectation
    is that the goals of person centered care will be
    pervasive in all interactions with participants.

25
How Can Staff Deliver Person Centered Care?
  • Must be modeled by supervisors
  • Must be a core value underpinning philosophy of
    all care
  • Must be understood-what does this mean for me in
    my position?
  • Must understand what is different-not just doing
    the same old thing but calling it by a
    different name

26
How Can Person Centered Care Support Be Offered
to Staff?
  • Well-being of staff a priority
  • Education/training to do job well
  • Clear job expectations
  • Equipment adequate, appropriate available
  • Accoutrements/accessories available to
    personalize care

27
Person Centered Care for Staff
  • Basic understanding by managers/administrators of
    what staff is experiencing in care
  • Sorrow
  • Sense of loss
  • Fear of situations that are beyond their control
  • Fear of aggression from participants
  • Managers recognize stress, strain and/or burnout
    of staff before critical stage (resignation)
  • Luther Manors exercises for Person Centered Care
    Staff

28
Person Centered Care for Families
  • Families respected as care partners
  • Seek family input regularly
  • Be sensitive to the familys perspective on care
  • Be sensitive to fears
  • Positive relationships are nurtured between staff
    and family members
  • Communicate, communicate, communicate!

29
Bibliography
  • Kitwood, Tom, Dementia Reconsidered,
    Philadelphia Open University Press, 1998.
  • Krugh, Christine, MSW and Bowman, Carmen S.,
    Changing The Culture of Care Planning A
    person-directed approach, Milwaukee Action Pact,
    Inc. 2006.
  • Shields, Steve Norton, Laverne, In Pursuit of
    the Sunbeam A practical guide to transformation
    from institution to household., Milwaukee Action
    Pact Press, 2006.

30
Contact Information
LaDonna Jensen, RN Marilyn Hartle, MSW, LCSW PO
Box 551087 Indianapolis, IN 46205 317-255-2248 la
donna_at_jentleharts.com marilyn_at_jentleharts.com
Write a Comment
User Comments (0)
About PowerShow.com