10 Benefits of Culture Change on Skilled Nursing

Culture Change (also known as person-centered care or resident-directed care) transforms the traditional long-term care model from medical facility to a supportive home environment.  This movement is designed to change the overall mindset and environment of nursing homes into personal communities.  Culture change is designed to nurture the human spirit of aging residents as well as take care of their medical needs.  Its focus is on both quality of care and quality of life as guiding forces for improved life experience and life expectancy.

Within the culture change model, seniors have more privacy and choices, much like they would in their own homes.  They are given more control over their daily lives including meal and bed times and the caregivers are given more autonomy to care for residents in this flexible environment.  Residents’ needs and preferences come first, and care community operations procedures are shaped by this perspective.  Even the physical structures are changing from large hospital-like units to smaller communities resembling more of a group-home atmosphere in which they are cared for by a dedicated team of caregivers.

10 Benefits of Culture Change

  1. Respects the right of the resident to make their own decisions and honors their need for control over choices in their daily lives.
  2. Reduces boredom and helplessness in residents.
  3. Improves mental health (reduces loneliness, depression, behavioral issues).
  4. Encourages a personalized home atmosphere by allowing residents to create their own living style in their rooms.
  5. Increases enjoyment and life expectancy of the patients.
  6. Focuses on using person-centered language that respects and honors the patient by putting the person first and then the characteristic second.  For instance, instead of a wheelchair-bound resident, the description is modified to a person who uses a wheelchair for mobility and instead of a feeder the patient is referred to as someone who needs assistance with dining.
  7. Focuses caregivers on person-centered care, rather than completion of tasks.
  8. Individual care focusing on personalized needs and preferences of the staff and the residents creates a supportive environment that puts people first, over the facility.
  9. Promotes a dedicated team approach rather than rotating assignments for staff thereby creating personal connections and familiarity for the residents.
  10. Creates a team-building environment for the staff based on consistency of staff teams.
  11. Reduces employee turnover which in turn keeps a steady team of familiar faces rather than the need for temporary staffing agencies with training needs and learning curves.

The essence of culture change is about transforming philosophies and management style so that aging is no longer synonymous with decline and illness.  The principles of culture change are founded in a new way of caring and being cared for that is based on choice, creativity, and flexibility.  The future of culture change lies in the commitment to improve resident and staff quality of life through empowerment.

For more information on the culture change movement, visit the Pioneer Network.

Photo credit: K?vanç Ni?

  • http://www.compassionate-touch.org/ Ann Catlin

    What started as a grassroots effort in the Midwest has gained momentum in very important ways. From the direct caregiver to the people with legislative power. True culture change goes beyond choice and building design. It reaches into our psyche and heart and changes us at a profound level. We become better caregivers and our lives are made richer. Quality of care isn't determined by the bricks and mortar but by the attitudes and actions of each of us. Thank you, Ryan for calling attention to this important topic of our times.

  • ryanmalone

    Thanks Ann for the comment. There is a lot of fantastic work going on in this space. I am hoping that some of this will pressure the residential care providers to accelerate person-centric care. I know that some are speaking about in terms of activity programming, but few are moving forward with a 360-degree approach.

  • lindaarmas

    This is a philosophy that makes sense and can be very beneficial to make nursing homes less “institutional” and improve quality-of-life not just for seniors, but for employees as well. My concern is that as long as caregiving is regarded as a minimum-wage, unskilled job there will always be a problem with employee turnover and substandard care in this industry. It's not just about money, but about the hearts of the people caring for our seniors and the importance of hiring staff with the right values. No amount of training can change a person's basic character or mandate true caring.

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    [...] then residents will feel better, as their needs are being comprehensively addressed. I think culture change should continue to be implemented because it results in better mental health for both…. The residents are in a better mood, which results in less depression, anger, anxiety, or agitation [...]

  • HollyL

    Well written article, though I have to agree with lindaarmas in that the substandard care will always be there.
    I work in long term care and see first hand the ‘cosmetic’ changes that have been made to the environment but the increasing need for employees who treat residents with compassion and respect. What I see more of is staff not being held accountable for their poor actions and interactions with residents and other employees. There are too many people in this ‘industry’ that just shouldn’t be in it. I believe that what draws them in is the above average minimum wage, not the fact that the job requires you to actually ‘care’ for people. You either have this ability or you don’t. It is a very demanding job that has mulitfacited responsibilities as well.

  • Austin Henry

    Very well written. I liked the post a lot. We must be always aware of the changes of our elders as old age is the only time when our elders needs our care the most.

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