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Several
years ago, FRIA led a coalition of consumers, providers, unions
and civic groups that brought some of the Culture Change Pioneers
to New York City. Their reform ideas create a vision and a movement,
created by providers and supported by consumers and unions. It recognizes
that to give truly individualized care to residents, we have to
“change the whole culture” of today’s nursing homes.
Culture change reformers have made nursing homes better places to
live and work and visit. They look to social service group residences
for models and to team management rather than traditional professional
hierarchies. They put decisions close to the resident, empowering
direct care staff who know the residents best. They schedule care
activities like meals and baths according to resident preferences
rather than specialized department routines. They create inclusive
communities to reduce isolation and loneliness.
Committing to culture change is a big step for a nursing home. It
takes commitment at the top, agreement by staff at all levels and
several years to find out how to do it effectively at a particular
home. The culture change movement is a rich source of best practices
with an end result that is profound, long-term and on going.
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