1 / 45

Person-Directed Care: the Heart of Culture Change DADS Culture Change Initiative Presented by: Mary Valente, LBSW, M

Person-Directed Care: the Heart of Culture Change DADS Culture Change Initiative Presented by: Mary Valente, LBSW, MPA ff. *. What is Person-Directed Care?. Decision-making. Self Determination and Choice. Needs and comfort before the task. Promotes respect. *.

laban
Download Presentation

Person-Directed Care: the Heart of Culture Change DADS Culture Change Initiative Presented by: Mary Valente, LBSW, M

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Person-Directed Care: the Heart of Culture Change DADS Culture Change Initiative Presented by: Mary Valente, LBSW, MPAff. * www.dads.state.tx.us/culturechange

  2. What is Person-Directed Care? • Decision-making. • Self Determination and Choice. • Needs and comfort before the task. • Promotes respect. * www.dads.state.tx.us/culturechange

  3. Person-Directed Care: the Heart of Culture Change Person-directed care is a simple, easy, and a low-cost to no-cost approach that can help a facility meet or exceed state and federal regulations. * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  4. “Honey, I’ve been through two world wars, the Great Depression, taught 3,297 children, administered four elementary schools and outlived every one of the pastors I worked with. I’m 89 years old and you’re telling me it’s bedtime?” * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  5. Comparing CulturesInstitution-Directed vs. Person-Directed Person-Directed Care: the Heart of Culture Change Reference: Pioneer Network, January 2012 * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  6. Institution-Directed Culture Reference: Pioneer Network, January 2012 • Standardized "treatments" based on medical diagnosis. • Schedules and routines are designed by the institution. • Work is task-oriented with rotated assignments. • Staff can perform similar tasks "on any patient" in the home.  * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  7. Institution-Directed Culture continued • Decision-making is centralized.  • A hospital-style environment.  • Structured activities. • Sense of isolation and loneliness. * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  8. Nursing Home Owner Administrator Director of Nursing Professional Nursing Staff Nurse Aides Residents Institution-Directed Culture continuedOrganizational Structure Family & Friends * * Source: NY State Office for the Aging, www.nursinghome411.org

  9. Institution-Directed Culture continuedSocial Interaction * Source: NY State Office for the Aging, www.nursinghome411.org. *

  10. Person-Directed Culturecontinued Reference: Pioneer Network, January 2012 • Caregiving relationship. • Residents and staff design schedules together. • Services are relationship-centered. • Staff bring personal knowledge into the caregiving process.  * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  11. Person-Directed Culture continued • Decision-making. • The comforts of home.  • Spontaneous activities. • A sense of community and belonging. * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  12. Residents Family Members Nurse Aides Professional Nursing Staff Director of Nursing Administrator Nursing Home Owner Person-Directed Culture continuedOrganizational Structure * Source: NY State Office for the Aging, www.nursinghome411.org. *

  13. Person-Directed Culture continuedPhysical Structure ^ Floor Plan of Missouri Veterans Home—St. James, Missouri, Architect: Kennedy Association Inc. * * Source: NY State Office for the Aging, www.nursinghome411.org. * Source: NY State Office for the Aging, www.nursinghome411.org.

  14. Person-Directed Culture continued Social Interaction * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  15. Person-Directed Care: the Heart of Culture Change Culture Change Goals • The focus is on relationships; this is the heart of culture change. • Keep the ‘I’ in individualized care. * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  16. Low * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  17. Person-Directed Care Pop Quiz Would I want this style of care in my own home? Use this ‘test’ question when thinking about current practices and how to change them. * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  18. Compare these pictures.Which style would you prefer? *

  19. A Brief History The first nursing facility rules were created by the federal government in 1967. * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  20. Nursing Facility Design ProgressionInstitutional Model The hospital-style institutional models were built before the 1970’s and continues today. www.dads.state.tx.us/culturechange * www.dads.state.tx.us/culturechange

  21. Institutional Model * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  22. Nursing Facility Design ProgressionAdditional Institutional Models Concept started in 1960’s and continues today. Cartwheel Plan K Plan www.dads.state.tx.us/culturechange *

  23. Nurses’ Station - Institutional Model * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  24. Kitchen - Institutional Model * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  25. Nursing Facility Design ProgressionAlternate Institutional Models Concept started in the 1980’s and continues to the present day. Courtyard Plan H Plan www.dads.state.tx.us/culturechange *

  26. Nursing Facility Design ProgressionEarly Culture ChangeModel Neighborhood Plan Concept started in the 1990’s and continues to the present day. www.dads.state.tx.us/culturechange * www.dads.state.tx.us/culturechange

  27. Nursing Facility Design ProgressionA Planned Culture Change Model Small House Plans Concept began in the 2000’s and continues to the present day * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  28. Small House Plan Can you find the nurses’ station? * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  29. Wings of existing plans can be remodeledas neighborhoods. Nursing Facility Design ProgressionRemodeling to Achieve Culture Change * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  30. Cost of Culture Change • Building new homes is expensive. • Remodeling has many costs, but can be managed in smaller planned steps. However: • Individualizing care is often COST FREE, and can START RIGHT NOW * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  31. Cost of Culture Change Dining Experience • Choice of meals • Choice of meal times • Use of china and glass • Liberalized diets • Restaurant style dining • In-room dining choices • Small group setting * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  32. Cost of Culture Change Bathing Experience • A person’s choice. • Warm/soft lighting. • Music or nature sounds. • Aromatherapy. • Clean and clutter-free. • Privacy and dignity. • Relaxing experience. * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  33. Cost of Culture Change Activities • Hospice Volunteers • Homebound and Lonely • Making a Difference • Unplanned as well as scheduled * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  34. Cost of Culture Change Building Relationships • Fireside chats • Supply changes • Learning Circles • Informal conversations to solve problems * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  35. Culture Change and Direct Care Staff • Reduces turnover. • Increases retention. • Improves job satisfaction. • Highlights importance of building relationships. • Gives a sense of ownership. * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  36. Culture Change and Direct Care Staff • Staff assignments. • Involvement in plan of care. • Flexible scheduling. • Activities led by staff. * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  37. The Language of Culture Change OLD • Wing, Unit • Diaper • Shower room, Whirlpool • Patient • Admit • Discharge NEW • Neighborhood • Brief, Undergarment • Spa • Individual • Move in • Move out * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  38. The Language of Culture Change OLD Lobby Nurses station Facility Elopement, Escape Dietary Ambulate Home-like NEW • Living room • Desk, Work area • Community • Left the building • Dining service • Walk • Home * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  39. Benefits of Person-Directed Care Individuals will experience: • Weight loss reduction. • Overall health stability. • Reduction of medications. • Improved social engagement. • Increased overall satisfaction. Staff will experience: • Empowerment. • Reduction in turnover and retention improvement. • Increased overall satisfaction. Staff working at an Eden Alternative home. * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  40. Person-Directed Care: the Heart of Culture Change Getting Started: • PLAN Form a committee, set priorities. • DO Assignments and leadership. • STUDYAre the changes working? • ACT Explore other possibilities. * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  41. Person-Directed Care: the Heart of Culture Change How do I help if I’m not connected to a nursing facility? The short answer is: “Community Engagement”. • Voting • Social clubs • Business meetings • Scouting • School projects www.dads.state.tx.us/culturechange * www.dads.state.tx.us/culturechange

  42. Person-Directed Care: the Heart of Culture Change Questions? * www.dads.state.tx.us/culturechange www.dads.state.tx.us/culturechange

  43. DADS Culture Change - Support Questions for DADS experts, contact: DADSculturechange@dads.state.tx.us DADS website for culture change information www.dads.state.tx.us/culturechange/index.html *

  44. References and Resources • Center for Medicare & Medicaid Services (CMS), http://www.cms.gov/default.asp • Texas Quality Matters, www.TexasQualityMatters.org • Edu-Catering and Action Pact: educational materials for Culture Change, www.culturechangenow.com • Pioneer Network, http://www.pioneernetwork.net/Providers/ *

  45. Person-Directed Care: the Heart of Culture Change THANK YOU! *

More Related