Don’t Make Me Play Bingo For A Banana !

1. Don’t Make Me Play Bingo For A Banana ! Todd Shackelford West Central Illinois Area Agency on Aging 217-223-7904

2. What is Culture Change? Paradigm Shift in the Delivery of Care Moving from Medical Model to Home Model Decentralizes Decisions to the Resident(s)

3. Why Change the Culture in LTC? Bette Davis speaking about Joan Crawford “She’s old. She’s tired. And she’s 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 !!!

4. 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

5. The Ombudsman’s Role in Culture Change

6. Ombudsman

7. CNAs

8. Nursing

9. Administration

10. Ombudsman Role #1 • Problem Solvers • Resident focused • Objectivity • See the big picture • Don’t have the “tapes” • Can provide guidance • Can provide solutions

11. Ombudsman Role #2 • Advocates • Resident involvement • Family involvement • Facility involvement • Regulator involvement • Other advocates involvement

12. 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

13. How do you eat an elephant?

14. 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

15. But, But, But • “I don’t have enough time” • That’s right - you don’t have enough time • Don’t give them fish. Teach how to fish • Work done now – saves time later • Sorts the men from the boys

16. “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?

17. “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

18. What’s it like to be a resident • (AKA – person who lives in a facility) • Personal Exercise

19. 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.

20. 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.

21. Be the Champion of Change!!!