Wisconsin Coalition for Person Directed Care

1. Wisconsin Coalition for Person Directed Care • WRAP • Social Worker • Director of Nursing • WHCA • WAHSA • Metastar • Ombudsman • Consumer • Division of Quality Assurance • Providers (NHAs) • Labor (SEIU) • Academia • Alzheimer’s Association • Physician

2. Mission Statement The Wisconsin Coalition for person directed care works toward fostering a culture that creates home and affirms the dignity and value of each individual. What are our objectives? The work of the Coalition has focused on three areas: Resource development and dissemination Stakeholder collaboration Community education and support The Wisconsin Coalition for Person Directed Care has a vision to lead long term care stakeholders to value and continually strive in creating an environment that affirms the dignity and value of each individual who lives and works in Wisconsin skilled nursing homes.

3. Would you live in your facility?

4. Baby

5. Teen

6. Marriage

7. Elderly Nursing Home

8. Two Types of Care: • Institutional • Resident Centered/ Resident Directed

9. Institutional Care Task Oriented Schedule Driven Medical Model Driven

10. Resident Centered/Resident Directed Care Resident CHOICE directs the life style, care, systems and daily routine. Residents who are unable to make choices, information is gathered from family and significant others to give direction regarding their daily routine. Observation of their behaviors will also provide direction.

11. Resident centered/person directed care is an ongoing, interactive process between residents, caregivers, and others that honor the resident’s dignity and choices in directing their daily life. This is accomplished through shared communication, education, and collaboration. Relationships developed as part of this process benefit all involved creating a community that affirms the dignity and value of each individual who lives and works in a nursing home.

12. Cultural change is a change in the feel of a building. One can read it on faces, feel it in the air and sense a new vitality, responsiveness and accountability on everyone’s part for the success of a building.

13. Nursing Home Employee Entrance

14. Recent Regulatory Changes Person Directed Care language has been built into the Interpretive Guidelines. Surveyors are observing and asking residents if they get to make choices regarding their care and daily routines.

15. F 172 Access and Visitation Rights Facilities must provide 24 hour access to any visitor who is visiting with consent of the resident.

16. F241 Dignity • Refrain from the use of bibs (clothing protectors) instead of napkins. • Respecting residents’ space, not changing radio/television stations. • Interacting/conversing with residents rather than each other while assisting residents. • Avoid the use of labels for residents such as “feeders”. • Restricting residents from use of common area restrooms. • Resident grooming in manner they prefer.

17. F242 Self-Determination and Participation Choices over scheduling is specified to include schedules of waking, eating, bathing, and going at bed at night as well as health care schedules.

18. F 252 ENVIRONMENT Institutional practices that homes should STRIVE to eliminate: Overhead paging Meals served on trays in dining rooms institutional signage labeling rooms Medication carts Wide spread us of audible seat and bath alarms Mass purchased furniture. Part of creating a homelike environment is emphasizing individualism, relationships and a welcoming atmosphere that makes residents comfortable: Surveyors should be alert to the psychosocial atmosphere of the home: Do staff stop and talk with residents, do they know the residents and respond pleasantly to their conversation and fulfill requests?

19. “Feeders are down 2 points today…now on to other farming news….”

20. Another starting point is “the language of culture change” “Part of transforming long-term care practice is finding new words to describe staff, programs, parts of the building and the “industry” itself.”

21. Language of Change

22. CHALLENGE Person Directed Care is about RELATIONSHIPS. Pick one Resident Ask what is one thing that could be done to make their day go well Make it happen for them We want to hear from you about the experience you had in meeting this challenge. What did the resident want to happen, how did the resident respond when you made it happen and how did you feel when you made it happen. Please go to www.wisconsinpdc.org then go to the Forum section. You will be asked to register. Complete the registration, then post your experience. Your experience will help to inspire others.

23. Wisconsin Clinical Resource Centerhttps://wcrc.chsra.wisc.edu/

24. Advancing Excellence in America's Nursing Homes (WI Resources)www.metastar.com/web/Default.aspx?tabid=274

25. Wisconsin Coalition for Person Directed Care www.wisconsinpdc.org/

26. Today • Outside my window, a new day I seeAnd only I can determine what kind of day it will be.It can be busy and sunny, laughing and gay,Or boring and cold, unhappy and grey.My own state of mind is the determining key,For I am only the person I let myself be.I can be thoughtful and do all I can to help,Or be selfish and think just of myself.I can enjoy what I do and make it seem FUN,Or gripe and complain and make it hard on someone.I can be patient with those who may not understand,Or belittle and hurt them as much as I can.But I have faith in myself, and believe what I say,And I personally intend to make the best of each day!

27. Resources 1. “Why Person Directed Care” – St. Anne’s Milwaukee, WI 2. “The Language of Culture Change: Mayday” by Karen Schoeneman. 3. “The Blue Print for Change” Marguerite M. McLaughlin, Quality Partners of Rhode Island. 4. Alzheimers Association – Greater WI Chapter. 5. Wisconsin: Coalition for Person Directed Care. 6. Brewster Village.