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Changing the Culture in Nursing Homes

Leadership and Collaboration Essential

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Changing the Culture in Nursing Homes

Know your resident's story and you will be well on the way to meaningful relationships, better experiences and culture change success.

Tom Grill

There is no way to separate leadership and collaboration from culture change. Without leadership and collaboration, there is no culture change. Relationships, organizational practices, and physical environments cannot change without support and conviction form nursing home leadership. Culture change in nursing homes is the key to long-term success.

Today’s long-term care leader is a role model for change who fosters collaboration, resulting in a shared vision. Therefore, leadership, collaboration, and culture change should be synonymous in long-term care.

As long term care professionals, the more we understand who our elders are the more we can identify opportunities to meet their needs and expectations. We must recognize the contributions of those we serve, exhibit genuine respect, and convey a true spirit of caring.

From employees to customers, we all have something in common: Our goal is to build and nurture an environment that is meaningful and purposeful to a life worth living. How we treat each other, and how we are perceived by others is reflected in the environment our elders call “home.” It cannot happen until we develop a sense of respect, fostered by leadership, and include the elder in the collaborative process of person-centered care.

Understanding the generation we serve is fundamental in developing a culture of respect. Many of our elders were born in the 1920s and 1930s, when “flappers” were dancing the Charleston and 30% of Americans still lived on farms. People were self-reliant and grateful. In 1920, the 19th Amendment had just given women the right to vote, right around the time the Band-Aid, penicillin, and insulin were invented. Charles Lindbergh flew solo over the Atlantic Ocean and the stock market crashed in 1929, followed by the Great Depression of 1930.

By the time this generation grew into young adults, the computer and credit card were invented, Japan had attacked Pearl Harbor in 1941 and we found ourselves in the midst of World War II.

When the Korean War came along, Mr. Potato Head was born and the first diet drink was sold in 1952. Teenagers were able to enjoy a new invention, the transistor radio, McDonalds was founded, and Disneyland opened in California.

Along came the Vietnam War, Liquid Paper, and the birth control pill. President John F. Kennedy was assassinated, Medicare was introduced as the government’s first national healthcare plan for the elders, Martin Luther King was assassinated, Neil Armstrong became the first man to walk on the moon, and the Beatles invaded the United States with their long hair and pop music. I was one of many children whose parents banned them from watching The Beatles on The Ed Sullivan Show. I later grew old enough to buy my first Beatles album with money I earned babysitting. Until that time, the Beach Boys vinyl album was playing on my record player. Yes, the record was “vinyl” and I played it on the “record player”. The world and the countries at war continued from Granada, Panama, the Gulf War, Somalia, Haiti, Afghanistan, to the never-ending war on terrorism.

Presidents came and the presidents went, each leaving something behind during their term that affects the care we provide to our elders today. Harry Truman was the first president to present a proposal for a national healthcare plan for the elders in front of Congress in 1945 and President Johnson signed Medicare into law in 1965. Ronald Reagan signed the Omnibus Budget Reconciliation Act in 1987, which included provisions for Nursing Home Reform, and Barack Obama signed the Patient Protection and Affordable Care Act of 2010 that is quickly changing the long-term care industry.

Improving long-term care is not a novelty. We’ve known for a long time that we needed to transform our nursing homes. We’ve been at it since 1986 when the Institute of Medicine Committee on Nursing Home Regulations issued a report to Congress, Improving the Quality of Care in Nursing Homes. It began the journey to change the culture of aging and to eliminate ageism.

Every day, as we return from work to the warmth of our homes and families, the question we should be asking ourselves is, “What have I done today to honor and respect the greatest generation?”

This was an excerpt from Frosini’s new book for nursing home professionals, Carmelina: Essential Nursing Systems for Long Term Care, which focuses on nursing systems that impact the quality of care and quality of life for those residing in our nation’s nursing homes.

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