Sunday, March 24, 2013

What in hell is the buzz about Culture Change?

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Culture change in a nursing home.  So what the hell is it?

My nursing home books point out the horrors of those places, it's true.  But I also touch on Culture Change and the fact that all nursing homes could, and should, embrace Culture Change and every one of them can make at least some changes anyway and some is better than none.

Culture Change is not a big mystery, nor is it anything that would cost the traditional nursing homes an arm or a leg.  Let's first look at why traditional nursing homes are not really any one's home.  Yes, people may live there, but then people live in prisons and jails and yet none of the inmates would say they are home.

Traditional nursing homes were designed after the Medical Model.  Now we can, right off the bat, understand why that model is not conducive to oozing with a 'homey' feel.  Who wants to go to a hospital, much less live in one?  I dare say few, if any do.

One of the more obvious problems in traditional nursing homes is the elephant in the middle of the living room.  In this case, it's the obtrusive nursing station.  It takes up a good share of the hallway where residents who use wheel chairs, canes or just plain find it difficult to navigate anyway, have to go around making just one more obstacle for those having problems navigating, get past that monstrosity.  Besides hogging most of the hallway, the counter sits up pretty high, forcing residents to 'look up' at the nurses.  This 'looking up' already emits the 'I'm higher than you are' feeling, making residents feel inferior right off the bat.  Imagine being in a wheel chair and feeling even lower than those who walk.  Not pleasant.  Get rid of those stations in my way!

Two residents to a you or I make a habit of sharing our bedrooms with a complete stranger, in all forms of undress?  No, I know I do not.  Even in a dorm room, the students probably don't walk around naked in front of their room mates.  Two to a room means HIPPA laws are a joke.  If I have visitors and the nurses and doctors are visiting my room mate, well, with only a flimsy curtain separating us, I will know a good share of my room mate's medical status and probably a good share of her medications too.  HIPPA laws are supposed to protect our information.  But, apparently nursing homes do not have to.

Two people to a room means one of us cannot have the freedom of looking outside whenever we want to.  Only the window person gets that luxury. (Thank you ever so much greedy nursing home owners.)  Do not be fooled into thinking two to a room means you get to choose who you want to room with.  Oh no.  If a facility is full, you will get shoved in with whomever the nursing home pleases, simply to fill to capacity and make them more money.  They may care about your preferences way down the road, but it might be after a few nights, weeks or months of a miserable room mate who is not compatible with you at all. 

Many times nurses will dispense medications at meal times.  Listen, there is a reason doctors prescribe certain medications to be taken at certain times.  Medication dispensing is not a one size fits all deal.  No, it should be given to the individual at the prescribed times.  Maybe meal time is not the prescribed times either.

While we are on medications, that med cart outside, in the hallway, has everyone's name and medications prescribed written in it.  If I visit Aunt Gertie, well, while a nurse is with a person in their room, I can flip through that med book and see what anyone else is taking and why.  Again, HIPPA laws just flew out the window.  

Do you have any habits at home that give you pleasure?  Maybe wearing that ratty old sweatshirt you got 10 Christmas's ago and it is full of holes and faded.  Well if you choose to wear that damned thing in a traditional nursing home, and if nurses argue with you about giving it up, if you disagree, it will now be a behavior, a habit to be broken.  Why?  No one comes to our homes to tell us how to dress.  Why should they get away with it now?  If I'm 65, 75, 80 or 90, have I suddenly become three years old in the staffs' estimation?  Yes, that is about the size of it.  WRONG!  

While this blog points a number of what's wrong in traditional nursing homes, making all of us scared stiff about going to one, we will discuss the Culture Change models.  We will see why those Culture Change models have to turn down applicants because they actually want to live there.  

Thanks for reading.  Feel free to give any suggestions or share ideas on my blogs.  All are very welcome to do so.