What in hell is the buzz about Culture Change?

Available at:

Barnes&Noble.com

Kindle

Amazon.com

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 room...........do 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.  

A good old fashioned American idea

I watched the movie: Lincoln the other day.  It got me to thinking about politics and the crap going on in D.C. for too many years now.  When Abraham Lincoln wanted his Emancipation Proclamation passed, he found a way around the political engine in his day, that wanted to squelch it. 

What was so special about that Thirteenth Amendment?  

Well not only did it make owning slaves illegal, many Senators and Congressmen knew if they voted 'yea'  for it, it could place their lives in danger. 

Section 1. Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction.

Section 2. Congress shall have power to enforce this article by appropriate legislation.

Source: http://en.wikipedia.org/wiki/Thirteenth_Amendment_to_the_United_States_Constitution

During the Great Depression of 2012 and 2013...........oops, sorry, got carried away there.  The First Great Depression of 1929, President Roosevelt certainly knew how to get around the obstacles of his day when people were out of work and America needed jobs, not empty promises and empty speeches. 

Watching some of the inauguration posted on the Internet (I refused to watch it all) and seeing the partying, it just reminded me of Nero fiddling while Rome was burning.  While many Americans are homeless, out of work, cannot afford food, shelter and clothing, much less hob nob with the rich and disgusting in D.C., we get this huge celebration rubbed in our faces.  What in Hell is there to celebrate in America right now?

Well, here's an idea.  Why don't the American people pick and endorse and assist an average citizen, a person who was not born into favor and advantage, but is like you and like me?  Someone who is not into playing politics, listening to lobbying fools pitching every damned idea that is anything but for helping the real people who do real voting. 

“Insanity is doing the same thing, over and over again, but expecting different results.”

Source:

http://www.goodreads.com/quotes/5543-insanity-is-doing-the-same-thing-over-and-over-again

Hasn't the insanity going on in D.C. been so not working?  When something isn't working, well, it needs to be scrapped and another plan should be put in place.

Call me crazy, tell me it cannot be done, but ya know, America was founded on ideas that others said: Couldn't be done.  Here we are.  You will say it takes huge amounts of monies to run a campaign.  Yet I read many stories last year and the year before, how Senators and Congressmen and women, still got voted in with less money than their competitors had.  Many Americans start businesses all the time, successful businesses, people who knew nothing about running a business.  It is America and it is the American way, people!

Hell, if Sarah Palin could have a Super PAC, stealing the donations, taking her family on a long vacation, and bought an RV, and ran for absolutely nothing, then anyone could do it.  Hell, I've met Political Science students who would work for a small salary, or even volunteer for the experience and college credit, who could run a campaign better than those fools who are paid big bucks for it.

We need a President who will use the government, like Roosevelt, to put Americans to work.  Lord knows America's infrastructure is falling apart,  in need of labor to fix roads, build and fix bridges and our electrical grids are vastly outdated and we need a fast train to compete with those airlines who rip passengers off left and right.  Can't be done?  Surely it can be done.

We need a President who would like a bipartisan group in D.C. but when they find out it isn't happening, then side step them.  Screw them anyway.

What's the worst that can happen?  We get a President, male or female, who gives a damn about their voters, who is one of us, who understands and does not turn a deaf ear or blind eye to the American people's wants and needs.  The worst anyone could say about such a President is: "That one cares too much."  Well there are much worse legacies a President could leave behind.

Think about it, find a leader with charisma, get a petition going, hire political science students to set up tables in every mall, every public place they can get in to and start a Super PAC for someone who will make a difference.

Someone who could say: "Lobbying is now outlawed."  We can control guns, we can control lobbying.  All lobbyists do is cheat, lie and bribe politicians.  We need someone to say: "No, Wall Street, you do not get the American tax money while paying big bonuses to people undeserving while Americans go hungry and homeless because of no jobs."    Someone to say: "No American car companies, you do not get American tax money because if you cannot make a decent product someone wants to buy, at a reasonable price, then step aside and allow American companies who can do that."  

A President who understands that if the majority of Americans are allowed to starve, then America is being destroyed from within.  A President who tells Congress and the Senate that: "If you can't do your job, you need a pay cut, not a pay raise." 

A President who can, and will, fire those businessmen in D.C. who only care about their rich friends.  You know, the ones Ronald Reagan put in there in the 80's when America really started to fail.

Remember, America is heading towards a two class system.  A two class system gave rise to the French Revolution and the killing of aristocrats.  

A two class system gave rise to Nazi Germany and Hitler.  A man that just 10 years prior to the German people starving, they considered his notions crazy.  When people starve, they have nothing to lose and they become the most dangerous people on the face of the earth.

Come on America!   Yes, it can and should be, done!

Let's talk about death squads

I'm the first one to admit how much I hate politics
and I hate having to play stupid political games,
especially in the workplace. But of all the places
I've worked in my lifetime, I've never had to play
more political, bull shit games, than I did as a
Social Services person in a nursing home setting.

In fact, if nursing home Administrators were as
concerned about the residents living there as much
as they were about those political games, even
traditional nursing homes would be better places to
live. In my book, politics has no place in a nursing
home where it simply messes up peoples lives and
makes no sense at all.

Recently many people have been quite upset over the public health care debate because certain
factions in the debate seem to be fixated on what
some have dubbed ‘death squads.’ The death squad
debate seems to stem from some people thinking it
will be mandatory for physicians to have end of life
discussions with elderly patients. If this is what
some people consider death squads, then nursing
homes in America have already been acting as such
death squads, it is simply that no one noticed or
cared, until we started to debate public health care.

If Americans think President Obama has placed
stipulations in his health care proposal about ‘death
squads’ because they think it will be mandatory for
older people to discuss end of life plans with their
doctors, then nursing homes have always fit this
description.
 
Staff members in the nursing homes, where I've worked, were always approaching me to ‘discuss
end of life, or Hospice plans’ with the elderly and
their families. It seems nursing home staff eventually do get tired of sending elderly people to the ER when they become ill because ‘the ER says
they cannot do anything more for them anyway’ as
the reasoning goes.
 
Unfortunately they are correct because Emergency Room personnel will only do so much and
apparently feel time and life saving efforts are
‘wasted’ on very old, very frail people. The
problem, when the elderly decide to get hospice
services, is Medicare will not pay for any more
room and board in a nursing home, so families have
to pay out of pocket for their loved one to stay in
the nursing home, which can be a significant cost.

I recall one of our residents who had a very sedentary  lifestyle, sitting her chair all day long, a fondness for sweets and she was over weight.  One morning I came to work to find out she was dead.  It seems she had diabetes, the kind where you should be on insulin.  Apparently those lovely nursing home nurses and doctors never saw fit to give her a blood sugar test.  She went into a diabetic coma and died all in one night.

Another lady was experiencing acute heart burn every evening when she tried to sleep.  Her husband kept telling the nurses, who, in turn, ignored his pleas.  Finally one of the nurses said she would give her an antacid each evening.  Well, well, a few night later that lady was rushed to the ER and suffered a massive coronary and died.  Even I know that acute heart burn can mean a pending heart attack.  But, hell, when people get old, no one seems to think they need quality health care.

So my advice: STOP believing all the BS you have been told by those who hate the idea of health care for all.  I think it can only improve on an already bad medical system that charges huge amounts of money while killing people in droves, especially the elderly, without batting an eye.  

 

Both available on:

Amazon.com

 

American Wages

Holidays each year make me stop and think as I see so many people shopping and lining up for the latest fad to buy for Christmas.  America spends, they spend in the big box stores, claiming they cannot survive without those cheap goods in those big chains.  They have few jobs in this year, 2012, yet they still shop for items they could live without, contributing to the big box store empires.  

I also start to ponder on the ruining of American lifestyles, the middle class that was, the decent wages that once were and the unions that made decent benefits possible.  I have also been reading about the Hostess company and how it 'just has to fold mainly due to union demands.'  I wonder.

Let's look back at wages, mom and pop local stores and *sigh* what used to be pretty decent health insurance.  

This company once offered decent insurance to families.

The year is 1970, I was a very young newlywed.  We were able to purchase a nice little house for $9,000 and our mortgage payments were a whopping $60 a month.  Now, mind you, my parents had a mortgage of $12 a month when I was a kid.  (Oh the inflation!) Now you have to pay $500 rent for a dump, and $12000 to $3000 for anything semi-decent.  

 We were able to bring home a week's worth of groceries for $40 a week.  My then husband, was making $9,000 a year at his job and we had health insurance that covered everything, no damn co-pay and that included prescription drugs.  We still had mom and pop local stores to shop at.  Yes, some chains existed, but for local shopping, the locally owned stores had quite a lot to offer.

In 1970, the Small town of Penn Yan, where I lived, had industry.  It had Michael Sterns, a clothing factory.  Pennsylvania House, a furniture company.  Penn Yan Express, a local trucking company.  The Boat Company, owned by the person who invented the tunnel drive system for boat motors.  There were quite a few places to work.  Slowly but surely, each and every one of those industries closed up shop and left the town.

 Women were seeking more opportunities in 1970.

Now let's look at 2012.  In 8 years George W. Bush and his cronies managed to bring America's economy to its knees. Now if you make a lousy $9 an hour, you are supposed to be grateful for no health insurance and no benefits.  Just what amounts to slave labor in the 21st century.

In the 1960's, my now husband, worked a big grocery store in Lafayette, Indiana.  He started as a bag person, bagging groceries and actually helping people out to their cars with the groceries.  He later worked his way up to a manager position.  Hell, in 2012 you are not even given bags in many stores, you are lucky if the sales person gives you a smile much less help with any groceries to your car. You get to bag your own groceries when you do get a bag.  So technology, and cheap employers, getting rid of bag people to save a few pennies, is supposed to be progress?  Right!  

The store Steve worked in Indiana in the 60's and 70's.

Wages:  I remember in 2000, I had a nice Bachelors degree, but the crappy area of NY's Southern Tier had few jobs to offer.  So in desperation I had to take a home health course and during the course, the instructor said: "You can make $6.50 an hour doing this for an agency.  That's really good money."  Okay, well I'm not sure what planet $6.50 an hour constituted really good money, but planet Earth was another story.  That agency she spoke of, amounted to a lousy 30 hours a week max, you got to drive over 50 miles one way to a client's home to work, and the agency offered no gas mileage and charged each client $75 an hour for services.  Our slice of that million dollar industry, for doing all the work, was a whopping $6.50 an hour.  Be still my heart, I think I'm rich!

Mom and pop stores once thrived in America.

We could collect these stamps when buying groceries and swap them for really cool stuff!  Now, you don't get a damned thing from grocery stores or gas stations, except a 'go to hell' attitude.

Did I mention that I had to take that home health course out of desperation because I could not find any other employment, and had to obtain food stamps, having 2 kids still in school and having a college degree?  God bless American employers!  So now, when you feel sorry for Hostess, feel like you cannot live without big box stores, that by the way, have depleted America of decent jobs, remember the $9 wage of the 1970's and take a good look at your $6, $8 and $9 of 2012 an know wages have stagnated or gone down because chains cannot afford the new healthcare.  All the new healthcare will do is force those rich chains to offer what once was offered, thanks to unions, to hard workers years ago.  

"No one who works for a living should live in poverty"

Could not have said it better myself!  Remember this as you spend in big box stores.