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.  

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

 

Some of the loveliest pictures on aging

You don't get much more beautiful in life than this!  Age well and have the time of your life!  You are all beautiful and unique.

• Assisted Living Care Guide: http://assistedlivingtoday.com/p/assisted-living/
• Memory Care Guide: http://assistedlivingtoday.com/p/memory-care/
• Nursing Home Guide: http://assistedlivingtoday.com/p/nursing-homes/
• Care Home Guide: http://assistedlivingtoday.com/p/care-homes/

• Independent Living Guide: http://assistedlivingtoday.com/p/independent-living/

Nursing home blogs don't fly?

I guess blogs concerning nursing homes don't fly so well, although my nursing home books are still my best sellers.

I haven't a clue why they aren't popular, but I do know, in college, students were just looking forward to working with kids and families.  It seemed like a more worthwhile endeavor I suppose.

Well, elderly people have families too and they are a worthwhile endeavor. 

Fixing nursing homes:  We can fix them by:
1) Get nursing stations out of the hallways
2) Stop making people share rooms with virtual strangers
3) Use medicine cabinets, and give medications at the proper times, not to everyone because it's convenient for staff
4) Have more staff, less psychotropic medications, this is much more cost effective, even for nursing home owners, happiness does not come from a bottle, it comes from quality of life.
5) Listen to the residents, don't blow smoke up their asses or even their family's asses, it's undignified
6) Treat the residents as individuals, not like some human cattle to be herded to meals, activities, etc.
7) Offer choices when it comes to meal times too, not just what is cheaper for the facility

God knows these are not the only ways to improve nursing homes, but it's a good basic start any facility can do, right now.  


• Assisted Living Care Guide: http://assistedlivingtoday.com/p/assisted-living/
• Memory Care Guide: http://assistedlivingtoday.com/p/memory-care/
• Nursing Home Guide: http://assistedlivingtoday.com/p/nursing-homes/
• Care Home Guide: http://assistedlivingtoday.com/p/care-homes/

• Independent Living Guide: http://assistedlivingtoday.com/p/independent-living/

Ahhhhhhhh Nursing Home Corporations

In order to be competitive, nursing homes offering a Culture Change environment, will find the list for people who actually want to live there will be long. Most people will flock to a facility that resembles their home, not some hospital.

It’s true, it will be hard for the elderly to maybe have to move, but moving to a nursing home that treats them right is a plus, not a bust. Certainly I have seen nursing homes forcing residents move anyway, for the nursing home’s convenience, so it is not as if residents have not been forced to move before, it is just that, maybe now, the moves will be for the better, for the improvement of their welfare and not at the whim of nursing home staff.

Elder care has become increasingly more competitive, like any other business. Baby Boomers are not willing, like the generation before them that was willing to simply conform and settle for rules and regulations of the ancient facilities. It’s time for a change and perhaps Medicare will be the catalyst to usher in some of the new changes.

While working in a nursing home I already knew the MDS, the instrument nursing homes and Medicare use to be able to justify the Medicare reimbursement money, has been redesigned to supposedly implement big changes. The changes are to, hopefully, make the MDS less generalized, sort of one size fits all mentally, to reflect much more individuality for each resident.

This is supposed to reflect a single resident’s personal challenges and needs much more than generic criteria that have been used, in my opinion, far too long to deliver good services to our nation’s elderly population.

Maybe the new Medicare cut backs will eventually help keep more nursing homes honest.

For far too long many facilities have, in my opinion, used Medicare to cheat the federal government out of tax monies, simply because the nursing home was able to slap a nursing home sign on their doors. Maybe this will also force facilities to have to train their nurse aides better to be able to deliver better services, since nurse aides have always been the primary care givers there. It is a popular belief, in traditional nursing homes, that treating people like humans with rights and with dignity, must be more expensive, not true.

If money were the only answer, then residents in a nursing home would be treated like kings and queens and be living in a palace. I have seen the money Medicare and residents pump into nursing homes, money that lines the pockets of a CEO or a COO and buys corporate mansions complete with swimming pools and expensive vacations. I have seen it even buying huge meeting halls and fabulous buildings called corporate offices. But I have not seen it buying a wonderful final chapter in the lives of the older people who have made the corporate head’s life wonderful.

Are the corporate heads the only ones entitled to a nice life, a life provided for them by riding the backs of older American’s miseries?

I have also seen the big money that buys the heads of pharmaceutical companies the same luxuries. It's not uncommon for a pharmacy charging older people, especially in a nursing home, $100 per pill simply because it is in the pharmacy’s best interest to prolong a life that pays $100 per pill and residents are forced to use the in-house pharmacy.

These are older people, who as a captive audience, have to sign agreements to buy medicine, while in the nursing home, from the company pharmacy because it is simply their policy under the guise that it is for the old person’s own good to do so, or that a corporation has their best interest at heart.

Traditional nursing homes are places where misery and despair come home to roost like chickens in early evening on a farm. People go to war these days and are called heroes, yet once they too are old, all of that will be forgotten until a few shovels of dirt cover their coffins and if they are lucky, when old, they will be able to live life out in their own homes, but probably not.

I look around a traditional nursing home and I see an old man slumped in a chair, a man whose parents probably once loved him and nurtured him.  A man who probably loved his children and nurtured them, who now needs some assistance with everyday tasks that we, in our younger years, take for granted.

This must be said

I think the anonymous blogger in the news who ranted about school lunches is commendable. However, just like when I attended Social Work classes, the news is about kids,what they eat and so on.In college, young students said:"I want to help kids, that's so worthwhile."  Really? It seems in our society kids are a more worthwhile endeavor. 
 When I was in public school we were served gooey french toast, fatty macaroni and cheese, hot dogs until they came out our ears.  Cake and ice cream for desserts, pizza, and pizza burgers.  Were we fat?  Nope. We got off our asses and went outside, rode our bikes and mom and dad had to yell at us to come in when it was dark.  We exercised it off, no video games,no sitting in front of a TV shoveling chips and soda pop into our faces.


So this brings me to how we worry about our kid's meals at school.  Blame everyone but the parents allowing those fat kids to sit and sit.  But when it comes to the elderly,we can shove mom or dad,grandma or grandpa into impersonal nursing homes because 'someone else must care for them.' 


I've written a book concerning this subject,but,alas,the elderly just don't concern much of society or TV talk show hosts.  Shame on America.  But for those who do care, I am listing some great literature concerning alternatives to nursing home care.  I sincerely hope people will check this information out and once again,give a damn about the elderly.  We have become one ungrateful nation to treat our elderly loved ones so shamefully.




 • Assisted Living Care Guide: http://assistedlivingtoday.com/p/assisted-living/

• Memory Care Guide: http://assistedlivingtoday.com/p/memory-care/
• Nursing Home Guide: http://assistedlivingtoday.com/p/nursing-homes/
• Care Home Guide: http://assistedlivingtoday.com/p/care-homes/

• Independent Living Guide: http://assistedlivingtoday.com/p/independent-living/

The aim with these guides is to help people faced with deciding what type of care to choose for a loved one make the best possible decision. 

Old Woman Where Did You Come From?

She sits looking out the window
She knows she got old somehow
She used to be a raving beauty
But she never let it make her snooty


In a nursing home she rocks and looks
She used to go dancing, she loved to cook
Now she's doing something she'd vowed never to do
She went from a mansion to living in a shoe


She once wore satin and laces
She once was beautiful
She could tell by the looks on their faces
She once traveled to far away places


The young people taking care of me
This frail old woman is all they now see
I was once young too, she wants to cry
But all she can do is sit and sigh


I lived in big houses
I once wore fancy blouses
Now I'm stuck in this miserable place
I'm stuck with you louses


I'm still a human, don't you see?
I've not changed inside
Just because you now take care of me
You herd me around, just allow me to be


You young ones tell me what to do
Do I tell you what's good for you?
At five in the morning, I'm out of my bed
Where do I need to be, are you out of your heads?


An old woman now I may be
I once was young too
Why can't you see?
You live long enough, you too will be me

Growing old and counting

Soon I will be giving a presentation at the college where I graduated as an undergrad.  I'm looking forward to it and I hope to help students, soon to be graduating, understand what they are up against,should they work with the elderly.


I hope I do well and I hope I can get a grassroots movement going to bring Culture Change to every nursing home in America.  That is my aim.