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 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.  

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.

Penn Yan blog

I'm trying a new font here, it looks good and seems to work well.

My new blogs will now, for a good while anyway, consist of small town, one in particular in NY, and the pluses and minuses of small town living in NY.

Living in America, almost anywhere, can be very pricy anymore, thanks to Corporate America and wayward politicians who care for nothing but money, the people be damned is their motto.  So small towns all suffer from:
A) Lack of jobs
B) Lack of decent stores
C) Lack of decent services of most any kind

Sure, sure, plenty of die hards will try to defend small town America, but they are delusional and would defend most anything.  Nice try.

This is the Penn Yan blog, of my own making.  I know from where I speak because I've lived in this town for about 35 years.  It is a pretty town nestled on Keuka Lake and would be much more pleasant if not for the bad Chamber of Commerce, lack of services, not great medical emergency responders not very good fire responders.  Good luck if you need either one in a hurry.  You will be SOL.  

I'm going to talk about all that is wrong in this small town.  Call me cynical, but I call it realistic and reporting all I have observed in 35 years.  Yes, it is a quiet place to retire, but if you need emergency medical help, you best jump in someone's car and head for the local hospital and hope for the best.

Small towns do not have to be provincial in their thinking or their ways, but I guess no one told this to anyone in Penn Yan because they are as provincial and narrow as they come.  Stay tuned for more.