Resources on General Culture Change and Long-Term Care
The following resources have been collected to assist you as you work to change the culture of long-term care, and their inclusion does not imply any endorsement or recommendation by the PEAK-Ed staff or Kansas State University. We hope that you will find some of these resources helpful to your organization regardless of where you are in the Culture Change journey. Please note that web sites change rapidly and in such cases the link may be outdated. Some websites will include automatic forwarding to the new address. If this is not the case, try the more general web site address. Please send information on links which are outdated or do not work or suggestions for additional resources to gerontology@ksu.edu.
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The Kansas Department on Aging site includes information on programs, publications, legislative news, events calendar, links to Kansas Senior Centers and Area Agencies on Aging, Medicare prescription drug program and Senior Health Insurance Counseling as well as information on licensure and evaluation of adult care facilities in Kansas. Their home page is located at http://www.agingkansas.org/. There is also a page devoted to the PEAK award program at http://www.agingkansas.org/kdoa/programs/peak.htm. KDOA is one of the sponsors of the PEAK-ED project.
American Bar Association (ABA) Commission on Law and Aging (COLA) is dedicated to examining law and policy issues affecting older persons. http://www.abanet.org/aging.
Brown University Center for Gerontology and Health Care Research. Facts On Dying: Data on care at the end of life. http://www.chcr.brown.edu/dying/
Culture Change
Now, created by ActionPac, has pictures and stories about
facilities committed to culture change. http://www.culturechangenow.com
The Eden Alternative’s official website: http://www.edenalt.com
Essential
Lifestyle Planning / Learning Community. ELP is a specific structure
for person centered planning that focuses on finding out what is important
to someone, what health, safety, and risk means to the person and to those
who know and care about him/her; and figuring out how someone can be supported
in having a balance between happy and safe while making the best use of
public dollars.
General interest articles: http://www.elpnet.net/elpgeneral.html
Web site: http://www.elpnet.net/index.html
Guide to non-commercial links to mental health, aging well and eldercare. http://www.helpguide.org
IDEAS Institute The mission of IDEAS Institute is to provide solutions that improve the life of older adults through the conduct of rigorous applied research. Our highly respected staff examine the therapeutic potential of the environment—physical, social and organizational—as it relates to frail and impaired older adults. http://www.ideasinstitute.org
Medicare Quality Improvement Community website has some tools and information related to consistent staffing at http://medqic.org/dcs/ContentServer?pagename=Medqic/MQPage/Homepage . At the main page click on nursing homes on the top information bar, then on the next page click on individualized care on the left side.
Pioneer Network.
This is the website for the founders of long-term care culture
change. http://www.pioneernetwork.net
Providence
Mt. St. Vincent has information about resident-directed care:
http://www.providence.org/Long_Term_Care/Mount_St_Vincent/e75Resident.htm
Wellspring Innovative Solutions, Inc., 2149 Velp Avenue, Suite 500, Green Bay, WI 54303. Contact: phone 920.434.0123 fax 920.434.9269 http://www.wellspringis.org
Backseat
Bingo. This animated documentary dispels societal preconceptions
about romance and older adults. A candid group of 70, 80 and 90
something seniors share personal revelations on their continued need for
love and intimacy. A multiple award winner, the video draws its
strength from the honesty of the seniors who not only discuss their own
mortality and the conscious choice they make to keep going on despite
hardships, and the loss of loved ones and friends. A powerful reminder
that love and desire (in their various forms) remain an integral part
of healty aging and personal well-being. Ideal as a discussion starter
to help caregivers and family members broach the often overlooked subject
of intimacy among older adults. (6 minutes, DVD). Terra Nova Films:
http://www.terranova.org
Chronic Anxiety
in the Elderly. This
program addresses the problem of anxiety in the elderly and the diseases
associated with the problem. Interviews with sufferers of Geriatric Anxiety
Disorder (GAD), provide insights into the agony of the condition. General
anxiety disorders, their symptoms, and physiological manifestations are
examined, including chemical imbalance, psychosocial implications, and
the emotional impact on the aged brought on by radical societal changes.
Caffeine, cigarettes, and alcohol are also discussed. (27 minutes, video)
Films Media Group: http://www.films.com
Communicating With Moderately Confused Older Adults. Using actual footage of individuals with Alzheimer's disease and related disorders, geriatric experts highlight the characteristics and most effective approaches for understanding and helping moderately confused older adults. An extensive program guide accompanies the video. (20 minutes, video). Terra Nova Films: http://www.terranova.org
Communicating with Oriented Older Adults demonstrates techniques of empathy, listening, nonverbal communication, questioning and information. In Communicating With Moderately Confused Older Adults experts use footage of people with Alzheimer's disease and related disorders to show most effective approaches for understanding and helping these individuals. Communicating With Severely Confused Older Adults demonstrates characteristics and intervention techniques with actual older adults experiencing severe confusion. These videos are part of a series on mental health and older adults (each a 20 minute video and program guide). Terra Nova Films, Inc: http://www.terranova.org
Communicating
With Severely Confused Older Adults. Characteristics and intervention
techniques associated with the later stages of dementia disorders are
defined and demonstrated with actual older adults experiencing severe
confusion. Seeing these touching examples of gentle understanding will
give new insight to those viewing this video.
(20 minutes, video). Terra Nova Films: http://www.terranova.org
Enhancing Self and Sense of Home. What makes a place
feel like home? How necessary is this feeling to the smooth operation
of a facility for people who are experiencing dementia? Viewers will learn
the ways in which personal needs are fulfilled within homelike settings
and how a facility can improve resident functioning by making simple adaptations
in the physical and caregiving environments. Through individual resident
profiles, this video illustrates facility staff using a step-by-step process
to identify problem areas, recognize underlying needs that aren’t
being met, and then create more supportive, homelike solutions that recognize
a resident’s former roles, relationships and routines, that supports
the resident’s memory of him-or herself and that gives the resident
a greater sense of control or privacy. (33 minutes, video). Health
Professions Press: http://www.healthpropress.com
Maximizing Cognitive and Funcational Abilities. How do
the physical and caregiving environments of a long-term care facility
influence the functioning of its residents with dementia? Viewers will
learn to appreciate the challenges presented by typical residential facilities
when residents have to navigate daily activities with a host of age-related
cognitive and sensory deficits. Deteriorating abilities to maintain independence
are a hallmark of dementia, but they needn’t lead directly to helplessness.
With simple changes to the environment, facility staff can maximize functional
independence and minimize disabilities. Here is a step-by-step process
for identifying barriers and finding respectful, supportive solutions.
Through individual profiles of residents, viewers learn to apply this
sensible problem-solving method to some of the common challenges presented
by toileting, dressing and mealtime activities in long-term care facilities.
The reward for this approach is an enhanced quality of life for residents
and staff alike. (40 minutes, video). Health
Professions Press:
http://www.healthpropress.com
Minimizing Disruptive Behaviors. Professional caregiving staff deals regularly with disruptive behaviors in residents with dementia but often does not have adequate tools to decipher the underlying causes of these behaviors. Through this video, viewers learn to evaluate all aspects of the caregiving environment before working on individualized solutions. Does a behavior result from normal changes of aging or the disease process? Is it caused by distressing environmental stimuli or by some critical unmet need? When and where does it occur? Does it only happen with certain people? When a resident’s whole environment is considered, some surprisingly simple solutions can emerge. This video profiles several residents who are exhibiting common problematic behaviors, including leaving the unit and rummaging. It takes viewers step by step through a problem solving process that can effectively reduce or even eliminate many kinds of disruptive behavior. (21 minutes, video). Health Professions Press: http://www.healthpropress.com
Older Voices:
Interviewing Older Adults. Interviewing older adults, especially
the frail and sick, can be challenging even for a trained interviewer.
Many factors can influence their willingness and ability to participate
in a study. Because of this, interviewers who have been trained to collect
data in a standardized manner must also learn to be flexible enough in
their techniques to accommodate the special needs of older adults.
(46 minutes, video). Terra Nova Films: http://www.terranova.org
Pioneer Network
/ CMS Video (2002). Innovations in the Quality of Life. (2 ½
hours). This video is from a satellite broadcast on September 27, 2002.
Topics covered include: the Pioneer Network, what is culture change, what
does a transformed culture look like, and how regulations and culture
change can work together. "I" format care plans and new techniques
in bathing are discussed and demonstrated. Video is available at the KDHE
library or may be purchased from the Pioneer Network: http://pioneernetwork.org
Restraint-Free Care and the Environment: Scenes from a Swedish
Nursing Home. This video describes significant design and practice
elements, supporting individualized, and restraint free care in an exemplary
long-term care facility in Gothenburg, Sweden. The materials are particularly
useful to administrators, staff, advocates, and consultants in long-term
care and to students of design, gerontology, and the health professions.
(15 minutes, video). University of Pennsylvania School of Nursing: http://www.nursing.upenn.edu/centers/hcgne/gero_tips/RES_Videos.htm
Sensory Changes in the Elderly. This training program is designed as an overview of the most common sensory changes in older people. Suggestions of correction and/or compensator interventions are offered. A study guide is included with the video. (19 minutes, video). Terra Nova Films: http://www.terranova.org
American Society on Aging and Pfizer, Inc. (2002). Healthcare and Aging Awards: Recognizing Innovation and Quality. This booklet describes winners of the 2002 Healthcare and Aging awards. First place was the "Voices of Ages Choir," an intergenerational music group of young people and nursing home residents in Philadelphia. More information about past recipients or applying for awards is at http://www.asaging.org/awards (click on Healthcare and Aging Awards). The Pfizer website contains a video clip of the choir: http://www.positiveprofiles.com
Holman, B. & Holman, L. (1998). Lessons in leadership from your neighborhood. Louisville: V. G. Reed & Sons.
Institute of Medicine. (2001). Improving the Quality of Long-Term Care. Washington, D.C.: National Academy Press. This book reports on the state of long-term care at present and includes information about culture change reforms.
Langer, E. (1989). Chapter 6 on ‘Mindful aging’ in Mindfulness. Reading, MA: Addison-Wesley. A classic book proposing that age may be more a social concept than a biological one.
Lustbader, W. (2000). Thoughts on the meaning of frailty. Generations, 23(4), 21-24. Lustbader, one of the founding Pioneer Network members, describes what it means to be dependent.
Lustbader, W. (2001). The pioneer challenge: A radical change in the culture of nursing homes. In Noelker, L. & Harel, Z. (Eds.), Linking Quality of Long Term Care and Quality of Life. New York: Springer Publishing Company.
Medqic (Medicare Quality Improvement Community). Consistent Assignment brochure/poster. This downloadable brochure or poster can be customized by adding a label with your facility information on the first page. Material prepared by Quality Partners of Rhode Island. Black and white pdf copy. Color pdf Copy.
Schwarz, B.,
& Brent, R. (Eds.) (1999). Aging, Autonomy, and Architecture:
Advances in Assisted Living. The four parts of this book address issues
that are pertinent to aging and long-term care: idealism and realism,
attributes of place and behaviors of people, provision and consumption
of care, and design: who cares?
Stone, R. (2001). Research on frontline workers in long-term care. Generations, 25 (1), 49-57.
Stone, Robyn, (2002). Evaluation of the Wellspring model for improving nursing home quality. Available at either the Institute for the Future of Aging Service’s web site: http://www.futureofaging.org or at the Commonwealth Fund’s web site: http://www.cmwf.org
This page last updated on 2/16/07