I have worked with nurses AND aides from foreign nations such as China, Haiti, the Phillipines- and it hasn’t been an overwhelmingly good experience. There is a HUGE language barrier, real and at times used as an excuse for poor care. I don’t think foreign born nurses and aides give even half the quality care American counterparts do. They make a lot more mistakes, they cannot read and understand orders and care plans (nevermind asking them to write a care plan!)…they need far better education and supervison. I would rate a Chinese nurse to be equal to an American CNA…it’s scary to think these people are here working as RN’s.

WASHINGTON - Foreign nannies long have helped to raise American children. Now immigrants are moving into another aspect of caregiving in increasing numbers: tending to the needs of nursing home residents. And they are winning a larger share of the highly skilled positions, according to a report released last week by AARP.

The ability to recruit nurses and other trained health workers overseas, the report said, will be a critical factor in determining whether millions of baby boomers receive high-quality care in their old age.

“The quality of the long-term care received by older persons in developed countries will depend increasingly on the quality of engagement with the less developed countries that are likely to supply more of the workers in the future,” the report said.

In particular, by the time those in the baby boom generation reach their mid-70s and 80s, many nurses and aides may come from China, say industry officials, who regard that country as a recruitment frontier.

A growing trend
The U.S. trend is part of a worldwide phenomenon in which rich countries with aging populations are turning to immigrant caregivers from the developing world, the report found.

Immigrants long have occupied such low-paying U.S. jobs as farm work, and in recent years they have moved into higher-paying construction jobs. But in big cities they now account for more than one-fourth of the nurses and aides in nursing homes, the report said.

Hiring immigrants has helped nursing homes meet staffing needs, but also has raised concerns about language and cultural barriers between caregivers and elderly patients, some of whom suffer from illnesses such as dementia.

“We’re talking about the care of the oldest and frailest people in the country, so it does raise questions about training and cultural exchange,” said Elizabeth Clemmer, associate director of the AARP Public Policy Institute, which sponsored the study.

About 12 percent of foreign-trained nurses report problems understanding English-speaking patients and staff, according to research cited in the report. This is the case despite requirements that nurses be proficient in English.

Foreign nurses are seen as less likely to speak up if a doctor’s orders seem confusing or wrong. “American-trained nurses are more assertive,” said Louise Maus of the American Association of Homes and Services for the Aging, which represents nonprofit facilities. “The ones who are coming (from abroad) are well-trained clinically, but there still can be questions as to cultural differences.”

Worries from home
There also are concerns in the immigrants’ home countries. Many of these nations have weak health care systems, even greater shortages of skilled professionals, and a higher burden of illness among their citizens. The draining off of trained workers by developed countries that can offer higher pay and better working conditions is exacerbating all those problems, experts say.

In the United States, the demand for foreign caregivers is the result of historically low unemployment, said Ron Hoppe, a founder of WorldWide HealthStaff Association, a North Carolina company that recruits health care professionals from overseas.

Low-skilled jobs are particularly hard to fill. “Burger King is paying as much or more as the local nursing home is able to pay nursing assistants,” Hoppe said. “Employers just have a very, very difficult time.”

Nursing home work is demanding, and calls for overnight and weekend shifts. Many Americans see it as low-status employment. “These kinds of jobs are considered unattractive,” AARP’s Clemmer said. “If the United States were to treat these jobs differently, there would be less of a need for immigration.”

Foreign nurses come here under an immigration program for skilled workers. There is no equivalent program for less-skilled workers, such as nurse aides, although President Bush’s proposed guest-worker plan would change that. The number of illegal immigrants working as caregivers in nursing homes is thought to be relatively low, because states require employees who deal with patients to undergo background checks.

FOREIGN NURSES AND AIDES
Across the United States, the number of immigrant nurses has risen dramatically.

• Nurses: Since 1990, the number of immigrant nurses providing long-term care has nearly quadrupled. About 64,000 immigrant nurses were working in nursing homes in 2003.

• Nursing aides: The number of foreign-born nursing aides working in nursing homes nearly doubled to 145,000 in 2003.

Another great read from Nursing Home Magazine.

Million Dollar Baby was a good movie. Frankly, I was expecting much less. But sometimes, you go looking for one thing and find another.

Director/star Clint Eastwood claimed that at his age and career stature, he was more interested in telling a story than in making money. But, as it turned out, he made lots of money with this movie. Sometimes, you go looking for one thing and find another.

Speaking of which, consider all the time and energy nursing home administrators (NHAs) spend looking, in this case, for lost items. Lost items are a serious issue. Some lost items (clothing, personal belongings) serve more as a nuisance, and their recovery is primarily a matter of customer satisfaction. Other lost items (dentures, hearing aids, etc.), though, generate a more significant sense of urgency because they have material value, are costly to replace, and have significant potential survey/compliance issues. Here’s where “looking for one thing and finding another” comes in—and the tale of the “Million Dollar Baby” doll.

Consider the following scenarios: Resident A reports a lost personal clothing item—a nightgown. Let’s look at the Four Rs: replacement cost—$15; regulatory exposure—minimal at best; relations (public) impact—minimal and manageable; and response—the NHA replaces the item at cost and makes no attempts at root-cause analysis of the initial loss. In other words, the response is close to zero.

Resident B reports the loss of her hearing aid: replacement cost—$800 minimum; regulatory exposure—high “quality of life” vulnerability (F313); relations (public) impact—high (family will tell everyone); and response—the NHA stops everything, skips lunch, and personally embarks on a facility-wide tour to find the hearing aid. It is found and returned. Crisis averted!

Resident A now loses a “Raggedy Ann” doll: replacement cost—a minimal $8; regulatory exposure—none (or so it would appear); relations (public) impact—minimal; and response—the NHA quickly offers to replace the Raggedy Ann doll at cost and, once again, makes no attempts at root-cause analysis of the loss. In other words, the response is minimal at best.

But wait! Unbeknownst to the NHA, Resident A becomes depressed over the loss of her Raggedy Ann doll (she has had it since she was a little girl; the resident is 88, the doll, 85). She won’t accept the replacement; although she is hard of hearing and partially blind, she recognizes the smell and feel of her old doll. The new one, to her, is just a stuffed toy. The old one is all of her childhood memories in a nice, neat (well, maybe not so neat), fluffy little package with a bow on it (two in fact—one in the doll’s hair and one on the back of her dress). Resident A stops eating and becomes withdrawn and immobile. Now at risk for developing a decubitus ulcer, she represents potentially significant survey issues, potentially significant treatment costs, and painful legal and administrative costs (Is this, in fact, a “Million Dollar Baby” doll?). The soon-to-arrive Statement of Deficiencies, form CMS-2567L, will not mention the Raggedy Ann doll, but it will spell out numerous violations of F-tags for “quality of life” (F310, F314, and F320) and may hint at “actual harm,” along with a threat to “deny payments for new admissions” and a notification that “CMS must terminate your provider agreement” if you fail to achieve substantial compliance. Throw in lost revenue of 15 fewer admissions per month at their average daily rate over a three- to six-month period during the “informal dispute resolution” process, in addition to development and implementation of a Plan of Correction, the associated legal and consulting fees, increased insurance premiums, potential settlements or legal judgments, etc., and a million dollars starts to sound like a bargain for Raggedy Ann.

Admittedly, this scenario is hypothetical and extreme—but also entirely possible and insidiously beneath the surface for the NHA who tends to respond in an informal, relaxed manner to lost items. This well-meaning but complacent NHA has missed the cause-and-effect relationship of the lost doll and Resident A’s potential declining clinical picture and its many and varied dire consequences.

But (unlike Million Dollar Baby), let’s have a happy ending, shall we? Resident B loses that darned hearing aid again and, in the process of stopping everything, skipping lunch, and touring the entire facility to find it, the administrator stumbles over Raggedy Ann! (Sometimes, you go looking for one thing and find another.) The hearing aid turns up an hour later, and all is well.

Moral of the story: Don’t rely on the administrator’s luck. Take resident losses seriously and think through all the possible consequences. Don’t end up looking for an easy solution and finding problems you never expected.

Quality-of-Care F-Tags Referenced

F310 §483.25(a)(1)(iv) Activities of Daily Living—Eating: A resident’s abilities in activities of daily living do not diminish unless circumstances of the individual’s clinical condition demonstrate that diminution was unavoidable. This includes the resident’s ability to eat.

F313 §483.25(b) Vision and Hearing: To ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities….

F314 §483.25(c)(1) Pressure Sores: A resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable.

F320 §483.25(f)(2) Mental and Psychosocial Functioning: A resident whose assessment did not reveal a mental or psychological adjustment difficulty does not display a pattern of decreased social interaction and/or increased withdrawn, angry, or depressive behaviors, unless the resident’s clinical condition demonstrates that such a pattern is unavoidable.

Sad. And bad…for the Union to use poor staffing as an excuse. Poor management and supervison, and a lack of policy and procedure most likely led to this event.

Roy Dolgos, director of the Illinois Department of Veterans Affairs, has ordered an internal investigation into the death of a resident of the Illinois Veterans Home in Quincy who wandered away from the home Thursday.

“The Illinois Department of Veterans Affairs and the staff at the Quincy home send their deepest condolences to the family and loved ones of Mr. William Gilson. We would also like to thank the volunteers, from the Quincy community and beyond, who helped with the search,” said Januari Smith, a spokesman for the department.

Gilson, 84, was found dead at about 1:45 p.m. Friday in Cedar Creek, where it runs through Parker Heights Park. Gilson was reported missing from the Veterans Home at about 6 p.m. Thursday after apparently wandering away. He had been a resident of the home for about a week.

Chuck Dyer, a close friend, visited Gilson at about 5:10 p.m. Thursday. He said Gilson was eating supper and seemed to be in good spirits. When he heard that Gilson was missing, Dyer said he was “totally shocked.”

A citywide search for Gilson continued through the night, coordinated by the Adams County Emergency Management Agency. It ended Friday afternoon when Jeff Meyer of Quincy’s Central Services Department found Gilson’s body.

Adams County Coroner Gary Hamilton said he’s received preliminary autopsy results and no foul play is suspected. However, it may take three weeks to get a final report that includes a cause of death.

John King, a nurse at the home and president of Local 787 AFSCME, blames chronic understaffing for Gilson’s death.

“We’ve been short-staffed for probably eight years. I’ve been complaining for the past five years,” King said. “I’m sorry to say it, but maybe it’s what had to happen. It’s a terrible thing for the family to go through. But I know what we need and what we don’t need because I’m there every day, and there is a problem.”

He described the Kent building where he works as having three doors — two in the back of the building and one at the front. He said at some times one nurse and one attendant are the only ones available to watch over all the residents and those access points.

King said the Veterans Home needs another 30 certified nurse assistants to get staffing “back to normal.”

Read the rest of this article—>

Hmm. We will be following this story…

(CNN) — Louisiana Attorney General Charles Foti Jr. has issued 73 subpoenas in an investigation into allegations that euthanasia may have taken place at one of the hospitals flooded by Hurricane Katrina, he told CNN Wednesday night.

The subpoenas were served on employees of all levels at Memorial Medical Center, which is owned by Tenet Healthcare, because “cooperation, lately, has not been as good as I had hoped,” Foti said.

The subpoenas require that people appear before investigators for questioning.

“Some people were not coming forward. We learned Tenet sent out a letter that had a chilling effect,” Foti said. “We had no choice but to issue these subpoenas.”

“They [Tenet] seem to be in a position of protecting themselves, while we are just trying to get to the facts of what happened at the hospital,” the attorney general said.

CNN obtained the memo — dated October 14 — to which Foti was referring.

In it, Tenet’s assistant general counsel, Audrey Andrews, advised staff members that “in the aftermath of Hurricane Katrina, you may be contacted by a government representative or a representative of the media.”

“In fairness to you, if you are contacted by a representative of a state or federal agency, or if you are contacted by the media, you may wish to first confer with legal counsel. You have certain legal rights about which you should be aware.

“First, you have the right to decide whether or not you wish to be interviewed. You can consent or decline. The decision as to whether or not you consent to be interviewed is yours alone,” Andrews said.

However, she added that if anyone spoke to investigators, they were obliged to “provide truthful information in response to questioning.”

Three days after Katrina flooded most of New Orleans, staff members at Memorial had repeated discussions about euthanizing patients they thought might not survive the ordeal, according to a doctor and nurse manager who were in the hospital at the time. Katrina came ashore August 29. (Full story)

After allegations of mercy killings surfaced, Foti’s office asked that autopsies be performed on all 45 bodies taken from the hospital after the storm.

Tenet has told CNN that most of the 45 patients who died were critically ill, and about 11 patients died the weekend before the hurricane struck and were placed in the morgue.

“We have asked for certain records from Tenet 15 days ago, and we have yet to receive them,” Foti said. “We have also asked for the location and address of every employee working at the hospital at the time of the hurricane, and they have not provided that either.”

A spokesman for Memorial denied that the hospital has been uncooperative.

“We have never discouraged any employee from working with the Louisiana attorney general’s office. In fact, we know that some have already spoken to his representatives. We’ve been cooperating with the attorney general’s office, and have spoken regularly about employee interviews,” the spokesman said.

Culture Change is happening all over the place. In Illinois, it looks really good. Some homes here are highlighted as to what exactly it is they are doing to make change…

CHICAGO—Today, Illinois nursing homes are taking significant steps to put the “home” back in nursing home. By joining in a revolutionary shift in thinking about life in long-term care facilities—called the Pioneer Movement—nursing home leaders and staff are cultivating elder-centered communities that are more life-affirming, satisfying and meaningful for residents.
Through this growing national movement, thousands of health care professionals from around the country are breaking free from the institutional, hospital-like model that has served as the blueprint for today’s nursing homes. These professionals are:

Making the nursing home environment more home-like;

Having the same staff permanently assigned to the same residents;

Offering buffet meals and restaurant-style service;

Developing spa-like settings for bathing;

Creating smaller neighborhoods within a larger facility;

Bringing in pets, plants and children; and

Offering further opportunities for community involvement, daily activities and increased quality of life.

“Our hope is that the Pioneer Movement will transform the culture of aging in America,” says Myrtle Klauer, an expert on Pioneer Practices and director of resident services at the Illinois Council on Long Term Care. The Council is a statewide association of nursing home professionals whose members are leading the way for the Pioneer Movement in the Midwest. For example:

Residents living at Capitol Care Center in Springfield now have permanently assigned staff that gets to know them and better understand their health conditions, needs and interests. Residents also wake up, bathe and go to bed when they want, instead of following a regimented schedule. The facility is also creating separate neighborhoods within the facility, each decorated with home-like touches chosen by the residents.

Countryside Care Centre in Aurora recently launched a fine dining program to replace its standard tray-based food service. Residents choose from expanded menus that include soups and desserts; enjoy off-tray choices, linen napkins and tablecloths; plan formal dinners that include wine; and are greeted by a hostess during lunch and dinner.

Residents living at Sheridan Health Care Center in Zion enjoy buffet dining. Individuals choose from a variety of hot and cold foods; serve themselves or receive restaurant-style wait service; and sit at tables covered by linen tablecloths and napkins and decorated with flowers. During breakfast, residents enjoy offerings from an omelet station. In addition, this facility is part of the Lake County Pioneer Coalition, in which area professionals share success stories on creating home-like environments for their residents.

Dozens of Illinois nursing home professionals are members of the Illinois Pioneer Coalition, a group dedicated to changing the culture of nursing homes in Illinois. This group sponsored the Illinois Pioneer Summit on Oct. 12 and 13, when experts from around the state met to discuss this historic change with hundreds of Illinois nursing home representatives.

“We want to advance from the standard model for nursing home care to one that is more focused on the residents’ quality of life,” said Klauer. “Residents should have more independence, being able to get up when they want to, choose what they want to eat and go to bed when they’re ready. We want the staff to know more about the residents they serve and develop closer relationships with them. The overriding goal is to make Illinois nursing homes more like a real home.”

Another nursing home gets cited, a resident died after she fell down stairs, in her w/c.

LORAIN — A local nursing home was cited by the Ohio Department of Health after an 90-year-old woman fell down several stairs in her wheelchair and died, according to an Ohio Department of Health spokeswoman.
Autumn Aegis Nursing Retirement Community, 1130 Tower Blvd., was cited for failure to ensure that each resident received adequate supervision and assistance devices to prevent accidents, according to the agency’s investigation report.

Delores Gayoso, 90, got through a secured door in her wheelchair at Autumn Aegis on Oct. 8 around 9 p.m. and tumbled down several stairs. Lorain County Corner Dr. Paul Matus has said Gayoso landed in a position where she asphyxiated herself. Her death was a direct result of the fall, he said.

”It was determined that the facility failed to provide adequate supervision to prevent an elopement and failed to ensure that assertive devices (door alarms) used to prevent elopement functioned properly,” the report said.

The citation is a level ”J” because there was an immediate jeopardy, according to Michelle LoParo, spokeswoman for the Ohio Department of Health. Citations are classified A through L, with A being the least serious and L being the most.

The Ohio Department of Health conducted an investigation after the nursing home filed a facilities self-report documenting the incident. The department finished its investigation Oct. 17 and Autumn Aegis received the citation Oct. 20. The home has 10 days to respond to the complaint.

The report specified that Gayoso was severely confused and had a history of exit-seeking behavior. The resident was placed in ”immediate jeopardy when she exited an exterior door that did not alarm, fell down five concrete steps in her wheelchair and landed upside down on a concrete pad,” the report said.

Within the next 10 days, Autumn Aegis will submit a plan of action or dispute any and all of the allegations with reasons, LoParo said.

Michele Schlabach, spokeswoman for Sprenger Retirement Centers, which owns Autumn Aegis, has said the door Gayoso exited is locked with a code that is only available to staff and family members.

Read the rest of this article—>

Nursing Homes Magazine is a great resource for those who work in LTC. I subscribe to this and there is also an online version. Here is a sampling of what is available from the web site:

Managing diabetes awareness in long-term care
Targeting the right resources is key to saving time while improving care

During the past three years, the medical establishment has been flooded with information about diabetes. Healthcare professionals have been swamped with an array of Web sites, papers, reports, and seminars loaded with the latest facts on diabetes prevention, testing, diagnosis, and care. The problem for busy nursing staffs is how to determine what is valuable so that scarce time is spent wisely on issues that will most benefit patients.

Information management has become a hot topic in long-term care settings. Overburdened staffs are being challenged to stay up to date on the latest developments in diabetes treatment not only to improve long-term care but also to mitigate litigation, negative publicity, and other factors that have adversely affected the nursing home industry in recent years.

Many nurses and nursing assistants, however, are finding it nearly impossible to wade through the reams of material that come their way on a daily basis. Some rely on their education and training, which often do not take into account the most recent changes in diabetes care or constantly updated standards issued by the American Medical Directors Association (AMDA), American Diabetes Association (ADA), and other organizations. These standards cover virtually every aspect of the disease, from glycemic control and lifestyle modification to pharmacologic interventions and much more; understanding them is vital.

This article is designed to help nurses and others cut through the clutter and locate relevant, credible, and reliable sources of information that they can access quickly and easily. Providing user-friendly online resources, newsletters, and continuing education programs should give these busy professionals a good starting point to help them manage diabetes information effectively.

Included in this article are web sites and other resources we can refer to when we have questions:

Make Use of the Web
One effective strategy is to make use of the numerous online diabetes resources. For example, the ADA’s Web site (www.diabetes.org/cpr) not only provides diabetes care standards but also reports on research (i.e., clinical trials), a diabetes risk test, and diabetes expos, among other topics. In addition, the site offers a range of information on meetings and educational opportunities, research, clinical practice recommendations, journals, books, research papers, and more.

Similarly, AMDA (www.amda.com) has issued a standard titled, “Managing Diabetes in the Long Term Care Setting,” as well as other information on diabetes care. Other credible Web sites include:

The Centers for Disease Control and Prevention (www.cdc.gov/diabetes/faq/index.htm)

U.S. Food and Drug Administration (www.fda.gov/diabetes)

Joslin Diabetes Center (www.joslindiabetescenter.com)

International Diabetes Center (www.parknicollet.com/diabetes)

National Institute of Diabetes and Digestive and Kidney Diseases (www.niddk.nih.gov)

National Federation of the Blind (www.nfb.org)

A comprehensive site (www.mendosa.com) developed by a freelance medical writer who specializes in diabetes lists articles, columns, and online pieces about all aspects of diabetes—from symptoms to the latest treatments. The site also lists and links to all of the 800 or so substantive resources for diabetes, including charitable organizations, publications, universities, medicines, companies, agencies, and so on. Web sites for 178 equipment suppliers are listed along with sites for medication, software, and blood glucose meters and nearly two dozen diabetes-focused food companies. Another 146 general diabetes sites, as well as directories, studies, and other material, can be found on this site. Because its area of coverage is wide, it might be worthwhile to delegate a staff member to set aside some time to explore this site.

Subscribe to Newsletters
Another way nursing staffs can stay up to date is by subscribing to newsletters that pertain to diabetes management. ADA has a wonderful electronic newsletter—Diabetes E-News Now! Health Care Professional Edition—that is very helpful. A recent issue, for example, discussed topics such as new diabetes drugs, weight gain and diabetes, the use of exercise to combat a diabetes-related metabolic syndrome among older adults, and news on various professional meetings.

Other newsletter sources include:

Diabetes in Control (www.diabetesincontrol.com/index.php)

DiabetesLibrary.org (www.diabeteslibrary.org)

MEDLINEPlus (http://medlineplus.gov)

CMEonDiabetes.com (www.CMEonDiabetes.com)

From the October 27th issue of Nursing Assistant Trainer: Oral care

Care of the mouth and teeth is a very personal matter, and some residents find it difficult to let someone else provide it for them. Some will clamp their teeth together or refuse oral care entirely. A glass of water after every meal to wash away food particles should be part of each resident’s care plan.

To examine the oral cavity, good lighting, gloves, and a tongue depressor are needed. The oral inspection should be performed in a slow and careful manner to prevent bruising or tearing the mucous membrane.

Before performing an oral assessment or any procedure related to mouth care, always explain to the resident what you intend to do. Unconscious and semiconscious residents may be able to hear but unable to respond.

To examine the oral cavity, do the following:

Examine the lips for sores, dryness, and cracking
Remove any dentures or partial plates and examine them carefully for chips and cracks
Check teeth for chips, looseness, or signs of decay
Look for redness and swelling of the gingiva and mucosa
Inspect the inside of both cheeks, the palate, the tongue, and the floor of the mouth for paleness, white patches, and sores
Note whether halitosis is present
Report any problems you observe

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.

From the October 20th issue of Nursing Assistant Trainer: Aggressive Residents

There are a number of reasons why nursing home residents and visitors may become aggressive—nursing homes can be frustrating environments. When someone becomes aggressive, whether verbally or physically, you need to discover and, if possible, eliminate the cause of the behavior. CNAs should attempt to avoid actions that might trigger the aggression, and try to prevent the aggression from escalating.

The way you respond to an aggressive person often determines how much the behavior escalates. Try these techniques for calming and hopefully diffusing this type of situation:

Keep your voice calm. Try not to sound angry or frustrated. When giving directions, use short words and sentences.

Maintain an appearance of control. People tend to stiffen, stand taller, and lean forward when they get angry. Appearing angry can escalate the other person’s aggression. Give the other person the impression you are calm and in control by keeping your body relaxed.

Give the person space. If an aggressive person needs to walk around the room and wave his or her arms, let it happen. Physical activity might release some of the stress. If you move closer to the person, he or she may feel threatened and the person’s agitation might increase.

Don’t argue. Don’t try to argue with people who are being aggressive. You will not win, and they will only become more upset. Being reasonable is often the last thing they are interested in. Don’t attempt to defend yourself against accusations. Wait until calm has been restored, then, listen, and if appropriate, quietly state your position.

These techniques may help the other person to calm down before aggression becomes physical.

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.

Another good article about culture change. While I agree we need to change nursing homes-that sterile, medical model that focuses and uses NURSING CARE as an excuse to manage resident’s lives…I think some people are expecting too much. With funding going the way it is, only the very sick and ill will be admitted pretty soon. Those who are better off, will need to find alternatives.

When it’s time for Paula Connell to go to a nursing home, she knows what she wants.

She wants a dining room with tablecloths, linen napkins and a restaurant-style menu.

She wants a spa that offers massages.

She wants to make her own decisions — about when to get up and when to go to bed, about when she’ll take her shower or bath, about when she’ll eat and when she’ll take her medications.

She wants to stay in a “neighborhood,” not on a “nursing unit.”

Above all, she wants to continue to live life to the fullest — to enjoy spontaneous activities with family and friends, to continue learning new things, to be involved in her community.

Sound like an unrealistic scenario?

Connell says it’s definitely a possibility as nursing homes throughout the country are beginning to embrace a new philosophy called “culture change” that aims to make residents’ lives more satisfying and meaningful.

The goal of this “culture change” movement — also called the “pioneer movement” or “person-directed care” — is to combat the three plagues of long-term care: Loneliness, helplessness and boredom.

“Culture change is getting away from a medical model to a more social-based model,” said Mike Duffy, administrator of Good Samaritan Home in Quincy. “Culture change is really putting the resident first.”

While nursing home residents’ medical needs continue to be met, more attention is paid to their social needs and overall quality of life.

Most importantly, the elderly are given more power to make decisions on their own.

“People are used to variety and change. They’re used to their own patterns,” Duffy said. “We’re trying to be in tune and addressing people’s desires and wishes.”

Read the rest of this article—>