Culture Change in Nursing Homes: What Works, What Doesn’t (Video: 1:59 mins.)

Most people agree that changes in the stereotypical, traditional nursing homes are long overdue. What makes a nursing home really feel like home? What needs to happen to make that a reality? What are some of the barriers that negatively impact progress? A University of Pennsylvania research study about culture change in nursing homes focused on these concerns. After staff interviews were done, three nursing homes reported these results:

Barriers to Change

1) Exclusion of nurses to culture change activity (While nursing assistants were not mentioned here, I’m inclined to believe they were also excluded.)

2) Perceived corporate emphasis on regulatory compliance and the "bottom line” (money)

3) High turnover of administrators and caregivers

Promoters of Change

1) A critical mass of "change champions"

2) Shared values and goals

3) Resident/family participation

4) Empowerment at the facility level

Clearly, changing nursing homes successfully involves input
from all levels of staff, residents, and community. Incentives encouraging achievement of new and shared goals are also effective.

You can read more details about this study here.

You can view this video on the importance of inclusiveness in culture change proceedings.

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Hospice and Nursing Homes Blog

Nursing Home Culture Change: Working with State Regulators (Pioneer Network Video 2:36 mins.)

Many people don’t plan to live their last days in nursing homes. However, with over 37 million Americans over the age of 65, a large segment of them will live and die in nursing homes. Culture change, which focuses on living life with dignity, can include the following:

1) Flexible Schedules

Everybody doesn’t have to eat, sleep, and bathe at the same times.

2) Intergenerational Activities

Relationships between children and the elderly are encouraged. The unique, beneficial exchanges that take place in this context are lacking too often in today’s society.

3) Interactions with Animals

Appropriate animals provide companionship and improved health.

4) Independent and Social Activities

Nursing home residents feel respected when their input is welcome regarding activities they can do independently. They also appreciate social activities that keep them connected with others.

There are several models of culture change for nursing homes. They all respect and incorporate input from residents and staff members in such areas as decision-making and scheduling. The Household Model is a product of the Pioneer Movement. Small groups of residents form households resembling "homes" where they have opportunities to develop quality relationships in a calm environment.

In this Pioneer Network video, Steve Shields describes how his organization approached working with state regulators to remodel an existing nursing home into the Household Model.

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
Hospice and Nursing Homes Blog

Culture Change: Transformation of Four Nursing Homes (Video: 5:16 mins.)

The following includes an excerpt from my book, "Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes.” Baby Boomer Haven refers to an imaginary nursing home based on best practices of some, but not nearly enough nursing homes that exist today.

“Welcome to Baby Boomer Haven! It’s a treasure to have you. My name is Ruth, and I’ll be your tour guide today. The first thing you need to know about our nursing home is that it’s real for some, but imaginary for too many others. Everything we enjoy here already exists in nursing homes scattered throughout America, but not in nearly enough. We’re having this tour today, so you can become familiar with possibilities that all nursing home residents should be experiencing, no matter where they are located.

When baby boomers seeking institutional healthcare show up in the millions, nursing homes like ours should be ready to receive them with welcoming lights shining in every window. Now, more than ever, nursing homes should be focused on ongoing state-of-the-art improvements. The comfortable life we live is as close as society’s handshake with commitment to quality healthcare, particularly for the ill and elderly.

We love many things about living here, but what we enjoy most is that we’re treated with dignity as adults. Our feelings and opinions matter. You’ll understand this better during the tour when you see our physical environment, the freedom we have in deciding how we live within our limitations, and the nurturing manner in which all employees interact with us.”

There are several models of culture change for nursing homes. They all respect and incorporate input from residents and staff members in such areas as decision-making and scheduling. This video from the Pioneer Network captures the transformation of four nursing homes in Anywhere, USA.

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
Hospice and Nursing Homes Blog