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Showing posts with label assisted living. Show all posts
Showing posts with label assisted living. Show all posts

Wednesday, March 7, 2012

Person-Centered Care: Nursing Home Culture Change (Photograph Research, Video 4:00)


Change is not always easy, especially if there is widespread acceptance that practices are working well the “wrong” way. Fortunately, the growing movement of nursing home culture change across America is transforming beliefs in what the “home” part of nursing home really should look and feel like. In many cases, reluctant staff members who resisted change at first are seeing the benefits, particularly regarding improvements in residents’ health.

Even something simple like automated historical digital displays of residents' photographs to remind staff of each resident’s personhood can positively impact patient-staff communication. Researchers at the University of Kansas School of Nursing displayed residents’ historical photographs in digital frames in their rooms. They compared audio-recorded staff-resident conversations before this intervention with conversations afterwards. Results indicated increased staff person-centered talk and less task-oriented talk. Residents spoke more about interpersonal topics. Their engagement and reminiscence improved. Implementing low-cost historical photo displays in residents' rooms enhanced person-centered communication. 

Many other interventions can advance person-centered care in nursing homes. Staff members who have made the paradigm shift from traditional nursing home settings to nursing homes with person-centered environments and practices can best explain the transformations of themselves and residents. 

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback at many booksellers and in e-book form at Amazon and Barnes and Noble booksellers.

Friday, January 14, 2011

Older Adult/ Senior Bullies in Long-Term Care and Senior Communities


Some people wake up and change. Others just roll over. I’m referring to the bullies of our pasts and others who have become older adult bullies. These bullies are now terrorizing residents in long-term care and assisted living facilities, senior centers, and retirement communities around the country.

Welcome to the irony of older adults practicing ageism. The first time I witnessed older adults bullying others was at a senior center where, after a great deal of resistance from members, the age for joining the center had finally been lowered from 62 to 55 years old. Most local senior centers had already lowered their membership age years before this center. Several older members were openly rude to younger members who joined. At lunchtime, I watched them “reserving” tables for their older friends and leaving leftover seating for younger members. I overheard negative comments about “those new young people” stated loudly enough for everyone to hear. I even witnessed an attempt to get a younger member in trouble. I reported all incidents I witnessed to the administration. They said they were “working on the problem, but change takes time.” Unfortunately, many older adults don’t have a lot of time ahead of them. No one should have to spend their golden years being victimized daily by mean-spirited bullies.

These are some hurtful actions of “mature” bullies:

1.    Block off seats for their little cliques at mealtimes and events.

2.    Criticize, ridicule, and lie about those who don’t meet their standards of acceptance regarding race, ethnicity, sexual orientation, religion, economic background, and any other criteria they condone.

3.    Steal and destroy property to flaunt their power and harass victims.

4.    Physically abuse victims by pushing, hitting, punching, or kicking them. They sometimes justify this as an “accident.”

A former school principal, I know bullying is a problem that only gets worse when it’s ignored. Too often the victims are vulnerable and defenseless. Some, such as those targeted because of their sexual orientation, become so depressed they commit suicide. Observers are often too afraid themselves to take a stand. The administration must be seriously involved. These are some guidelines that can help solve problems of bullying:

1.    Commit to and promote principles of equality and respect for all residents/members.

2.    Do a confidential needs assessment on bullying to determine how severe the problem is. General needs assessments should be done annually.

3.    Have open discussions involving residents, staff, and community members about bullying, its causes, and solutions. Consultants with expertise in bullying, conflict resolution, diversity, etc. can be especially helpful.

4.    Provide extensive staff training in how to handle bullying among themselves and those they serve.  Continue to educate residents/members. Victims need the support, and bullies need to be reminded that eliminating bullying is an ongoing priority.

5.    Review and change procedures that can decrease the power of bullies. For example, eliminating reserved seating and implementing another seating procedure can prevent bullying cliques from saving blocks of the best seats for themselves.

6.    Create and disseminate a zero tolerance policy on bullying along with channels for reporting incidents and resolving them.

7.    Keep in mind that the goal is to create a culture where no bullying is the standard embedded in how the institution operates. There must be consistency in implementation and visible recognition of everyone’s dignity and rights.


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.

Sunday, February 21, 2010

Homophobia in Nursing Homes, Long-Term Care, Assisted Living, and Home Care (LGBT Video 4:01 mins.)

Life can be horrendous living in a community where you are excluded and harassed. This is the experience of many elderly lesbian, gay, bisexual, or transgender (LGBT) people living in nursing homes, long-term care, assisted living, and even those receiving home care from healthcare workers. Consider how you would feel being dependent daily on bigoted caregivers who resent your presence. Imagine being isolated socially by fellow residents regularly or only being included because you hide a major part of your identity. Either way, damage to your emotional and physical health can be devastating.

The “Michigan Daily” reports that LGBT elderly increasingly have been “disrespected, shunned, or mistreated in ways that range from hurtful to deadly, even leading some to commit suicide.” Important solutions to this problem include a national drive to train long-term care providers in equitable and compassionate care, and a move for separate, but equal care.

Implementation of culture change in senior institutions requires sensitivity and commitment to the creation of person-centered environments that welcome LGBT residents. As this award-winning LGBT documentary titled  “Gen Silent” explains so well, no one should have to live in fear in order to survive. What kind of quality of life is that?





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.