Alzheimer’s Disease & Culture Change

1. Alzheimer’s Disease & Culture Change Is it really that different?

2. Cultural Change History • Medical Model to Social Model • Physicians & Nursing are the most important • Social Model • Eden Alternative • Restraint Free / Individualized Care (1987) • Federal rules • QUALITY of LIFE • Resident Directed Care

3. Foundations of Cultural Change • Best way to view this is the desire to improve the quality of life for residents & staff • Make our community places where people want to live vs. where they go to die • Make our community places where people want to work vs. where they have to go to work • Does your community believe in this? • Define what Quality is.

4. Five Core Principles • Respect • Empowerment • Community • Relationships • Choice

5. Respect • Voice views • Ideas • Opinions • Without fear • All should be considered in decision-making

6. Empowerment • Feel they make a difference • All are valued • Entitled to Information & resources • Some control over things that impact them • Yet respecting rules and the organization

7. Community • Evolve from Medical to Social model • “Would I do this in my own Home” • (Social, emotional, spiritual, and cultural needs) • Staff respected as complete individuals not the tasks they perform

8. Relationships • An ongoing activity • Initiating friendships • Strengthening these bonds • Friendships among Staff • Bonds between staff and residents

9. Choice • Range of options (Personal preference} • Right to make choices without penalty • Workers given Flexibility to make choices to get the job done • Consider company and rules

10. Summary • Everyone needs to make a commitment to make your community more homelike • Cultural Change begins with YOU • Success will come with this Knowledge and Commitment & Training • Constant reminders by Management • Continuous training

11. Memory Care • 1960’s – Non-Directive Approach • Carl Rogers • Acceptance of where the person is • Reflect their feelings • Be genuine & honest • Develop relationships

12. Memory Care • 1970’s – Reality Orientation • Ask residents specific questions • Develop a reality board • We will improve their memory • What happened?????

13. Memory Care • 1980’s - Validation “Therapy” • Based on Carl Rogers Approach • “The Disoriented Very Old” • Step into the shoes of another person • See through their eyes • Struggled to resolve an “unfinished life” • Repetitive motion • “Vegetation”

14. Memory Care • 1990’s - The Eden Alternative • Change the Physical Environment • Bring in Pets • Get all staff trained • Evils of Communities • Boredom • Helplessness

15. Memory Care • 2000’s - Person Centered Care • Resident is the Center of Care • Routines & schedules are secondary to the needs & desires and pace of the resident • Get all employees on board (Education) • Get residents & Families involved

16. Person Centered Care • Six Critical Components • Smaller neighborhoods • Restaurant style dining (Choices) • Respect • Individualized Living Space (Pictures, Decorations, etc) • Personal Growth ( education, volunteering, etc.) • Activities of Choice

17. Memory Care • 2009 -- Mind Mapping

18. Physical Environment • Open concept • Nursing station in the background • Window Boxes (Personal information) • Attractive • Family involvement • Staff orientation & training • Noise is a factor • Smaller vs. Larger

19. What is most important? • Ownership that cares about residents • Corporations that are not too “Top Heavy” • Management training that is realistic • Hiring and retaining staff that truly CARE = #1 • Hiring and retaining ENOUGH caring staff • Educating caring staff