transforming long-term care in texas: david seaton
TRANSCRIPT
Texas Culture Change Coalition2011 Symposium
“Culture Change in Texas: It’s Time”“Changing Long-term Care in Texas for
Aging and Disability”
September 23, 2011 Texas State University
Baby Boomers (78 million) turning 65 in 2011
10,000 per/day
Someone 65 today is expected to live 18.5 more years
2 of 5 (40%) will reach age 90.
Aging Society: “Silver Tsunami”
U.S. Nursing Homes
• Number of nursing homes: 16,500• Number of beds: 1.8 million
Long-term Care
• Greatest Generation (Compliant) - WWII
• Woodstock Generation
(Free Spirit) - Vietnam
Leaders
Pioneer Network – Advocacy & Training
Network grown to over 10,000 members
in past 10 years• Annual national confer – 1300 St. Louis• Coalitions in 38 states
www.pioneernetwork.net
International Leader in the Culture Change Movement
More than 20,000 trained Eden Associates & 300 Registered Homes world-wide
Founded in 1995
“The challenge is to create a Human Habitat where people of all ages come together day after day – eager and able to Thrive, not just Survive.”
Bill Thomas, MDFounder
The Three Plagues of LTC:
• Loneliness
• Helplessness
• Boredom Plagues of the human spirit, not the human body. Medical treatment offers no balm.
Plagues: Antidotes:
Loneliness ----------- Companionship
Helplessness -------- Choices
Boredom ------------- Variety
More than 20 million Children & Adults with cognitive disabilities require lifelong supports in U.S..
• Brain Injury• Developmental Disabilities• Intellectual Disabilities • Mental Illness • Autism• Other
Cognitive Disability
Transforming Long-term Care for all people.
Broader Culture Change Movement
Designed for the unique needs of younger individuals with long-term care needs.
• Developmental Milestone• Life Experiences• Long-term Aspirations• Longevity of Life
Texas:
Approx. 4,122 long-term care facilities
Capacity to care for 229,139 individuals.
Nursing Homes - 1,174
Bed Capacity - 126, 684
Mission-
Dedicated to promoting change and improve the way long-term care is provided for Texans who are aging or disabled, and the caregivers who provide support for them.
2011 Goals:• Create organization to promote culture change in Texas.
• Create awareness of CC in Texas
• Provide Educational opportunities about culture change.
• Create opportunities to network and collaborate on CC.
• Make it 2012!
Committees• Organization/ Administration:• Marketing/ Development: • Regulatory/Policy: • Education/Training:
Steering Committee
• Provider Associations • Provider Facilities • Consumer Advocacy Organizations • Government Organizations • Quality Improvement Organizations • Educational Organizations • Auxiliary LTC Organizations
Texas operates 13 campuses with 4,241
HB 3197
Relating to creating a pilot program to implement the culture change model of care at a state supported living center
1. Shift decision-making to the individual with the disability;
2. Implement continuous quality improvement processes that use objective data to improve practices and services;
3. Improve the workforce by reducing turnover
Rep. Coleman sponsored in the House, Sen. Deuell's sponsor in Senate.
The DADS Culture Change Initiatives mission is to promote and support nursing home providers as they transform from atraditional system-directed culture to one that is person-directed or centered.
www.dads.state.tx.us/culturechange/
July 25, 2011- Culture Change Symposium, Austin, TexasCulture Change: Enriching Lives in Nursing Homes
October 20, 2011 – DADS ICF/MR Provider & Surveyor Conference, Austin, Texas
What is Culture Change?
• A term that is used to describe fundamental changes in Long-term Care.
• A transformation in the physical,
organizational and psycho-social
environments based on person-centered
values.
6 Traits of Culture Change
• Residents have input about their care and activities.• Living environment that reflects a home, and the unique preferences of the resident.• Close relationships between staff, residents and community• Staff empowered to make decisions in best interest of resident.• Collaborative decision making.• Ongoing quality improvement initiatives
Comparing Models
Long-term Care LifeLong LivingInstitutional Home & Community
System-Centered Person-Centered
Custodial Growth
Disempowering Empowering
Risk Aversive Dignity of Risk
Hierarchical Control Resident/Staff
Impermeable Permeable
Diagnosis-symptom Person
The Goal
Institutionalized Care
Individualized Care
The Goal of Change:
• Move from institutional “system-centered” to individualized “person-centered” care.
• Relationship is the fundamental building block of a transformed culture
The Disenfranchised
“Loneliness is the most terrible poverty. “
- Mother Theresa
Long-term Care vs. LifeLong Living
Culture Change: A Change in Perception
“The Ability to make choices largely determines one’s quality of life.”
~ Bill Thomas, M.D.
• Process of Continual
Listening and Learning
• Focusing on what is
Important to the Person
• Acting on this in Alliance
with the Person
Person-Centered Care
“Nothing About Me,
Without Me”
Person-Centered Support
Person-Centered Living
A life centered on personal preferences & values that stress dignity, choice, and individuality.
From Golden -
"Do unto others as you would
have them do unto you."
To Platinum Rule -
"Treat others the way they
want to be treated.”
Commonality / Individuality
Core Principles of Culture Change
Self Determination
Purposeful Living
Belonging Choice
Support
Dignity
Sense of Community
Contributing
What would your P-C Care look like? What’s Most Important?
• Hobbies/Interests• Home Town• Volunteer• Sports• Music Type• Family/Friends• School
The Journey
Culture Change Is Not:
• Another rigid program or set of regulations
• It is not about rewriting policies and procedures.
• Much more than the 3 F’s
We do the best we can with what we know, and when we know better, we do better !
~ Maya Angelou
Culture Change
• Inspire
• Inform
• Involve
David Seaton, Founder/CEO
PO Box 705
San Marcos, Texas 78667
512-938-1127
LiveOakLiving.com
“Be the Change You Want
to See in the World” - Gandhi