Culture Change: Resident Choice

For those of you that have worked in long-term care as long as I have, you will remember when residents were fed in their rooms. This was the hospital model that nursing homes were originally based upon. It was also efficient from a labor standpoint.

Then the trend became to encourage all residents to eat in dining rooms or other dining areas. The main reason for this was socialization. It also encouraged a more homelike environment and an overall nicer dining environment.

Now many facilities have many short-term rehab residents. These residents often do not want to eat in the dining room with the others. They do not see themselves as residents in the facility like the others. They are only in the facility temporarily to get better and then go home.

Offering room service for those that want it may be a desirable option for some nursing homes again. Offering smaller dining rooms may be another option.

Most nursing homes have a variety of residents with a variety of needs and desires. Offering differing dining locations, along with a variety of menu options and dining time options, greatly increases customer satisfaction.

Culture Change: Resident Choice

An important aspect of culture change is providing residents with choices. This also includes assisting them with making those choices rather than assuming what choice they will make.

In meal service, the main areas of choice are what to eat, when to eat, and where to eat.

For information on menu choice options, go to http://farrelltraining.blogspot.com/2010/01/dining-culture-change-meal-selection.html.

For information on dining time options, go to http://farrelltraining.blogspot.com/2010/01/dining-culture-change-dining-times.html.

For information on dining locations options, see the next blog!

Culture Change: Homelike Environment

When homelike environment is mentioned, often we just think of the physical environment. This is certainly part of it. For more information on making the physical environment more homelike, go to http://farrelltraining.blogspot.com/2010/01/dining-culture-change-homelike.html.

However, the environment of any place is not just the physical surroundings, but also the atmosphere. An important part of homelike environment in long-term care is that the residents feel safe and comfortable.

Another aspect is privacy. Do residents feel that if they shut the doors to their rooms, their privacy will be respected? Will someone knock, ask if they can enter, and wait for permission before coming into the room? Or will they just barge in?

Do residents feel that they can speak up without fear of retribution? This is a major component of feeling safe.

Think of how you feel in your home. Do you think your residents feel the same way in theirs?

Culture Change: Balancing Resident Rights with Resident Rights

Sometimes what one resident wants is different from what another wants and these wants conflict. For example, if residents are sharing a room, one may like it quiet while another wants to play the TV or radio loudly all day. One may like a neat and clean room while another wants it cluttered.

The first rule is safety. No resident can do anything that could cause an unsafe condition for themselves or others. No matter how much a resident on oxygen wants to smoke, he/she cannot!

The second rule is to follow all regulations. These are not just federal and state long-term care regulations, including those for life safety, but also any city or county regulations related to physical plant and safety.

Finally, sometimes it just comes down to trying to use common sense and helping the residents compromise and set boundaries. Sometimes a room change is necessary.

Resident choice does not mean that every resident gets exactly what he/she wants all the time, even though we need to try very hard to make it happen. Balance is critical.

Culture Change: Balance is Critical!

Three major areas require balance:

• Resident choice and resident care
• Resident choice and facility operations
• Resident choice and resident choice

Although residents have the right to choose and the right to refuse care, we still have the responsibility to provide the care that they need. For more information, go to http://farrelltraining.blogspot.com/2010/01/dining-culture-change-balancing.html.

Although residents have the right to choose what they want, we still have businesses to operate. Businesses are in business to make money. If it is not making money, it is not a business, ti is a hobby. None of us do what we do as a hobby! For more information, go to http://farrelltraining.blogspot.com/2010/01/dining-culture-change-balancing_15.html

All residents have the right to choose. What happens when what one resident wants contradicts what another wants? This will be the topic of the next blog!

Culture Change: Culture Change in Long-Term Care

Culture change in long-term care is nothing new. The culture of long-term care has been changing and evolving for decades. As times change, the philosophy on what is an appropriate culture changes.

For more information on how the culture has changed over the years, go to http://farrelltraining.blogspot.com/2010/01/dining-culture-change-culture-change-in.html

Culture Change: Organizational Culture

Changing systems, such as meal service systems, can improve the quality of life for residents. Changing systems does not necessarily mean that the culture of the facility changes, however.

The culture of an organization is based on the values, beliefs, and attitudes of its employees. If it is not part of the culture that residents be treated with dignity and respect, it is not going to happen often. If it is not part of the culture for employees to recognize that residents have the right to make choices, it will not matter how many choices are available, the staff will simply make the choices for the residents.

For more detailed information on organizational culture go to http://farrelltraining.blogspot.com/2010/01/dining-culture-change-organizational.html

Happy New Year!

The New Year is always a good time to make new resolutions and promises to ourselves on what we are going to do. The tricky part, of course, is to implement those changes!

The New Year is also a good time to make changes to improve the life of our residents. Often these changes involve changing the culture in a facility. Funny, but if we change ourselves, what we think and what we do, we will also change the environment of those around us, including our residents!

This month's topic will be on culture change, with an emphasis on change in the dining service department.

For additional blogs on culture change, select "culture change" under labels to the left.