Definition of Culture Change
“Culture change” is the common name given to the national movement for the transformation of older adult services, based on person-directed values and practices where the voices of elders and those working with them are considered and respected. Core person-directed values are choice, dignity, respect, self-determination and purposeful living.
Culture change transformation supports the creation of both long and short-term living environments as well as community-based settings where both older adults and their caregivers are able to express choice and practice self-determination in meaningful ways at every level of daily life.
Culture change transformation may require changes in organization practices, physical environments, relationships at all levels and workforce models – leading to better outcomes for consumers and direct care workers without inflicting detrimental costs on providers.
Culture Change 101
Understanding the Core Principles and Values of Culture Change
Know each person.
Developing a relationship with each resident, knowing their needs and wants as well as their daily routines. Assigning consistent staff to each resident in order to cultivate this relationship.
Each person can and does make a difference.
Despite physical or cognitive impairments, every resident can contribute in some way. Finding a sense of “purpose” for every resident and offering choices for care routines, dining, and activities.
Relationship is the fundamental building block of a transformed culture.
Enhancing the relationships amongst staff with residents, staff with each other and with residents’ families can improve the overall quality of life for each resident. Incorporating a “Best Friends” approach to caring for the resident.
Respond to the spirit, as well as mind and body.
Moving from a task-oriented, medical model of care to one that is holistic, all-encompassing—addressing the entire well-being of each person.
Risk-taking is a normal part of life.
Allowing the resident to make personal choices even if that choice results in the resident taking a risk.
Put person before the task.
An approach to caring for each resident that places the priority on the care of the resident and not on “getting the task done”.
All elders are entitled to self-determination wherever they live.
Once a person moves into a long term care setting, they still have the same rights to make personal decisions (regardless of the outcome) as they did when they resided in their own home.
The community is the antidote to institutionalization.
Changing the environment from one of little or no choices and no relationships to one of self-determination, “family”, and a sincere sense of community.
Do unto others as you would have them do unto you.
The staff treats each as well as the residents as they themselves would like to be treated.
Promote the growth and development of all.
Shape and use the potential of the environment in all aspects: physical, organizational, and psychosocial/spiritual.
Practice self-examination, searching for new creativity and opportunities for doing better.
Recognize that culture change and transformation are not destinations, but a journey – always a work in progress.
Key Areas of Culture Change
Below are some common focus areas that illustrate how to transform a long-term care facility from a medical model to a more home like model. There are numerous ways of incorporating culture change into a home—these are a few examples: