A Brief Synopsis from Parts One and Two –
As we consider options for living into our later years, it is not out of the question that an Assisted Living Facility or Skilled Nursing Facility may be the best option (or maybe even the only option) for ourselves or our loved ones. But the current situation with these types of facilities leaves much to be desired, and Long Term Care Culture Change holds the key to making it better. Scroll down to read my two previous blogs to get the full picture.

So the question is, how do we recognize this culture change and how do we find facilities that have already put these changes into place?

First, it is important that you know what you are looking for, and to actually go look. A great place to start is with the “Artifacts of Culture Change” which can be found by clicking on this link: www.artifactsofculturechange.org.

As excerpted from The Pioneer Network’s Creating Home – A Guide to Better Care Options for an Aging America …

Key questions to ask skilled nursing facilities:

How is your nursing home involved in culture change?
Listen for: ”We have a committee that works on making our place a home for residents who liver here. Residents and families serve on the committee. Staff members attend culture change coalition meetings. … We have consistent assignment so that our staff can get to know the residents they are caring for, including residents’ individual needs and wishes.

Do the CNAs/Nursing assistants take care of the same group of residents each time they work, or do you rotate assignments after a period of time?
Listen for: “Consistent assignment.” “With few exceptions, our caregivers care for the same group of residents each time they come to work.”

Will my loved one be awakened at a set time in the morning, or will he/she have a choice?
Listen for: Residents may choose to sleep as long as they want without being awakened.

What is your policy regarding food choices and alternatives?
Listen for: “Let me show you a list of alternatives we always have on hand if someone does not like the main entrée being offered. Do you think your loved one would be satisfied with these? If not, we can usually accommodate her wishes.”

Can my loved one be given a shower/bath when he/she chooses?
Listen for: “Yes. We can accommodate a person’s lifelong pattern of bathing. Plus we understand about the special needs of persons with dementia. We have many creative ways to keep people clean, so we can adapt to their preferences and comfort, and still maintain cleanliness.”

How do you meet the special needs of persons with some type of dementia?
Listen for: “We educate our staff on how to best communicate with people with dementia. Because we have consistent assignments, staff know the residents well and can anticipate and meet their needs in flexible, creative ways. We also support and teach staff how to problem-solve difficult situations.”

For more questions to ask, click on this link to The Pioneer Network:  www.pioneernetwork.net

What if you can’t find suitable facilities in your area, or “the good ones” have no beds available?

Because of marketplace demand, person-directed care will become the only option in the future, but that will not happen overnight. As a consumer, you can do your part to influence the rate of the change by taking a few actions:

• Keep looking and keep spreading the word. The more that nursing home providers hear consumers asking for it, the faster they will be motivated to make the changes that we all want for our loved ones and ourselves.
• Visit nursing homes in your community to get a sense of whether or not they are practicing person-directed care. If a nursing home is unfamiliar with culture change, direct them to the Pioneer Network site and/or give them a copy of the Artifacts of Culture change.
• Become a part of your state or local culture change coalition to help bring about change in long-term care settings in your area. To find one in your area, go to www.pioneernetwork.net/Coalitions/Find.
• Join the email list of Pioneer Network so you can be kept informed of culture change news.

What can you do if your loved one is currently in a facility?

• Help the staff get to know him/her and you … quickly.
• Attend care planning meetings;
• Ask questions and share information – in writing – about who your loved one is, their life history and daily routines.
• Stay involved and don’t be afraid to speak up and be an advocate.
• Consider joining or starting a family council. For information on family councils, visit the Family Council Center on the website of the National Consumer Voice for Quality Long-Term Care (www.theconsumervoice.org).

In addition to The Pioneer Network, the following books are excellent resources:

• Nursing Homes: Getting Good Care There, by Virginia Fraser, Sara Hunt, Barbara Frank, and Sarah Greene Burger.
• Old Age in a New Age: The Promise of Transformative Nursing Homes, by Beth Baker.

As my three part series come to a close, I ask you the same questions The Pioneer Network asked me …

Imagine your own aging …
Will you want choices in where and how you live?
Will you want to be a part of a community of people who care about each other?
Will you act now so that all elders will enjoy a good life?
Will you join the culture change movement to help create old age in a new way?

If so, this is your call to action!