If you were not able to participate in past Conversations With Carmen, you may purchase access to the archived conversations and hear them at your convenience. Hear a variety of well-known Culture Change experts, addressing a full range of important topics. These webinar recordings, hosted by Carmen Bowman, offer a wealth of information for you and your staff. View them with as many people as you can fit in a room with a projector or just around your computer. Simply select the date and topic you're interested in and add it to your cart. When you have completed the purchase, you will receive an email with a link to the recording and a password. You will have access to the recording for 30 days.
You needn't miss out!
RECORDINGS AVAILABLE IN THE WEB STORE:
OCTOBER 21, 2016:
TOPIC: THE ALL-NEW CMS REGULATIONS - A First Look
PRESENTED BY: Carmen Bowman
With GUEST HOST: Glenn Blacklock, Action Pact Consultant
Last summer this same duo discussed the 403-page document of CMS’ proposed changes. A year later, trusting that CMS will follow through with the promised September release of the new regulations, they are seizing this opportunity to review the all-new CMS Regulations.
SEPTEMBER 16, 2016:
TOPIC: Getting Residents out of Wheeled Chairs
GUEST: Diana Waugh, BSN, RN, CDP | Waugh Consulting, LLC
We all know that wheels were put on chairs for transportation. That certainly makes sense and provides people with any limitation on their ability to get from point A to point B. How is it then that individuals who reside in many communities dedicated to caring, spend the vast majority of their time awake sitting in a wheeled chair? Something has gone awry with the application of a very specialized piece of equipment. Wheeled chairs were never meant as seating devices. But then we all know that. We can also state all of the negative effects of having people sitting in a wheeled chair… but there are still way too many people doing just that. There’s a mismatch between what we know and what we practice. We will look at the underlying change in belief that must occur to move to a new culture where wheeled chairs become simply a mode of transportation, and are unoccupied most of the time.
AUGUST 23, 2016:
TOPIC: Inspiring Environments for Mobility
GUEST: Lorraine Hiatt, PhD
Environmental Gerontologist, Planning, Research and Design for Aging
With a flair for design for aging, environmental gerontologist Lorianne Hiatt will get us focused on what mobility is and why it matters to older adults. She will share best practice in assessment of individual mobility as well as of one’s life space with inclusion of direct care givers/partners and the resident him/herself. Be challenged to be creative in using whatever exists in your environment as well as new ideas to encourage movement every day. Learn considerations for persons living with dementia, ways to mitigate risk, and take a look at the MDS data points for personal movement, life-space mobility and reimbursement potential.
JULY 22, 2016:
TOPIC: What Kind of Culture Does Your Language Create?
PRESENTER: Host Carmen Bowman
It is not news that the language of institutional care could use some work. Even CMS notes a needed language change by encouraging the elimination of labels such as “feeder” in its interpretive guidance for Tag F241 Dignity. Do these institutional words still abide in your culture? Facility, beds, frontline, work the floor, toileting, non-compliant, behaviors, difficult, activities, dietary, resident, elope, expire? Have you personally and community-wide adopted language that is softer, more normal, dignified? The best news? Changing language costs no money. Yes, changing language is a no-cost practice that does wonders to shift from an institutional culture to a home/natural/normal culture instead. Join us to learn more about the unintended consequences of traditional institutional language; word replacements to consider; and ideas on how to change language. Join our host Carmen Bowman as she shares from the paper she co-authored The Power of Language to Create Culture..
JUNE 17, 2016:
TOPIC: Reducing Unnecessary Wheelchair Use
Guest: Leslie Jarema, LNHA, Director of Health Services, The Forest at Duke CCRC
Approximately two-thirds of nursing home residents are in wheelchairs the majority of the time. Although not talked about much, the negative, iatrogenic consequences of overuse of wheelchairs are many: accelerated loss of muscle mass, pressure sores, significant discomfort and physical strain from operating chairs which increase risks for falling, injuries from falls, depression and pneumonia. Older people's health, mobility and self-image can suffer from too much time in wheelchairs. They are treated as less able, even spoken to differently, promoting a cycle of helplessness. The Forest at Duke is part of a movement that gives priority to the well-being of residents and their caregivers - above the functions of the nursing home or convenience of the staff.
MAY 20, 2016:
TOPIC: Improving Mobility the Advancing Excellence Way
Guest: Carol Benner, Advancing Excellence Campaign
For years we have talked about preventing and reducing falls, searching for the right solution. We even tied people to their chairs to keep them from falling, not yet realizing that the key to preventing falls is to improve mobility. Then we “alarmed” them, which only resulted in increased immobility. Mobility is the key to maintaining both physical health and quality of life. The Advancing Excellence Campaign has selected Mobility as one of its nine goals. With an expert panel, it has prepared a full set of quality improvement tools to help assess, measure and improve mobility for nursing home residents.
TOPIC: Dignity-Based Approach to Incontinence
GUEST: Susan Fry, Retired Culture Change Nurse Leader
Guest Susan Fry will report out on a multisite research study regarding a dignity-based approach to incontinence management. Join us to hear both the change steps and the exciting improved outcomes realized
MARCH 18, 2016
TOPIC: Alarms: The New Deficient Practice? Replacing Alarms with Better Practices
Presented by Carmen Bowman, co-author of "Alarms: The New Deficient Practice? Eliminating Alarms and Preventing Falls by Engaging with …. Life"
Join the discussion to ponder the use of alarms. Could it be that alarms actually fit CMS’ definition of “convenience,” which is not to be a reason for restraints at Tag F221? Hear how the use of alarms could be deficient practice on/for at least seven tags. Although no research shows that alarms prevent falls and there is evidence that alarms cause people physical and psychological harm, they are still used widely. Eliminating alarms has actually reduced falls in the homes that have done so, committing to the better practices of
proactively checking in with residents
focusing on mobility
anticipating needs and
engaging residents with real life
Based on the book Eliminating Alarms and Preventing Falls by Engaging with … Life co-authored by hostess Carmen Bowman, published by Action Pact.
TOPIC: Facing Risk: Care Planning for Resident Choice
GUEST: Karen Schoeneman, Retired Deputy Director CMS Division of Nursing Homes
Are you holding back on offering true choice to residents, even though you want to - for fear of deficiencies being cited, possible legal action or other negative outcomes? We challenge you to think again. It is possible to hone our skills in order to honor resident choice.
Everyone deserves the right to:
- Eat food that might be considered a choking risk,
- Go outside when one wants to
- Decline "alarming" alarms, etc.
Karen Schoeneman, a member of the steering committee of the Rothschild Person-Centered Care Planning Task Force, will teach the six steps of the new "Care Planning for Resident Choice" process, as well as the CMS requirements that mandate homes to honor resident choice.
TOPIC: The ROI of Using the Regulations to Promote Highest Practicable Quality of Life
GUEST: Ray Rusin, Retired Director, Rhode Island Survey Agency
Meeting basic needs should be a given. When they are, one can reach their highest practicable level of well-being. Yet health systems -- including the survey process -- tend to stratify efforts on the bottom tiers, focusing mostly on safety. Culture change outcomes are in our favor: improved quality of life and clinical outcomes, higher profit and better regulatory compliance. Learn how to use the existing and proposed regulations to promote highest practicable quality of life. Achieve the best ROI by having a thorough understanding of the CMS regulations.
TOPIC: I NEED A VACATION... and SO DO YOUR RESIDENTS!
GUEST: Jon Jordan, Wesley Life Wellness Director
Ever get the feeling that you just have to get away from it all? Most of us plan and anticipate taking that much-needed vacation. Do you know who probably needs that getaway more than anyone else? The residents in nursing homes, that's who. In Action Pact's continued quest to create normal lives for elders everywhere, guest host Glenn Blacklock will visit with Wesley Life Wellness Director Jon Jordan about their highly successful annual vacation trip for residents. Join us and learn more new ways to grow rampant normalcy for those you care for.
TOPIC: Using Mobility and Individualized Approaches to Reduce the Risk of Falling
Guest: Jo A. Taylor, BSN, MPH, Quality Improvement Specialist
Move from the traditional culture of functional decline to a culture of individualized care that reduces the risk of falling. An individualized culture replaces restraints, alarms, and antipsychotics with better practices such as resident-focused care instead of schedule-focused, including the encouragment of resident self-care. Most importantly, learn how to bring mobility to the forefront of life for residents with an environment for mobility that includes direct caregiver support (not just therapy), exercise activities and increased walking rather than wheelchair use. Start to turn the tides from excess safety to improved well-being. After all, as our expert guest Jo Taylor points it, older adults define their well-being by their functional status.
TOPIC: Rampant Normalcy
GUEST: Glenn Blacklock
Nationally known for successfully bringing normal life pursuits to nursing home residents, Glenn shares how to accomplish this, from his dual perspective as a recreation therapist and innovative administrator. He challenges what it means to be “frail.” Hear how residents have ventured out of the community to climb trees, navigate rivers, go boating, fishing, motorcycling; and also ventured inside the community, engaging their talents and pursuing wellness. Glenn encourages others to look at their home and community through residents’ eyes – where a good life every day is within their reach. Invite your whole team to do this together; it can’t be limited to one department anymore. Consider moving away from traditional “activity programming” to engaging residents with real life and what the Pioneer Network calls “rampant normalcy” -- all day, every day!
TOPIC: The New CMS Draft Regulations -- Comments due Sept. 14, 2015
GUEST: Glenn Blacklock, NHA, Action Pact Consultant
If you don't have time to read the 403-page document, tune in to this broadcast. You'll not only get the highlights, but also be able to contribute ideas about what to give comment on. Glenn Blacklock, an innovative NHA and culture change consultant, along with hostess Carmen Bowman, former CMS Policy Analyst, surveyor and culture change consultant, will share ideas regarding CMS proposed changes. They will also discuss ideas to encourage CMS to consider: in the realm of culture change practices, and especially more dignified/less institutional language throughout the regulations. After briefly mentioning being familiar with culture change, CMS states, “While CMS is engaged in the issues around long stay nursing home residents, we do not have enough verifiable information to propose specific changes to the regulations specifically applicable to long-stay situations at this time. We solicit comments on how the requirements could acknowledge the special needs of the long stay resident. In addition, because we also received comments regarding the need to specifically address the needs of short stay residents, we solicit comments on how the requirements could acknowledge the special needs of short stay residents."
TOPIC: Leveraging Collective Wisdom to Surpass QAPI
GUEST: span style="font-family:arial,helvetica,sans-serif;">Kelly O'Neill, Program Manager Stratis Health, MN QIO
Are you leveraging the collective wisdom of residents, family members and team members to create a culture of continuous quality improvement? QAPI is about making improvements, making residents lives better and staff lives better. Learn practical actions you can take to engage residents and staff in QAPI in meaningful ways. This information is based on lessons learned from the national QAPI demonstration project and the National Nursing Home Quality Care Collaborative.
TOPIC: The Artifacts of Culture Change
GUEST: Karen Schoeneman, Consultant, Retired CMS
The Artifacts of Culture Change measurement tool was funded and released by CMS in 2006. Designed to be used by communities to document concrete changes and reflect a move from institution to home, this tool will be described and explained in detail by its developers. Has your community implemented all 66 practices reflected in the tool? Learn how to use the Artifacts tool, how it has been used in grant projects around the country, and share your ideas for an Artifacts 2.0, now being considered. Most importantly, identify and implement practices you may not have considered in your journey to transform culture.
TOPIC: With a Little Help From Our Friends: Creating Community as We Grow Older
GUEST: Beth Baker, Author/Journalist
For her first book, Old Age in a New Age, award-winning journalist Beth Baker studied and wrote about the culture change movement. Now she has studied and written about the innovative ways to live people are devising as they approach retirement -- options that ensure they are surrounded by a circle of friends, family, and neighbors. Based on visits and interviews at many communities around the country, Beth Baker weaves a rich tapestry of grassroots alternatives such as cohousing, house sharing, a mobile home cooperative, a senior artists colony and neighbors helping neighbors in "villages" or "naturally occurring retirement communities." Times they are a changing; be aware of all the creative options.
TOPIC: Alarms: The New Deficient Practice? Eliminating Alarms and Preventing Falls by
Engaging with Life
GUEST: Carmen Bowman, co-author of new book with same title published by Action Pact
SPECIAL GUEST HOST: Glenn Blacklock, LNHA, Action Pact Consultant
Alarms – an idea whose time has come and gone. We’ll demonstrate that alarm use is now deficient practice at seven regulatory requirements. Although no research shows that alarms prevent falls, and there is evidence that alarms cause people physical and psychological harm, they are still widely used. Eliminating alarms has actually reduced falls in the homes that have done so, but what else have they done to reduce falls? Employ your creativity as we design ways to engage each individual with life according to his/her daily routine, personal preferences and ability. The results may astonish you. Eliminate alarms and prevent falls with new approaches. Based on the recent book of the same title, co-authored by our presenter and published by Action Pact.
TOPIC: Promoting Sleep IS Good Nursing Care
GUEST: Marilyn Oelfke, RN, LNHA, Action Pact Consultant
How many of us like to sleep? Do you love not having to set your alarm? In your community, is sleep honored? There are SO many benefits to being well rested: better mood, less depression and anxiety, increased alertness, even fewer falls. When medication administration and night checks with residents happen according to residents' schedules, patterns and needs, there are many benefits. Open dining can accommodate various sleep patterns and by supporting people's natural sleep schedules, we honor individual circadian rhythms, which diminishes stress (what we used to call “behaviors”) for residents. We provide health care, yet deprive people of sleep -- one of the healthiest natural functions for body and mind. Sleep is an important component of quality of care and quality of life, which are not only great ideas but also federal requirements.
TOPIC: The Deep Seated Issue of Choice: Practical Steps to Transform Dining
GUEST: Linda Bump, RD, LNHA
- Learn practical ways to maximize autonomy and individualization in dining.
- Honor residents' food and beverage preferences through cost-effective choice and accessibility.
- Understand the importance of personal choice and pleasurable dining experience in defining quality of life.
Carmen's conversation with Linda Bump will include discussion of the New Dining Practice Standards, as well as tapping into Linda's expertise for practical application. Linda served on the Pioneer Network Task Forces that developed the New Dining Practice Standards and Toolkit. She also authored and presented the white paper, “The Deep Seated Issue of Choice,” for the CMS/Pioneer Network Creating Home II national symposium on Culture Change and the Food and Dining Requirements. Hostess Carmen Bowman facilitated the CMS/Pioneer Network symposium and subsequent new Standards and Toolkit Task Forces.
TOPIC: Creating the 1st Healthy Living Community... Because we belong together!
GUEST: Steve Shields, CEO Action Pact
Action Pact is partnering with Liberty Hospital and Healthy Living Centers of America to build the nation’s first healthy living community in Liberty, MO specifically designed to integrate primary, acute and post-acute healthcare services within an inter-generational living community. The project will be anchored by a healthy living center designed to serve as the hub for healthcare integration. Designed as a village within the Liberty Clinic, the development will be both mixed-use and pedestrian-oriented, and will include restaurants, retail, medical and traditional office space, a short-term stay recovery hotel, assisted living and independent living and homes for people of all ages. Be inspired. Reject the old way. Reject what culture change leader Carter Catlett Williams calls ‘ghettos of old age or single age culture . . . because we belong together.”
TOPIC: Understanding the Culture in Culture Change:
Why organizational design is important
GUEST: LaVrene Norton, MSW, Action Pact Founder and Executive Leader
A leadership culture can be paternalistic authoritarian, participative management or shared. Learn from one of the foremost culture change leaders of organizational design how to:
Rethink: Shared Vision becomes the Future Pull
Restructure: Shared leadership and Self-led Teams
Renew: High Involvement
Relearn: Growth and Learning as Central to All Work
Redesign: Environmental Cues
Reaffirm: Growth and Learning as Central to the Daily Life of the People we Serve.
TOPIC: The Affordability of the Household Model
GUEST: Martin Dickmann, CFO Action Pact Development
Is the Household Model financially viable? Like institutional nursing homes, no two Households are alike. There isn’t a one-size-fits-all solution that works financially for every organization. We'll identify the key Household Model financial drivers and how to navigate them to create a financially sustainable solution. While no Household solution is universal, all organizations can afford to implement a solution customized for them. We will explore the framework for success!
TOPIC: Highest Practicable Level of Well-being Applied to Dining
GUEST: Linda Bump, RD, LNHA, Action Pact Consultant, first administrator of the Household Model
Using Lowenburg’s classic review of Maslow’s theory of human maturation as applied to food habits, Linda will explain how food use progresses from eating for existence to eating for self-actualization or highest practicable level of well-being as required by Tag 279. Looking at the theory and the regulatory requirement can contribute to our understanding of the successful outcomes experienced by culture-changed facilities. Residents move from “getting food” in a traditional institutional facility (consider the use of the terms ‘feeding’ and ‘feeders’) to eating for self-actualization, quality of life and highest practicable level of well-being in the transformed community focused on self-directed living.
TOPIC: Highest Practicable Level of Well-being applied to Systems: Survey and Institutions
GUEST: Ray Rusin, Rhode Island State Survey Agency Director, Founding President of RI Generations Culture Change Coalition
Did you know that Maslow’s theory of hierarchy of needs and the regulatory requirement for highest practicable level of well-being both apply to systems, too? Health systems, including the survey process, tend to stratify efforts on the bottom tiers, focusing mostly on safety while simultaneously preventing people living and working in the systems from reaching their highest practicable level of well-being. Join us in thinking and talking this through with the only leader in the culture change movement who is also a regulator!
TOPIC: Highest Practicable Level of Well-being is required by Regulation
GUEST: LaVrene Norton, MSW, Action Pact Founder and Executive Leader, with
Carmen Bowman, Edu-Catering, Regulator turned Educator, Hostess of Conversations with Carmen
LaVrene Norton was one of the leaders of the culture change movement who identified the seven essential domains of well-being in 2002. Together LaVrene and hostess Carmen Bowman will “take it up a notch” by showing how CMS nursing home regulations require that the highest practicable level of well-being be maintained or attained for each person and how the domains of growth, comfort, security, identity, autonomy, connectedness, meaning and joy are not only what really matter to people but are also embedded in regulatory requirements.
TOPIC: Dementia Beyond Disease
GUEST: AL POWER, MD, Board-certified Geriatrician, Eden Educator, Author of Dementia beyond Drugs and Dementia beyond Disease
In 2002, leaders of the culture change movement identified seven essential domains of well-being. Dr. Power has now turned his attention to these domains of well-being authoring his second book Dementia beyond Disease soon to be published by HPP. Hear Dr. Power on this Action Pact webinar first confront widely accepted and prevailing disease-based care practices that actually erode individual well-being. Then discover the many ways how well-being can be emphasized and enhanced in people living with dementia.
TOPIC: Hearing the Voice of Persons Living With Dementia
GUEST: MEGAN HANNAN, MS -- Action Pact Consultant, Developer of PersonFirst®, author of Becoming Who They Were
Hear the voice of the person living with dementia. When we hear their voice, we can understand them, honor their choice and help fulfill their needs. The five human needs of identity, inclusion, attachment, comfort, and occupation will be used as a lens to guide our view. Finessing our ability to hear their voice and honor their choice can only contribute to the worthy goal of reducing anti-psychotics.
TOPIC: MUSIC: Quickening People Living with Dementia to be "Alive Inside" Again
GUEST: DAN COHEN, MS -- Founder and Executive Director of Music & Memory
Kant called music the “quickening art.” Be inspired by the founder of Music & Memory how you can easily use music to help people living with dementia to be “alive inside” again. Since we now know it is within our power to stimulate a person’s brain, to quicken their spirit, and to bring joy, how can we not do it? Music also affords the side-effect benefit of movement, something many institutionalized elders, and all of us, need. Rooted in neuroscience research, the results are described as “nothing short of miraculous” and certainly contribute to efforts to reduce anti-psychotics.
Topic: The Validation® Method: A Tried and True Method of reducing Anti-psychotics
Guest: Naomi Feil, MSW, SCSW
Treat yourself to learning from developer Naomi Feil about the Validation® method, which provides a means for successfully communicating with persons with dementia -- something desperately needed by them, their caregivers and family members. Validation replaces the outmoded and person-devaluing methods of sympathy, redirection, diversion, reality orientation, and the therapeutic lie. Validation teaches how to “exquisitely listen,” empathize, “move into” the disoriented person’s world and validate feelings. Using Validation boosts self-esteem, builds trust and rapport and often assists the person to no longer need to resort to the past by creating a warm and welcoming present. Naomi will also touch on the valuable tool of Validation groups in which members not only “rise to the occasion” of their individual roles, but their intuitive wisdom often spills out to help one another.
Topic: Good Care Should be a Given
Guest: Maricel Glova, RN, Action Pact Consultant, experienced DON
Quality of life includes quality of care. In your community, do residents get to the bathroom when they need to? Better yet are residents' bathroom needs anticipated? In addition to the obvious benefits, this also leads to preventing falls. Is mouth care happening regularly every day? Are medications administered according to residents' schedules? And is sleep honored according to the person's circadian rhythm? Hear strategies for the varying stages of culture -- from traditional to households -- for ensuring that good care is a given. Only then can a resident achieve highest practicable well-being. This is not only a great idea but also a federal requirement.
OUR 2013 SERIES ON ALARMS:
Topic: Personalized Med Pass
Guest: Marilyn Oelfke, RN, Action Pact Consultant, retired administrator Perham Living
Topic: The Benefits Beyond Reducing Falls by Eliminating Alarms
Guest: Theresa Laufmann, RN, Co-DON Oakview Terrace, SD – an alarm-free home for 6 years
Topic: Eliminating Alarms and Proactively Preventing Falls by Engaging with Life
Guest: Jennifer Crimmins, Administrator Friendship Haven, Fort Dodge, Iowa
Topic: The Key to Alarm Elimination and Proactive Prevention of Falls: Relationships
Guest: Leslie Pedtke, Administrator Aviston Countryside Manor and developer of Through the Looking Glass staff experience of living in a nursing home
Topic: Regulatory Support for the Elimination of Alarms
Guest: Diana Weiland, RN, Public Health Advisor for the Office of Licensure and Certification
Topic: How Oakview Terrace has been Alarm Free for 6 years
Guest: Theresa Laufmann, RN, Co-DON Oakview Terrace, SD – an alarm-free home for 6 years
Friday, May 17, 2013
Topic: A QAPI and Compliance Approach to Eliminating Alarms and Preventing Falls
Guest: Matt Younger, Administrator, Section for Long-Term Care Regulation, Missouri Dept. of Health & Senior Services