Tales of Transformation
On this page you will find motivating stories from communities who have embraced Culture Change, promote Wellness, and are working to create Vibrant Living. The stories will change regularly and provide ideas and insights, share struggles, and make you smile -- perhaps even laugh out loud!
Lowdown at the Loo
The job of the High Involvement Action Team is to get everyone in the organization involved in the transformation process; to get them informed and excited about the changes happening in their community.
The High Involvement Team at Manor Park Retirement Community in Midland, TX (came up with a creative way to spread the word about culture change throughout their campus. They call it, “Lowdown at the Loo.” Now, in each of the 50+ bathrooms on campus, you’ll find a plastic sleeve in the stall or in front of the paper towel dispenser where the latest issue of “Lowdown at the Loo” is posted. As Manor Park begins to form neighborhoods from their four halls, it is a critical time to get folks excited and involved.
Sherice Barndt, a member of the High Involvement Team explains, “The team decided that if we covered all the bathrooms on the campus we could reach a variety of people - staff, residents and family. The team agreed we should limit the information so that it wasn’t more than could be read in a typical bathroom visit. We chose three topics to address: Highlighting Action Teams, Good News from around the campus, and What’s in a Name defining a term from the new culture change language.” The first issue defined “loo,” a British slang term for toilet.
A new issue has come out monthly for the last eight months and the team believes there has been a positive response from everyone involved. “It has generated interest and inspired questions for the Steering Team staff to address. Residents from Independent Living have become more curious and involved after reading the different issues of the ‘Loo’,” Sherice says.
From our February 2012 newsletter
A Nice Warm Bath
The Steering Team at St. Margaret’s in New Orleans, LA didn’t want to wait for their new building to make their environment more comfortable for the residents. After holding learning circles about what they could do in the current building that wouldn’t be cost prohibitive but would make residents feel more at home, they decided the bathroom would be a great place to start because it is used every day and by everybody.
The Steering Team set up two Action Teams, one for each floor, to get input from residents about what they would like in their bathing rooms. (Each floor has two, one with a whirlpool and shower and one with just a shower.) Each team went about getting resident input in its own way. One team asked four residents to be on the Action Team while the other team surveyed all the residents on the floor about their preferences.
Each floor decided on a theme for their bathroom; one a New Orleans/French Quarter theme and the other went for a beach design. Staff brought in paint swatches to help residents decide on paint colors and got their input on towels, shower curtains and décor. Charlie Vaugn, St Margaret’s maintenance man, also an artist, painted murals in each of the whirlpool rooms. While residents are in the tub, they now look upon a scene of French doors, open to a balcony draped in plants and the French Quarter below. The residents on the other floor have a beach scene to help them relax.
The residents were very excited about the changes. It created quite a buzz and they were always anxious for the next bit of the decor to be added. On a roll with the bathrooms, the CNAs decided to do away with the bathing schedule and asked each resident when he or she would like her bath or shower. They also decided that everyone would give baths instead of having one CNA as a bathing aide. The video “Bathing Without a Battle” helped them with new techniques, allowing residents who once fought bathing to be more relaxed. Even family members have noticed and appreciated the changes.
St Margaret’s proves once again, when you get lots of folks involved you can make a big impact with small changes and budget.
From our August 2012 newsletter
Compassionate Healing at The Cottages at Brushy Creek
Religious services have long been a staple in nursing homes. But, a new approach to nursing homes
requires a new approach to the spiritual and communal needs of those living and working there.
Rev. Ralph May, the chaplain at The Cottages at Brushy Creek in Greer, SC, has been cultivating culture change in worship services of this new community and in his own approach to spiritual service.
In addition to the usual weekly worship services, once a month around 130 elders, staff, family
members and volunteers gather for a non-denominational Christian service lead by the elders. A
potluck with dishes brought from the 12 cottage kitchens follows. “Our elders both offer and receive
compassionate healing,” said Rev. May. “There is the participation that comes from being in an
audience and participation that comes from speaking before a group and leading. The second kind
of participation brings with it the exciting anticipation of performance and the associated sense of
personal accomplishment. From beginning to end, Cottage elders lead our worship: starting with an
invocation, including the homily, on through the extemporaneous prayer of the people, and ending
with a benediction. We, the audience, benefit from their wisdom. They, the leaders, find purpose
and meaning in their continued participation in the community. Through it all, elders, family and
staff, are transformed through our service to one another. “
Many elders and staff participate in the choir, which practices weekly, and some elders take roles
leading parts of the service. Rev. May finds volunteers during his pastoral care visits and the weekly
services. “I’ll ask elders if they would like to help lead worship. I often have more volunteers than
parts,” he said. “We provide them with as much or as little support as the individual elder requires.
We have a diverse community. I match the abilities and gifts of the elder with their part of the service
to optimize the participation of each individual.”
Like many culture change efforts, these services have been transformative for elders. Rev. May
thought one particular elder who had a “wonderful, clear voice” would be a great addition to the
service, but she did not want to join in. Then, at the first worship service, she saw other elders singing
and leading worship. “Then she wanted to join the choir. Shortly there after, she became a worship
leader. This is a prime example of elder healing elder,” said Rev. May.
The elders aren’t the only ones transformed by this new approach to worship service. Rev. May feels
changes too. “One of the challenges for me was, and is, giving up the sermon. I am the preacher after
all. Well, not really; I’m not the preacher, I’m the chaplain. Preachers preach and chaplains support.
Supporting this style worship transforms my belief system. Culture change is not just happening out
there. The most important culture change is happening inside me. As I grow, my personal sense of
urgency for the need for continued transformation increases,” he said.
From our November 2009 newsletter
Chaplains are invited to join "Chaplains for Culture Change," our new LInkedIn group -- a forum for discussion about spirituality and Culture Change. (Share this with your chaplain!)
Let's Play Ball! Pennybyrn Goes Major League
All over the country, the baseball season is now in full swing (pun intended), but at Pennybyrn at Maryfield in High Point, NC, it’s always baseball season. At least once a month for the past two years they’ve been clearing out everything in the town square of the facility to make room for the baseball diamond. It’s always the same match-up: The Pennybyrn Racers (residents) against The Maryfield Staffers (staff). There is plenty of cheering, base stealing and smack-talk. It’s at least as rowdy and as much fun as anything you’ll find in the major leagues. “Everyone gets involved,” said Janet Golden, Lead Activity/Life Enhancement, “People who don’t usually come out for activities bat the ball.”
All agree the baseball game is a highlight in the Pennybyrn community. But, there was one game that almost didn’t happen. The game was scheduled during the week the survey team was at Pennybyrn to conduct the annual survey and this gave Administrator Vonda Hollingsworth pause:
“On the way to work that morning, I thought to myself, ‘Jeez, I wonder what they will think?’ When we play, it is loud and crazy with everybody running this way and that, trying to steal bases, and residents being pushed in wheelchairs or running arm in arm with staff round the bases. Would the surveyors think we are putting our residents’ safety at risk? I knew the surveyors would be right in the middle of it since they were working out of a room in our town square.
Then I thought - what am I doing? Whose choice is it to take a risk? I am “taking chances” right now-driving my car. Individuals should be able to decide themselves what risk they want to take. Our residents are LIVING and living life is all about little risks everyday. If they want to play ball, my apprehension should not stop them. I thought there might be a real chance the surveyors would not like our game - but that was a risk I was willing to take. To my delight, several of the surveyors stop working to watch our game. They laughed and even cheered. It turned out they thought it was wonderful! I am so glad that I didn’t allow my hesitation to limit our residents’ ability to choose their life that day.
LaVrene Norton witnessed a game on a visit and was delighted to witness some serious living going on when she saw a resident being whizzed around the bases in her wheelchair – legs straight out in front of her with a look on her face that was wide-eyed exhilaration.
That’s how you play ball!
From our May 2010 newsletter
The Kitchen’s Always Open
￼Many night owls will tell you they get some of their best ideas in the dark hours. Community Care of Rutherford County (CCRC) in Murfreesboro, TN got one of its best ideas because of its many night owl residents. CCRC, while organized in neighborhoods, with one central kitchen and dining room, makes food available to residents 24 hours a day, seven days a week.
Staff had noticed that there were several night owls among the residents. “If you’ve always been a night owl, that doesn’t suddenly change when you move into a nursing home,” Dietary Director Trena Serrano said.
Of course, sleep patterns affect other patterns. “By sleeping in the day time and being awake at night, these residents’ eating cycles were non-traditional and accommodations needed to be made,” Mark King, Director of the nursing home said. The solution was to make a la carte menu available during night hours.
The work duties in the traditional nursing home kitchen center on preparation for opening and closing the kitchen. If the kitchen were kept open 24/7, it would no longer be necessary for second shift workers to complete duties such as preparation for breakfast before closing the kitchen. Cleaning schedules were adjusted as well. Since the third shift dietary worker would have time to do these duties on third shift, they could add this extra shift coverage without adding additional staff hours - merely reassigning one daytime worker to nights.
Leadership asked for a long-term, dietary daytime worker to consider reassignment to the hours traditional kitchens are closed (9 p.m. to 5 a.m.). They wanted someone who in addition to having short-order cooking experience, demonstrated concern for residents, was self-motivated, cleanliness conscious, and not afraid to work at night. Without much effort, one volunteered and took on the responsibility to work Sunday through Thursday. She is paid a shift differential and a part-time coworker covers Friday and Saturday nights.
The night owls benefitted right away. When everyone saw this, they decided to offer a la carte menu all day, every day, so that all residents might have the benefit of eating when it suits them. When a resident wants something to eat, a staff member calls the order down to the kitchen, the kitchen calls back when it is ready and then the staff member goes to the kitchen to bring the order back to the resident. “Sometimes it gets busy,” Trena says of the extra effort put on staff by the process, “But staff buy into the philosophy of doing what makes the residents happy. They don’t say, ‘We can’t do that!’ They say, ‘What can I do?’”
Perhaps as a direct result of this new availability of food, all current weight-loss can be tracked to illness. In fact they are seeing healthy weight gain among the residents, according to Trena. In July 2011, 569 a la carte orders were made.
From our Sept., 2011 newsletter
Lessons of a Lifetime
When Household Coordinator Jan Braun saw a story on TV about a young boy who writes famous people asking them what the most important thing in their life is, she thought “What is it about Tom Cruise or the Pope that is any more special than anyone else? Everyone has had their own successes and challenges.” And thus was born the “Lessons of a Lifetime” project at Shorehaven Health Center in Oconomowoc, WI.
Staff members were asked to ask residents, “What are the two most important things in your life you’d like to pass on?” Braun said it was a great way for staff to connect with residents and their family members, who were asked to help answer in cases when the resident was unable to talk. Staff were asked to answer the question as well. All the answers were then collected to be put into a booklet. Braun asked a resident who was a teacher to go through them all with a red pen and check for spelling and grammar errors. The resident also put them in order according to the age of the person who answered. The book starts with an entry from a resident who is 101-years old and continues on to include 18-year old staff members. Braun said that everyone, no matter their age, has things they have learned in their life.
Every resident was given a copy of the finished book that includes great candid photos from the households. Braun was pleased to be able to take a copy to the funeral of a resident who passed away to share with the family this special part of the person’s life.
The Lessons of a Lifetime project is a great way for people in the Shorehaven community to get to know one another both in the interview process and also after publication. As residents and staff pick up the book and flip through, they learn about each other and have things to talk about. It also honors every person involved by acknowledging the value in each person’s life, no matter age or role in the Shorehaven community.
From our June 2011 newsletter
Homelessness Skit -- Powerful Message now a Major Motion Picture!
The need for true home for elders living in nursing homes suddenly becomes urgent when one realizes the many similarities between these elders and the homeless. Lack of privacy, loss of personhood, feelings of powerlessness and dependency are overwhelming for those living in traditional nursing homes, and on the street.
Action Pact trainings often include an examination of these similarities to create motivation and momentum for culture change work. Two members of the Steering Team from Pilgrim Place in Claremont, CA (http://www.pilgrimplace.org/) decided to put together a skit to illustrate the similarities to their peers as part of this training. Independent Living resident Eleanor Scott Myers and Staff Developer Rachel Von Stein play a homeless person and elder in a nursing home respectively. The two characters have a frank and empathetic discussion about the parallel indignities in their lives. The skit was so well done and powerful, they were encouraged to video tape it to be used as part of the PersonFirst® trainings done throughout the organization. “[People in the trainings] see things they had never thought of before that a resident might feel because of things we do,” said Sue Fairely, VP of Health Services at Pilgrim Place.
The skit is now available on YouTube: http://www.youtube.com/watch?v=Opd2cgN7Pnw
We encourage you to check it out and share it to awaken that urgency in your organization.
From our November, 2011 newsletter
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