< Culture Change

The 3 R’s: Renewal

So many things we do in our daily lives are a matter of routine. We do things the way we do because it is the way we've always done it. We do it without thinking. We do it without realizing there could be a better way. We take the most common, straight drive to work and sometimes get there without even remembering the trip because it is such a habit. But there is a road more scenic. Taking this road, while it may require breaking out of our routine and being a bit more aware, can add to our lives instead of being just a waste of time.

For a health care facility, taking the scenic route means renewal of the spirit for the staff, residents and community. Life at Perham Memorial Hospital and Home used to be very routine, with few options for the residents to choose to carry out their day, according to Marilyn Oelfke, Perham's Senior Director of Long-term Care Services. They knew they were providing high quality health care but knew something was missing in quality of life.

"We knew it just wasn't the best we could do for the residents," she says. So, like many other facilities which have chosen to make changes for better care, the folks at Perham researched models of care by visiting other facilities who were well on their way to reaching that goal.

Rich Newman, Administrative President of Pennybyrn at Maryfield, considered his organization's trip to Meadowlark Hills in Kansas the key to jump starting the process. "It was instrumental in getting people excited," he says. " Actually being there captures you to what the experience is." Pennybyrn and many other facilities enlisted the help of Action Pact and other activist groups to encourage community and consider options in changing the culture in their homes.

Once the decision was made to make a change, the next step was to get the staff on board. The staff at Perham and Pennybyrn went through PersonFirst™ training. Oelfke believes this training helped the staff become more sensitive to what it's like to be aging and to identify elders' individual needs and simple pleasures.

Right away, Brett Dewolf, Director of Environmental Services at Halcyon House, saw sparks of leadership and enthusiasm among the staff. These people worked with the others on staff to change the philosophy of the caregivers, Dewolf says.

This is a very important time in the process because it gives the staff a chance to remember why it was they entered the field in the first place. It's a chance to renew the commitment to the residents they serve and the purpose and meaning it brings to their job. The happier and more fulfilled the residents are, the happier and more fulfilled the staff is and vice versa.

The three great plagues afflicting frail, institutionalized elders, according to Dr. William Thomas, founder of the Eden Alternative™, are loneliness, helplessness and boredom. Getting them involved in the way their life is run is the best medicine for these problems. Building genuine and meaningful relationships with staff and other residents helps in the fight on loneliness. Having a say in decisions combats helplessness and being involved in the joys and routines of daily living, mixed with variety and spontaneity sends boredom on its way.

Learning circles, held on a regular basis, are a great way for elders and caregivers to make decisions and have a genuine influence on their households and neighborhoods. Families are not only involved in learning circles in the households, but often volunteer to take training to learn to facilitate circles with elders living with dementia.

"Residents are starting to learn that their input is important and that they have a say," Dewolf asserts. Sometimes, it goes even beyond that. Raeline Evenson, Executive Director at Dorchester Health and Rehab, says that she sees elders being responsible and empowered to do things on their own. "The residents are more demanding in a good way. They're making their own decisions. It's truly positive," she says. "They're more willing to get involved and they're looking out for each other. They have a new purpose in life. They see that they are still needed and valued."

So now, these renewed elders are reaping the benefits of raising their voices. At Dorchester they have begun to get involved in everyday activities such as setting the table, folding towels, gardening and visiting with each other. Also, the staff will occasionally bring in their children to visit with the elders, which is a joy for all involved.

The folks at Halcyon House are even more adventurous. They've gone on snowmobile rides. And, come spring they went mushroom hunting as many of them had done every spring of their life. They often plan and prepare out elders' favorite recipes (with or without mushrooms) in the kitchen for all to share.

The renewal process brings about big changes while spending very little money. What's more amazing is the awakening as this process is embraced and the pleasures of daily living return. Oelfke has witnessed a resident who used to sit slumped in a chair open her eyes. Dewolf recalls a comment made by a resident that let him know it's working. "We never expected that life would be so good again," she said.

Renewal is the first step in a process of total culture change. But to those who are making the journey, it may be the most important. Oelfke fully understands this. "Change the model of care and change the house. If you don't change the model of care, you can't have a different home," she said. Newman echoed that sentiment when he said that they are working on team building now so that the energy will be there when they open the doors on the full household model after reframing and renovation.