2019-11-15 What do people think about when they hear the word What - PDF document

2019-11-15 KEYNOTE ADDRESS Jennifer Hartwick , MSc Put LIVING First Director of Strategic Projects Creating a Culture Where Everyone Thrives Schlegel-UW Research Institute for Aging Jennifer Hartwick, MSc. Director of Strategic Projects 26 27 Schlegel-UW Research Institute for Aging Centre of Excellence for Innovation in Aging The Schlegel-UW Research Institute for Aging (RIA) is a charitable foundation dedicated to enhancing care and quality of life for older adults. We drive innovation to tackle the biggest issues facing an aging population. By creating a vibrant community where older adults live, students learn and researchers explore, the RIA is transforming the way we age in Canada. 28 29 Partnership approach Model for innovation RESEARCH EDUCATION PRACTICE Developing Building a Advancing Best Practices Skilled Workforce World-Class Research 30 31 1

2019-11-15 What do people think about when they hear the word What is Culture Change? aging ? 32 33 Perceptions of aging Perceptions of aging The way people talk about aging is influenced by the story that society tells There is no one old age. Old age is what about what it means to age. we make it. And unfortunately in North America, we live in a shared culture that has come to regard old age as a time of Medicalization of aging decline. Segregation of older adults We’ve come to think benevolently of older people as broken versions of their formerly impressive selves. Stigma Dr. Bill Thomas Walk With Me | Toronto, ON | March 25, 2014 34 35 This needs to change. Is your organization currently on a culture change journey? The culture change movement can help! 36 37 2

2019-11-15 What is culture change? In the most general terms, culture change is a social movement that supports a shift from an institutional approach towards a social model of living; a shift in focus from providing care to supporting living. What does “putting living first” We must still provide excellent care without making it the central focus of each mean to you? interaction with residents. Culture change calls us to put living first. 38 39 Culture change is… Culture change is not… • Championed by collaborative • A top-down mandate “Culture change may require changes in leaders implemented or imposed by fundamental organizational and individual beliefs others • Mobilized through • An end product or outcome and philosophies , in practices , in physical partnerships and collaboration environments , in relationships at all levels and in • Open to new possibilities • Solely a quality improvement initiative workforce models . These kinds of changes lead to • An evolving process • A specific program or model better outcomes for elders, their families, and • Builds upon strengths by of care direct care workers.” reflecting on the best of what • A one-size fits-all approach currently is and by working Pioneer Network towards what could be 40 41 Domain Institutional Social Primary focus Focus on care Focus on living (and care) Resident/team routines Scheduled routines Flexible routines Team members assist Team assignments Team members rotate same residents Decision-making Decisions for residents Decisions with residents Physical environment Environment = workplace Environment = home Planned, flexible, Activities Structured spontaneous Departmental structure Hierarchical departments Collaborative teams Team members care for Relationships Mutual relationships residents Sense of community Us and them Community Long-Term Care Models (adapted from Fagan, 2003) 42 43 3

2019-11-15 Requirements for resilient change Requirements for resilient change At the beginning, I thought, oh my God, there is no way. And Personal transformation Personal I’m sure if people were honest enough…they’d say that when [she] stood on that platform that day and started talking to us about culture change, 75% of people in that room thought [she] was whacked. Operational transformation Operational There’s no way. You know, we’ve been doing it this way for so long, the ministry standards [are] in place, the long term care Environmental transformation Environmental act [is] in place, there’s no way. But then I started thinking, what if we could change? Am I willing to put the brakes on and do what it takes to get us Societal transformation Societal where we need to go, even if it takes us 10 years to get there? And then, I stared thinking, wow, what a legacy to be part of that.” Testimonial from a Schlegel Villages Team Member 44 45 Requirements for resilient change Requirements for resilient change Personal Personal • Advisory Teams • Conversation Cafés Operational Operational • Organizational realignment Environmental Environmental Societal Societal 46 47 Requirements for Resilient Change Ownership and Empowerment Personal OLD CULTURE NEW CULTURE Operational “We all have ownership “I need to get the buy- and an important role Environmental in of my staff.” to play.” Societal https://www.youtube.com/watch?time_continue=197&v=zlD8FEaeGwI 48 49 4

2019-11-15 Working Together To Put LIVING First: A Guidebook to Change Designed for anyone interested in embarking on a culture change journey within their community The Importance of Language in Culture Change 50 51 Why worry about words? Words The process of re-defining our language is a part of a larger journey. Words are tools we can use to rethink Matter! what we’re doing, how we work together, and how we’re sharing these ideas with our residents and their families. It’s a starting place for discussions about how we can improve our care and services. Changing our words alone won’t change our practices — we need to make a commitment to do both. • Choose your words carefully Person-centered care is so much more than a project or a program. Our new – “think before you speak!” vocabulary must do more than simply describe our surroundings. It must convey • our new relationships and our new way of thinking if it is to bring lasting culture Changing our language change to our communities. is an easy starting point Joan Devine Director of Education, Pioneer Network 52 53 Language is important! INSTITUTIONAL LANGUAGE SOCIAL LANGUAGE What are some examples of Allow Encourage, support stigmatizing language? Diaper Brief The elderly Elders, older adults, people What inclusive terms could Patient Resident, individual, neighbour we use instead? Admit/discharge Move in/move out Staff Team members Table adapted from Schoeneman’sarticle at: http://www.pioneernetwork.org/CultureChange/Language/ 54 55 5

2019-11-15 Appropriate language What prevents us from using Appropriate language is: inclusive language? • Accurate How can we incorporate • Respectful inclusive language in our • Inclusive daily conversations? • Empowering • Non stigmatizing Alzheimer’s Western Australia 56 57 Your BELIEFS become your THOUGHTS . Your THOUGHTS become your WORDS. Your WORDS become your ACTIONS . Your ACTIONS become your HABITS . Your HABITS become your VALUES . Your VALUES become your DESTINY. 58 59 Collaborative leadership is key LEVEL OF MEMBER ENGAGEMENT The Role of the Leader Command and Collaborative Consensus control leaders leaders leaders 60 61 6

2019-11-15 The “Wise Gardener” Understanding Frost The Eden Alternative refers to leaders as “Wise Gardeners”… • Frost is an inevitable part of the culture change journey. • They help to make the home a fertile ground for growth and • Change consumes warmth, which must be steadily re- improvement. infused into the community • They build safe and trusting environments and foster a generosity of • Life happens (leadership changes, other transitions, spirit that is necessary for building and supporting teamwork. Ministry/inspection issues, illness, renovations, getting • When there are challenges, rough patches, or “frost”, they continue to “stuck”…) warm the soil and patiently wait to foster growth when the time is • Frost doesn’t kill a garden or a culture change journey. right. Loss of faith does. • They help make team members, residents, families, and volunteers feel appreciated and respected; when they feel safe in expressing their opinions and having what they say count towards making Eden Alternative improvements. 62 63 Effective culture change leaders… • Embrace and model values • Be visible and curious. • Stimulate people’s imaginations • Collaborate Where to begin… • Build trust and self-esteem • Provide an anchor • Promote growth • Share thanks and praise 64 65 Dining Room Enhancement Mealtime practices checklist C Connecting CONNECTING Usually Sometimes Rarely H Honouring Dignity I make sure that residents are happy where they sit and who they sit with. O Offering Support I sit with residents at the table to socialize. Six key principles… I Identity I make eye contact, smile, and use gentle touch with residents who communicate without words. C Creating Opportunities I encourage residents to stay for as long as they want in the dining room (e.g. for a cup of tea) E Enjoyment 66 67 7