Culture Change and
Person-Centered Care
Culture Change
Background
Examples
Benefits
Culture Change: What is It?
National movement aimed at improving long term care services for elders and individuals
with disabilities.
The Three Components of Culture Change
Staff
OrganizationResidents
Core Principles of Culture Change
Self Determination
Purposeful Living
Belonging Choice
Support
Dignity
Sense of Community
Contributing
Where Did We Begin?The Institutionalized Model
Medical Model
System-Centered
Custodial Care Conformity
Task-Oriented
What Comes to Mind When You Think of a Nursing Home?
Fluorescent Lights
Sterile
Hospital BedsIntercom System
Nurses’ Station
Medicine Carts
Where Are We Headed?
In 2011, the first Baby Boomers reached age 65.
By 2030, 72 million people will be aged 65 or over.
A Need For ChangeLeading Organizations in Culture Change:
The Eden Alternative
Founded by Dr. Bill Thomas
End the Three Plagues Found in Nursing Homes:
HelplessnessLonelinessBoredom
Eden LifeLong Living
Applies the Eden Principles to individuals with disabilities.
Same Principles, Different Needs
Eden Alternative
Eden LifeLong Living
Nursing Home Residential Home
Elders Non-Elders
CNAs DSPs
Shorter Term Longer Term
Full Life Life Interrupted
Person-Directed Person-Centered
Person Directed
Person Centered
Staff Centered
Provider Directed
Person-Centeredness Continuum
Low HighPioneer Network
Listen to these dining examples. Where would they fit on the continuum?
What is the Goal?
Institutionalized Care
Individualized Care
Person-Centered Care
Know the Person
Individuality and Uniqueness of
Every Person
Empowerment
Responsive, Permeable Environment
Person Has Input About Wants
Daily Pleasures
Artifacts of Change
Staff recognition
Elimination of call systems
Resident Recognition
Staff and residents are at the center of the change process!
New Paint
Children
Animals
Plants
How Do We Get There?Empower Residents and Staff
Improve Quality of
Life
Feedback
Create Urgency
Have Knowledg
e Incorporate Artifacts of
Change
Improve Care
Does Culture Change Work?
YES!Research shows that
Culture Change implementation
increases quality of life and decreases
staff turnover.
The High Cost of Turnover
The direct cost of losing one direct care employee is $2,500.
One Study Proves….
E. Elliot, "Occupancy and Revenue Gains from Culture Change in Nursing Homes: A Win-Win Innovation for a New Age of Long-Term Care," Seniors Housing & Care Journal, 2010 18(1):61–76.
Nursing homes engaging in culture change can not only
improve their residents' quality of life, but can also
achieve better financial returns.
2004 200884%
86%
88%
90%
ControlCulture Change
Occupancy Rates
Culture Change adopters could expect to see an additional
$584,073 in revenue per year.
The Bottom Line
Better Trained and
Empowered Staff
Less Turnover
Better Care
Increased Resident and
Family Satisfaction
More Referrals
Doing What’s Right is Good Business.
A Better Place to Work…
A Better Place to Live.
Culture Change is NOT a quick fix or a marketing ploy.
It is the systematic change of an organization in order to
provide a better place to live and work.
What is the Key?
Complete Support From Leadership!
Take Culture Change With You!
Small Steps Can Have a HUGE Impact!
Great Culture Change Literature
Old Age in a New Age: The Promise of Transformative Nursing Homes by Beth Baker
What are Old People For? How Elders Will Save the World by William H. Thomas, M.D.
The Journey of a Lifetime: Leadership Pathways to Culture Change in Long Term Care by Nancy Fox
Life Worth Living: How Someone You Love Can Still Enjoy Life in a Nursing Home by William H. Thomas, M.D.
The Silverado Story: A Memory-Care Culture Where Love is Greater than Fear by Loren Shook & Stephen Winner
Keep Up with Culture Change Happenings!
Changing Aging Blogstream:http://www.changingaging.org
Pioneer Network:http://www.pioneernetwork.net
Eden Alternative:http://www.edenalt.org
Eden LifeLong Living:http://edenlifelonglinving.org
Texas Culture Change Coalition:http://www.txccc.net/
The Picker Institute, Long-Term Care Improvement Guide:
http://pickerinstitute.org/wpcontent/uploads/2010/10/LTC_Improvement_Guide.pdf
Visit these websites for more information on culture change in long term care, where it is headed, and how you can be an agent of change!