Philosophy shift changes 'home' to a home

Staff

Published Monday, August 30, 2004

By Ann Austin, Tribune staff writer

Viewing a person as an individual and understanding them are two essential parts of any relationship. But those aspects can be overlooked in a career when performing ones' tasks, especially in an institutional setting.

In such a situation, it's hard for close, positive relationships to form, which is why St. John's Lutheran Home continues to strive for a culture change. The culture change focuses on altering employees' and residents' perspectives about the nursing home environment. The employees at St. John's want to bring a new atmosphere to the place, different from long, sterile hallways and rigid schedules; one more like home.

St. John's is already two years into the culture change program with the assistance of a company called Action Pact Inc., which shares information and advice on restructuring nursing homes and reorganizing the way things work.

St. John's has made plans to restructure the building itself with smaller sections that have a kitchen, living room and dining room to be more a home and less a hospital. There are no longer sections or floors, but communities and neighborhoods with names like "Sunnyside" and "Northwoods."

Another focus of the program is to put the person before the task at hand, considering what would be better for residents instead of worrying about finishing a mopping job or getting a resident to eat a certain number of meals. Instead, employees will be able to take time to listen to stories or inquire about a resident's grandchildren.

Already, residents may eat anytime between 7 and 10 a.m., or sleep through and have a snack later. They also do not have set times or places to bathe. Residents may choose to take a bath or a shower when they want. Even though these changes are simple ones, it takes a great deal of effort to change the system, according to Megan Hannan, consultant for Action Pact who has been educating employees on making the culture change.

"It's a big change for organizations, the leaders and elders themselves," she said. "It's a self-awareness about how traditional culture (organizational) makes it easier to be non-person centered."

"It affects every piece of our organization," said St. John's Administrator Carol Kvidt. Kvidt became the administrator three years ago, but has known about the idea of culture change for many years and has been striving to incorporate it Kvidt is a certified Eden Alternative associate, along with five other employees at St. John's. Eden Alternative is a program which focuses on creating habitats for human beings rather than facilities for the frail and elderly by incorporating life into the facility with animals, children, plants, etc.

Kvidt is driven to make the change because she believes it will be beneficial to everyone involved: residents, their families and employees.

Hannan has outlined three elements for a culture change. The first is to work with staff and residents to make life better in the homes, to change expectations and foster an understanding.

The second is a physical renovation of the home - changing the sterile, institutional setting into a home-like setting with common spaces for residents. And third is an organizational re-design, moving residents from the bottom of the hierarchy to the top, giving them more respect and consideration for their lifestyle.

"It's a lot about decision making - shared decision making," Hannan said.

Hannan said residents need to have more control over simple things like getting dressed, eating, and they need to have purposeful work.

"Nursing homes are good at keeping people healthy, but still do everything for them and do things to them instead of with them," she said.

She said the elderly are treated like they aren't able to make their own decisions or capable of doing things for themselves, when they very well could be.

"In our society people don't have respect or consider them whole persons if disabled, aged or frail," Hannan said.

People are conditioned to value independence and the ability to be a good producer, she said. Though such values are rampant in the United States, other cultures value what the elderly have to give: Their wisdom and ability to share stories about their life.

Hannan said there are groups throughout the United States which are striving to change the current perspective of the elderly, as being burdens. In addition to the Eden Alternative group and Action Pact Inc. there is a group called the Pioneer Network which has also been focusing on changing the entire culture's

perspective on aging and the elderly.

These changes may take years, and there is much left to be done, said Kvidt.

But she said it's encouraging to see how far St. John's has come.

"It's just a really interesting journey that we're on," she said.

For more information on the organizations listed, visit their Web sites at: culturechangenow.com, www.edenalt.com and pioneernetwork.net.

(Contact Ann Austin at ann.austin@albertleatribune.com or 379-3435.)

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