Our Culture Change Initiatives


Overview

Culture change is a “transformation anchored in values and beliefs that return control to elders and those who work closest with them.”  Its ultimate vision is to create a culture of aging that is “life-affirming, satisfying, humane and meaningful.” 

Culture change or a resident centered approach means The Home has an environment in which:

• The living environment is designed to be a home rather than an institution
• Work is organized to support and allow all staff to respond to residents’ needs and desires
• Care and resident-related activities are decided by the resident
• Management allows collaborative and group decision making
• Close relationships exist between residents, family members and staff

Over the last 15 years, many culture change organizations formed.  Some of these organizations are the Pioneer Network, the Eden Alternative and the Greenhouse Project.  The Home has modeled its culture change journey on the Pioneer Network.

Our Culture Change Initiatives   

Our Facility

The William Breman Jewish Home began its Culture Change journey in 1995 when the present skilled nursing home and rehabilitation center was in its design phase. Certain design features of the facility enhanced The Home’s ability to embrace and promote Culture Change, such as:

• Eight (8) units of 12 residents
• Two units on each floor; each with its own kitchen and dining room
• Floor to ceiling windows throughout the facility
• Living Room and Garden Room on each floor
• Spa Bathing Room

Our Staff

The Home has begun several staff-related Culture Change initiatives. These include:

• Consistent assignment so that  residents see the same caregivers (registered nurse, licensed practical nurse and certified nursing assistant) almost every time they are on duty.  Caregivers get to know what each resident wants and needs as well as noticing changes in the resident’s condition.  This has been expanded to include housekeeping and dietary staff.
• Licensed practical nurses and certified nursing assistants attend and participate in care planning meetings.
• “Partners in Caring” boards on each floor to identify staff members working on the specific floor.
• Mentor Program to help new staff members orient to The Home.
• Peer involvement in interviewing for new staff member hiring.
• Focus groups to solicit staff opinions and ideas.

Our Residents

Residents participate in The Home’s Culture Change initiatives across a variety of areas including:

• Focus Groups
       o Focus groups to solicit resident ideas and feedback such as the renovation project of the spa
          bathing rooms.
• Feedback  on Consistent Caregivers
       o Residents are more comfortable with caregivers who know and understand their
          personal needs and preferences. Residents do not have to explain to new staff
          how to care for them day after day.  This also allows for residents and their
          family members to develop relationships with staff over time.
• Input on Dining Services
       o Liberalized diets were implemented.  This allows each resident to choose the food
          items that he or she wishes to eat without any dietary restrictions.
       o Residents select from a menu each week.
       o Meals are served in each unit’s kitchen and dining room.
       o Cloth napkins are used.
       o Serving trays were eliminated.
       o Monthly exhibition cooking takes place.
       o Resident Food Committee meets monthly to sample new dishes and recipes. 
          This helps determine new menu choices.

Family Council

The Family Council is a group of family members of The Home’s residents.  Membership is open to relatives, legal guardians and friends of current residents of the Home.  The Family Council meets quarterly.  The meeting serves a variety of purposes:

• to exchange information
• to educate about pertinent topics (End of Life Decision Making)
• to promote communication between families and The Home  
• to facilitate family members getting to know each other and helping to welcome new family members to The Home

The Portrait Project

The Portrait Project is an opportunity for staff members, family members, volunteers and visitors to learn about our residents.  The portraits will facilitate residents having conversations with each other and helping residents to develop friendships within their neighborhoods.

This project consists of two parts.  First, each resident and, where necessary, a family member are interviewed to learn about the resident’s habits, interests, favorite past times and hobbies.  Next, a professional photographer takes a picture of the resident.  The interviews and photographs are displayed in the dining room area on each floor.

Welcome Home Program – Coming Soon

The Welcome Home Program is a peer support program that is being developed to assist and ease adjustment for new family members as they move a loved one into The Home.  This former family member will volunteer to meet with new family members prior to, or shortly after, admission to befriend, offer support and hear concerns.
 
He or she will share his or her adjustment stories and experiences and will continue the relationship with the family member until adjustment.  The former family member will discuss relevant topics such as realistic expectations, effective communication with staff, contacting the Ethics Committee and visiting residents with dementia with the new family member.