Culture Change

Long term care has been and continues to be "institution-centered," focusing on the medical needs of "patients" and the interests of management.  There is an emerging push for long term care to become more "person-centered" -- shifting focus to the person (not patient) and staff/client relationships.  This kind of change involves significant and ongoing efforts on the part of the institution and demands change in environment, training, care protocols, job descriptions, and management styles, to name just a few. 

CAC's scholars and partners are involved in Culture Change on multiple levels including establishing and testing best practices in: programming, communication, pain treatment, end of life care, nurse decision-making, organizational change, and environmental change.  Again, our focus is the broad spectrum of long term care - our scholars and partners are working to change the culture of family caregiving and institutional care alike.

Almost Home: Curricular Design, Outreach, and Evaluation

Based at UWM, documentary filmmaker Brad Lichtenstein produced and directed Almost Home, a film that tells the story of a continuing care facility taking on culture change, and the people who live and work there.   Lichtenstein collaborated with the CAC in designing the outreach plan and on-line curriculum.  Together we hosted Almost Home: Changing the culture of care, a summit of outreach partners and the general public.  The outreach efforts for Almost Home were extensive, and included 13 national partners, over 40 screenings of the film, and over 2,000 free copies distributed.  In 2007, CAC embarked on phase two of Almost Home Outreach, with efforts focused on partners in employee assistant programs and faith-based organizations. CAC will be evaluating this second phase of outreach for Almost Home, and the use of AH as an educational tool that can bring about changes in attitudes and behavior.  

Collaborative Project between local Nursing Home and UWM

With funding from two local foundations, this project aims to implement culture change and redesign the long-term care services for older adults based on a person-centered, social model of care. Christine Kovach, Professor of Nursing and CAC Scholar, is serving as Education and Evaluation Consultant for the project. Addie Johnson, doctoral student in the Department of Architecture and Certificate in Applied Gerontology Program, is employed on the project 30 hours per week as a "Change Agent." While the goal of culture change for this organization applies to all older residents, the main focus of this consulting project is on the care of older adults with advanced dementia. The purposes of this person-centered care project are to:

• Move from a hierarchical to a flatter democratic organizationalstructure. This may be facilitated by moving to a neighborhood and household structure with rotation of staff possible between "sister" households;

• Develop and maintain educational and procedural processes that support empowerment and effective leadership by middle managers;

• Empower frontline staff through organizational structure changes, certificate, educational and other incentive programs;

• Institute procedural changes on four households for achieving person-centered care of residents with dementia

Creative Engagement and Culture Change

Oneida Collaboration

CAC is coordinating a consulting team of scholars and community partners to work with the Oneida Nation as they plan a visionary new building project that aims for true "aging in community". The CAC consultants include Anne Basting, Gerald Weisman, Beth Meyer-Arnold, Sarah Morgan, Stephanie Sue Stein, Chris Kovach, Brad Fulton, and Addie Johnson. We have gathered many times, beginning in 2006, working on issues of person-centered care, green design, aging in community, and incorporating Oneida values. Together, the CAC and Oneida teams are using the latest research about evidence based, therapeutic design in planning the structure. Importantly, we are implementing design elements that emerge from the specific cultural background of the Oneida people. CAC is also working with the Oneida Nation to identify potential funding sources to support the design and building process, the design and implementation of new operations in the building, and the evaluation of the new facility.

Environmental Change at Luther Manor Adult Day Center