Culture Change Movement in Long Term Care

I recently attended a meeting in Portland, OR, regarding long term care as an Oregon State Certified Ombudsman for Long Term Care. There is a movement in long term care to make long term care change from just caring for a resident into having the resident experience life much like they did before being forced into having others care for them. Residents haven't changed from who they were all their lives just because they are now living in an "institution". This movement addresses residents as individuals instead of the usual group getting all the same food, activities, care and environment. Here are some of the ideas I heard as suggestions for making this change for residents of long term care.


Life story questionnaire is a way to get to know each resident about their lives before long term care. How did they spend their day? What was their joy?

* Favorite music
* Favorite meals
* What did they see all day at home?
* did they have house cats?
* Were there live plants in their homes?
* did they enjoy a fish tank?

Some of the best practices to make a day better for long-term-care residents is to remember:

* Patience is needed
* Make repetitive - repeating is really O.K.
* Answer as first time you have been asked the question. Keep it fresh
* Jokes in morning set mood for the day
* Agitation spreads so defuse it before it goes further
* Validate even senseless. Everyone needs to be validated no matter what else is going on.
* Coloring outside the lines just fine as perfection is not really that important

Games:

* O’ho
* Roll dice to spots
* Trivia
* Songs
* Life style stories
* Grab bag poetry
* Good news stories

Activities:

* Garden time
* Walks
* Bible study
* Pet therapy
* Interact with music
* Laughing Yoga

Restorative Activities

* Blend home in the institution.
* Therapeutic needs
* Entertaining
* Meaningful fun that suits residents
* Geared for options and abilities
* Create what they want
* Know what builds their soul
* Life enrichment Dept.: Laughter, fun and interacting with purpose


Other things that can make life like it was before someone had to be a resident of a facility

* Choice as to when residents get up i.e.: 7:30-9:30
* Buffet style meals instead of trays
* Consistent staffing with staff meetings sharing ideas in a learning circle
* I also read that having a staff member be assigned to a resident as a "best friend" can make life have more meaning. We all need a best friend even when old and sick.

Small group activities that:

* Engage
* Innovative
* Inspire

Here are some fun activities that bring smiles and a sense of what life was before being in long-term-care

* Pie eating contest
* Dog shows
* Brewing beer
* Wine tasting
* Pajama day for staff
* Make dog biscuits
* Have car washes
* Husk corn
* Make salads
* Make pies

* Have evening activities. Not everyone wants to just sit in front of the TV or go to bed. Older adults do have social lives and activities after dark when they are home. They should also have this pleasure in long term care.

Volunteers need purpose to keep them, so don't give them silly meaningless activities. I have volunteered often where I know if I were to stop tomorrow, no one would even miss me. Make the volunteer an important member of the team and they will stay.

Have more moments

* On the day of each resident's birthday have the resident have their own gift and their own cake. In "real" life we don't have a group birthday cake at the beginning of the month. We wake up to the joy of our own special day. Residents of long term care deserve the same.

We all need something to:

* To do
* To care for
* Care about
* To love
* To hope for

In Foster Homes some of the activities could be:

* Real life activities like polishing the silver, combing the dog etc
* Scrabble
* Cooking fun where "usual" life returns
* Copy what we do at our homes like making a bed, feeding the bird and more
* Ask residents what they like and incorporate those likes into their lives