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Culture Change

A nursing home is a place residents call "home." A place where someone lives and calls home should nurture the human spirit as well as meet medical needs. Culture change is a movement that seeks to create an environment for residents, which follows the residents' routines rather than those imposed by the facility; encourages appropriate assignments of staff with a team focus to make deep culture change possible; allows residents to make their own decisions; allows spontaneous activity opportunities; and encourages and allows residents to be treated as individuals. Deep culture change is an important component of the right of residents to “care and services to attain or maintain the highest practicable physical, mental and psychosocial well being;” as promised in the 1987 Nursing Home Reform Law. It is the role of the Ombudsman to advocate for residents and their right to make choices to direct their care and life in long-term care facilities. Below are documents and resources that may help ombudsmen in their work to achieve resident-directed care.

Resources

The Role of the LTC Ombudsman in Culture Change: Promoting Resident Directed Care in Nursing Homes and Assisted Living (NORC 2007)
This resource brief is designed to generate ideas about how long-term care ombudsmen can promote systemic, resident-directed care practices in facilities. Included are examples of state and local ombudsman program involvement in promoting culture change practices, offers tips for ombudsman advocacy, discusses the role of the ombudsman and lists salient resources.

Ombudsman Best Practices: Supporting Culture Change to Promote Individualized Care in Nursing Homes (NORC 2000)
This paper presents long-term care ombudsman practices in supporting culture change in nursing homes, drawing on lessons learned by State Ombudsman Programs that have engaged in such initiatives. It includes an overview of the issues, relevant practice precedents and examples of best practice. The section “Lessons Learned” examines important considerations for state and local ombudsmen who want to begin or continue culture change efforts.

Changing the Nursing Home Culture (March 2008)
Alliance for Health Reform Culture Change Issue Brief

Pioneer Network
A grassroots movement to transform the culture of aging in America. The movement is called culture change, the transformation of traditional institutions and practices into communities in which each person's capacities and individuality are affirmed and developed.

Training

Culture Change Inservice Training (NORC)

Quality Partners of Rhode Island - coordinated a 2004-2005 CMS pilot of QIO work in nursing homes. Individualized Care: The Key to Quality and Retention

Texas Ombudsman Training Manual: Module 6 - Advocacy from Individual Complaint to Culture Change: Trainer's Notes; Participant Material; PowerPoint

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