Legislators Push for Culture Change at Colorado Nursing Homes
May 06, 2009
From: In Denver Times
Legislators push for ‘culture change’ at Colorado nursing homes
Billie Bliesner, 84, and Susan Black share a laugh on the playground at Exempla Colorado Lutheran Home in Arvada. The playground was put in to attract neighborhood children so that home residents can interact with people of all ages. Photo by Andy Piper
A bill to make sure that Colorado’s nursing home residents aren’t dying of boredom and loneliness is flying through the legislature.
The 65 House members already have unanimously endorsed House Bill 1196, which would take some of the money in fines against nursing homes and use it to promote a culture change.
The bill now is in the hands of the Senate, which should hear it next week.
Culture change means letting residents make as many choices as possible regarding their daily lives: when they wake up, how many baths they take, what kind of food they eat and what kind of activities they do, say the bill’s sponsors, Rep. Cheri Gerou, R-Evergreen, and Sen. Betty Boyd, D-Lakewood.
“In a lot of nursing homes you do nothing, but here, we do everything,” Billy Bliesner, 84, a resident of Exempla Colorado Lutheran Home in Arvada, said Wednesday.
“We do different things every day, and 90 percent of the time we do things that we have asked the facility to provide for us. We play bingo, we bowl, we play basketball – not on regular basketball courts, of course – we play cards.”
Lutheran Home started embracing culture change in 2003, and by 2006, a sea change had occurred, said director Susan Black.
“It takes a while,” Black said, noting that Lutheran Home embraced the 10 principles of the nonprofit Eden Alternative, which says culture change is “a never-ending journey.”
The first principle, stating the problem, is that “elders living in nursing homes aren’t dying of chronic disease, but of loneliness, helplessness and boredom.”
Combating loneliness could mean putting residents in touch with their loved ones or with pets. Lutheran Home has one dog and seven cats – and, yes, one of the cats seems to gravitate toward residents who are close to death, Black said.
Combatting boredom means imbuing daily life with variety and spontaneity.
“It means unexpected and unpredictable interactions, getting up when you want to get up, deciding that you want to go somewhere different for lunch, or eat something different for dinner,” Black said. “It’s not the same horrible regimen day after day.”
Combatting helplessness means letting residents give as well as receive care. At Lutheran Home, residents help plant the spring garden and take charge of birthday parties for staff.
“It’s not an easy thing to do,” Black said of the effort to change the culture. Changing from a fixed meal schedule to open dining took six months. Eliminating bibs at meals took three months.
“People think that would be easy, but it’s not,” Black said. “We’re doing this because it’s the right thing to do, because nursing homes should be vibrant communities.”
The big payoff is lower staff turnover, far less absenteeism and much better scores on satisfaction surveys, Black said. “It becomes an environment where you want to go to work.”
Billie Bliesner does a little bowling at the Exempla Colorado Lutheran Home in Arvada. Photo by Andy Piper
Bliesner, the 84-year-old resident, said she’d be happy to live the rest of her life at the home, and she hopes she’s good for many more years.
“We not only have good food as a first choice, but we always have an alternate dinner,” Bliesner said. “I like seafood and turkey and soft corn, but what I really like is whenever I’m hungry for a hamburger or a hot dog, I can have that.”
The residents are always making suggestions about activities, “but we’re the last ones to decide,” she said.
“You have never seen a nursing home like this. When you walk in, you are greeted, but no one is running around in a uniform – it’s almost like they’re walking around in my home.”
Bliesner said she can leave with her family or take excursions to go shopping or to her doctor’s office.
“The staff is wonderful,” she said. “We scrutinized the staff, asked a lot of questions. Everybody is happy here; there is not a lot of arguing, like you get in a lot of nursing homes.”
Ruth McKee’s mother, Mary Drake, was in five nursing homes or assisted living centers in seven years before she died in 2007 at the age of 96.
McKee learned about the culture-change movement after her mother’s nursing home closed suddenly and there was a scramble to find another. She made sure that her mother went to homes that embraced culture change.
“It’s a paradigm shift in how services are delivered,” McKee said. “This is their home, and they need to decide as much as they can for themselves.”
People often agonize about the decision to put their parents in an unfamiliar nursing home, but McKee said she mostly felt gratification after making a careful choice.
As much as anything, it was knowing that her mother got to eat her favorite breakfast, bacon and eggs, every single day.
Her mother’s last home was Peaks Care Center in Longmont.
“They allowed pets; they let residents decide when they want to eat,” McKee said.
Her mother tended to stay in her room, but staffers were able to coax her out for activities, she said. “She had a restorative aide, physical therapy. She got to be friends with one of the skilled nursing people.
“And do you know what he did one day when he was driving by the home? He stopped by with a bouquet of flowers for my mom.”
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Category: INsider, News, Politics
Tagged: betty boyd, cheri gerou, culture change, exempla colorado lutheran home, house bill 1196, nursing home
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