Transforming Long-Term Care in Texas: David Seaton

Texas Culture Change Coalition2011 Symposium

“Culture Change in Texas: It’s Time”“Changing Long-term Care in Texas for

Aging and Disability”

September 23, 2011 Texas State University

Baby Boomers (78 million) turning 65 in 2011

10,000 per/day

Someone 65 today is expected to live 18.5 more years

2 of 5 (40%) will reach age 90.

Aging Society: “Silver Tsunami”

U.S. Nursing Homes

• Number of nursing homes: 16,500• Number of beds: 1.8 million

Long-term Care

• Greatest Generation (Compliant) - WWII

• Woodstock Generation

(Free Spirit) - Vietnam

Leading Organizations in Culture Change

Leaders

Pioneer Network – Advocacy & Training

Network grown to over 10,000 members

in past 10 years• Annual national confer – 1300 St. Louis• Coalitions in 38 states

www.pioneernetwork.net

International Leader in the Culture Change Movement

More than 20,000 trained Eden Associates & 300 Registered Homes world-wide

Founded in 1995

“The challenge is to create a Human Habitat where people of all ages come together day after day – eager and able to Thrive, not just Survive.”

Bill Thomas, MDFounder

The Three Plagues of LTC:

• Loneliness

• Helplessness

• Boredom Plagues of the human spirit, not the human body. Medical treatment offers no balm.

Plagues: Antidotes:

Loneliness ----------- Companionship

Helplessness -------- Choices

Boredom ------------- Variety

More than 20 million Children & Adults with cognitive disabilities require lifelong supports in U.S..

• Brain Injury• Developmental Disabilities• Intellectual Disabilities • Mental Illness • Autism• Other

Cognitive Disability

Transforming Long-term Care for all people.

Broader Culture Change Movement

Designed for the unique needs of younger individuals with long-term care needs.

• Developmental Milestone• Life Experiences• Long-term Aspirations• Longevity of Life

Texas:

Approx. 4,122 long-term care facilities

Capacity to care for 229,139 individuals.

Nursing Homes - 1,174

Bed Capacity - 126, 684

Mission-

Dedicated to promoting change and improve the way long-term care is provided for Texans who are aging or disabled, and the caregivers who provide support for them.

2011 Goals:• Create organization to promote culture change in Texas.

• Create awareness of CC in Texas

• Provide Educational opportunities about culture change.

• Create opportunities to network and collaborate on CC.

• Make it 2012!

Committees• Organization/ Administration:• Marketing/ Development: • Regulatory/Policy: • Education/Training:

Steering Committee

• Provider Associations • Provider Facilities • Consumer Advocacy Organizations • Government Organizations • Quality Improvement Organizations • Educational Organizations • Auxiliary LTC Organizations

Texas operates 13 campuses with 4,241

HB 3197

Relating to creating a pilot program to implement the culture change model of care at a state supported living center

1. Shift decision-making to the individual with the disability;

2. Implement continuous quality improvement processes that use objective data to improve practices and services;

3. Improve the workforce by reducing turnover

Rep. Coleman sponsored in the House, Sen. Deuell's sponsor in Senate.

The DADS Culture Change Initiatives mission is to promote and support nursing home providers as they transform from atraditional system-directed culture to one that is person-directed or centered.

www.dads.state.tx.us/culturechange/

July 25, 2011- Culture Change Symposium, Austin, TexasCulture Change: Enriching Lives in Nursing Homes

October 20, 2011 – DADS ICF/MR Provider & Surveyor Conference, Austin, Texas

What is Culture Change?

• A term that is used to describe fundamental changes in Long-term Care.

• A transformation in the physical,

organizational and psycho-social

environments based on person-centered

values.

6 Traits of Culture Change

• Residents have input about their care and activities.• Living environment that reflects a home, and the unique preferences of the resident.• Close relationships between staff, residents and community• Staff empowered to make decisions in best interest of resident.• Collaborative decision making.• Ongoing quality improvement initiatives

Comparing Models

Long-term Care LifeLong LivingInstitutional Home & Community

System-Centered Person-Centered

Custodial Growth

Disempowering Empowering

Risk Aversive Dignity of Risk

Hierarchical Control Resident/Staff

Impermeable Permeable

Diagnosis-symptom Person

The Goal

Institutionalized Care

Individualized Care

The Goal of Change:

• Move from institutional “system-centered” to individualized “person-centered” care.

• Relationship is the fundamental building block of a transformed culture

The Disenfranchised

“Loneliness is the most terrible poverty. “

- Mother Theresa

Long-term Care vs. LifeLong Living

Culture Change: A Change in Perception

“The Ability to make choices largely determines one’s quality of life.”

~ Bill Thomas, M.D.

• Process of Continual

Listening and Learning

• Focusing on what is

Important to the Person

• Acting on this in Alliance

with the Person

Person-Centered Care

“Nothing About Me,

Without Me”

Person-Centered Support

Person-Centered Living

A life centered on personal preferences & values that stress dignity, choice, and individuality.

From Golden -

"Do unto others as you would

have them do unto you."

To Platinum Rule -

"Treat others the way they

want to be treated.”

Commonality / Individuality

Core Principles of Culture Change

Self Determination

Purposeful Living

Belonging Choice

Support

Dignity

Sense of Community

Contributing

What would your P-C Care look like? What’s Most Important?

• Hobbies/Interests• Home Town• Volunteer• Sports• Music Type• Family/Friends• School

The Journey

Culture Change Is Not:

• Another rigid program or set of regulations

• It is not about rewriting policies and procedures.

• Much more than the 3 F’s

We do the best we can with what we know, and when we know better, we do better !

~ Maya Angelou

Culture Change

• Inspire

• Inform

• Involve

David Seaton, Founder/CEO

PO Box 705

San Marcos, Texas 78667

512-938-1127

DS@LiveOakLiving.com

LiveOakLiving.com

“Be the Change You Want

to See in the World” - Gandhi