Sustainability in training programs that improve patient and resident outcomes is critically important. Upper and middle managment must embrace change initiatives in order to successfully compete in an increasingly crowded marketplace.
But what happens after these programs are implemented? Far too often we hear that wonderful “culture change” programs faded in time, often because the champions were no longer with the company, or had moved to other positions. Unfortuantely for the organization, this means an investment of time, money and resources had gone to waste. This may be a result of poor planning and program implementation or simply a matter of not enough staff to oversee the program to ensure its success. In addition, many such programs are limited by proper funding and acceptance by upper management to the extent that there is never a cohesiveness to keep the elements of the program working smoothly.
It IS possible to have program sustainability. With proper planning, collaborative efforts with training partners and the placement of champion leaders throught the employee spectrum, sustainable programmming is very possible. In fact, we know that it can work! Below are just some examples of how programs can be made sustainable.
- Champion leaders are made of upper, middle management and staff. All team members working together on change initiatives is vital.
- Management should encourage problem-solving skills among all staff as new programs are implemented. Without idea generators, how would new practices every get off the ground?
- Provide incentives for staff who practice culture change initiatives and embrace these in their everyday care routines. By including simple accountability systems using champion leaders, this will insure that new tools are being used effectively and efficiently.
- Make certain that everyone understands the big picure of why new practices are being implemented.
- And finally, sustainability is afterall, not just about how you run your business but how you treat your staff.
When elderly people spend time in a hospital, they often leave more disabled than when they got there. That’s pretty stunning considering the condition they may be in when admitted. Some of the most common reasons for hospitalization are injuries from a fall, pneumonia, infection, cardiovascular disease and dehydration. Treatment of the acute condition frequently doesn’t include special care needed to prevent rapid, and sometimes irreversible, physical and mental deterioration. Weakness from bedrest, weight loss, adverse drug reactions, delirium, and hospital-acquired infection are all too common. At a time with people 65 and older make up the fastest-growing segment of our population, our hospitals should take notice. Fortunately, some are. Special services such as the Acute Care for Elders (ACE) unit exist, but in only small number of our 5000+ hospitals in the U.S. What’s different about this specialized care? There’s a greater emphasis on maintaining mobility and preventing functional decline, cognitive assessment, a communal dining room to encourage better nutrition and social interaction, early discharge planning, and staff with training in geriatrics play key roles. I’m glad to see that hospitals are addressing this pressing issue, but wonder if it’s enough to prepare for the sheer number of us baby boomers beginning to need this kind of care.
Does your local hospital highlight special care for older patients?
What happens when an eldercare professional becomes a family caregiver? This situation hit home when my husband had a cycling accident and fractured his hip. I was surprised by my reaction to suddenly becoming his care partner, juggling the role of home nurse, personal care attendant, meal provider, and problem solver of getting around in our two-story house. Somewhere in the mix I was also moral support and empathizer. The first week centered on creating a new routine, helping with pain management and personal care. Oh, and wound dressing changes. I quickly was reminded why I never became a nurse, calling a nurse-friend in a panic because the dressing from the hospital was stuck to the wound and I was sickened by pulling it off! If I’m perfectly honest, I felt angered at times by this turn of events that intruded our lives- I didn’t have time for this! It didn’t help seeing my active husband now using a walker- making him “old” to my eyes, bringing up fear about what’s to come as we age.
Now four weeks later I’m a bit more philosophical and I wonder about the interplay of personal and professional roles for those of us with years of experience in eldercare services. As an occupational therapist and dementia care educator I’d like to think I know something about managing home care. But I acknowledge that when it’s personal it’s a totally different dynamic. The boundaries become fuzzy and my emotions make it hard to be as objective as I would be in a professional role.
Luckily our situation is temporary. I know so many people for whom caregiving is endured for years, like my nurse friend who recently lost her husband to dementia and cancer. She cared for him at home for five years. We all will be eldercare partners at some point. I guess we have to suite up, show up, do the best we can, and allow others to help us out along the way.
Let’s imagine that you have dementia. What would you miss? What would you forget about that you enjoy? We all forget the details of our lives and often take the little things we enjoy for granted. People living with dementia can rarely seek out enjoyable activities independently and often even forget what used to bring them pleasure. That is unless memory is triggered. Knowing that, how might you activate pleasure linked to past experiences?
One great resource is the small book titled, 14,000 Things to be Happy About by Barbara Ann Kipfer. She gives us hundreds of things that make us smile because they conjure up the sights, sounds, smells, and feel of what it’s like to experience them. Dairy farms, fresh flowers, the sound of tap dancing, a camping tent, finger painting, candy apples, the smell and color of fresh fruits, bubble gum, bridges, and puppies are a few examples. You can pick up her book at any bookstore or even thrift stores to prompt memories.
Or, along with elders, come up with your own “Happy Book”. Then think of ways to bring those experiences back again for people living in your community. For example, we put up a tent in the backyard at our community and had a campfire in a small charcoal grill. That changed the whole feel of the backyard; it became a campsite that one family had enjoyed on vacations. The stories shared around that fire were priceless and they would never have relived the time together without the simple trigger of a tent and campfire. From such stories you will find even more things that you can use another time to bring enjoyment to so many people.