By Karen Read, MSN, RN, Nurse Educator, Liberty Lutheran
Firmly committed to the principles of person-directed care, Liberty Lutheran Senior Services began its culture change journey over three years ago. This journey was not undertaken lightly. There was much study, education and organizational reflection prior to our commitment to this never ending journey. Transforming our organization from institution to home is no simple task. It involves changes in philosophy, environment and organizational structure. Liberty Lutheran will be unlike a traditional nursing home. We are creating communities for our elders where the spirit is nourished as well as the body being tended. Research demonstrates that residents living in a person directed environment experience improved appetites, increase activity levels and more effective pain relief. Working in this environment, staff experience increased job satisfaction, reduced employee turnover and increased staff retention. Understanding that this transformation of our communities requires expertise and “lived experience” that we did not possess, Liberty Lutheran engaged the services of the Action Pact consultant group, a nationally known change agent in the field of person centered care to be our guides on this journey.
The book Old Age in a New Age articulates “all of us understand the magnetic pull of home in a visceral way”. The following three initiatives have been articulated by experts as instrumental in transforming the traditional medical model nursing homes into “home”. These three initiatives have become Liberty Lutheran’s compass for our journey:
- Renewal of the Spirit– involves renewing the spirit of those that work within the organization in order to do the profound work of transforming the nursing home. Renewing the spirit for residents, families and staff as they work together to create purpose and meaning within their facility. Staff will work in different ways; developing leadership skills as well as additional skills to work within the smaller household. Elders with memory loss can also find their way of renewing their spirit, moment by moment, through person centered care and opportunities for moments of home and family.
- Renovation into Home -is the second initiative. Leadership of the nursing home needs to look into the physical environment and reshaping the current medical model nursing home into smaller households which contains a living room and kitchen for each household. These smaller intimate spaces respond better to the intimate private needs of the resident and families.
- Reframing the Organization- is the third initiative and to most organizations is the most difficult. It involves flattening the organization to bring more people into active membership and participation in a community. Formal leadership moves to the household and neighborhood level.
Liberty Lutheran is well on its journey toward renewal, renovation and reframing. As with any innovation, there is no one sure path to success or even guaranteed success but with the growing evidence base of improved quality of care and quality of life outcomes for the elders living in culture change nursing homes, we are responding.