The Struggle With Choice

Resident choice is a cornerstone of culture change. As we transform our organizations, we are constantly asking ourselves, “How does this promote or honor the residents’ self-determination, preferences and daily pleasures?” This awareness, however, does not mean we don’t still struggle with how to balance these choices against other important concerns, such as resident safety.

The folks at Bridgewater Retirement Community in Bridgewater, VA recently found themselves in just such a struggle. A resident living with Parkinson’s disease was given a curling iron. During her first attempt at using it, she dropped it and it burned her leg. The incident report on her burn caught the attention of Josh Lyons, Vice President of Health Services. It said that staff had taken the curling iron and that if the resident wanted to use it she would ask them for assistance. “I thought, ‘I burned myself while grilling and my wife didn’t take the spatula from me’,” he said.

So, he called the unit supervisor who was surprised to hear from him on the subject. Josh raised his concern about letting the resident make the choice of whether or not she wanted to take the risk of burning herself using the curling iron. While the supervisor was glad to hear that he cared about the issue of choice, she explained that it was not the first time the resident had hurt herself trying to hold onto things made difficult by her tremors. The resident and staff had had a conversation about the curling iron and together had come to the solution.

“The fact that we are having these conversations, these struggles, is so important,” said LaVrene Norton, Founder of Action Pact. “Ten years ago no one would have thought twice. The curling iron would be gone and that would be that. Staff having these discussions with residents, amongst themselves and with leaders is where we will find the power to change the mindset on issues around resident choice. Perhaps the best answer was not achieved. Was the resident truly satisfied with the decision she made with staff? Were there other solutions not thought of? Are we all willing to continue to have open conversations and truly listen to one another?  Can we agree that residents should be able to direct their own lives? These are all things we have to ask as we struggle.”

“I really can’t say if I would have seen the situation differently, or at all, before we began our culture change work,” Josh said. “But now I really can’t imagine not thinking the resident should have a choice [in the matter].”

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