Light the candles, it’s the 10thanniversary of Conversations with Carmen, the monthly culture change webinar hosted since 2009 by
Carmen Bowman, MHS, BSW, for Action Pact!
After 100 or so interviews over the past decade with some of the top innovators of culture transformation, “I’ve learned so much,” says Bowman.
On the third Friday of every month except December, she highlights one of a wide range of topics – e.g., integrating pets and children, involving elders in community volunteering, getting residents up and out of their wheelchairs, using Validation to communicate with those living with dementia, enhancing residents’ dining experience, complying with the latest CMS directives while maintaining normal life, and more.
“It’s reinforced my thinking,” she adds. “Culture change is still the answer… you will save money, make money, (and have) better compliance, satisfaction, recruitment, and (staff) retention.”
Bowman’s own wealth of experience as an activities director, state surveyor, trainer, author, and advocate brings a unique perspective to the conversations. It all started in college while she was volunteering as a social work student in a nursing home.
“I actually fed residents – this was back when a volunteer could do that without training – and I fell in love,” says Bowman. “I realized that a person could make a beautiful moment for people even while they’re eating… I discovered the power of dignity, how to talk with people and not at people, how to cover for embarrassment, and how to offer choice in every interaction. It came naturally.”
After college, Carmen was working as an activity director when she learned about Dr. Bill Thomas and the Eden Alternative. She read his book, Life Worth Living, and was immediately hooked, she says. She began to develop the concept of “meaningful engagement” with residents to replace “activities” in her daily work, all while working on her Master’s Degree in Healthcare Systems. This would have been more than enough for most people, but Carmen went a step further and applied for a position as state surveyor in Colorado. Her hiring made her the nation’s first certified activities professional to become a state surveyor.
“Colorado should be commended because they had a well-rounded team that also included pharmacists, dietitians, social workers, and therapists at a time when many states hired only nurses as surveyors,” she says.
Bowman was a surveyor for nine years and then became a CMS policy analyst, helping to train other surveyors and develop new CMS interpretive guidance for activity professionals. Later as a contractor for CMS she co-developed the Artifacts of Culture Change measurement tool, authored background papers, and facilitated the two national Creating Home symposiums, co-sponsored by CMS and the Pioneer Network. A third symposium focusing on Quality of Life is just starting to be talked about, she says.
Carmen co-founded the Colorado Culture Change Coalition, worked with the Pioneer Network to develop numerous educational resources, authored eight books with Action Pact relating to culture change, and founded her own consulting firm, Edu-Catering: Catering Education for Compliance and Culture Change.
In 2009, Action Pact Executive Leader, LaVrene Norton, invited Bowman to host a monthly webinar.
“What a blessing that she asked me, of all people,” says Bowman. “Thank you, LaVrene!”
In choosing discussion topics for the webinar, Bowman keeps her finger on the pulse of culture change nationally and monitors news from organizations like Action Pact, the Eden Alternative, and the Pioneer Network. Sometimes there is an ongoing or developing issue that she wants to call attention to.
One unfortunate trend right now, she says, is “fake life” experiences, like giving elders robotic dogs or plastic babies to hold rather than real ones. “Why do we think a doll is what an adult needs?” she asks. “I’m truly puzzled by it.”
Instead, let’s all work on getting real babies into long-term care environments, she urges. “Babies and children need the love of elders, and elders need the love and touch of babies and young children … Let’s be creative and do this together, it can’t be just the activity director.”
Though inspired by her webinar guests, she is disheartened by the overall slow pace of change which she fears is actually beginning to slide backwards.
“All too often, an organization’s culture change leader retires and a new one comes in and lets things stagnate, or in some cases reverses a lot of what the predecessor did,” she explains. Or, a new company takes over and reverts to the old, institutional way because it’s familiar and “easier to manage.”
What they don’t understand is that the hard work of culture change is the easiest way in the long run, she says.
“Let’s say you actually learn how a person likes to live their life … and then we serve her the way she likes. It ends up being more efficient … what we think is harder is way more efficient and creates a better life for the person as well as work life for the caregiver,” she says. “Individualized care and resident-directed life is what we are supposed to offer, what everyone wants, and what now sets a community apart. Wouldn’t it be something if a changed culture was actually the common practice? That’s the goal, we can’t give up and if a monthly conversational webinar about relevant topics can help, I’m proud to be a part of that.”