Flying High with Self-led Teams

MARVIN’S PILOT GOT IT RIGHT!

One of the most unifying and powerful accomplishments of self-led teams is realizing that no job and no person is viewed as greater than another. The equation itself is simple: no greater than or less than, only equal to. So every job is just as important as the next. All the jobs that need to be done in a household are done to help the members of that household have a better day. It doesn’t matter if it is wiping the table or taking out the trash or helping with medications. Self-led teams do not get hung up on titles, you simply get in where you fit in that day. Continue reading “Flying High with Self-led Teams”

KEEP IT REAL

HOME-LIKE ISN’T GOOD ENOUGH.

By Glenn Blacklock, Action Pact Consultant

It’s not home if it’s not real. You can’t fake it.
A vendor once tried to sell me a music box that made bird-like sounds. I didn’t buy it. I want to hear real birds sing. It’s the vibrant life behind the
song that makes the difference.

And no matter the packaging or how many advertising dollars are spent trying to convince me that Diet Dr. Pepper tastes like regular Dr. Pepper, my taste buds don’t lie. I know the difference. It’s like that with home. Even the frailest among us knows the difference between homelike and home…

Continue reading Glenn’s terrific article, published in McKnight’s Senior Living on Jan. 30.

Tear Down That Wall!

As a teenager I visited my Aunt Karla who lived in Berlin. I had been there before but was too young to really understand what the city was all about and how significant it was to my life.

It was in Berlin that my parents met and married. My father was an honor guard at the famous JFK speech. My brother was born there. I loved the city with its busy business district, restaurants, and shops, all of which exuded an energy that felt good. But there was some ugliness to it as well with its reminders of the war and the thought of how isolated the people were in the worst of times. And that wall… Continue reading “Tear Down That Wall!”

Sim-plis-i-tea

I was recently interviewing a team member at a CCRC campus, and I asked for her thoughts on what she felt the organization does well. Her answer was tea. Wait… what? Turns out they had a new client moving in, and when the admission interview was done, a few things were learned, one being that the woman was English and that she had a customary love of tea. Upon returning to the facility, this information, along with all the medical needs, was shared with the nursing team. Move in day came, and as the woman was settling in the nurse came in to see her and introduce herself. Normal stuff, but instead of a clipboard or a blood pressure cuff, this nurse was carrying a shiny silver tray with a fancy tea set full of piping hot water. I’m not sure what words wereTeacup handoff-2 spoken in greeting, but I don’t think she had to say anything. Her actions spoke louder than words, and those actions offered the warmest welcome possible.

A cup of tea. Now mind you this cup was served in style and with forethought; imagine the difference in the story above had it been a Styrofoam cup with a tea bag soaking in it. How powerful though, that this affinity for tea was something that the nurse grabbed onto and followed up on. Sometimes in our rushed worked day we complicate things too much – we get tied up in our tasks and our documentation and…and…and. Stepping back and taking the time to honor another person like this nurse did is the real heart of the matter. The old saying is really true – It is the little things that matter the most. What opportunities are there in your normal day to seek out and then follow up on making someone’s day in some simple way? What do you do in your organization to encourage and recognize staff who routinely act in ways that make life better for those around them? Challenge yourselves to take some time to work on building stronger relationships with those around you – staff and resident alike. Use tools like Action Pact’s Daily Pleasures interviews to discover the little things that would put a smile on someone’s face – and then follow through on it. Be bold and visible, be anonymous if that is what you prefer, but work to create a climate where random acts of kindness become the norm rather than the exception. And remember – it can be as simple, and important as a cup of tea.

Read all recent posts here

Brain Game: Tendency to Mimic Behavior Can Lead to Positive Change

A recent episode of “Brain Games” featured a social experiment on human behavior. They staged a waiting room where everyone (except one person, the subject) was instructed to stand up every time they heard a beeping noise.Brains

After only a few beeps, the subject began standing up with the rest. She was not rewarded or instructed to do so, but she did it anyway. Slowly all the other participants left the waiting room, leaving only the subject. She kept standing at the beep. Then as new subjects entered the waiting area, all but one person mimicked her behavior and stood at each beep.

We humans are funny creatures. We have a natural tendency to go along with the crowd. Perhaps wanting to fit in is a survival mechanism, or maybe it is a social thing. Regardless, the fact is that even without logical reason we will conform to the environment and behaviors around us. We see it in residents demanding clothing protectors, even thought they never used them before. We see residents head back to their rooms after the evening meal and, at the call light, race to go to bed even though they used to enjoy staying up in the evenings. Could this be an anchor that has held long-term care in its institutional mindset?

Doing what everyone else does is a powerful human trait, but maybe we can use this tendency to create positive change. If people are so strongly driven to replicate the behaviors they are exposed to, then let’s give them some positive behaviors to grab ahold. And this goes for staff, families and residents alike. Look at an objective in your daily environment. What behaviors are mimicked by others? Are they positive ones? Are we building people up or tearing them down? The good news I see in the Brain Game experiment is that even when just one person exhibited a behavior, those around joined in. So it only takes one person to get something positive started.

We have the opportunity to use this human trait to make change, to plant seeds for positive behaviors and actions. If those around join in and behave the way we behave, then we can be a catalyst for change. However, we must be very consistent and aware of how others see us. If we are positive and supportive sometimes, and grumpy and talk about others behind their backs at other times, which behavior will others most likely repeat? Try playing some brain games of your own, and present those around you with positive behaviors. At the same time be very conscious of any negative behaviors you may be conforming to and speak up about them.

So What Have You Done?

Driving home the other day I heard an interview that caught my attention. It was a reporter/writer that had spent a lot of time studying South Africa over the years. He focused on a visit where he was invited in to see Nelson Mandela, who was in his later years. Mr. Mandela apparently often made jokes to get conversations started, but this one had a jab in it, the reporter said. Mr. Mandela said something about how nice it was that someone would come visit an old man with nothing new to say. Mandela went on to say he had done what he could do, and then asked the reporter what it was he had done? That stopped the reporter in his thoughts, and he found himself asking that very question. And, listening in my car, I found myself asking myself that very question.

While I am no expert on Nelson Mandela, I do know that he was a man who saw things that were not right, and so he fought to change them. This, of course, is why many people have stood up and faced their own fears: to fight for what they thought was right.  It is why I joined the culture change movement years ago.

Mandela faced oppression in every facet of life. The institutional, medical model that remains in long-term care creates its own type of oppression. Mandela’s wisdom and ideology in battling oppression can teach us and guide us, or irritate us enough to stand up. Here are some quotes from Mandela that speak to our many culture change struggles:

“There is no such thing as part freedom.” 

There is no passion to be found playing small – in settling for a life that is less than the one you are capable of living.”

“After climbing a great hill, one only finds that there are many more hills to climb.” 

“I learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear.”

For those new to this movement to change long-term care Mandela might say to you:

“It always seems impossible until it’s done.”

And another thing that is for some reason so hard for us to do:

“Forget the past.”

I count myself lucky and am proud to have worked with so many amazing people in this culture change movement, and more specifically within so many great places where amazing changes have taken place. The layers of oppression have been peeled back for some. New lifestyles and families are being created in households across the country. But if Mandela were to ask me, “So what have you done,” my answer would be, “Not enough!”

There is still much work to be done. Many souls and dreams remain imprisoned in task-based systems that rule the day in so many places. We need to stoke the fires of passion for change. We need to remind ourselves of the urgent need for change. We must continue to learn from each other, for as Mandela says, “Education is the most powerful weapon which you can use to change the world.”

And one last poke by the late Nelson Mandela, may his wisdom continue to change the world:

“Any man or institution that tries to rob me of my dignity will lose.“

If you are looking for information on where to start or what to do next, explore our website where you will find information on learning circles, workshops focusing on specifics areas of change, and PersonFirst®. And help support and inspire others who are working to change elder care by sharing your success stories and plans for 2014 in our comments section.

mandela

Glenn Blacklock has a Master of Arts in Leisure Studies with emphasis in Therapeutic Recreation. As Administrator of Big Meadows Nursing Home he led the organization through their culture change journey. Glenn is the creator of the Action Pact workshop Unlock the Life Within and, in his current role with Action Pact, has guided nursing homes across the country through their transformation to households.

Integrating Touch Into Our Daily Interactions

A while back I was walking along, my mind ruminating on negative thoughts and worries. I found myself getting a little stressed out, tensing up and getting even more worried. And then, I suddenly felt better. A load had been lifted and perspective returned. The cause of this relief? My 6-year-old ran up to walk with me, reached up and held my hand (he was singing a little too as I recall). Poof – the negative thoughts went right out of my head. I relaxed and began enjoying the walk and the things around me. Something about that simple touch gave me just what I needed. I am very lucky in this way. I am a jungle gym, a preferred seat and a transportation device for my young son. Occasionally his older sister might throw a hug my way and his older brother might too, in the right setting. I have a loving wife and good friends that provide me with many opportunities to give and receive some form of touch or another.

Not everyone is this fortunate. Some shy away from touch and deprive themselves of the connection that I feel is as basic a human need as we have. Some, like far too many elders living in nursing homes, find themselves longing for positive human touch that comes too infrequently. This is especially true for the very frail, as many people fear causing pain by touching them, not knowing how the lack of touch hurts in a different way. It is sad to think about how many people are deprived of this basic human need when all the ingredients for meeting it are literally at our fingertips.

Photo by Samantha Whitefeather
Photo by Samantha Whitefeather

But wait, you might say, some people have had horrible experiences in their lives with inappropriate and unwanted touch. Some simply avoid contact with others out of fear of rejection or other reasons. Are these folks best just left alone? In “The Importance of Touch” by Beverley Anne Star and Sara Joy David, Ph.D.,  there is some good info on how the benefits of positive touch can be relearned. The authors write, “All such touch must be exchanged in a manner that respects the boundaries of the persons receiving and giving the touch. In a touch-phobic society, where many individuals are unaccustomed to physical contact, it may take a while for touch to feel welcome and natural…… However, just as we can reclaim our taste buds – jaded by excess use of spices, sauces, and other stimulants – we can re-educate our nerve endings to enjoy gentle, appropriate touch.”

They make another point that is particularly applicable to those living in nursing homes with overhead paging, call lights and chair alarms: “The body registers noise pollution as assaultive. The automatic tightening of muscles to armor (protect) and defend themselves produces sensations that range from mild discomfort to extreme pain. Gentle, appropriate touch can help the body to relax without more intrusive intervention. Caring touch can restore equilibrium and balance.”

If we want people, especially those in nursing homes, to truly be well, we must work to meet the basic need for human touch. Here are some ways we can make it happen:

  • Dancing (Picture that dining aide who jumps out there with a resident when a good song comes on, holding hands while moving to the music.)
  • Holding hands to say the prayer before a meal
  • Massage sessions (Research this and use professional trained staff. Often our elders need light touch massage and not deep tissue massage.)
  • Hugs (One therapist cited in the article mentioned above suggests fitting in 12 hugs per day for everyone.)
  • Simple handshakes when greeting someone
  • A hand on the shoulder when talking

Sometimes I see alternatives to human touch being used – a dog or cat to pet, soft stuffed animals, etc. – but as the article states: “There is no substitute for the gentle, loving touch of someone who cares.”

What are your thoughts? What ideas do you have to make positive touch happen more? How do we assure the frailest among us are not deprived of touch?

Glenn Blacklock has a Master of Arts in Leisure Studies with emphasis in Therapeutic Recreation. As Administrator of Big Meadows Nursing Home he led the organization through their culture change journey. Glenn is the creator of the Action Pact workshop Unlock the Life Within and, in his current role with Action Pact, has guided nursing homes across the country through their transformation to households.