Why We Do Learning Circles

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The learning circle is the handy hammer of culture change – anyone can use it, it’s simple, it’s intuitive and it’s the tool you come back to, over and over, with each new piece of home life you build. For the Household Model to function at its potential, the organization must be reconfigured, doing away with traditional silos and hierarchy. The learning circle is the tool that can assist the organization in that work. Continue reading “Why We Do Learning Circles”

Reflecting on Person-Centered Care with Call the Midwife

The 21st Century’s British Invasion seems to be that of highly engaging BBC television series. Downton Abbey and Sherlock Holmes have a rabid fan following. Call the Midwife, a series based on the memoirs of a nurse working in London’s East End in the 1950s, is all sorts of charming as well. In addition to being entertaining, the Call the Midwife holiday special offers a great lesson in person-centered care of elders, especially those living with dementia. Continue reading “Reflecting on Person-Centered Care with Call the Midwife”

When Hierarchy Reigns, Culture Change Efforts Flounder

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We can create homey spaces, offer elders more choice and change long standing institutional practices, but culture change and the Household Model will not be effective unless we flatten the organization. As long as hierarchy reigns, elders will not be in control of their own lives. And as long as departmental silos dictate the way things are done, staff closest to elders will not be able to do what they can to help elders live a meaningful life in a place that truly feels like home. A nursing home can have a warm appearance, a friendly atmosphere, do fun and interesting things with its residents, but unless the decisions of daily life are made by elders and those closest to them, the culture is still one of one-size-fits-all-this-is-just-the-way-it’s-done.

Elders can’t make choices in the moment when what they want needs to be OK’d by three different people, one or two of whom may not even know them. One of the things we all enjoy about being in our own homes as opposed to work, a hotel or even at a friend or family member’s home, is the freedom to make spontaneous decisions, to have things the way we like them and go about our day according to our own schedule.  A household or neighborhood team comprised of staff from all disciplines that makes decisions together and is responsible to one another can most effectively meet elders needs. Cross-training and versatile workers within the team allow more people within the team to respond to the elder in front of them instead of having to go find someone else who can do the job. It can also be a great benefit at the busiest times of the day when extra help is needed in one particular area.

Only when the household or neighborhood teams have the responsibility, authority and flexibility to make decisions can they reach their full potential for giving individualized care and creating true home for the elders they serve.

The process of flattening the organization is not something that is done overnight. I suggest 3 steps to move forward with this process.

  1. Make your organization one of Shared Leadership.
  2. Use Learning Circles to help staff communicate.
  3. Create an environment of High Involvement.

We will go into more detail about each of these steps in upcoming blog posts. Please share your own challenges and successes in flattening the organization in the comment section.

LaVrene Norton is the founder of Action Pact, an organization devoted to changing the culture of care environments for elders – making it possible to live in a homey place & have a good day every day, no matter how frail one becomes.  Action Pact has assisted care organizations on their journey to households since 1997. Norton is co-author with Steve Shields of In Pursuit of the Sunbeam, and publisher of a variety of educational books, workbooks and videos focusing on the Household Model.

You Gotta Have Friends

In a 72 year (seriously…72 years) study, Harvard University researchers have been looking for answers to what makes for a happy life. An article in The Atlantic reported on the results. Subjects were interviewed at various points in their lives examining stressful events, lifestyles and so on. Continue reading “You Gotta Have Friends”

If You Are Happy and You Know It…Pass It On!

Wellness means different things to different people. Unfortunately, many seem to think that wellness means lack of illness. If this were true, then many of the elders in nursing homes everywhere are doomed to a life void of wellness. In my years of experience I have found this “wellness = lack of illness” equation to be false. It simply does not compute. I have met many, many, many (ok you get the point) people in my life who had various illnesses yet would tell you point blank that they were feeling quite well, thank you. So how can this be? Continue reading “If You Are Happy and You Know It…Pass It On!”