Creating Home and Poetry

Through our PersonFirst® trainings, Action Pact has long promoted community circles as a tool for meaningful engagement with residents living with dementia. An open-ended question is posed to the group and each resident, sometimes with encouragement from staff, answers the question or comments on the topic. In this way, staff and residents get to know each other better and build community with the side benefit of gaining a better understanding about how best to serve the residents in their daily lives.

The residents of The Village Court, the memory support neighborhood of Asbury Place Maryville in Maryville, TN, recently took their “fun circle” (as they call it) in a creative direction. Continue reading “Creating Home and Poetry”

Noise in Nursing Homes

We know a nursing home can be a noisy place and many organizations have been working to reduce the noise, especially of overhead pagers, for example, in an effort to create a calmer environment. But according to a recent study by Dr. Laura Joosse, Assistant Professor in the College of Nursing at the University of Wisconsin – Milwaukee, elevated sound levels can also add to the agitation of those living with dementia. Continue reading “Noise in Nursing Homes”

United Methodist Highlights Their Culture Change Efforts

We are excited to share United Methodist Homes of New Jersey’s newsletter focusing on their culture change efforts. The newsletter features articles on many aspects of their transformation; from a change to less medically oriented uniforms, to plans for a new physical environment, to their work through the stages to the Household Model with Action Pact, to culture change in Assisted Living. You can read it all here.

Helping Out and Staying Active

Geurt Van Sant is a man who likes to work, likes to be helpful. His move to Hearthstone: A Ministry of Wesley Life in Pella, IA  was not going to change that. “I’m going to be doing something until the day I have to crawl to get out to the yard to help,” he said. “I enjoy doing that kind of work – work that just has to be done.” Continue reading “Helping Out and Staying Active”

Why We Do Learning Circles


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”

4 Ways High Involvement Supports Organizational Transformation

High involvement is essential for deep transformation. W. Edwards Deming, a statistician, was credited with Japan’s rise in manufacturing after World War II. The improvements were seen clearly in the quality of Japanese cars that began to dominate American highways in the 1970’s. Deming’s processes gradually came to influence the entire auto industry. In his book Out of the Crisis, published in 1982, he detailed 14 points vital to transforming business. His 14th point: Transformation is everyone’s job. Continue reading “4 Ways High Involvement Supports Organizational Transformation”

Challenging Ourselves to Be Strong

In our July 2012 newsletter we shared a story from Household Coordinator Janet Fleming at Samaritan Bethany in Rochester, MN about a special Memorial Day in their brand new households. Here she continues the story of how residents and staff were motivated to do more exercise and walking in memory of their loved ones:

Challenging Ourselves to Be Strong

Last fall, we had our first household initiative challenging ourselves to be strong, walk, exercise and choose active events that promote balance and dexterity. We called any activity that was more, well, active, a “Strong Choice,” and worked with our restorative nurse to plan more activities like that.

As an afterthought, we decided to post a piece of paper in our dining room for each resident and nursing assistant with their name on it and a line for each day of the week. Each time a resident or nursing assistant made a “Strong Choice” they each got to put a green dot sticker on their paper. We went through lots of dots. Residents tried new activities. More open discussions began with residents about their active life. We discovered that some residents did not have as much planned restorative activity as they wanted. We learned a ton.

My co-workers enjoyed seeing public evidence of their hard work with the stickers on the sheets. Open evidence of which staff had lots of dots and which had only a few dots generated good discussion. There was no prize. It was not a contest. It was just effort made visible. It took a lot of energy, and at the end of the second week we took a happy break from the dots.

We had such good results that the next month Samaritan Bethany promoted this challenge throughout the building. Using the same idea, they made a contest for staff. In order to emphasize documented restorative activity, Samaritan Bethany chose only to use dots for documented restorative activities.  Residents and staff in Essex House struggled with the new rules. It was as though only part of our previous efforts counted, when all of them mattered to us.

With the contest, we also saw that it was possible to overemphasize the role of staff in the residents’ restorative life. We spent time thinking and talking about the difference. Could a strength challenge just facilitate the resident’s active life? If we are all on the same page, is it possible for us to just enable their active choices?

Memorial Walks: Combining the Ideas in 2012

In early March this year we began discussing a new idea for challenging ourselves to keep up our strength. We wanted to do something very different, but still keeping the best parts of our green dots challenge. With Memorial Day’s approach, an opportunity became clear. We decided that each day we would dedicate our “Strong Choices” to the memory of a loved one. Each day we put up a poster with a person’s name on it and for each “Strong Choice” instead of a green dot we would use flower stickers with our names on them.

I visited with residents to ask about people they would especially like to remember on Memorial Day. When I spoke to the first resident, I reminded him of our green dot strength challenge. He told me that he knew he needed to walk more, but sometimes it was just easier to sit.

I said, “Me too. We are all looking for something that will get us up and moving.”  He told me about watching another resident get stronger, and told me he would like to be able to walk unassisted into the dining room. I said, “I think it is possible.”

The next man I spoke with had been weakened by illness over the winter. With tears in his eyes, he said, “I don’t walk anymore.”

I said, “We will help you. You can do it.” He was walking by that afternoon. It was his own choice to stand with his walker, rather than transfer himself into his wheelchair.

Once we started walking, it was easier to understand. The poster of the day hung in our dining room, and in the morning we would read about the person we were honoring. The next morning we would look at the huge floral tribute we had created together, and hang the poster honoring another person. Most of our residents have those tributes to their loved ones hanging in their rooms to this day. Our memorial walks went on for six weeks as day after day we honored the loved ones of both residents and staff. 


Changing Dining Atmosphere

Changing the atmosphere in the dining room is a great first step in an overall plan to creating a more enjoyable dining experience for elders. The folks at Bridgewater Retirement Community in Bridgewater, VA found a creative way to heighten awareness of the need for change in dining practices throughout the organization. Continue reading “Changing Dining Atmosphere”