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Creating a Person-Centered Culture: The Key to Finding Home

2019; Elsevier BV; Volume: 20; Issue: 8 Linguagem: Inglês

10.1016/j.carage.2019.10.002

2377-066X

Joan Devine,

Mental Health and Patient Involvement

Each one of us starts our culture change journey by learning, growing, and experiencing “a-ha moments” in a way that touches us personally. On my personal culture change journey, I have been fortunate enough to visit quite a few communities across the country where I experienced those moments. Have you ever walked into a community and had that a-ha feeling — that here is a community where they have truly created home? For me, the most recent a-ha experience was last spring when I had the opportunity to play hooky for a few hours while attending the annual conference of AMDA — The Society for Post-Acute and Long-Term Care Medicine in Atlanta. I paid a visit to Park Springs, a Life Plan Community in Stone Mountain, GA. I spent a few wonderful hours experiencing their community, including their Garden and Lake Households, whose residents are living with dementia in the only Dementia Care Matters Butterfly Home in the United States. I had heard of the great work being done by Andy Isakson, the owner and operator of the community, and that prompted me to make this visit because I wanted to see just what this “Butterfly Model” was all about. Reading about this model had been inspiring, but as we all know theories are great, but the proof is in the seeing — and in this case, the feeling! What was it about Park Springs that created this feeling of home? It was the smiles, and it was hearing each member (that’s what they call both staff and residents) as they greeted Andy, who hosted my visit, with smiles and hugs. It was listening as he called them each by name and shared stories and reminisced with them. The colors on the walls were bright, and the décor looked like it had been designed by the people who lived there, with meaning in the furnishings and the decorations on the walls. Park Springs had a pace that was easy, not rushed, and was centered around taking the time to be with the residents. The staff seemed to be confident in who they were and how they interacted with all the members, both other staff and residents. It was clear that the elders were receiving quality care, but it was so much more than that: it was a quality of life that was evident as I walked around the households. I saw elders living with dementia who appeared to be at ease with their environment and were comfortable with the staff and with each other. How did they achieve this? What I learned was, like most things worth achieving, it didn’t happen overnight. It required commitment from every level of the organization. All the staff went through extensive training on supporting the dementia care philosophy of Dementia Care Matters (DCM) and learning what it takes to be a Butterfly Community. This philosophy starts with knowing that feelings matter most and shifting from “doing” to achieving an emotional connection, and understanding that this is the heart of being person-centered. The members at Park Springs have been the recipients of innovative training methods focused on improving self-awareness and emotional intelligence. Through coaching, they have learned to transfer their learning directly into practice. Next, the team at Park Springs, guided by the teachings of DCM, learned that accepting and joining a person in her or his reality is the only way to reach people. This requires seeing, hearing, and feeling the lived experience of people living with dementia on a minute-by-minute basis.A culture change journey in PALTC is an evolution from institutional care, which is schedule- and medical model-driven, to person-centered care, which prioritizes resident choice in planning care. Check out the many videos on DCM’s website as well as those from Park Springs, and you will see and hear in so many different ways from the team that they understand that while we can’t “fix” dementia as a condition, we can fix our approach. As clearly seen at Park Springs, leadership is key if there is going to be a shift from task-based “care” to real emotional connection. That was evident in not only hearing from but watching Andy and the other members of the leadership team I’ve had the privilege to get to know both during my first visit and subsequently. At the Pioneer Network Conference this past August, several members who are direct care staff from Park Springs participated in one of the sessions on “Growing Workplace Culture.” They shared with attendees that receiving person-centered care as employees has been a part of their journey, and it supports the success of the work they do in a Butterfly Home. The attendees at the conference got to meet and to hear from the Park Springs members — and Dr. David Sheard and Peter Priednieks, the founders of DCM. I was blown away by the Butterfly Home at Park Springs, and I’ve been inspired by what we have learned from these innovators who are changing dementia care through the work of DCM. But, just as this issue of Caring for the Ages looks at dementia care from many perspectives, true to what the Pioneer Network is we choose not to focus on only one model of dementia care. Nor do we ascribe to only one way of carrying out our mission, which is to create, “a culture of aging that is Life-Affirming, Satisfying, Humane, and Meaningful.” We understand that being person-centered doesn’t apply only to individuals — it also applies to organizations. Most of us have learned, in the work we do, that there is seldom a one-size-fits-all way to do things. Our quality dementia care is grounded in the Pioneer Network’s values and principles, including knowing each person, recognizing that relationships are the fundamental building block of a transformed culture, recognizing the need to put the person before the task, and understanding that we need to shape and use the potential of the environment in all its aspects: physical, organizational, psycho/social/spiritual. Attendees at the Pioneer Network conference in August heard how these principles are integrated not only into the Butterfly Model but also into models like the Montessori Method, the Eden Alternative, the Green House Project, and Action Pact’s Household Model. They also heard it from dementia care experts like Allen Power, MD, Jennifer Brush, and Govind Bharwani, PhD. And most importantly, they heard a message that reflected “wisdom and courage … [from] wonderful, loving, courageous guides”: the individuals who are living with dementia who share their stories, such as “Alzheimer’s: The Journey” blogger Brian LeBlanc. Just as every individual living with dementia is a unique person, each community serving residents living with dementia is unique and needs to find its own path, grounded in a person-centered culture. Ms. Devine is director of education of Pioneer Network. Founded in 1997, Pioneer Network is a not-for-profit organization that has pioneered and leads the national movement of culture change to person-directed elder care. Today, it is a large, diverse group of passionate individuals from the entire spectrum of aging services.