scripps gerontology center is miami university's center backexcellence for the study of aging. scripps becameinterested in person centred care because we have done a number ofprojects that really focus on consumers and so being interested in person centred carewas a natural outgrowth of that focus on consumers, residents, participants, the older individuals.
person-centred care to me is letting the individual make their own choices and make theirown decisions. the residents do not live in ourfacilities but we work in their home and that that is the atmosphere we try to project, that we have very caringstaff, very dedicated staff. we really try to honor individualresident preferences so you may see people you know, they get up early and are dressed and ready for their day
early, having breakfast in the diningroom. you may find other people little bit later in the day maybegetting up at 9:30, 10:00, 1030 in their pajamas having coffee and a danish in the dining room just like they wouldat home. person-centered care is just making sure that that elder is getting what they need inthe way in which they would like to receive it. i became interested in person-centered care through myown work as a direct care worker actually and skilled nursing and throughthat
it really became clear to me that we had a lotthat we had to do, a lot tasks that need to be done but itwas much more pleasant, the work with more pleasant and we had a much better time if we wereactually enjoying the elders at the same time as we wereworking with them and talking with them, sharing stories, learning about themand their preferences and what they enjoy and their history, and when i was able to do that in my ownwork it it made it much more fulfilling andactually i was much more efficient
and enjoyed that time with the elders muchmore. they have choice. they determine when they want to get upin the morning they determine what they'd like to havefor meal; breakfast, lunch and dinner. they decide which activities they wantto participate in, which they don't. it's given them choice that's what it's like for them.they're back in charge of their lives we tried to really personalize thecare that we provide here and i think that's very evident inspirit of our building. the essence of person-centered care really isrelationships the interaction between
the individual and those that are closest to them,people that they see every day, those that are helping them with and their dailytasks, with things that they'd like to do andaccomplish in their day. as an example if an elder has been determined to havea swallowing problem by a speech therapist, maybe as a resultof a stroke and the recommendation from the speechtherapist is that that elder should be on
thicken liquids. for person-centeredcare that means the individual, the elder decides whether or not they wanna be on thicken liquids. it means the staff, the partners, the employees, the nurses talking to that elder about the risk of making that choice. person-centered carethen says if the owner decides, "i know what therisks are, i'm willing to take those risks i don'twant my
liquids thickened." person-centered caredoesn't thicken their liquids. at the end of the day most importantly it's not about any of us that's involved, it's about that consumer and that's whatwe have to remind ourselves of completely. no matter howhard, how challenging that task is at theend of the day that person is saying, "thank you somuch." and guess what, you've had the opportunity to actually make adifference. i'm proud of that for ya! i knowyou gotta be proud,
pretty proud? yeah. yeah. if we all truly believe that the people and thatare at end of their life are as important as the people at thebeginning of life than there's no reason not to do this. direct care workers benefit i think from person-centered care in thattheir work is more meaningful. you're not just a task doer. you're notjust someone who comes in and takes care of the laundry or comes in and helps withbathing. you are someone who is important to thatindividual
because if your relationship withthem and you bring something to that relationship that is unique andi think we don't do a really good job honoring the work that direct carepartners do, that direct care workers are engaged in. and so when you can feel that you'rereally contributing to the process and that your, your contribution ismeaningful, i think it's it's a a benefit for thosewho are working as well. i say if i'm gonna walk the face of this earth i need to have a purpose and
if i'm going to be a job eight hours aday is going to wear me out it needs to be a job that's gone where meon a good way. how do you make things better for people? how do you teach people that that's what'sgoing to make you feel better? that's a culture change. is teaching people that service makesyou feel good, and services what we're all about.we're a service industry. for someone to know that you have agenuine care and compassion for their needs is gonna come through.
she is a lifeline, she helps make sure that i can live my life the way i wanna live my life and youhaven't even seen my tomato garden. you see each one of these people as anindividual, as a human being they had a life before they got here they wereprofessionals, business people, religious doctors, servicemen, whatever they werethey were before they got here and you have to respect them is that.they were members, contributed to society likewe are now. no different than we are, just a littleolder, and
and when you look at them like that i meani'm not kidding, i love my people. it's just ,it's a good place to be. if you wanna have a close knit staff and you wanna have a goodreport you have to treat them as family. they're not a number and they're not a namebadge they're one of your family is the same as theresidents, the residents are family too. that's what it is it's one big happyfamily, that's the way it has to be. i'm part of the family we're still a big familyreally. sure! the only difference is
well a lot of differences, but the main one as theygo home and come and go at various times. i lovecoming to work every day. its like i said, it's a home away fromhome i feel like the elders have become part of myfamily. staff, very close-knit with a staff especiallyif your offices in that house you really get to know the staff very well. it's just very easy to love your job when you work here. being able to leave here and know thatyou made an impact or you did your best
to try to help some body is something that i feel like i needespecially after doing it for five or six years now. i' don't think i could ever go into anyother type of work now. this is what it's going to you i mean weare what healthcare and long-term care isgoing to be. going to and looking at in the future iswhat we've been built upon and you were doing all the thingsthat everyone else is looking at doing and itworks. first and foremost it's putting
quality of life first. if you put quality of life first inresidential choice first your senses will follow and yourfinancials will follow you. operationally will be a soundorganization. it's really putting resident care needs as primary in all things and sometimesit costs money to do that and we shouldn't balk at that. we should look and really unique, outof the box opportunities to really provide the best care for our residents.
it doesn't surprise me that person-centered care has been linked to positive outcomes in elder care for nursing homesand for other organizations. i think that people crave relationship ithink they crave connection with others and this is a vehicle for that to happenin a system that has traditionally been very cold, very sterile and none of us want to live in thosetypes of environments. so, in those organizations that arepracticing person-centered care i, it does not surprise me at all that theywould be experiencing
benefits from that, on multiple levels. ithink that connection, that human connection is hugely important and when you're able toreally focus on that and make that a priority for yourorganization i think that you will reap lots of benefits from it. if i was explaining person-centered care to some one who was new to it, i would tell them thatit's okay to take the time to get to know the individual. that the work that youspend, the time that you spend getting to
know that person, is going to be so important in the workthat you do with them from that point forward it's going to inform everything that youdo. so get to know that individual. take a few minutes, it's okay to takea few minutes to sit down and talk with someone when you're going to be engagedin a relationship that's going to be veryintimate in many ways. you're going to be doing things and assistingthat person in ways that most other people do not have the opportunity to.
so, you wouldn't want a stranger caring foryou. you wouldn't want a stranger helping you bath. you wouldn't want a stranger helping youget ready for bed in the evening so you'd want to get to know someonebefore you start to help them with those types of things and so i would really encourage someone new to person-centered care to make building the relationship their first priority. it's easy to get in rut and to dothings the same way over and over again. i just had it nursecall me into the break room and said, "susan were having trouble with
having a resident take a shower becauseshe prefers one stna." and i asked the nurse,"well what's wrongwith that? how can we make that happen? what are ourchoices here?" instead i'm saying that that shower isgoing to be at a certain time with a certain person that they may not care for, but insteadreally really staying focused on the residentand what the resident would prefer. we're understanding as time goes on that if we do that it's better foreveryone. it's better for the staff, it's
better for the organization, it's betterfor the family, it's better for everyone. a resident who is happy is easier to take care of. they're more pleasant, they're morecooperative, they're just, they're more willing, they're morewilling to engage, they're more willing to trust, they're more willing to let you sharetheir life. blending the department's is has been part of our culturechange and i think it's been very successful
for being rewarding. its kinda likedietary, we have 95% of our dietary is cross-trained in stna, 100% of our housekeeping staff and laundry staff are cross-trained as an stna. the lpns, the stna's is that direct care, this is what it's all about, is, "right here i'm taking care of you. i'm face to face. i'm touching you. i'mgiving you your bath." this is what it's all about because ifyou lose that piece you've lost a lot of care and touch. i, i feel very strongly about that. ithink what we generally try to do is
compare what happens in a traditional nursinghome to what doesn't happen in our houses. as an example, we may say to the elderassistant "if you're working in abc nursing home,which is a traditional nursing home what will you be doing at 10:30 in themorning?" and they can generally repeat exactlywhat they're going to be doing, and then we say, "we don't know whatyou'll be doing at 10:30 here because we don't know what the eldersfor wanna be doing
10:30 here." and that helps themunderstand as they're beginning, what the maindifferences is, is that it is an elder driven model, not a staffdriven model. i think many individuals think ofperson-centered care as something that they have to do in addition to the work that they do, already, andfor me it didn't really isn't that way. i see person-centered care as a way ofchanging the way you do the work verses addingonto the work that you have to do. you don't say, "i have to help this personwith a bad and i have to help them to
bed, i have to help them with their meal and i have to do person-centered care ontop of all that." it is the way that i assist that person, in bathing, the way that i help them getready for the day that makes it person-centered or not. it'snot an additional piece that has to be added on it really flows througheverything that you do. listen to what your consumers have tosay, what's important to them, from the services that they're going tobe receiving. you have to be a person who is able tomake a decision because some of those
decisions might be life-saving. i do believe that most of ourstaff or if not all of our staff can learntasks that's not the difficult part. teachingsomeone how to toilet or clean the floor cook something that's not the difficultpart. the part is to recognize that they are a kind person and they are willing to to look beyondthemselves to the residents so that they can serve the residents. the magicthat takes place here's what happens
inside. empowering these elder assistants, those who have not had a voice mostanytime, anywhere. to empower them, to see them grow, intheir jobs, to grow as people both personally and professionally forthem to know that they have a voice the they take ownership of theirindividual houses, that's what makes us work. we have taken our it's typicalmanagement structure and completely inverted it.
that triangle where i'd be on top, i'm down at the bottom which is probably agood place for me, but the elder assistance, any organizationcan work with their stna's to empower them. they know what's going on. that's thebiggest part of your workforce, help them to do their job to the best oftheir ability, let them know that they're valuable and you have your own magic. if we're nothappy then what are the odds that we're goingto be really happy around our residents
and its so, the whole goal is place isto take care of those residents. they are our focus,they're the reason we're here,not an interruption, not, they are why we're here. so, they want toknow, i mean, and at the end it just makes the resident's home a better place. welli think it it doesn't matter if it's going to be ashort stay or long stay. if we like to take care of that resident as the stna, well we need to have a good interest in them. we need to know what they like what kind of life they
what did they achieve in their livesand so on, so that we get to know that person better. i feel that i reach out to my residents their personalities are differentso you can have to approach them in an individualized sort of way and you learn that as you work withthese residents. the importance of knowing the staff and knowing theresidents and knowing their families and being seen by them and seeing them andknowing their families and their personal issuesthat, that,
in making me aware that you know the manyou care and you can help where you can, those are the subtlelittle things that help to begin to build the foundation to improve a nursing home. it's not strict like regular nursing home where you walk in and you're handed a paper with your schedule of what you have to do today and thisperson and that person needs a bath and everything like that i mean we do have tasks we have to doto do during the day but we juggle and prioritize based off of whatthey wanna do during the day.
we don't have a time frame to go in that room and get done in 10 or 5 minutes, no. we have to do it the right way, whateverthey want, that's a good thing in here. you have to be dedicated here to put upwith us all the time. they can't look atthis as a job they've got to look at it as a partof taking care of people and they need to be considerate and if your hairs outta placeor you need some lipstick they do it.
they just take care you, they keep an eye onyou. all the time they're here, they're here anan 8 hour period, 8 hours, but just to pay attention asthough they were a sister, or brother, or mom, ora dad. that's the way they should look at itwhen they come in. you have to get people to understand that it's not about removing a nursesstation that it's not simply about serving family-style, that it isn't
just about only passing medicinestwice a day, it's about changing your mind andrealizing that everything you decide has to be in concert with what the elder wants. at the end of the day here you it's not paperwork has been filed itsnot production supplies that have, you know, you deal with 21 people and you keep them
happy you, keep them clean, you keep them fed, you keep them smiling i don't believe anybody comeshere to die this may be the last place they live during their life, but live is the word, and i'm, is the key word that's the operativeword. while they're here living i'm gonna make it the best place that it can be for them. i mean that's that'smy calling. we decided to make this video because we felt that that we were, we hadlearned
a number a very important things about how organizations do this care andwe'd heard some inspiring stories and those things just don't comeacross an academic journal article or even in a magazine article forproviders. so, the opportunity to share those things with other organizationswith other direct care workers we hope that people who are beginningthis journey towards a more person -centered care process will use these stories toinform and train
and inspire their staff to go forwardand in this direction
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