Cultural Change In Long-Term Care

Understanding Cultural Change in Long-Term Care

"Cultural change" is a frequent label given to an older adult service change movement based on personal beliefs and practices in which the voices of the elders and those who deal with them are regarded and respected. Choice, dignity, respect, self-determination, and meaningful life are fundamental person-directed ideals (Chisholm, et. al., 2018).

Cultural changes in long-term care concern meaningful connections and service, in which care givers and staff know people they care for so that people may have a purposeful life and feel "at home" wherever they may be. Part of the feeling at home is to create more private, pleasant and individualized living areas. Those who offer practical care in healthcare facilities are referred to as "certified nursing staff" or CNAs. Some cultures have changed the name of the nursing homes to "resident assistants." Care givers who work in their homes are referred to as "home healthcare workers" or "homeworkers," depending on the activities they carry out and the job they conduct (Chisholm, et. al., 2018).

With culture changes, actual links between residents and employees from all position description are flourishing and there is a genuine sense of connection and community. This involves the significant participation of the families, friends and the larger community outside the building walls itself.

• There was no strong clinical and management foundation for healthcare workers on which cultural change could be based. Bachelor and higher degrees in nursing homes are underrepresented. More over 50% of the nursing directors, who occupy the highest positions in the nursing department, possess an associate or diploma in nursing; less than 1/3 has a Bachelor of Science. Certification, which is linked to higher degrees of professionalism, only has one third of the nursing directorates and is seldom seen in the institution among other nurses (Eliopoulos, 2013).
• Inadequate assistance for schooling was provided. Leadership of the institutions considered education rather than essential activities to be "extras." Employees time spent participating in education was not seen as important investment to support and promote the skills of staff, but as a burden which interfered with the work of residents.
• There was little availability of instructional technologies. None of the participating care homes had access for instructional purposes to LCD projectors, Video recorders, computers, or Internet (Tyler & Lepore, 2017).

To begin overcoming these roadblocks, it may be useful to support the following initiatives:

1. Ongoing efforts to review, improve, and maintain staff capabilities (which are particularly critical in light of the increasing complexity and sensitivity levels of residents); and

2. Realistic staffing numbers based on resident acuity, with staff educational requirements taken into consideration to ensure and maintain competence;

3. Effective ways for disseminating to nursing home administrators the findings of studies proving the reason to invest in staff development, including the financial benefits;

4. The development of innovative educational techniques that make education widely accessible and engaging to employees.

5. Methods of creating a learning culture in each nursing house so that all employees realize the need for ongoing learning (Seaton & Edwards, 2011).

References

Eliopoulos, C. (2013). Let’s Open Our Eyes to the Barriers to Culture Change. Retrieved 23 September 2021, from https://www.hmpgloballearningnetwork.com/site/altc/articles/lets-open-our-eyes-barriers-culture-change

Tyler, D. A., & Lepore, M. J. (2017). Barriers and Facilitators to Adopting Nursing Home Culture Change. JCOM, 24(11).

Seaton, D., & Edwards, C. (2011). Culture Change in Long-term Care: Its History and Development, Principles, Implementation and Legislation.

Chisholm, L., Zhang, N. J., Hyer, K., Pradhan, R., Unruh, L., & Lin, F. C. (2018). Culture change in nursing homes: What is the role of nursing home resources?. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 55, 0046958018787043.