1. Texas Culture Change Coalition2011 Symposium“Culture Change in Texas: It’s Time”“Changing Long-term Care in Texas for Aging and Disability”September 23, 2011 Texas State University

3. Aging Society: “Silver Tsunami” Baby Boomers (78 million) turning 65 in 2011 10,000 per/day Someone 65 today is expected to live 18.5 more years 2 of 5 (40%) will reach age 90.

4. U.S. Nursing Homes Number of nursing homes: 16,500 Number of beds: 1.8 million

5. Long-term Care Greatest Generation (Compliant) - WWII Woodstock Generation (Free Spirit) - Vietnam

6. Leading Organizations in Culture Change

7. Leaders Pioneer Network – Advocacy & Training Network grown to over 10,000 members in past 10years Annual national confer – 1300 St. Louis Coalitions in 38 states www.pioneernetwork.net

8. Founded in 1995 International Leader in the Culture Change Movement More than 20,000 trained Eden Associates & 300 Registered Homes world-wide

9. “The challenge is to create a Human Habitat where people of all ages come together day after day – eager and able to Thrive, not just Survive.” Bill Thomas, MD Founder

11. Helplessness

12. Boredom Plagues of the human spirit, not the human body. Medical treatment offers no balm.

13. Plagues:Antidotes: Loneliness ----------- Companionship Helplessness -------- Choices Boredom ------------- Variety

14. Cognitive Disability More than 20 million Children & Adults with cognitive disabilities require lifelong supports in U.S.. Brain Injury Developmental Disabilities Intellectual Disabilities Mental Illness Autism Other

15. Broader Culture Change Movement Transforming Long-term Care for all people.

16. Designed for the unique needs of younger individuals with long-term care needs. Developmental Milestone Life Experiences Long-term Aspirations Longevity of Life

17. Texas: Approx. 4,122 long-term care facilities Capacity to care for 229,139 individuals. Nursing Homes - 1,174 Bed Capacity - 126, 684

18. Mission- Dedicated to promoting change and improve the way long-term care is provided for Texans who are aging or disabled, and the caregivers who provide support for them.

19. 2011 Goals: Create organizationto promoteculture change in Texas. Create awareness of CC in Texas Provide Educational opportunities about culture change. Create opportunities to network and collaborate on CC. Make it 2012!

20. Committees Organization/ Administration: Marketing/ Development: Regulatory/Policy: Education/Training:

21. Steering Committee Provider Associations Provider Facilities Consumer Advocacy Organizations Government Organizations Quality Improvement Organizations Educational Organizations Auxiliary LTC Organizations

22. Texas operates 13 campuses with 4,241

23. HB 3197 Relating to creating a pilot program to implement the culture change model of care at a state supported living center 1. Shift decision-making to the individual with the disability; 2. Implement continuous quality improvement processes that use objective data to improve practices and services; 3. Improve the workforce by reducing turnover Rep. Coleman sponsored in the House, Sen. Deuell's sponsor in Senate.

24. The DADS Culture Change Initiatives mission is to promote and support nursing home providers as they transform from atraditional system-directed culture to one that is person-directed or centered. www.dads.state.tx.us/culturechange/

25. July 25, 2011- Culture Change Symposium, Austin, Texas Culture Change: Enriching Lives in Nursing Homes October 20, 2011 – DADS ICF/MR Provider & Surveyor Conference, Austin, Texas

26. What is Culture Change? A term that is used to describe fundamental changes in Long-term Care. A transformation in the physical, organizational and psycho-social environments based on person-centered values.

27. 6 Traits of Culture Change Residents have input about their care and activities. Living environment that reflects a home, and the unique preferences of the resident. Close relationships between staff, residents and community Staff empowered to make decisions in best interest of resident. Collaborative decision making. Ongoing quality improvement initiatives

28. Comparing Models Long-term CareLifeLong Living Institutional Home & Community System-Centered Person-Centered Custodial Growth Disempowering Empowering Risk Aversive Dignity of Risk Hierarchical Control Resident/Staff Impermeable Permeable Diagnosis-symptom Person

29. The Goal Institutionalized Care Individualized Care

30. The Goal of Change: Move from institutional “system-centered” to individualized “person-centered” care. Relationship is the fundamental building block of a transformed culture

31. The Disenfranchised “Loneliness is the most terrible poverty. “ -Mother Theresa

32. Culture Change: A Change in Perception Long-term Care vs. LifeLong Living

33. “The Ability to make choices largely determines one’s quality of life.” ~ Bill Thomas, M.D.

34. Person-Centered Care Process of Continual Listening and Learning Focusing on what is Important to the Person Acting on this in Alliance with the Person

35. Person-Centered Support “Nothing About Me, Without Me”

36. Person-Centered Living A life centered on personal preferences & values that stress dignity, choice, and individuality.

37. From Golden - "Do unto others as you would have them do unto you." To Platinum Rule - "Treat others the way they want to be treated.”

38. Commonality / Individuality

39. Core Principles of Culture Change Self Determination Sense of Community Dignity Choice Belonging Support Purposeful Living Contributing

40. What would your P-C Care look like? What’s Most Important? Hobbies/Interests Home Town Volunteer Sports Music Type Family/Friends School

41. The Journey Culture Change Is Not: Another rigid program or set of regulations It is not about rewriting policies and procedures. Much more than the 3 F’s

42. Culture Change We do the best we can with what we know, and when we know better, we do better ! ~ Maya Angelou

43. Inspire Inform Involve

44. “Be the Change You Want to See in the World” - Gandhi David Seaton, Founder/CEO PO Box 705 San Marcos, Texas 78667 512-938-1127 DS@LiveOakLiving.com LiveOakLiving.com