Before the plan was put into place data was collected so that the changes could be measurably recorded (Rosher, 2006).
In addition, before the plan began Phase I, the nursing home staff was retrained and agreement and enthusiasm for the plan was attained.
The culture change program was as success. Several residents were recorded as developing new energy and drive for life when allowed to pursue previous interests. One resident, who had dementia approached a newly obtained bird and talked to it for 15 minutes. She had raised birds during her adult life before entering the center and she was still able to advise others on how to care for and feed pet birds. Another resident who was blind and hearing impaired came alive with excitement when she was provided bunnies to pet and care for each day (Rosher, 2006).
Another study gauged at recording nurse response to patients with dementia illustrated the all too common response of forcing the residents to comply with schedules and interests that were convenient for the staff members, and ignoring any possible interests of the residents.
This study included 54 nursing home nurses from several different nursing homes and concluded that nurse responses to the patients was often lacking compassion or understanding (Kovach, et al., 2006).
In Common Problems in Hospitalized Older Adults, several issues were noted to prevail among the elderly population confined in homes. They included sleep issues, changes in mental status and sensory deficits that were not as prevalent before entering the hospital setting.
With almost three decades of experience in the nursing home field I think that my design of a nursing home that stimulates the elderly residents is based in solid information and evidence obtained over the years.
To change the pattern that research continues to see with regard to the elderly mental decline once they enter residential care facilities I would design homes that had a much different standard of practice.
My homes would mandate that residents entering the homes sit down with staff and family members and have an open honest discussion about the resident's interests...
These interests would be recorded and a plan would be designed that would incorporate those interests into the resident's daily activity once he or she became a reside at the nursing home.
For instance, if a resident was about the enter one of the nursing homes that I created and it was discovered that the resident enjoyed raising birds before becoming a resident, I would be sure the plan of care included obtaining a pet bird for that resident to care for while living in the nursing home.
If the resident had an active part in children's Sunday School at the church before coming into care, I would mandate that the resident be transported to a church each Sunday where he or she would be able to see and interact with children.
At times it will be impossible to incorporate the exact interests the resident had before entering care but every effort would be made to provide a closely matching interest.
If the resident entering had been an active baseball fan, and attended many games before coming into care, but had dementia now and could not be transported safely and reasonably to baseball games at a stadium, efforts would be made to bring baseball to the resident. The staff would keep track of televised games and be sure the resident was provided an opportunity to watch them. The resident would be encouraged to collect baseball cards and it might be possible to transport the resident to local high school baseball games on Friday nights.
I would fund these activities through grants obtained from the Areas of Aging.
The goal of my nursing home plan would be to create a more mature and active activity plan for the aged, thereby creating a more well rounded end of lifer experience for them and their families.
References
____(2006) Common Problems of Hospitalized Older Adults. Journal of Gerontological Nursing
Kovach, Christine, RN; Kebler Sheryl RN; Simpson, Michelle, MS (2006) Behaviors of Nursing Home Residents With Dementia, Examining Nurse Responses. Journal of Gerontological Nursing
Rosher, RB, Robnison, RB (2006) Barriers to Culture Change Journal of Geontological Nursing
