Many of us believe that nursing homes are cold, institutional places. Often, sadly, this stereotype has proved to be true. But currently, many are working at instituting a shift in how nursing homes operate. This movement is called culture change, and it involves rethinking how people are cared for in a nursing home.
Spearheaded by the Pioneer Network, culture change involves some concepts that seem fairly simple in concept. Rather than running a nursing home according to a task-based schedule, which may involve one worker going up and down the halls to administer baths or change sheets, nursing homes would operate according to an individualized approach. This approach puts the patient's needs front and center, allowing for the highest possible quality of life. Staff members would have more one-on-one time with a smaller group of patients, allowing them to know when a resident wants a bath, as opposed to just giving a bath at a certain time.
Just as care becomes more individual and less regimented, so too should the facility look less like an institution and more like a home. This might involve changes in layout and appearance. One notable example of this approach is the Eden Alternative. There are several hundred homes across the country that have been "Eden-ized," meaning they are full of plants, animals and children. Rather than surrounding the elderly with surroundings that remind them of the end of life, they are surrounded by life, and preliminary studies of the method show that residents and their families are happier.
However, as you might imagine, changing the look and feel of nursing homes doesn't come cheap, and since many people are already worried about how they'll afford a nursing home now, there's no telling how long it will take to fully implement these ideas.
For more on nursing homes and other forms of long term care, see the links below.
Related HowStuffWorks Articles
- "A Consumer Guide to Choosing a Nursing Home." NCCNHR. May 2007. (March 9, 2009)http://www.nccnhr.org/uploads/NhConsumerGuide.pdf
- "A Guide for Families: Making the Transition to Nursing Facility Life." American Health Care Association; National Center for Assisted Living." (March 9, 2009)http://www.longtermcareliving.com/pdf/making_transition.pdf
- "At Rhode Island nursing home, death comes purring." CBC News. July 26, 2007. (March 9, 2009)http://www.cbc.ca/health/story/2007/07/26/cat-death.html
- Chapin, Meldrena. Lecture at HowStuffWorks.com. Feb. 26, 2009.
- Coleman, Mary Thoesen, Stephen Looney, James O'Brien, Craig Ziegler, Cynthia A. Pastorino and Carolyn Turner. "The Eden Alternative: Findings After 1 Year of Implementation." Journals of Gerontology. 2002. (March 9, 2009)http://biomed.gerontologyjournals.org/cgi/content/abstract/57/7/M422
- Cornell University. "Aggression Between Nursing-home Residents More Common Than Widely Believed." ScienceDaily. June 4, 2008. (March 9, 2009)http://www.sciencedaily.com /releases/2008/06/080602170924.htm
- "Culture Change in Nursing Homes." National Citizens' Coalition for Nursing Home Reform. 2006. (March 9, 2009)http://www.nccnhr.org/uploads/culturechange06.pdf
- Dentzer, Susan. "A Nursing Home Alternative." PBS. Feb. 27, 2002. (March 9, 2009)http://www.pbs.org/newshour/bb/health/jan-june02/eden_2-27.html
- Duhigg, Charles. "At Many Homes, More Profit and Less Nursing." New York Times. Sept. 23, 2007. (March 9, 2009)http://www.nytimes.com/2007/09/23/business/23nursing.html
- Emerzian, A.D. Joseph and Timothy Stampp. "Nursing Home Reform: Its Legislative History and Economic Impact Upon Nursing Homes." Benefits Quarterly. 1993.
- Engber, Daniel. "Naughty Nursing Homes." Slate. Sept. 10, 2008. (March 9, 2009)http://www.slate.com/id/2199606/
- Harrington, Charlene, Steffie Woolhandler, Joseph Mullan, Helen Carrillo, David U. Himmelstein. "Does Investor Ownership of Nursing Homes Compromise the Quality of Care?" American Journal of Public Health. September 2001. (March 9, 2009)http://www.ajph.org/cgi/content/full/91/9/1452
- Henneberger, Melinda. "An Affair to Remember." Slate. June 10, 2008. (March 9, 2009)http://www.slate.com/id/2192178/
- Klauber, Martin and Bernadette Wright. "The 1987 Nursing Home Reform Act Fact Sheet." AARP. February 2001. (March 9, 2009) http://www.aarp.org/research/legis-polit/legislation/aresearch-import-687-FS84.html
- "Living in a Nursing Home: Myths and Realities." American Health Care Association, National Center for Assisted Living. (March 9, 2009)http://www.longtermcareliving.com/family_guide/myths/myth1.htm
- Matthews, Joseph L. "Choose the Right Long-Term Care." Nolo. July 2002.
- Morris, Virginia. "How to Care for Aging Parents." Workman Publishing. 2004.
- "Nursing Home Care." The AGS Foundation for Health in Aging. March 15, 2005. (March 9, 2009)http://www.healthinaging.org/agingintheknow/chapters_ch_trial.asp?ch=15
- Pear, Robert. "Violations Reported at 94% of Nursing Homes." New York Times. Sept. 30, 2008. (March 9, 2009)http://www.nytimes.com/2008/09/30/us/30nursing.html?_r=1
- Pioneer Network Web site. (March 9, 2009)http://www.pioneernetwork.net/
- Rosher, Richard B. and Sherry Robinson. "Impact of the Eden Alternative on Family Satisfaction." Journal of the American Medical Directors Association. May 2005. (March 9, 2009)http://www.jamda.com/article/S1525-8610(05)00194-5/abstract
- "The Evolution of Nursing Home Care in the United States." PBS. (March 9, 2009)http://www.pbs.org/newshour/health/nursinghomes/timeline.html
- University of Illinois at Urbana-Champaign. "Long-term Care Health Coverage a Hidden Casualty of Economic Slide." ScienceDaily. Dec. 4, 2008. (March 9, 2009)http://www.sciencedaily.com /releases/2008/12/081204133602.htm