LifeLong Living; Building a Long‐term Culture for Continued Growth
David Seaton, Owner
San Marcos, Texas
What Is Culture Change?
“Culture change” is a national movement for the transformation of adult long‐term care services, based on person‐directed values and where the voices of person and those working most closely with them are solicited, respected and honored.
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Models of Care
Long-term Custodial
ActiveTreatment
LifeLong Living
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Company
Residents
Staff
• Empowerment• Choice• Relationships• Dignity• Quality of Life
• Policy & Procedures• Limit Risks/Safety• Compliance• Avoid Liability• Profitable Biz
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LifeLong LivingCulture
A Great Place to Work & LiveTrain for the Culture you Want
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8 Culture Killers
1. Not Walking the Talk
2. Being Too Busy
3. Asking team members to do things, then not doing the parts you need to do
4. Not Providing Information
8 Culture Killers
5. Not Listening to Your Team
6. Not Letting People Do Things Their Own Way
7. Ignoring Conflict
8. Not Giving Credit
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Scurvy - disease resulting from a lack of vitamin C; symptoms include weakness, feeling tired, and sore arms and legs. Without treatment, decreased red blood cells, gum disease, changes to hair, and bleeding from the skin may occur.
Malnutrition
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Psycho-Social Malnutrition
Lack of access to people and things that are of most importance;Results in apathy, withdrawal, anxiety, depression, and afailure to thrive
“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, MDFounder
* Loneliness* Helplessness* Boredom
The Three Plagues of Long-term Care
Plagues: Antidotes:
Loneliness ‐‐‐‐‐‐‐‐‐‐‐ Companionship
Helplessness ‐‐‐‐‐‐‐‐ Choices
Boredom ‐‐‐‐‐‐‐‐‐‐‐‐‐ Variety
LifeLong Living Principles
• Relationships
• Community – Sense of Belonging
• Purpose & Meaning
• Person‐Centered & Choice
• Reciprocity & Collaboration
• Healthy Living Culture
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Basic Building Blocks for Human Development
• Reason to get out of bed• Daily structured activities• Fuller Day – too much free time• Safety/Security/Support (safety net)• Be around Others – peers, friends• Normal Sleep• Good Diet• Take Medication, as prescribed• Exercise/Physical Activity
Somewhere to Go, Something to Do, Someone to do it with
• Institutions Regulate and Control
• Habitats Nurture and Grow
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Comparing Models
Long‐term Care LifeLong LivingInstitutional Home & Community
System‐Centered Person‐Centered
Custodial Growth
Disempowering Empowering
Risk Aversive Dignity of Risk
Hierarchical Control Resident/Staff
Impermeable Permeable
Diagnosis/Disability Person with condition
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People don’t like:
• Being told what to do• Being criticized• Being judged• Be managed• Being corrected• Having consequences• Being powerless
“I Often Don’t know What to Do,
But I Usually know What Not to Do.”
This I’ve Learned
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Journal of Personality and Social Psychology:
#1 Contributor to Happiness in Life -
Autonomy: the feeling that your life’s activities and habits are self-chosen and self-endorsed.
Autonomy is when we have the exhilarating power of choice
Happiness
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The Ability to make Choices Largely Determines One’s Quality of Life
Unmet Needs
Depression Anger
Can’t Get What Wants
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T.V.
Fun
Hanging Out
Eat/Smoke/Drin
Sleeping
Therapy
Pie of Life - Existing -
Person
Work
Family
Friends
RecreationCommunity
Hobbies
Volunteer
Thriving
Commonality / Individuality
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Human Nature
FRIENDS
Relationships
Self Determination
Purpose
Belonging Choice
Support
Dignity
Sense of Community
Contribution32
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Self-Actualization
Esteem Needs
Belongingness and love needs
Safety Needs
Physiological Needs
Achieving one’s full potential
Prestige and feelings of accomplishment
Intimate relationships, friends
Safety and security
Food, water, warmth, rest
Self-fulfillment needs
Psychological needs
Basic needs
“Nothing About Me, Without Me”
Person-Centered Principle
Person‐Centered:
Balance between what’simportant to & forthe person
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Important FOR a person includes being healthy & safe.
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Important TO a person includes relationships, meaningful things to do, community life, fun.
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1. Residents have input about their care and activities.
2. Living environment that reflects a home, and the unique preferences of the resident.
3. Close relationships between staff & residents
4. Direct Staff empowered to make decisions.
5. Collaborative team decision making.
6. Ongoing quality improvement-growth & change
Traits of a Changed Culture
* Know & seek to understand
* Be of genuine service
* Be guided by the person
* Struggle for difficult goals
* Try what might be possible
* Enhance the dignity of the person
* Bring out the good in people.
When People Matter More Than Systems
- Michael Kendrick
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So What Do People Want?
• Sense of Home & Community
• Meaningful Activities
• Friends/Relationships
• Fun / Enjoy Life
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David Seaton, Owner/President
San Marcos, Texas
512.567.1704
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