Conversations with Carmen:
Changing Culture in Long-Term Care

Carmen's sessions are held the third Friday of every month at 12 noon Mountain time (11am Pacific, 2pm Eastern) and run about an hour each. To sign up, just add any session to your shopping cart and pay online with your credit card. Be sure to provide a valid email address so you can receive instructions on how to join the webinar. You can also register by calling our offices at (414)258-3649.

Friday, January 15: What Residents Really Want
with guest Sue Misiorski, BSN, National Director of Training and Organizational Development for PHI, Founding President of Pioneer Board of Directors, and current PN board member.

Sue Misiorski, an experienced culture change advocate, reminds us to explore what matters most to the individuals living in residential care centers. For example, when asking elders about the single most important factor to having a good day, the answer is often something as simple as "I just want to be able to get to the bathroom when I need to." This conversation will delve into:

• Maslow's hierarchy of needs (are we thinking about it?)
• Defining excellent customer service in a self-directed culture (is it that only certain staff members can assist residents to the bathroom?)
• Versatile workers (what if everyone was a CNA?)
• Asking the right questions and anticipating resident needs (call lights are used less, family and resident satisfaction soars)
• Prioritizing culture change projects to ensure Maslow's hierarchy of needs is honored

Friday, February 19: The Creating Home II Food and Dining National Symposium Review, Results and Recommendations
with guest Karen Schoeneman, CMS Deputy Director, Division of Nursing Homes

Session cancelled due to the cancellation of the Symposium itself.

Join us for a conversation with Karen Schoeneman culture change lead for CMS' Division of Nursing Homes and an original Pioneer Network member. It was Karen's vision to bring all the right people together to talk about innovation and regulatory issues for the first Creating Home symposium and now there have been two. Carmen Bowman under contract with CMS was the facilitator and wrote the background paper for the symposium. Carmen and Karen will review what took place at the exciting Creating Home in the Nursing Home II: A National Symposium on Culture Change and the Food and Dining Requirements on Feb. 11th, 2010 including all recommendations collected and any next steps determined.

Friday, March 19: Food For Thought
with guest Linda Bump, RD, LNHA, Culture Change Pioneer, Action Pact Consultant

Linda Bump is a pioneer in the culture change movement both as a licensed administrator and registered dietitian who has "done it". Because of this she was recently invited to be an expert speaker and write a white paper for the CMS/Pioneer Network Creating Home in the Nursing Home II: A National Symposium on Culture Change and the Food and Dining Requirements. Linda will share just a taste of the contents of her book Life Happens in the Kitchen and a co-authored Action Pact book and training DVD Nourish the Body and Soul. Linda is famous for showing what is possible. She begins with what is possible to do even still in the traditional, institutional model and then what becomes more possible in the progression from transformational to neighborhood to household model. Listen in to find out what makes what Linda calls "excellence in individualization" and for some fabulous ideas such as the Visiting Chef.

Friday, April 16: Personalizing Diets and Med Pass
with guest Dr. Matthew Wayne, MD, CMD, Medical Director for multiple nursing homes

Dr. Matthew Wayne is a medical director who has been the forefront of promoting self-directed care. He was featured on the CMS satellite broadcast Clinical Case Studies series and was invited to be an expert speaker and write a white paper for the CMS/Pioneer Network Creating Home in the Nursing Home II: A National Symposium on Culture Change and the Food and Dining Requirements. As a physician, Dr. Wayne will share how easy it really is to liberalize diets and personalize medication pass. He will touch on monitoring clinical outcomes, what should happen when a person chooses not to follow a physician's order and, from a clinical perspective, what the physicians', nurses' and facility's obligation is to the person.

Friday, May 21: Getting Your Residents Outdoors
with guest Elizabeth Brawley, Environmental Design Consultant

Residents all too often do not get outside. "Safety" worries are often the reason why. Yet the benefits of being outdoors actually mitigate many negative, "unsafe" outcomes. Elizabeth Brawley a leading environmental design consultant and author will share tips on creating as-safe-as-possible outdoor areas. Doses of sunshine contribute to maintaining circadian rhythm, promoting better sleep and vitamin D synthesis for healthy bones, all of which help to prevent falls. It is well know that being outdoors prevents depression and reduces agitation. Sleep disorders, all too prevalent in long term living environments, result in sleep medication and hypnotic use which are strongly linked to falls and hip fractures. This conversation will focus on ideas to woo residents outside with covered porches, raised gardens, safe rockers and gliders, walkways for exercise and by holding group activities outdoors.

Friday, June 18: Dementia Beyond Drugs - Changing the Culture of Care
with guest Dr. Al Powers, MD, Board-certified Internist, Geriatrician, Nursing Home Practitioner, Eden Alternative Mentor and Educator

Board-certified internist, geriatrician, nursing home practitioner, Eden Alternative™ Educator and musician Dr. Al Powers has recently contributed greatly to the culture change movement with his new book Dementia Beyond Drugs: Changing the Culture of Care. We are hoping this book will become a manual for physicians, nurses, social workers, administrators, students and anyone on the quest to create a relationship-rich and psychotropic drug-less culture especially for those living with dementia. During this conversation, Dr. Powers will explain how to move away from the institutional model - viewing individuals as patients defined by their dementia and using prescribed medications to control their "troublesome" behaviors - to what he calls an experiential model of care "dementia beyond drugs" in which many people formerly sedated "awaken" from what Dr. Powers describes as their "calmatose" state with remarkable outcomes.

Friday, July 16: Unlocking the Life Within - The Key to Elder Wellness
with guest Glenn Blacklock, Action Pact Trainer and Consultant and LNHA

What is wellness really? Even in the newest of buildings designed to be as close to home as possible we are still discovering that something is missing. When we peel back the oppressive layers of institutional living, we discover doors elders themselves may have forgotten existed. Exploring wellness gives us the keys we need to open those doors. This approach to wellness focuses on abilities and ways to refuel the positive life force that each individual has within them. Wellness applies to everyone- even the frailest of the frail. With Glenn, who has researched and developed new training materials on wellness, this conversation will explore wellness concepts, new ideas to try and how to get the most out of the great things already happening in your home.

Friday, August 20: Eliminating Restraints by Engaging the Whole Person
with guest Theresa Laufmann, Co-Director of Nursing at Oakview Terrace, Freeman SD

Join the conversation in taking a step back to think about why we use restraints and "less restrictive devices," namely alarms. Are they working? We know this about physical restraints but are also discovering that even alarms physically and psychologically harm people while not really eliminating falls. In fact, eliminating all restraints including alarms has reduced falls in the homes that have made commitments to no longer use them. Oakview Terrace is one of these leading homes. This enlightening and encouraging conversation with Theresa Laufmann, co-DON at Oakview and expert on eliminating restraints and alarms, will encourage you to think differently, hear how it can be done and be creative in engaging the whole person in order to eliminate the need for any kind of restraint.

Friday, September 17: The New Negative Outcome and Harm from Not Honoring Choice
with guest Judah Ronch, PhD, Psychologist, Professor and Interim Dean of the Erickson School of Aging

As a psychologist working in the field of aging, Dr. Judah Ronch, knows the psychological outcomes of choice and lack of it. He will teach us about "surplus safety," "the right to folly," our "future self" and how choosing and eating food supports good cognitive and emotional health. Dr. Ronch will explain the positive outcomes of being given choice as well as the negative outcomes from not being given choice -what may very well be the "new negative outcome and harm from not honoring choice" not many people are talking about yet even CMS has given additional attention to with new (July 2009) guidance for Tag F242 Self-determination and participation.

Friday, October 15: Technology's Contribution to Regulatory Compliance
with guest Jack York, Owner of It's Never 2 Late Adaptive Computer Systems

We're finding that computers and all you can do with them are contributing to compliance with several "heavy hitter" CMS requirements: Tag F240 Quality of Life, Tag F241 Dignity, Tag F242 Self-determination and participation, Tag F246 Accommodation of Needs, Tag F248 Activities and Tag F309 Quality of Care. Computers connect residents to the world and provide choice like never before; adaptations accommodate and promote dignified use of computers like never before; applications such as visual care plans help staff know their residents and plans of care like never before - all contributing to quality of life and compliance with these federal requirements like never before. Carmen, regulator turned educator, will explain the compliance link while Jack York shows technology's capability to affect residents' quality of life in this engaging and interesting conversation.