Creating a Culture of Resident Care-
In his book “Being Mortal” Atul Gawande focuses on what he calls the 3 Plagues of the LTC Industry: Boredom, Loneliness and Lack of Purpose. To define each: Boredom is the lack of engagement mentally, Loneliness is the lack of engagement emotionally and Lack of Purpose is the persistent feeling of being a burden and a taker rather than a giver.
When left unchecked and unattended residents begin to experience these plagues. This starts the cycle of feeling unloved, which leads to the thought that they are unloved which causes them to behave in manners to reject people from being loved and this perpetuates the emotions/thoughts/behaviors cycle. This cycle is the fruit of not meeting the emotional needs of people and we all experience this. Some of us are more resilient than others yet it happens. The great news is we can effect change for the better as leaders in our industry.
The solution: Engagement is the antidote to every one of these plagues. There is not one thing that engagement, done in a consistent proactive, positive and encouraging manner cannot solve.
Engaging with our residents as human beings (not ‘was-ings’) is the basis of the type of engagement we are talking about today. Whether our residents or ourselves, we must all be in a perpetual state of growth, learning and becoming. I would challenge the thought that our residents are beyond being able to learn or grow as the desire to grow never stops in a human being willingly. We are either so discouraged or defeated that we stop ourselves. It is our duty to provide our residents with opportunities at life again and help them to live fully engaged meaningful days.
In doing so, we must needs treat the residents with dignity and respect, as you would want to be treated, speaking to them as adults. We are all made in the image of God and as such have innate and inherent dignity. When we are engaging with the resident when they are having disruptive behaviors it is key to keep in mind this principle as it will help us to handle and redirect these behaviors to more productive forms of communication and support. This in turn helps them to live in the smaller facility community which includes both rights and responsibilities. Everyone has rights and responsibilities to be kind, polite, and respectful to the other residents in their community. Lastly, community involvement is key and multi generational aspect is fundamental. Inviting people outside of the facility to come and interact with the residents is tremendously beneficial to everyone involved.
When following the Maslow’s Hierarchy of Need concept (Basic Needs, Psychological needs & Self-fulfillment needs) the above will make
sense. When using this concept; Whole Person Care (Body, Mind, Soul/Spirit) can actually be accomplished. When we engage our residents through positive interactions while meeting their basic ADL’s, providing not just good food but an awesome dining experience, keeping their homes and rooms in a clean, fresh state we are meeting their basic needs and supplying them with emotional and physical strengthening.
When you are smiling at the residents, shaking their hands or bending down to talk with them, bringing compassion and concern with your questions and comments, you provide them with the emotional feelings and thoughts that they are truly cared for, are loved. In turn they feel safe, they feel secure and they know they can “be”.
From here the daily activities they participate in will increase, they will decrease their isolation tendencies, as they now feel they belong in a community, that they are accepted. Their need for love, one that feels severed due to removal from family or their home, is being filled as they engage with relationships with staff and with other residents.
This in turn provides opportunities for them to give to others, which will help them build their self respect and feeling of life having meaning again. I believe this is why so many people challenged with dementia find caring for a stuffed animal or baby doll do so well, is because they are connecting back with their time as a parent, when life’s purpose was to nurture and support their child/children.
Proactive, intentional, positive and encouraging engagement is where success is seen and we can see the roots have changed. New fruit of engaged, living residents are alive before you with smiling faces. An atmosphere of peace and life emanates from the building and resonates when visitors walk in. Comments are being made, people are wanting to live in your home and life is great everyday.
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