Valuing Our Elders by Changing the Culture in Healthcare Organizations

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Windsor Healthcare teaches hospital CEOs, nursing home administrators, other healthcare leaders about ways to embrace person-centered care movement, such as offering the elderly choices in eating arrangements, bathing routines, other lifestyle approaches. Creating cultures of caring in nursing homes is the focus of a national workshop being conducted today by representatives of New Jersey’s leading nursing home provider, Windsor Healthcare Communities, at the Pioneer Network Conference.

Windsor Healthcare

"The key is working with each individual in care. Treating each individual with respect and providing choices in everyday living, while assuring their safety and health, is the goal," said Windsor Heathcare VP Batsheva Katz.

Creating cultures of caring in nursing homes is the focus of a national workshop being conducted today by representatives of New Jersey’s leading nursing home provider, Windsor Healthcare Communities. “Let Them Be ... Gaining Control by Letting Go,” is the title of the discussion at the Pioneer Network’s national conference for 1,100 hospital CEOs, nursing home owners and other healthcare executives in Seattle.

Batsheva Katz, vice president for Quality Initiatives at Windsor Healthcare, and Emi Kiyota, founder of Ibasho, a nonprofit organization dedicated to creating socially integrated and sustainable communities that value their elders, and a consultant to Windsor Healthcare, are leading a discussion about the opportunities as well as the challenges in changing the culture in healthcare organizations providing services for the elderly and others who need long-term care.

They are offering guidance to for-profit care organizations on how to embrace a person-centered care movement led by the Eden Alternative. Giving residents choices on how to live, eat, relax, congregate and even bathe, rather than insist that residents fit within an institutionalized regimen, is at the core of the movement.

“We are sharing our efforts in achieving corporate buy-in to culture change with person-centered care as the goal,” said Katz. “At the national conference, we are explaining how we are making the change, starting with corporate buy-in, while creating strong, empowered staffs where teamwork is highly valued. Instead of cold, institutional buildings, we want our homes to be warm and inviting and our residents to feel comfortable and respected.”

Windsor Healthcare Communities, all located in New Jersey, include Ashbrook Care & Rehabilitation Center in Scotch Plains, Briarwood CRC in South Amboy, Buckingham at Norwood CRC in Norwood, Canterbury at Cedar Grove CRC in Cedar Grove, Cornell Hall CRC in Union, Greenbrook CRC in Green Brook, Llanfair House CRC in Wayne, Merwick CRC in Plainsboro and Windsor Gardens Care Center in East Orange.

Examples of changes include giving residents choices in eating arrangements. Some facilities now are offering smaller table settings. At Merwick, a pianist regularly provides background music for diners. In one dining room, residents eat family style and staff members regularly join them for their meals.

Another change is occurring in the bathing routines. “We are training staff to look at bathing from a resident’s perspective. If a person would rather bathe at night, we work to accommodate that. Through the use of towels, we enable residents to achieve a greater level of privacy. And we’re softening lighting and colors in shower rooms to make them more spa-like.”

They are also caring for residents with dementia differently, in keeping with a new approach espoused by the Center for Medicare and Medicaid Services to decrease the number of nursing home dementia patients on anti-psychotic drugs. Windsor Healthcare staff, working with attending physicians, reduce the drug use of its residents with dementia, as appropriate.

“In one of our buildings, a resident with dementia was particularly combative. He was wheel-chair bound and was losing his ability to speak. He was angry, frequently swinging his walking cane at the staff. We slowly reduced his anti-psychotic medications, while at the same time creating boards with key phrases and words he used. He was able to point to the words he wanted to say. He started joining other residents in the dining room. He walked himself slowly to the nursing station to help himself to water. He was a different person.”

"The key is working with each individual in care. Treating each individual with respect and providing choices in everyday living, while assuring their safety and health, is the goal," said Windsor Healthcare VP Batsheva Katz.

“We continue to work on our transformation at Windsor Healthcare,” Katz told her audience. “The whole model of care is changing for the better. We are always examining what we are doing and why to make sure it is something that benefits our residents.”

Katz said the evolution starts with achieving corporate buy-in. “Support from our finance department was critical to our success,” she said. “We persuaded our finance officers to give us leeway in how to spend money. That enabled us to make programmatic changes. We worked within the same overall budget but with the flexibility, we were able to pay more attention to resident needs rather than continuing the old model of institutional living. And we made every dollar count.”

Staff acceptance was critical as well, she said. “No longer did Corporate issue orders but instead shifted to a supportive approach. Working with staff, we have been rewriting policies and procedures to reflect person-centered values.”

“We have a very strong team network now. We want our staff to dream and dream big about what they want to accomplish for those they serve.”

About Windsor Healthcare
A family-owned company, Windsor Healthcare provides clinically sophisticated sub-acute care, as well as comprehensive nursing care, in nine communities throughout New Jersey. Windsor Healthcare takes pride in its progressive thinking in healthcare models and partnering with the most well regarded medical providers in the state. With leadership experience in short and long term care for 35 years, Windsor Healthcare has the resources and capabilities to provide the highest quality care through a full range of services. Learn more at http://www.windsorhealthcare.org.

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Becky Taylor

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