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What Is Culture Change?

Have you ever visited a nursing home? What was it like? Did it feel more like a hospital or like a home?

Culture change works to create home wherever elders live. The term culture change refers to a transformation of services for elders. Culture change focuses on person-directed care, sometimes also referred to as person-centered care. In this approach to care the voices of individuals needing care and those working closest with them always come first. It involves a continuing process of listening, trying new approaches, seeing how they work, and changing routines and organizational approaches in an effort to individualize and de-institutionalize the care. Person-directed care values include dignity, respect, purposeful living, and having the freedom to make informed choices about daily life and health care. Care is directed by and centered on the person receiving care.

Culture change in long-term care is about meaningful relationships and service, where caregivers and staff really know the people they care for, so that individuals can continue to live a meaningful life and feel "at home" wherever they are. Part of feeling at home is creating living spaces that are more private, comfortable, and personalized.

"Our society needs an engaged and engaging elderhood because such a life stage offers the best possible refutation of the doctrine of youth's perfection. Most of us will need to see, with our own eyes, that a valued and valuable elderhood truly exists before we voluntarily surrender our adulthood. As a society, we, perhaps more than any other people who have ever lived, need elders. We need a renewed elderhood that can help older adults become the elders they were meant to be."

Dr. Bill Thomas
Another part of culture change is to support and nurture the staff who help elders and others in care settings or in their own homes. Those who provide the hands-on care in nursing homes are called "certified nursing assistants" or CNAs. Some culture change nursing homes have renamed them "resident assistants." Caregivers who work in people's homes are called "home health aides" or "homemaker assistants," depending on the tasks they perform and the work they do. "Direct care worker" (DCW) is a term that applies to those who provide direct, hands-on care in any setting. It is important that these workers, whatever title they have, feel respected, like their work, and want to continue doing it. The need for these workers is growing as members of the baby boom generation are growing older. 

With culture change, true relationships between residents and staff from all job descriptions flourish and a true sense of belonging and community flourish. This includes the meaningful involvement of the residents' families, friends, and the greater community outside the walls of the building itself.

NEXT > Why Do We Need Culture Change in Nursing Homes?
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