1. The Phases of Culture Change Pilgrim Place in Claremont Sue Fairley – Vice President of Health Services

2. What Is Culture Change? "Culture change" is the common name given to the national movement for the transformation of older adult services, based on person-directed values and practices where the voices of elders and those working with them are considered and respected. Core person-directed values are choice, dignity, respect, self-determination and purposeful living. Culture change transformation supports the creation of both long and short-term living environments as well as community-based settings where both older adults and their caregivers are able to express choice and practice self-determination in meaningful ways at every level of daily life. Culture change transformation may require changes in organization practices, physical environments, relationships at all levels and workforce models – leading to better outcomes for consumers and direct care workers without inflicting detrimental costs on providers.

3. Living into culture change... Pilgrim Place’s decision to move toward “resident-centered/resident-directed care: has less to do with changing the culture of Pilgrim Place and everything to do with replacing the traditional medical model of care that currently defines our skilled nursing facility. The culture of Pilgrim Place is well-known for its high level of resident involvement with decision-making, intentional caring for one another and fulfillment of the individual’s potential and personal rights. At present, those in need of long term care relinquish key elements of that culture and many of the personal “rights” they have nurtured over the years when they become Health Center residents. Replacing the current institutional model cannot be accomplished overnight. It will take months of transition as we learn new staffing patterns/accountabilities, re-think how everyday nursing/dining/household tasks can be accomplished, modify approaches to regulatory requirement and contemplate how we can remodel elements to accommodate a more home-like environment. -Bill Cunitz, President/CEO

4. Values and Beliefs Shape Essential Elements of the model… The neighborhood is each residents home and sanctuary The people who live here direct their own lives both collectively and individually The boundaries of a persons neighborhood are clear and respected as a matter of course Grace, a shared sense of what is sacred in the neighborhood and its people is deeply valued, consciously created and preserved. Ritual, spontaneity, friendship, spirituality, celebration, recreation, choice, interdependence, art and humor are all manifested in a culture of grace.

5. Values and Beliefs Shape Essential Elements of the model…cont. The people here are loved and served by a responsive, highly valued, decentralized, self led service team, that has responsibility and authority Leadership is a characteristic and not a position. Leaders support and are supported by values driven, resource bearing principles and practices as a way for each person to actualize his or her full potential All systems including treatments exist to support and serve the person within the context of his or her life pursuits

6. Values and Beliefs Shape Essential Elements of the model…cont. We build strong community with one another, our family, our neighbors and our town The physical buildings and all its amenities are designed to be a true home. “Institutional creep” in design and culture is treated as a “wolf at the door”

7. Action Team Chart Steering Team Bathing Environmental Design Organizational Design Spiritual LifeCommunicationPersonFirst Life Enhancement ClinicalDiningEvaluation

8. Timeline for Change June 1 st Great Rooms completed and new staffing model in place November 1 st Rehabilitation Center complete Friday December 7 th “VIP” Event invitation to the community