“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.
In many nursing homes, the care is facility-centered, not person-centered. For example, in facility-centered care, the staff tells the residents what time they have to get up, get dressed, bathe, and have their meals. This is usually based on institutional type routines and schedules with regards to staffing and shifts. In person-centered care, the residents choose when they would like to get up in the morning, when they'd like to bathe and get dressed and have their meals. They also choose their foods based on their own preferences and not on what limited choices the nursing home tells them they have.
In facility-centered care, the building looks institutional- not like a home. It often feels cold, sterile, uninviting, and depressing. All the furniture is the same and residents cannot have their own decorations and personal furnishings. Person-centered care offers buildings that are much smaller than the typical nursing home and are built more like groups of small family dwellings rather than a hospital building. Residents are able to plan and participate in activities they find interesting and are able to use their skills and abilities in projects, chores, and hobbies that give them purpose and identity.
Facility-centered care is mostly medical in nature. The focus is on diagnosis, treatment, and management of disease. Individuals receiving this type of care are usually passively involved and not part of the decision making process about their care plans. Person-centered care encourages and empowers patients to be active partners in directing their own care.
The first and most important term to eliminate from your vocabulary is the "f" word-- that's right, stop using the word "facility!" Nursing homes are not "facilities," they are "care communities" or "care homes." And the folks residing there are not "patients," they are "residents." When they first come to the nursing home, they are not "admitted," they are "moving in." Thus they are "moving out" when they leave, and not "discharged."
Proverbs 16:31 says, "Gray hair is a crown of glory; it is gained in a righteous life."
We live in a youth-obsessed culture. Everything about our culture screams that youth is good and old age is miserable. You only have to turn your tv on for a few minutes to see this play out in commercials...SO many commercials are for anti-aging products and all the faces on the screen are flawless and beautiful. The travel commercials feature young and beautiful people on a beach. The car commercials show young handsome drivers of fast cars. If you see older persons on television, they're usually frail ("I've fallen, and I can't get up!") or disabled. They get featured in commercials for life insurance and home health services. Where are the commercials that depict aging persons as active, thriving, wise, and happy? Why don't we see gray haired wrinkled ladies on a beach or a bald old man driving a fast car? (And maybe the better question is, why don't we want to see those people?)
Listen to the conversations around you and the words that come out of your own mouth. Do you hear or say things like, "I don't want to have gray hair," "Look at these awful wrinkles," ""Getting old stinks," "I'm not telling you how old I am!"
Whether we realize it or not, we are often contributing to the perception that aging is a bad thing, something to be dreaded and endured. We often unknowingly try to hang on to our youth without considering the amazing gifts that come with getting older. Yes, our bodies will not work as well as we age, but that's because they weren't designed to be immortal! (Remember we are going to get new, imperishable bodies in heaven!) But aside from our bodies not working like they used to, we gain so much as we age. In general, we become more patient and calm because we've learned not to sweat the small stuff. We've had years of life experience to taste and see that the Lord is good and He will carry us through whatever hardships we encounter. We are able to see the fruits of our labor as our children grow and have their own children, and we begin to enjoy our children as our friends. A long life is a gift from the Lord in which we have more days to experience His blessings and faithfulness to us, and to testify to His goodness to those around us. Let's start working to create a culture that respects, honors, and values both the aging process and aging persons. If scripture tells us that gray hair is a crown of glory, we need to be obedient to that idea in our own hearts and then help others to believe it and live it out too.