Implementing Culture Change in Long-Term Care: Benchmarks and Strategies for Management and Practice

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"As one who is involved in the culture change movement and is trying to review the huge volume of available resources, I find it refreshing to have a book that draws it all together....I highly recommend this book to administrators who are overwhelmed at the thought of implementing change in their environment. The author has done an excellent job of making it seem quite possible to make culture change a reality."--Doody's Medical Reviews

"The publication of Implementing Culture Change in Long-Term Care marks the beginning of a new era in the aging services profession. This book is the Rosetta Stone of the culture change movement. Dr. Jurkowski's skillful blend of theory, research, and practice addresses the movement's most urgent needs and makes the work of culture change advocates accessible to a broader and more influential audience....This book is the future in paper and ink."

From the Foreword by Bill Thomas, MD

Founder of the Eden Alternative and the Green House Project

This text offers a strategic approach for promoting an active culture of change in long-term care facilities for older adults and people with disabilities. It discusses the philosophical framework for the delivery of care in these settings and addresses the changing landscape of our long-term care population. With the aim of transforming these facilities from institutional settings to person-centered, homelike environments, the book offers administrators and practitioners numerous strategies and benchmarks for culture change, and addresses tools and resources to support the culture change process. The text describes how these benchmarks have been met and provides ways to address not just knowledge, but also attitudes and behavior, important components of a culture change strategy.

The book compares and contrasts current long-term care paradigms-the medical model, the rehabilitation paradigm, the independence and dignity model, and strength-based approaches-in order to see how they facilitate or impede culture change. It provides best practice examples of benchmarks to be attained along with strategies to promote this process. These benchmarks and strategies are based upon the Artifacts for Culture Change Assessment Tool developed by the Centers for Medicare and Medicaid. The text describes ways to build a blueprint and strategic processes for integrating these benchmarks into a long-term care setting, addressing the entire process from assessment through evaluation. It also provides tools enabling readers to learn from their own process via a feedback loop, and includes strategies to facilitate partnerships with family, staff, and community.

Key Features:

  • Elucidates benchmarks that can be implemented in long-term care settings, using the Centers for Medicare/Medicaid's "Long Term Care Artifacts" assessment tool as an intervention
  • Focuses on care practices, the environment, the inclusion and integration of family and community, leadership benchmarks, and workplace practices
  • Includes robust examples of best practices within each of the main artifact arenas
  • Incorporates tools and strategies for assessing the philosophical paradigm of a long- term facility that can help or hinder the culture change process
  • Provides discussion and reflection questions and websites for additional resources
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Editorial Reviews

Doody's Review Service
Reviewer: Sharon G Thomas, BSN (University of Missouri-Columbia)
Description: There are many resources on culture change in long-term care. In fact, there are so many that workers in the field have trouble choosing which resources to use and often just give up and wait for regulations to guide them, with the result that compliance becomes their goal. In this book, the author brings together the basic thoughts and tools necessary to get started on the culture change journey that focuses on person-centered care.
Purpose: The purpose, according to the author, is to support administrators and long-term care staff in facilitating a culture that focuses on dignity and the least restrictive environment for residents in long-term care, rehabilitation, and other care settings. If there is to be culture change, we cannot continue to do things the way they have always been done. Rather than focusing on tasks, staff must focus on strengths and desires of residents. In his very eloquent foreword, Bill Thomas, MD, founder of the Eden Alternative and the Green House Project, states, "This book offers us a context within which we can consider these changes." This book meets the author's objective in a clear and practical way.
Audience: It is intended for everyone interested in the culture change movement, and it is written at a level that both professionals and lay people can understand. Families would benefit from reading it as part of the selection process of a long-term care environment for a loved one. The author, a social worker and educator, is very influential in the field of long-term care and culture change.
Features: The book covers culture change from identifying the need to changing existing paradigms about long-term care and strategizing the process. It includes how to benchmark current practices in different environments and set goals to achieve desired outcomes. The Artifacts of Culture Change Tool is thoroughly discussed. Each section ends with discussion/reflection questions that help clarify the material. The valuable appendixes include resources, websites, and a listing of vocabulary that needs to be considered to support the new paradigm of culture change.
Assessment: As one who is involved in the culture change movement and is trying to review the huge volume of available resources, I find it refreshing to have a book that draws it all together. Of course, the resources the book provides are valuable, but having them in one book makes it easy to keep track of all of the choices. I highly recommend this book to administrators who are overwhelmed at the thought of implementing change in their environment. The author has done an excellent job of making it seem quite possible to make culture change a reality.
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Product Details

  • ISBN-13: 9780826109088
  • Publisher: Springer Publishing Company, Incorporated
  • Publication date: 5/28/2013
  • Edition description: New Edition
  • Pages: 316
  • Sales rank: 1,247,143
  • Product dimensions: 5.90 (w) x 9.00 (h) x 0.70 (d)

Meet the Author

Elaine Theresa Jurkowski, MSW, PhD, is an Associate Professor and Graduate Program Director at the School of Social Work, Southern Illinois University Carbondale (SIUC). Dr. Jurkowski also coordinates the Certificate in Gerontology through the College of Education and Human Services at SIUC. Her professional background includes both social work and public health. Dr. Jurkowski has spent most of her career writing about access to care issues for older adults and people with disabilities and has been effective in shaping policy and program efforts in the United States, Canada, India, and Niger. She is the author of Policy and Program Planning for the Older Adult, numerous book chapters, and professional articles. She is a member of APHA, CSWE, and GSA, and presents nationally and internationally.
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Table of Contents




Chapter 1 The changing landscape of our long term care population

Chapter 2 Introduction to Long Term Care Settings and Culture change.

Chapter 3 Philosophical paradigms impacting long term care settings.

Chapter 4 Artifacts of culture change - Overview of purpose and measurement practices.


Chapter 5 Care Practices

Chapter 6 Environment benchmarks/artifacts

Chapter 7 Family and community benchmarks/artifacts

Chapter 8 Leadership benchmarks/artifacts

Chapter 9 Workplace practice benchmarks/artifacts

Chapter 10 Outcomes


Chapter 11 The assessment process: Identifying a road map for success.

Chapter 12 From Assessment to Action: Building on the planning process

Chapter 13 Partners for change: Residents and Family

Chapter 14 Building coalitions of effective change agent teams

Chapter 15 Legal and regulatory bodies and the culture change process

Chapter 16 A vision for the future

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