Transcript Massachusetts Culture Change Coalition

Massachusetts Culture Change
Coalition
Dining Culture
Culture Change
The only thing that should change
when someone moves into a
nursing home is their address
Culture Change
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It is a journey, not a destination
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Residents, Family & Staff
Goals
OBRA supports Culture Change
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483.15 - Quality of Life
Culture Change
By identifying and implementing the
Resident’s wants and needs you will
meet OBRA Regulations
“each facility provide care and services to attain or
maintain the highest practicable physical, mental,
and psychosocial well being of each resident…”
Culture Change - Massachusetts
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Conferences in Massachusetts –
2006 Consistent Assignment
2010 Dining Experience
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Benefits to Residents
Benefits to Staff and Facility
DPH
Culture Change –
Consistent Assignment
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Considerations:
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Waking and sleeping
Meals
Food Preference
Daily Routine
Bathing frequency, time & method
ADLs
Activities
Culture Change
Defining Dining …It’s About Me
Pioneer Network.org
Creating Home in the Nursing Home II -- A National
Symposium on Culture Change and the Food and
Dining Requirements 2010
Culture Change - Nutrition
CMS Interpretation:
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Culture Change Input and Questions
Survey and Certification Group:
S&C-07-07 S&C -08-09 and S&C-09-39
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Time between meals
Food brought in from other sources
Culture Change - Nutrition
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S&C-07-07
F-Tag 368 and 370
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These are regulatory questions sent from culture
change groups and the CMS answers
Questions 1, 2, 11 & 15 relate to food
Culture Change - Nutrition
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S&C -08-09 and S&C-09-39
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09-39 clarifies 08-09
F-Tag 371 and 242
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Food Procurement and Self Determination and
Participation
Culture Change - Nutrition
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DPH & regulations
OBRA 1987
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Survey process
Participates in MCCC and conferences
May require waiver of some regulations
Contact DPH with questions
Refer to references
Culture Change - Nutrition
Dietitians - Nutrition Educators
 Residents & families:
– Assessing and care planning
– Increase nutrition education opportunities
 Identify
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risks vs. benefits of choices
Have the right to make bad decisions
 dignity/rights
Culture Change - Nutrition
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Dietitians – as Nutrition Educators
– Liberalize diet
 Ask
preferences
 Monitor for changes
 Re-evaluate with resident
 Document
Culture Change - Nutrition
Dietitians - Nutrition Educators
 Staff
– Clinical – DON, CNAs, Therapies
– Dietary/Nutrition
– Increase communication among all areas
Culture Change - Nutrition
Goal is to reduce incidence of
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Weight loss
Pressure sores
Supplement use
Dehydration
Culture Change - Dining Experience
How to achieve goal :
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Choice in foods
Choice with meal times
Consistent assignment
Culture Change- Dining Experience
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Resident Rights’ Week- October 2010
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Massachusetts programs’ activities
 Cooking contests
 Luncheons
 DPH speakers
 Dining Scarves
 Arc-ct.org – Dining with friends video
Culture Change – Dining Experience
Mass facilities that are a work in progress:
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St Camillus in Whitinsville- Bill Graves
Loomis House – Lori Todd
Holy Trinity in Worcester – Diane Buckley
Culture Change- Dining Experience
National resources for Culture Change:
 Eden Alternative
 Pioneer Network
 Consumer Voice (NCCNHR)
 Picker Institute
 Advancing Excellence Campaign
Culture Change – Dining Experience
Culture Change in Massachusetts
Mass Advocates for Nursing Home ReformMANHR: 800-988-4450
Mass Senior Care: 617-558-0202
Mass Aging Services: 617-244-2999
Long Term Care Ombudsman: 617-727-7750
Culture Change – Dining Experience
Welcome to the table. Bon appétit
Elizabeth M. Bradley, MEd, RD/LDN
Long Term Care Ombudsman Program