what is culture change? · company residents staff • empowerment • choice • relationships •...

LifeLong Living; Building a Long‐term Culture for Continued Growth

David Seaton, Owner

San Marcos, Texas

What Is Culture Change?

“Culture change” is a national movement for the transformation of adult long‐term care services, based on person‐directed values and  where the voices of person and those working most closely with them are solicited, respected and honored.

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Models of Care

Long-term Custodial

ActiveTreatment

LifeLong Living

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Company

Residents

Staff

• Empowerment• Choice• Relationships• Dignity• Quality of Life

• Policy & Procedures• Limit Risks/Safety• Compliance• Avoid Liability• Profitable Biz

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LifeLong LivingCulture

A Great Place to Work & LiveTrain for the Culture you Want

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8 Culture Killers

1. Not Walking the Talk 

2. Being Too Busy 

3. Asking team members to do things, then     not doing the parts you need to do 

4. Not Providing Information

8 Culture Killers

5.   Not Listening to Your Team 

6. Not Letting People Do Things Their Own Way 

7.   Ignoring Conflict

8. Not Giving Credit

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Scurvy - disease resulting from a lack of vitamin C; symptoms include weakness, feeling tired, and sore arms and legs. Without treatment, decreased red blood cells, gum disease, changes to hair, and bleeding from the skin may occur.

Malnutrition

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Psycho-Social Malnutrition

Lack of access to people and things that are of most importance;Results in apathy, withdrawal, anxiety, depression, and afailure to thrive

“The challenge is to create a Human Habitat where people of all ages come together day after day –eager and able to Thrive, not just Survive.”

Bill Thomas, MDFounder

* Loneliness* Helplessness* Boredom

The Three Plagues of Long-term Care

Plagues: Antidotes:

Loneliness   ‐‐‐‐‐‐‐‐‐‐‐ Companionship

Helplessness  ‐‐‐‐‐‐‐‐ Choices

Boredom  ‐‐‐‐‐‐‐‐‐‐‐‐‐ Variety

LifeLong Living Principles

• Relationships

• Community – Sense of Belonging

• Purpose & Meaning

• Person‐Centered & Choice

• Reciprocity & Collaboration

• Healthy Living Culture

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Basic Building Blocks for Human Development

• Reason to get out of bed• Daily structured activities• Fuller Day – too much free time• Safety/Security/Support (safety net)• Be around Others – peers, friends• Normal Sleep• Good Diet• Take Medication, as prescribed• Exercise/Physical Activity

Somewhere to Go, Something to Do, Someone to do it with

• Institutions Regulate and Control

• Habitats Nurture and Grow

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Comparing Models

Long‐term Care LifeLong LivingInstitutional                              Home & Community

System‐Centered                     Person‐Centered

Custodial                                   Growth

Disempowering                        Empowering

Risk Aversive                            Dignity of Risk

Hierarchical Control                Resident/Staff 

Impermeable                            Permeable

Diagnosis/Disability                Person with condition                         

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People don’t like:

• Being told what to do• Being criticized• Being judged• Be managed• Being corrected• Having consequences• Being powerless

“I Often Don’t know What to Do,

But I Usually know What Not to Do.”

This I’ve Learned

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Journal of Personality and Social Psychology:

#1 Contributor to Happiness in Life -

Autonomy: the feeling that your life’s activities and habits are self-chosen and self-endorsed.

Autonomy is when we have the exhilarating power of choice

Happiness

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The Ability to make Choices Largely Determines One’s Quality of Life

Unmet Needs

Depression Anger

Can’t Get What Wants

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T.V.

Fun

Hanging Out

Eat/Smoke/Drin

Sleeping

Therapy

Pie of Life - Existing -

Person

Work

Family

Friends

RecreationCommunity

Hobbies

Volunteer

Thriving

Commonality / Individuality

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Human Nature

FRIENDS

Relationships

Self Determination

Purpose

Belonging Choice

Support

Dignity

Sense of Community

Contribution32

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Self-Actualization

Esteem Needs

Belongingness and love needs

Safety Needs

Physiological Needs

Achieving one’s full potential

Prestige and feelings of accomplishment

Intimate relationships, friends

Safety and security

Food, water, warmth, rest

Self-fulfillment needs

Psychological needs

Basic needs

“Nothing About Me, Without Me”

Person-Centered Principle

Person‐Centered: 

Balance between what’simportant to & forthe person

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Important FOR a person includes being healthy & safe.

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Important TO a person includes relationships, meaningful things to do, community life, fun.

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1. Residents have input about their care and activities.

2. Living environment that reflects a home, and the unique preferences of the resident.

3. Close relationships between staff & residents

4. Direct Staff empowered to make decisions.

5. Collaborative team decision making.

6. Ongoing quality improvement-growth & change

Traits of a Changed Culture

* Know & seek to understand 

* Be of genuine service

* Be guided by the person

* Struggle for difficult goals 

* Try what might be possible

* Enhance the dignity of the            person

* Bring out the good in people.

When People Matter More Than Systems

- Michael Kendrick

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So What Do People Want?

• Sense of Home & Community

• Meaningful Activities

• Friends/Relationships

• Fun / Enjoy Life 

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David Seaton, Owner/President

San Marcos, Texas

DS@LiveOakLiving.org

512.567.1704

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