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Wednesday, November 2, 2016

Who is Responsible for Furthering the Mission?

© Imelda Maurer, cdp
Several years ago I participated in a marvelous workshop entitled “Choreography of Culture Change”. One of the questions I brought with me was the role of  Human Resources in this whole marvelous shift of culture.  I think I didn’t know how to pose my concerns well, but concerns I had, because I saw in a particular Sisters’ nursing home community that HR was hiring persons that met HR’s paper qualifications period. In my estimation the consequences were chaotic oftentimes for both other staff and the residents. And of course turnover in more than one department was a major problem.
There is a new HR Director in that aging services community now and she wrote about how she sees her job. I share it with her permission:
“I look forward to partnering with you as we move forward together to further our Mission and Vision. Please know that I am here to serve all of the Sisters and employees. My main focus is to foster a work environment that embraces our core values which ultimately will create the pleasant home environment that all the Sisters deserve.”
With this focus, this HR Director will, I know, be evaluating potential employees on much more than academic, professional, certification or licensure requirements. She will be looking for candidates who are capable of and desirous of fostering “a work environment that embraces our core values”.  And in creating that “pleasant home environment”, employees will also be working in a happier, more contented, more professional environment.  THAT’s Culture Change!
Who’s responsible for furthering the mission? Everyone who walks through the door of the community. And HR is a vital link in enabling that to happen!


Thursday, September 1, 2016

Just a Thought

© Imelda Maurer, cdp  September 1, 2016

Earlier today a Sister friend posted on our Congregational e-bulletin board Pope Francis' "A  Prayer for our Earth" on this day which has been marked by Francis as the World Day of Prayer for the Care of Creation".  Here is just the very first part of that prayer:

"All-powerful God, you are present in the whole universe
and in the smallest of your creatures.
You embrace with your tenderness all that exists."

I stopped after reading/praying just that much with this thought flooding my heart:  Wouldn't it be a tender gift if every frail elder living in a nursing home or a convent infirmary could lay her head on her pillow at night knowing and feeling that during the day she had experienced that embrace of God's tenderness --- in the face and actions of those who by assignment or appointment are there to meet her needs.  Wouldn't that be wonderful!  Wouldn't that be in total alignment with Congregational documents, Chapter statements and mission statement!

Just a thought.

Tuesday, August 23, 2016

"Can the Environment Hold the Vision?"

©  Imelda  Maurer, cdp  August 23, 2016
One of my Facebook friends posted the following poem this morning.  

You Start Dying Slowly by Pablo Neruda

You start dying slowly
if you do not travel,
if you do not read,
If you do not listen to the sounds of life,
If you do not appreciate yourself.
You start dying slowly
When you kill your self-esteem;
When you do not let others help you.
You start dying slowly
If you become a slave of your habits,
Walking everyday on the same paths…
If you do not change your routine,
If you do not wear different colours
Or you do not speak to those you don’t know.
You start dying slowly
If you avoid to feel passion
And their turbulent emotions;
Those which make your eyes glisten
And your heart beat fast.
You start dying slowly
If you do not change your life when you are not satisfied with your job, or with your love,
If you do not risk what is safe for the uncertain,
If you do not go after a dream,
If you do not allow yourself,
At least once in your lifetime,

How true all of this is. I read it through the lens of any older adult.  That passion, that purpose and meaning is so vital to being fully alive as long as we have breath.

There are two necessary factors necessary for living with purpose and meaning: the initiative required on one's part to live  precisely with that passion, and the environment in which one finds oneself.  If elders are to find purpose and meaning, there must be possibilities within their environment for that to be present, facilitated and nurtured. I am reminded once again of the statement repeated again and again in a presentation I heard on a totally different topic two years ago:  "Can the environment hold the vision?" This question should be posed and studied and returned to often by any individuals or teams responsible for providing aging services -- in any setting!

Wednesday, August 17, 2016

I Can't Abide It!

© Imelda Maurer, cdp   

I'm in a "red hat" mood as I write this morning -- the 'red hat' indicating that part of my personality that instinctively reacts with strong emotion to issues/events I consider valuable or important.

The issue is about how aging is too, too often presented to Sisters.  As a gerontologist, I studied the aging process and the various theories of personality development.  What I know about aging is rooted in a solidly grounded knowledge base, affirmed by my own experiences as a woman in her eighth decade of life.

The women in whose circle I am so honored to be a part are characterized by their life of selfless service to others.  They want to do good; they want to be good.  If and when they are given directives on how to be good -- and I refer specifically to the issues around aging -- if the words come from another Sister, those words, validly or not, are empowered with a special credibility by the audience.

My most recent exposure to such a presentation to elder women and men religious held the same familiar pessimistic view of aging only as an experience of loss and decline.  The spirituality suggested is that of "letting go".

We experience loss throughout the life cycle. Losses are not experienced for the first time when we leave "active ministry".  We do not have to learn -- for the first time -- how to deal with loss when we are in our later years. This concept and lived reality merits its own chapter!

Aging does not always bring physical or cognitive disability. Additionally, how we age is uniquely individualized. When we generalize otherwise, we are guilty of ageism.

I groan for my Sisters when I become aware of common presentations on "aging and spirituality" because
---  "letting go" is only half the story
---   "letting go" is not an experience unique to our later years; and
---    because spiritualizing myths and negative biases about aging does not provide a solid foundation of spirituality,
---   this false foundation does not reflect the God of Mercy, Compassion and Abundant Providence who planned the whole of life for those so cherished by the very action of creation.

As I listened to the address I'm referring to, I had to take a break and view something that shows an entirely different picture of aging.  I've had this clip on my blog before, but I think it is so affirming of the other half of "letting go" that I  share it again.  It is an ad for women's health, but it is so marvelous in presenting so many qualities of life in our later years.

Treat yourself to this one minute clip here

Tuesday, August 16, 2016

"I have found my tribe"

At a Pioneer Network Conference some years ago, Karen Schoeneman who directed the nursing home regulatory section at CMS talked about her initial experience with the Pioneer Network. Actually Karen was present as a co-founder of this wonderful organization, the Pioneer Network.  Karen expressed her strong identification with these other co-founders, persons who believed that residents in long term care settings should be in the drivers seat this way:  "I felt that finally I had found my tribe."

Those are strong and profound words from a  person who might have become just another bureaucrat in Washington DC writing nursing home regulations, but who instead maintained her integrity as a passionate advocate for changing the culture of aging and aging services.

That spirit within this pioneer network continues and it was deeply sensed and acknowledged by certified nursing assistants who attended this year's annual conference held in New Orleans.  One of those CNAs wrote of his experience at this gathering in New Orleans in the blog at CNA EDGE.  You can access that blog here entitled "Among Kindred Spirits" here . I encourage  you to read it.

Monday, August 8, 2016

If You Are a Family Member BE AN ADVOCATE

©  Imelda Maurer, cdp
If you are a family member or a friend of someone who is receiving aging services in any environment -- home, assisted living or nursing home setting -- it is so imperative for the well-being of that person or those persons with whom you have this relationship that you see your role as an advocate for that person or those persons.

Acting as an advocate is a work of Mercy. Pope Francis has reminded us during this Holy Year of Mercy that true mercy is not practiced by words only, but by actions.

My suggestions here do not imply that staff is not maintaining clinical standards, or that things in the aging services organization or not what they should be.  Rather, I urge a healthy collaboration with the interdisciplinary team, providing a second pair of ears and eyes as well as a loving heart. What I suggest and urge are three aspects of advocacy for your family member

1)  Informed consent. Never take the direction or interpretation of any healthcare provider as the final word without an adequate explanation. If a new medication or therapy is prescribed, or if a change  in either is recommended, an advocate should have sufficient information to either consent to or to refuse the recommendations. It goes without saying, of course, that if a family member is capable of making decisions, then s/he should receive the information necessary to make such an informed decision to accept or to refuse treatment. In such circumstances, the advocate can best serve by listening to the desires and needs of the family member and by helping to answer his/her questions if there are any.I

2)  Know the standards of care. To be an effective advocate, you must know the standards of care. You cannot advocate for another if you don't know "what the rules are."

I'll give an example from my early days as an advocate, embarrassing as it is to reveal!  I was in my beginning weeks as an ombudsman. The daughter of a nursing home resident told me that her mother complained that on mornings when she needed to use a bedpan, if she were eating her breakfast (from her tray on an overbed table) no staff member would bring her a bedpan, telling her she had to wait until after breakfast.  When I approached the administrator about this, she told me with great confidence, authority and good humor why no bedpan was offered under the circumstances at hand: "If the CDC got wind that we were doing that, we'd be fined like you wouldn't believe!"

I remember being puzzled, but I didn't know what to do with the answer I had received.  This administrator, one with a great lack of integrity in this instance, got one over on the advocate -- because I couldn't answer her explanation.  I wouldn't have had to quote a regulation, I would only have to say that this nursing home resident has a right to have her needs accommodated -- whenever they arise.

3.  Be that second pair of eyes and ears.  As a family member you visit often and take time to sit and listen to your family member.  Because you really know that person you pick up nuances of mood, physical and/or mental changes.  You may well become aware of issues that even good staff may miss merely because you know the person so much better.  So discuss these observations with the charge nurse, or with the home health nurse that comes in.

I saw a chart that is recommended for nurse aides to use for this very purpose.  I offer it here  for your use as a guide, not to be checked and handed in, but to be used as a guide and as talking points if you detect changes in your family member.

(When you click on the link, you may get a warning about viruses.  The site is safe.)

Friday, August 5, 2016

Making Connections

©  Imelda Maurer, cdp

As I write this, it was two days ago to the hour that we gathered for the final session of the Pioneer Network Conference, our luncheon and its stirring program.  Since my return, I've been doing the mundane tasks of getting back into my routine as well as addressing some issues with short deadlines. 

At the same time, I'm aware that I have several business cards here on my desk, indications of new connections  I made at the Conference.  I'll do more than just adding this data to Outlook.  I'll be in touch with these new-found common-visioned colleagues.  I've also been  mulling over my experiences at the Conference and, as at every conference, I came home with ideas about how to implement some of my "what if", some of my "why can't . . . " visions.  There are two projects I will work to implement this coming year.

A CNA who was at the Conference has already reflected on one experience that provided a clear connection between what she heard at the Conference and how it applies to her work every day as a CNA.  The following is the core of what Yang writes in reflecting on a conference experience:

This really is “what it’s all about.” A person centered environment means that as we approach and respond to our elders, we pick up on the cues that provide us with an awareness of how they as individuals are perceiving the situation and use this as the context for our interaction with them. An unhurried and indirect approach with a light touch creates an atmosphere of cooperation and reassures our elders that they are in control.

The full entry can be accessed here.

The investment of time and money involved in participating in a national conference is totally wasted if new ideas learned are not put into practice back at home.  Does your organization  have and implement a policy about staff bringing back conference ideas and insights?  Is there an expectation that these ideas will be shared with staff and stakeholders?  Fiscally, it is just being responsible. Ethically, I believe we are morally impelled to act on what we know helps to move from INSTITUTION, even if it is a "loving institution", to HOME.

Wednesday, July 13, 2016

“Her mind is shot – resign.”

© Imelda Maurer, cdp
July 13, 2016

The title of this post is a tweet from Donald Trump sent late last night responding to Judge Ruth Bader Ginsburg’s comments about his competency to hold the office of President of the United States. It is the most recent example of ageism being 'alive and well' in the field of politics and throughout our society.

Such statements are blatantly ageist, blatantly prejudicial. Ageism – with all of its negative effects for older adults, and future older adults – will continue to flourish until us as a society name this prejudice that permeates our society. And the journey of a thousand miles begins with a single step.  Which brings me to the question posed in yesterday’s post:  “What are the challenges?” I offer two here.

On a personal level:
We must challenge ageist statements whether they are directed to us personally, or if they are general prejudicial statements. When a sales clerk calls me “young woman”, I refute it nicely and graciously but firmly.  After all, the basis for anyone calling a woman in her 70’s a young woman is because our society sees youth as a more acceptable state than age. This bias must be acknowledged and addressed. 

We must monitor our immediate responses to events and persons that may reflect that we are drawing a conclusion based on chronological age. This practice will lead to a greater consciousness about the degree of ageist attitudes that heretofore have been present but unacknowledged, and therefore not attended to.

On an organizational level:
For those of us whose work involves services for older adults, the previous suggestion of checking immediate responses to persons and events holds true also.  Do we automatically believe that this person or that cannot accomplish a certain task because of his/her age or state of presumed disability?

A second aspect is to assure that all policies related to aging services are free of a negative ageist bias.  An easy test of that is to see if any policies are age-based:  “When a Sister reaches the age of 75 ----.”    If Sisters are required to have their driving skills tested ONLY because they have reached a certain age that is ageism being practiced openly and blatantly.  Insult is added to injury when the driving skills test is done not by an occupational therapist specialist but by a representative of an insurance company! Clearly, the concern of the insurance company is its bottom line.  Period.

I have had participants in workshops argue the previous point with me.  I stand on solid gerontological principles in this regard however. If we want a convenient, orderly organization, the ageist policies may be the way to go.  If we want an organization where every member is encouraged to continue to develop and live life as fully as possible, we will do away with “when a Sister reaches the age of 75 ------”. It may be a little messier and require a little more time with individuals and/or situations, but it is the more honorable way to facilitate life in an organization.  It honors the dignity of the older adult who is seen and judged as a whole person, not someone categorized because of her chronological age.

Tuesday, July 12, 2016

Ageism Snakes its Way into Politics

This political election cycle h as been crazy, as so many pundits have reminded us.  Indeed it has been a strange and unpredictable period of political history. However, even in the midst of this unpredictability, examples of ageism are front and center. Its presence proves that our culture is soaked in the prejudice of ageism.

Four years ago an 84-year-old Clint Eastwood spoke to an empty chair during the Republican Convention.  It did not go over well.  The most common ‘analysis’ by pundits was age-related:  “What were they thinking, asking an 84-year-old-man?”

Two years ago Chuck Todd interviewed Nancy Pelosi in the context of national elections possibly resulting in the Democrats regaining control of the house.  Chuck wondered if Former Speaker, Nancy Pelosi, would seek that position once again, asking her if she didn’t think that perhaps she was too old for that position. 

Last month there was much chatter about the unfortunate decision of Bill Clinton to visit Attorney General Loretta Lynch while their planes were on the tarmac in Atlanta.  One commentator mused that he wondered if perhaps Bill Clinton is “not at the top of his game” any longer.  In other words, Bill Clinton, at age 69 – in making what many consider a very unwise decision – made that decision because he’s slipping, because, after all, he’s 69.  What else can you expect?

To date, no one in the public area has come back to denounce any of these instances as ageist, as negatively prejudicial.  Had Chuck Todd suggested that Pelosi is unqualified as Speaker because she is a woman, he would have lost his job at NBC.  Sexism – not acceptable.  Had someone suggested that Clint Eastwood’s flop performance was due to his Irish ancestry, the outcry would be to denounce ethnic prejudices.  Racism -- not acceptable.

But  ageism? No one speaks up against blatantly ageist remarks.  Why? A major reason is because collectively, as a society, we do not recognize this bias. Ageism is so ingrained in our culture that we don’t sense its presence. We too soak it up without realizing it.

And what’s the challenge:  There are two.  See this space tomorrow.

Saturday, July 2, 2016

What does our Gracious God Who is Rich and Merciful desire for us in our later years?

The Communications Director of our Congregation extended an invitation to all the Sisters to share a reflection on how our specific ministry reflects the spirit of this Holy Year of Mercy. I submitted mine to her today and share it here with you, my blog readers.

-----     -----     -----

It was a cold December evening in Charleston, WV, 1988, as I was making an unannounced after-hours visit to a nursing home in my role as ombudsman. After about an hour visiting residents, I was retracing my steps down the hallway toward the front exit.   Although it was only 7:30, many of the rooms were already darkened and their occupants in bed for the night.  From such one darkened room I heard a resident call out from his bed.  I was nearing his doorway, and though I could not yet see into his room, I remembered having talked with him earlier. He was a WWII veteran; his right arm had been amputated at the shoulder.  I asked from the hallway, “Can I help you?”   The answer was quick and strong:  “A hug.”  I walked into this man’s room and gave him a simple hug; he settled back onto his pillow and I made my way home.

A simple response to a vulnerable elder’s expressed heartfelt need.  I hope there was some message of his being loved eternally and unconditionally.

Francis tells us in “The Name of God is Mercy” that “Mercy is deeply connected with God’s faithfulness.” Francis also says clearly that true mercy is not words alone, that active love and compassion must find voice in action.

My current efforts – through writing, workshops, presentations, visits to motherhouses and provincialates, and consultative services – are to stir a new consciousness among those who, by election or by appointment, are called to serve those elderly Sisters who need supportive aging services. This new consciousness calls for transforming the institutional culture of retirement centers to places where life is still lived to the fullest. Transforming the culture, the operative philosophy, opens doors to heretofore unimagined scenarios of life in the midst of frailty and illness.

Life blossoms each day with:
          ♦ Knowledge that one’s dignity is being recognized and honored.
          ♦ Experiencing purpose and meaning in one’s day and life.
          ♦ Richness of meaningful relationships.
          ♦ The exercise of choice about every possible event of their day.
The Sister is no longer living in an institution, she is living at HOME!

Our God, Gracious, Kind and Merciful, Rich in Mercy -- as the psalmists tell us-- wants this quality of life for each of us, wants us to have what fulfills us and enables us to live more fully.  My efforts in ministry to make such life possible for Sisters across the country are surely a work of mercy.

Wednesday, June 29, 2016

Our Legacy of Preparation for Ministry

Sister Jane Behlmann, CSJ, is the archivist here at the St. Louis provincial house. She often posts information about their Sisters’ history. With her entries, Sister Jane usually includes pictures related to whom or to what she is writing about.

Yesterday's post included the following quotation taken from the CSJ Annual, 1936, a annual reporting of events within the province over the preceding year:

“Regular classes for the sisters in the St. Louis missions were held at the Provincial House [Our Lady of good Council Convent, Cass Avenue] every Saturday during the scholastic year. The summer session, which is always held at Fontbonne College, opened on June 28 and continued until August 3. Each day chartered busses took fifty-two sisters to and from Fontbonne. Nothing but a love of obedience and zeal for souls could have sustained the sisters in this daily routine of labor in the acquisition of knowledge, spiritual, cultural, and intellectual, to be used later in promoting the interests of God and Community.”

Posted is the following picture of Sisters (from several different Congregations) attending classes during the summer of 1946. Such realities of multitudes of nuns spending their summers advancing their education  were not uncommon as the Sister Formation Conference took hold.

This aspect of our history as women religious in the United States is clear: there was an intentional effort from our beginnings to send Sisters to study --  to acquire the knowledge, ”spiritual, cultural and intellectual” necessary to effectively “promote the interests of God and Community.”

The challenge today is to be convinced in the depths of our souls that the ministry of service to our own elder members is the same as any and all works of mercy – another definition of apostolic ministry – that have characterized all our ministries to others.

When that conviction becomes part of our collective consciousness, we will also see and act on its implications, only one of which is to continue our legacy of adequate, competent professional and spiritual preparation for ministry to our own

Tuesday, June 7, 2016

Scalloped Potatoes Brought to you by Betty Crocker and Corporate Food Processors

What follows is the list of ingredients taken directly from the box of Betty Crocker Scalloped Potatoes.  There are brief explanations for some of the 40 ingredients in this "food".

1.  Dried Potatoes

2.  Wheat flour

3.  Niacin – a vitamin – Vitamins and minerals found naturally in foods are lost under food processing conditions. Therefore manufacturers add back synthetic or natural forms of these substances to maintain the nutritional value.

4.  Iron – a mineral

5.  Thiamin Mononitrate – a synthetic form of the vitamin, Thiamine, Vitamin B-1

6.  Riboflavin – a vitamin

7.  Folic Acid – a vitamin

8.  Maltodextrin – polysaccharide that is used as a food additive. It is produced from starch by partial hydrolysis.

9.  Corn Starch

10.  Salt

11.  Potassium Phosphate –Phosphates are used to enhance the characteristics, cooking performance, and value of the foods in which they are used.”
 From a page linked to the National Institutes of Health: "the public should be informed that added phosphate is damaging to health.

12.  Monosodium Glutamate – Also known as MSG, this chemical is used as a flavor enhancer.  The Food and Drug Administration (FDA) has classified MSG as a food ingredient that's "generally recognized as safe," but its use remains controversial. For this reason, when MSG is added to food, the FDA requires that it be listed on the label.

 13.  Canola and/or partially hydrogenated soybean oil – Partially hydrogenated fat molecules have Trans fats, and they may be the worst type of fat you can consume. These trans fats are also present in margarine and ‘butter spreads’.

14.  Potassium Chloride – Used as a flavor enhancer, as a replacement for the potassium lost due to processing, and to provide flavor without increasing the amount of sodium in the food.

15.       Sugar

16.  Natural Flavor – The definition of natural flavor under the Code of Federal Regulations is: “the essential oil, oleoresin, essence or extractive, protein hydrolysate, distillate, or any product of roasting, heating or enzymolysis, which contains the flavoring constituents derived from a spice, fruit or fruit juice, vegetable or vegetable juice, edible yeast, herb, bark, bud, root, leaf or similar plant material, meat, seafood, poultry, eggs, dairy products, or fermentation products thereof, whose significant function in food is flavoring rather than nutritional”   (21CFR101.22).

17.  Paprika

18.  Whey

19.  Dried Celery

20.  Dried Onion

21.  Wheat Starch

22.  Mono and Diglycerides – Mono- and diglycerides of fatty acids (E471) refers to a food additive composed of diglycerides and monoglycerides which is used as an emulsifier. This mixture is also sometimes referred to as partial glycerides.

23.  Soy flour

24.  Nonfat Powdered Milk

25.  Lactic Acid

26.  Yeast Extract –Yeast extract is the common name for various forms of processed yeast products made by extracting the cell contents (removing the cell walls).

27.  Enzyme Modified Cheddar Cheese (milk, cheese cultures, salt, enzymes) – Enzyme-modified cheese (EMC) is cheese curd which has been treated with enzymes to produce a concentrated cheese flavor ingredient.

28.  Calcium Lactate – Calcium lactate is a black or white crystalline salt made by the action of lactic acid on calcium carbonate.

29.  Spice

30.  Enzyme Modified Cream – From Cargill’s website:  Through natural processes enzymes and cultures act on the proteins, fat, and carbohydrates of fresh dairy products to develop highly flavorful compounds. During this process of enzymolysis and fermentation, the dairy product is transformed into a highly concentrated, intensely flavored ingredient. The process is controlled to inactivate enzymatic activity and ensure proper flavor development. The ingredients will not change in flavor profile or texture over the span of their shelf life.

31.     Silicon Dioxide (anticaking agent) – This is also known as silica.  It is a major component of quartz. I  do not know what function it has in processed food.

32.  Yellow Lake 5 Food Coloring – Yellow No. 5 is an azo dye that imparts a lemon-yellow color to foods, drugs and    cosmetics.

33.     Yellow Lake 6 Food Coloring FD&C Yellow No. 6 Lake is a color additive used for drug dosage forms such as tablets and capsules. It is also approved for use in foods and cosmetics.

FD&C Yellow No. 6 Lake imparts a reddish-yellow color to medicinal dosage forms.
FDA performs regulatory review for color additives used in foods, drugs, cosmetics, and medical devices.
FD&C specifies the color is approved for use in food, drugs and cosmetics. FD&C Yellow No. 6 Lake may be safely used as a color additive when following FDA specifications.
To form lake colors, straight dyes (such as FD&C Yellow No. 6) are mixed with precipitants and salts. Aluminum may be a component.
34.  Artificial Color – from the website of the American Chemical Society: “Why bother with artificial, or synthetic, food colorings? Aren’t there enough natural colors to go around? A big reason to go artificial is cost. Synthetic dyes can be mass-produced at a fraction of the cost of gathering and processing the materials used to make natural colorings.”

For more information go to

35.  Dried Blue Cheese (milk, salt, cheese cultures, enzymes)

36.  Enzyme modified Blue Cheese (milk, cheese cultures, salt, enzymes) – Enzyme-modified cheese (EMC) is cheese curd which has been treated with enzymes to produce a concentrated cheese flavor ingredient.

37.  Soy

38.  Lecithin – Lecithin is used in many foods as an emulsifying agent (emulsifiers help keep the fat from separating).

39.  Sodium Phosphate – Sodium phosphates are often used as emulsifiers, thickening agents, and leavening agents for baked goods. They are also used to control pH of processed foods. They are also used in medicine for constipation and to prepare the bowel for medical procedures.

40.  Freshness preserved by Sodium Bisulfite – (Seriously, this is taken directly from the ingredient list! I don’t think Big Agriculture sees it as oh so ironic!)


If you want home cooked, cooked-from-scratch, scalloped potatoes, here is the ingredient list for that recipe from the Betty Crocker Cookbook:
1. Potatoes
2.  Milk
3.  Onion
4.  Butter
5.  Flour
6.  Salt
7.  Pepper

More tomorrow on how this relates to this blog’s articulated focus on aging and aging services.

Monday, June 6, 2016

"Eat Food"

Michael Pollan, in his book, “In Defense of Food” says there are three simple rules for eating for health:
1.       Eat food.
2.       Mostly plants
3.       Not too much

Let’s look at that first rule of Pollan’s:   “Eat food.”  This ‘food’ is in contrast to processed foods that might more accurately be labeled “food-like”. Yesterday I stopped at a Panera’s Bakery for a bagel and coffee breakfast on the way home from a very long trip to and from Texas.  I noticed a poster entitled “The No No List”. It is a long, long list of chemicals and additives that Panera has already eliminated or will eliminate from all its products within the next six months. I'm going to try to post that list on this blog.

When I arrived home, a neighbor had dropped off two boxes of food:  Archway Oatmeal Raisin Cookies (a Target product I believe) and Betty Crocker Scalloped Potatoes

These are the ingredients listed for the cookies.  Ingredients are always listed in descending order of predominance by weight.  Those ingredients in bold font are ingredients found in a typical oatmeal raisin cookie recipe.

Bleached and unbleached wheat flour
Reduced Iron
Thiamine Mononitrate
Folic Acid
One or more of the following:
Canola oil, corn oil, palm oil, soybean oil
Rolled oats
High fructose corn syrup
Corn syrup
Modified corn starch
Baking soda
Nonfat dry milk
Whole eggs
Potassium Sorbate (preservative)
Natural and artificial flavor

Which cookie do you think is less costly to prepare? An oatmeal raisin cookie from a box or one from the oven?

Which one tastes better?  Which one is a healthier choice?

We'll tackle the ingredients in  the box of scalloped potatoes later.

Saturday, May 21, 2016

We First Eat with Our Eyes Part II

Continuing with the thoughts in my last post here, I share  a couple of pictures that were taken in two different convent retirement settings.


This was the table setting for Easter.  Pleasant to the eye!  The food service line is separated from the dining area by an attractive, curved glass-brick type barrier.  Attractive in itself, and only about five feet high, it has the effect of adding grace to meal time.

The Sisters' custom here is to seat only four at each table. The decision was deliberate.  It is easier for each to hear the other with just four chairs, and, it was explained, if there is a Sister with any cognitive impairment the four per table seating facilitates greater participation in the conversation. This operational activity is an example of aligning practice with mission, of making sure that the environment supports the vision.

The following photographs depict "presentation".  In this provincial house setting, the Sisters are served restaurant style.  In my visits there, service has always been warm and gracious.  There is never a long wait for a Sister's meal to arrive --- and to arrive with such art and grace!

This was the menu for Chinese New Year's: Egg drop soup, cashew chicken and steamed rice, homemade egg rolls and fruit. All made 'from scratch'!

This portrays a typical weekday evening meal.

The woman who directs the kitchen is a person with a passion for what she does.  In correspondence with  Rosanne, she responded to a resource I thought she would appreciate: "I find that the more information I have, the better care through food, I can provide to the Sisters."

"Care through food"!  What a great and valid concept!  Every person serving elders is a care giver!  Every person so engaged is offering the ministry of service! Thank you, Rosanne, and all the Rosannes in our retirement settings!

Thursday, May 19, 2016

We First Eat with Our Eyes

One of my favorite times each Wednesday is reaching for the Food Section of the daily newspaper. I always enjoy looking at the recipes and deciding if this one or that one is one that I want to try soon or perhaps just add to my collection of recipes for another day.  The food editor always has an interesting column elaborating on the theme of what recipes and/or restaurants are featured.

This week’s column started out with this:  “They say we first eat with our eyes. . . . The visual appearance of food is part of the experience of eating it.  Often the better it looks, the better it tastes.”  Just a few days earlier I had seen a short video addressing the high risks of older adults being malnourished. There are many factors involved in older adult malnutrition, but let us never underestimate the role of visual and olfactory stimulus in good nutrition.

With that, let us not neglect the role of what I call grace in our daily life. 

Meals can be a task necessary to assuage hunger and to maintain bodily health.  Or meals can be a time of grace: an experience of sharing nutritional, attractively presented food, cooked with purpose and care for those being served. 

Meals can be served in an environment that focuses only on task, or the table and the dining room can be an environment honoring the reality that our meals are experiences of nurturing body AND spirit.

Meals can be experienced as a continuation of our Eucharistic meal.

Providing an environment that supports this vision of and experience of food for soul and for the body does not add a single penny to the operating budget! 

What awaits in the dining room for you and those you serve?

Thursday, May 12, 2016

Expensive Dementia Drugs --- Ineffective? Harmful?

If you are age 60  or over, or if you have any degree of concern or responsibility for anyone over age 60, you should know about the book "Worst Pills, Best Pills" and use it frequently as a reference. The information contained in both this published volume and in the monthly companion newsletters reflect the highest degree of academic excellence  and integrity in research. The material is directed to "older adults" -- meaning over 60.

The May issue of the newsletter, Worst Pills, Best Pills News, was in my mailbox today. Page three features an article entitled "Memantine:  Still a Poor Choice For Alzheimer's Disease".

The trade name for memantine is Namenda. We've all seen the direct-to-consumer TV commercials advertising this drug, as well as similar ads for Aricept. As a matter of fact, the ads tell us that the two drugs used in combination are more effective than either drug taken alone.

Though the ads appeal to the compassion, devotion and sense of protection that a family member feels for someone living with dementia, the true story of the effectiveness of these drugs is quite different. In fact, Public Citizen's Health Research Group, the official name of the organization that publishes this newsletter I'm quoting from, categorizes this drug as a "Do Not Use" drug. They cite as the reason that there is no  persuasive evidence that it is effective, "making the drugs known risks unacceptable."

The risks refer to common side effects which are these:  dizziness (a risk factor for falls in older adults), headache, constipation, difficulty breathing, hallucinations and confusion.

Rare side effects include inflammation of the pancreas, kidney failure, bone marrow failure, heart failure, liver failure --- the list continues.

And what does the Federal Drug Administration (FDA) report to the public regarding the drug's effectiveness in the face of these side effects?  The newsletter quotes an FDA medical officer: "Only a small minority of patients treated with memantine showed even a minimal or moderate improvement, with no patients showing a marked improvement, and the most common response being no change."

The authors of a study done in 2011 concluded "… evidence is lacking for the benefit of memantine in mild Alzheimer's disease, and there is meager evidence for its efficacy in moderate Alzheimer's disease."

Most telling is the drug' s product labeling which, according to this article, states: "At this time, there is no evidence that memantine prevents or slows neurodegeneration in patients with Alzheimer's disease.

So let's look at what Big Pharma, even in the eyes of the FDA, is pushing:
A drug that is very expensive, a drug that has common, serious side effects, a drug that shows "meager evidence for its efficacy."

As far back as twenty years ago, I heard respected geriatricians tell their audiences the same thing that I have written here.  One doctor put more of a face on it, telling us, "If you have an aunt who has been diagnosed with Alzheimer's, forget Aricept and Namenda.  Take the money that you would have spent on those prescriptions and take her to her favorite fancy restaurant every month or more often.  It won't cost nearly as much and it will do her more good than the drugs."

That advice is still good.  Now to update my Advance Directives Form:  if I am diagnosed with dementia, I do not want to be given Aricept or Namenda.  I refuse that treatment.

And another update to my directives:  I do not want to be put on thickened liquids.  We haven't talked about those studies have we?  "Watch this space."

Monday, May 9, 2016

Is there a Deborah in your house?

Recently I was a guest in a convent which is home for some of my host Congregation’s retired Sisters.  The residence also includes services for their frail members in an unlicensed setting.

Soon after my arrival I became aware that one of the Sisters was on hospice care after a change in her conditions just a few days earlier.  In the early evening that Sister died.  With her was the woman who has served the Sisters as the RN for several years and other staff persons. Two other staff persons returned to the convent when they received news of Sister’s death.  I saw them come in, tearful but wanting to be present at such a sacred moment. As word spread, Sisters also made their way to keep vigil with the body.

The following morning, Deborah, a staff person who works with Life Enrichment activities, and who also writes notes of interest on a chalkboard outside the dining room each morning, had written the following:

Life ... so fragile
Loss ... so soon
Hearts ... so broken

The note was so reflective of the event the Sisters and staff had just experienced.  Posting it for each Sister and each staff person to see acknowledged the shock, the loss, the grief. It acknowledged the presence of community and the subsequent pain within the entire community – Sisters and staff. The note acknowledged and celebrated community.

Additionally, this notice, so poignant, honored the Sister, her physical presence having just been lost to the community. 

There were tears shed by many who read these words. Good tears.  Tears that are part of the mourning journey, a journey we must go through, not avoid.  Tears of love for the one just lost, and so many others that we lost in a lifetime, and for those who are still in our circle.  Tears of gratitude that someone wrote words that express what it is our heart and soul, but perhaps cannot articulate with such grace.

I hope there is a Deborah in every Sisters’ convent, or that that spirit is cultivated in every convent.

Tuesday, May 3, 2016


The Pioneer Network Conference is far and away the absolute best venue for stretching ones knowledge and imagination about how aging and aging services can be transformed into a humane, value-laden, purposeful life for our elders. 

The following information is taken directly from the website of
It is a listing, on one page, of all the offerings at the Pioneer Network Conference in New Orleans, July 31 - August 3.

I am offering a half-day Intensive, Intensive # 5 on Monday, August 1. It involves a look at and study of how one's congregational documents reflect the spirit of the standards of care expressed in the Federal minimum standards of care for licensed nursing homes. We will reflect on and discuss how service to our own members is truly a ministry of prophetic witness, a stance to which we are called as women religious.

Whether a Sisters' nursing home is licensed or not, no one can argue against maintaining, implementing "minimum standards of care" in any retirement setting for our Sisters.
I always enjoy looking at the presentations offered with the same excitement with which, as a child, I used to look through  again and again the Sears Christmas Catalogue that the postman delivered!  Enjoy!

Conference Intensives

Pioneer Network Workshop Intensives allow for a deep dive into crucial topics. Experienced Guides, who can demonstrate with hands-on practical approaches, will get to the heart and soul of the subject matter, while giving you the nuts and bolts that you can take home and use immediately. These Workshop Intensives are designed especially for YOU – the Pioneer attendee. So prepare for a day of interactive intense learning experiences.

For our 2016 conference, the Workshop Intensives will take place on the first day of the conference: MONDAY, AUGUST 1, from 8:00 am to 5:00 pm. There will be four full-day Intensives and nine half-day Intensives offered. You can register for one full-day intensive or the pair of half-day Intensives that works best for you.

 Monday, August 1 Intensive Schedule
 8:00 – 11:45
 Intensives 1
 11:45 – 1:15
 Lunch (Exhibit visits & networking)
 1:15 – 5:00
 Intensives 2

FULL-DAY INTENSIVES (click on Intensive name for details)

HALF-DAY INTENSIVES 8:00-11:45 (click on Intensive name for details)
INT #6: Love Matters: Leadership Lessons from Wise Women (repeated in afternoon time slot)

HALF-DAY INTENSIVES 1:15pm – 5:00pm (click on Intensive name for details)
INT #10: Love Matters: Leadership Lessons from Wise Women (repeat of morning session)

 Full-Day Intensives: 8:00-5:00 (with 90-minute lunch)
Working Together to Put Living First: A Culture Change Guidebook  
This all-day intensive explores one organization's award-winning, collaborative culture change journey, guided by Appreciative Inquiry, and engages participants in a variety of practical resources from a new, research-based guidebook organizations can use to begin or strengthen their culture change efforts. This comprehensive intensive will feature a variety of perspectives, from researcher, senior leaders, care partners, and elders themselves. First, participants will engage in self-reflection and strategic-planning activities aimed at building a solid foundation for culture change. Then, participants will engage with practical, yet fun, strategies and resources to mobilize a culture change journey guided by Appreciative Inquiry.
Jennifer Carson
, Researcher, University of Nevada, Reno
Susan Brown
, Research Coordinator, Schlegel-University of Waterloo Research Institute for Aging  
Jessica Luh-Kim
, Director of Program Development and Education, Schlegel Villages

Building a Culture of Person-Directed Living: Four Key Elements
Everything in the area of aging services is moving towards an approach that recognizes the sovereignty of the individual receiving supports and services.  Terms like 'person-centered care' and 'person centered planning' are bandied about, oftentimes without a clear definition or framework of what is meant by these words.  This presentation provides a highly experiential glimpse into the four core elements of person directed living, the ultimate expression of elder empowerment that effectively shifts power and focus to the elder and the care partner closest to them. 
Cean Eppelheimer
, Organizational Change Consultant, PHI
Kathy McCollett
, Organizational Change Consultant, PHI

Person-Centered Life in Assisted Living: 
Navigating a Shifting Landscape

Missed it 
last year?
Back by 
This intensive will explore current trends and best practices in person-centered assisted living. Your interactive day will confront some of the myths and realities of assisted living. You will explore how meeting clinical, social, and emotional needs in the face of increasing acuity can be done without compromising person-centered principles. At the same time, you will accrue useable tools and best practices to create better person-centered living environments.
Juliet Holt-Klinger
, Senior Director of Dementia Care, Brookdale Senior Living
Jeanne Heid-Grubman
, Administrator, Franciscan Retirement Community

Getting it Right for Each Resident: Creating a Culture of Prevention and Continuous Improvement
Your performance outcomes are measured by each person's daily experience in your care. This session will help you get to yes for these three questions:
  1. Do people who can, get better?
  2. Do you catch early warning signs and use your best clinical skills to intervene and prevent avoidable events?
  3. Do residents maintain their routines for when they eat, take their medicines, get up and go to bed?
Learn how to be a leader who engages all your staff in a continuous loop of communication and collaboration. Everyone knows what needs to be done, and their part in it. 
Barbara Frank
, Co-Founder, B&F Consulting
Cathie Brady
, Co-Founder, B&F Consulting
David Farrell
, VP of Sub-acute Operations, Telecare Corporation

 Half-Day Intensives 8:00-11:45 (with 90-minute lunch before the afternoon sessions begin) 
Build your own full day intensive 

Sisters: Still Called to be Pioneers, Poets and Prophets  
Pioneer Sisters coming to this country came without any blueprint for meeting the needs of an immigrant population in their new environment. Yet, we are bearers of a rich legacy of diverse ministries, executed with vision, competence and compassion. We again find ourselves at a place without blueprints: when aging-related services for our members require the bulk of personnel, finances, and planning. We are still called, by our vocation to respond with vision, competence and compassion. This session provides tools for seeing with new eyes how aging services should be seen and implemented as a profound element of Congregational mission.
Sister Imelda Maurer
Note: This is session is repeated in the afternoon
Love Matters: Leadership Lessons from Wise Women
Wise women, including our mothers and grandmothers, have taught us valuable lessons in life. Through their caring we have learned to laugh, play, sing, dance, dream, and then realize those dreams. Through their wisdom we have learned values and manners, how to treat people, and how to persevere through difficult times. Through their hearts we have learned unconditional love. These are all meaningful lessons for leaders working to transform the culture of aging. In this powerful session, you will be embraced in the caring heart of wise women leaders, and you will be nurtured and transformed as a leader for change. 
Nancy Fox
, Chief Innovation Officer, Vivage Senior Living
Susan Ryan
, Senior Director, The Green House Project
Denise Hyde
, Community Builder, The Eden Alternative
Sarah Rowan
, Elder Wisdom Keeper
Sandy Ransom
, Great Grandmother
Jude Thomas
, Founder and Mother of Eden

We're All In This Together: Multiple Stakeholder Insights On Integrating Quality Improvement In a Large System
Change presents challenges and opportunities. How change happens determines success. This intensive engages participants in learning about and using an evidence-based approach that makes quality improvement (QI) easier and more likely to achieve its full potential. The step-by-step method integrates QI into staff members' everyday habits, enabling continuous innovation. Stakeholders from the Department of Veterans Affairs— including residents, frontline staff, managers, and national leaders—will share insights from their experiences using the method and will engage participants in hands-on learning. Participants will practice applying the approach and will leave with individualized plans for their own QI projects.
Christine Hartmann
, Researcher, Bedford VA Medical Center
A. Lynn Snow
, Researcher, Tuscaloosa VA Medical Center/University of Alabama

Supporting Well-being for the Person with Dementia: 
It Begins with Comfort
As the US population ages, long-term care organizations are called to address the ever changing needs of persons with dementia. Questions regarding autonomy and personhood are at the center of quality of care and quality of life for people who have trouble thinking.  Adopting comfort-focused strategies for people with dementia is answer.  This session will explore the theories and evidence supporting a comfort model of care as well as how to implement this best-practice model in your organization.
Tena Alonzo
, Director of Education & Research, Beatitudes Campus
Karen Mitchell
, Comfort Matters Nurse Educator, Beatitudes Campus
Karen Harper
, Community Director and Dementia Coordinator, Isabella Geriatric Center
Deidre Downs
, Corporate Director for Social Work and Supportive Care Programs, Cobble Hill Nursing Home
Robert Herel
, Director of Social Work, Cobble Hill Nursing Home
Liza Long
, Dementia Care Unit Manager, Cobble Hill Nursing Home
Sharon Blake
, Dementia Coordinator, The New Jewish Home

Integrating Complementary Therapies in Our Elder's Lives and Our Work
You will experience "a taste" of many complimentary therapies in this session to have an understanding of their benefits and identify ones you may want to dive into in a deeper way.  Program goals include bringing about social integration, relaxation, a sense of community and a healthy approach to our human needs.  Other benefits are ways of managing pain, stress and isolation and demonstrated positive outcomes for elders and staff.  We will discuss challenges and successes of incorporating these therapies into everyday life of our Elders. 
Evy Cugelman
, Innovations Specialist, Vivage Quality Health Partners
Elizabeth Flatter
y, Wellness Director, Friendship Haven
Raquel Jarrard
, Assisted Living Director/RN, Friendship Haven

 Half-Day Intensives 1:15-5:00 (with 90-minute lunch after the morning sessions end) 
Build your own full day intensive
Note: This is an exact repeat session from the morning Intensives.
Love Matters: Leadership Lessons from Wise Women
Wise women, including our mothers and grandmothers, have taught us valuable lessons in life. Through their caring we have learned to laugh, play, sing, dance, dream, and then realize those dreams. Through their wisdom we have learned values and manners, how to treat people, and how to persevere through difficult times. Through their hearts we have learned unconditional love. These are all meaningful lessons for leaders working to transform the culture of aging. In this powerful session, you will be embraced in the caring heart of wise women leaders, and you will be nurtured and transformed as a leader for change. 
Nancy Fox
, Vivage Senior Living
Susan Ryan
, The Green House Project
Denise Hyde
, The Eden Alternative
Sarah Rowan
, Elder Wisdom Keeper
Sandy Ransom
, Great Grandmother
Jude Thomas
, Founder and Mother of Eden

From the Executive's Desk: Motivations, Experiences, and Outcomes  
Are we really moving from flavor of the month to a widespread change in culture? Hear from executive leaders about their case for deep, sustained organizational change.  What motivated these innovators' personal and organizational transformations?  Participate in a candid conversation and reflections from these pioneers about their experiences and approaches to change, including the most significant barriers that got in their way and the drivers that kept them moving forward.  We'll discuss the outcomes they achieved and leave you with strategies for influencing leaders in your organization to commit to deep and sustained change. 
Megan Hannan
, Executive Leader, Action PACT
KaraLe Causey
, Owner, Haven Nursing and Rehab Center
Steve McAllily
, CEO, Methodist Senior Services
Jeff Jerebker
, Blogger, Author, Elder Care Influencer
Glenn Van Ekeren, President, Vetter Health Services

Advancing Care Excellence for Seniors (ACE.S): Integrating Nursing Skills for Person Centered Care
Calling all nurses!! The National League for Nursing (NLN) and PHI (Paraprofessional Healthcare Institute) have partnered to provide evidence based training tools for gerontological nurses, using as a foundation the NLN's Advancing Care Excellence for Seniors (ACE.S) program and PHI's Coaching-communication skills. With funding from the Retirement Research Foundation (RRF), this curriculum is being taught to practical nurse educators across the country.  Join us to engage in conversations and interactive teaching strategies that explore the role of nurses through the eyes of the person served and that identify aspects of self-awareness and self-management as core to effective gerontological nurses. Participants will leave the workshop with ideas about how to integrate coaching communication skills and ACE.S teaching strategies to improve the quality of care for older adults and their caregivers. 
Sue Misiorski
, Director of Coaching and Consulting, PHI
Anna Ortigara
, Organizational Change Consultant, PHI

Culture Change Dining Can Work from Trayline to Household
In this session, we will show communities at all stages of Food Service in Skilled living how to implement Culture Change and deep seeded resident choice.  Just because you have not gotten off a trayline or using a satellite does not mean you cannot implement aspects of Culture Change that will have significant impact on the lives of your residents. 
Jonathan Addess
, Regional Director of Culinary and Nutrition Services, ACTS Retirement Communities

Let's Get Unreal! Practical Tools to Incorporate Creativity for Life Enrichment
Discover thrilling possibilities when relationship-centered enrichment occurs in an experience that leaves elders saying things like, "You're a brain stretcher. You make us look outside our world," and "This makes the week. Do we think of pains and aches? No we don't." Kareen King, Creative Engagement Specialist, shares field-tested tools that foster the desire Elders have to learn, play, discover, create, belong, and express themselves. Groundwork will be laid on the basics of creative improvisation and how it works with storytelling, poetry, conversation, music, and more. Participants will both learn and experience techniques, and will discover how creativity can occur during personal care and mealtime, not just during planned activities. 
Kareen King
, Registered Drama Therapist, The Golden Experience

Concurrent Session A
Tuesday, August 2, 10:30am - 12noon

Working Together to Support Well-Being:
An Upstream Approach to Eliminating Downstream Interventions
in Care for Persons Living with Dementia
Increasingly, healthcare professionals are moving from pharmacological approaches 'treating' persons living with dementia to an array of non-pharmacological 'interventions'. While this shift may appear progressive, it perpetuates a reductionist, biomedical paradigm that is reactive rather than proactive. Most distress represents expressions of unmet needs. Instead of treating ill-being, our primary goal should be supporting well-being. After exploring the meaning and importance of well-being for persons living with dementia and their care partners, this session offers a practice example of one organization's journey to engage all community members in working together to promote well-being through an initiative called the 'Dialogue Project'.

Jennifer Carson, University of Nevada, Reno

Preventing Falls: An Innovative Approach to Restorative Nursing
This session will discuss how decreased mobility is the primary cause of falls and an overall deterioration in the health of residents. Traditional restorative nursing programs do little to address balance, strength and endurance issues that lead to immobility. This session will discuss exercise & restorative nursing programs that prevent falls by enhancing mobility, balance, strength and endurance of residents. It will describe how to set up an environment to help promote safe mobility and how to capture the program on the MDS restorative nursing section.

Jeri Lundgren, President, Senior Providers Resource
Sue Boyd, Vice President of Quality Assurance, Elim Care

The Role of Compassion in Elder Care
We are born to relate, to connect and to bond. The most noble of human relationships is compassion. No other profession is as closely associated with the virtue of compassion as is eldercare. What is compassion? What is the scientific evidence that explains and supports compassion? What is the leader's role in establishing a culture of compassion? The answers to these questions will be discussed during this session. We will discuss how compassion interfaces with the five universal needs and yearnings that make each of us human: To Be; To Become; To Belong; To Be our Best; and To Reach Beyond... Content of this presentation is based on the recently published book "The Return of Compassion to Healthcare," written by Dr. V. Tellis-Nayak.

Dr. V. Tellis-Nayak, Senior Researcher, National Research Corporation
Mary Tellis-Nayak, VP Quality Initiatives, My Innerview

Rewriting Dementia: Using Poetry to Engage, Creatively Stimulate and Empower Those with Dementia 
In this session, you'll learn innovative ways to engage, creatively stimulate, and empower people living with dementia. The Mind's Eye Poetry method challenges stereotypes and advocates for a new approach to engagement. Learn how to plan theme-based, one-hour sessions that result in the creation of poetry using the ideas, words, and phrases of the individual living with dementia. This session is tailored to all caregivers, whether caring for someone in their own home or in residential care communities.

Molly Middleton Meyer, Poet, Mind's Eye Poetry

Aging Well - Living Fully 
Aging well requires continuously finding purpose and meaning in living. 
Using a custom-created questionnaire, our international team is collecting stories from older adults to build knowledge and understanding of what it is like to age in a variety of circumstances. From this we are developing a tool to help persons in late life find wellbeing as they define it for themselves. We will share stories, what we've learned, and the tools and processes we've developed and continue to test.

Helen Guthrie, President, Guthrie Consulting, Inc.
Kathy Laurenhue, CEO, Wiser Now, Inc.

Takin' It to the Streets! Engaging Consumers in Redefining Care
and Revolutionizing Their Expectations

historically, revolutions are successful only when the people affected lead the charge. And so it is with revolutionizing culture change. The time has come for us to collaborate with and empower those directly receiving care and their care partners all along the continuum. Eden at Home, an initiative of The Eden Alternative, is the perfect vehicle to engage consumers in a meaningful way. Through a series of workshops that delve deeply into person-directed care values, care partners learn that the caregiving and care receiving experiences can be not only meaningful, but very different experiences than previously thought.

Kim McRae, President & FCTA (Family Caregiver Turned Advocate), Have a Good Life
Mel Coppola, Owner, Hearts in Care

Building an Environment: The Human Approach

The session will describe how an organization can achieve real culture change in a residential household using the adapted Butterfly Home model developed by U.K.'s Dementia Care Matters. Participants will engage in a mini-workshop using tools to create a dementia friendly environment. The importance of enhancing residents' meal experience and ways to do so will also be discussed.

Renate Sainsbury, General Manager, Lifestyle Options Retirement Communities
Jennifer Mabugat-Chan, Director of Care/Clinical Lead, Lifestyle Options Retirement Communities

Person Centered Rehabilitation: The NET Model and the Role of Team Collaboration in Clinical Success 
The NET model represents an innovative approach to providing rehabilitation to individuals living with moderate to severe dementia that is grounded in person-centered care, team collaboration and the promotion of meaningful engagement. NET results in positive functional outcomes and enhanced engagement, as documented in a recent research study. This session will introduce the NET model, highlighting the ways in which it represents culture change in rehabilitation services, lessons learned, and a review of the research and its findings.

Kelly Carney, Executive Director, Phoebe Ministries
Jennifer Howanitz, Director of Rehabilitation Services, Phoebe Ministries

The Need for a Social Revolution in Residential Care
Research suggests that programs fostering engagement and peer support provide opportunities for residents to be socially productive and develop a valued social identity. This interactive session will explore a re-conceptualization of current practices that focus on entertainment and distraction, to one that centers on resident contributions and peer support. Presenters will offer a model for discussion—Resident Engagement and Peer Support (REAP)—for designing interventions that advance residents' social identity, reciprocal relationships and social productivity. Attendees will leave with viable take away strategies that have the potential to revolutionize current psychosocial practices from resident care to resident engagement.

Kristine Theurer , Founder, President, Java Group Programs, Inc.
Robyn Stone, Executive Director, LeadingAge Center for Applied Research

"Help me understand" Mrs. Katie: Empowering Positive Partnerships with Residents and Families
Are you frustrated by family members? Are you tired of confrontations with daughters who just don't understand? With her mother's words "Help me understand" and a knowledgeable steadfast voice, learn how one family member developed a positive partnership with the nursing home staff. Their success was based on knowledge, person-centered care, mutual respect and gratitude. The Preferences for Everyday Living Inventory and how it supports development of positive partnerships with staff, residents and families will also be discussed.

Karen Alizzi, VP of Residential Care, Madlyn & Leonard Abramson Center for Jewish Life
Rita Morris, Family Member

Alzheimer's and Memory Cafes:

Effective and Fulfilling Events for People Living with Dementia, with Families and Friends.
An Alzheimer's or Memory Cafe is a non-judgmental and safe environment where people living with dementia and their families can relax, have fun, and connect with others in the same situation. Many cafes have fostered friendships between participants. This session will inspire you and help you start your own cafe.

Jytte Lokvig , Founder and Facilitator, National Alzheimers Cafe Alliance
Jan Olsen, Co facilitator, Alzheimers Cafe

Eliminating Workplace Violence in Nursing Homes:
Experiences of Two Coalitions in Connecticut and New York City

Working in healthcare is rewarding, but can also be dangerous. CNAs have the highest incidence of workplace violence of any American worker. Seventy percent of nursing home staff are assaulted at least once a month; Certified Nursing Assistants an average of nine times a month. Over the past two years, two separate groups of nursing homes, in Connecticut and New York City, addressed this issue. Both groups worked with the Union representing their staff. This workshop will provide overviews of the approaches utilized and examples of assessments, curricula, policies, training activities and results. Nursing home staff will speak about their experiences in creating safer homes.

Lois Schram, Consultant, L/S Gerontology 1199SEIU Labor Management Project
Janice Dabney, Assistant Director, Labor Management Project, 1199SEIU Training & Employment Funds

Engaging Residents and Families in CAUTI Prevention
Nursing home infections are the leading cause of mortality and morbidity for residents. Prevention of these infections is critical in order to promote resident safety. Engaging residents and families as partners in care around infection prevention is essential to promoting person-centered care, plus is an important opportunity to increase resident safety. Hear examples of how to engage residents and families in reducing CAUTIs; and identify tools and resources to educate staff, residents and families.

Lori Smetanka, Executive Director, National Consumer Voice for Quality Long-Term Care
Sue Collier, Clinical Content Development Lead, Health Research & Education Trust

Person-Centered Care and Implementation of CMS Proposed Rule Changes

This session will review and analyze the new proposed CMS rules for nursing facilities. Attendees will learn how person-centeredness is incorporated as a key principle, and will discuss how these rules can be effectively implemented to promote person-centeredness as well as improved quality of care in other domains. The limitations, pitfalls, and unintended consequences of these proposed rules along with challenges in implementation will also be identified in order to develop strategies to prevent shortcomings, undesirable actions or outcomes.
Guide: Jonathan Evans, MD
Panel: To be announced

Concurrent Session B

Tuesday, August 2, 1:30pm - 3:00pm

Grand Transformations: Organizations Making Bold Moves
Successfully repositioning an occupied residential building takes leadership, vision, creative planning, quality care delivery, sound financial modeling and risk. Two organizations will describe how to overcome challenges, such as the logistics of relocating residents in a high occupancy setting, phasing, and coordinating with local and state licensing agencies. They will describe why they took these bold moves, how they managed the strategic position of the organization and the expectations of the residents during design and construction. Both transformations resulted in creating all or mostly private rooms and dedicated household environments.

Vernon Feather, Senior Vice President, SFCS Architects
Janet Lorenzon, Administrator, Liberty Lutheran
Cathy Emig, Administrator, Kendal Crosslands

Transforming Dementia Care through Collaboration and Connectedness
During this interactive session, we will evaluate current stigmas, culture and practices and examine how learning from the perspective of individuals living with dementia enhances our ability to transform the culture of dementia care. The LIVING in My Today program will be introduced as an example of supporting individual strengths, personhood, relationships and personal well-being.

Melynda Anderton , Social Worker, Schlegel Villages
Jessica Luh Kim, Director of Education and Program Development, Schlegel Villages

Moving Toward a Person-Centered End-of-Life Experience
This session will focus on transforming the culture of end-of-life care to an individualized, person- and loved-one-centered experience. We will discuss assumptions and biases as well as practical methods of learning about people at the end of their lives and treating them as individuals with a lifetime of experiences, accomplishments, opinions and preferences. End-of-life symptom assessment and development of individualized, dignity-promoting treatment measures will be discussed. The intended outcome is increased understanding of methods of assuring that individuals and loved ones experience self-determined death in accordance with their wishes and values.

Elizabeth Hopkins, Clinical Nurse Educator for Hospice, Palliative Care & Rehabilitation, 
New Mexico VA Health Care System

Twenty Percent = Success Programming: Re-evaluating the Activities Model to Address Lack of Participation and Engagement
As we continue to strive for person-centered care and truly understand residents as individuals, we must also learn to re-invent and discover new offerings in the arena of activities/life enrichment. With the coupling of generations in long-term care, one approach to engage and facilitate quality of life will no longer suffice. By dissecting and analyzing participation, and admitting there is room for improvement, Nicoya & Senior Care Centers are challenging staff with new initiatives that do not resemble activities as we know them but instead seek to meet residents where they are rather than conform their interests to a predetermined model.

Sara Kyle, Director of Resident Wellness, Nicoya Health and Lifestyle
Jana Russell, Manager of Resident Wellness, Senior Care Centers

Love is All You Need: Making Intergenerational Programs Work
Natural communities include people of all ages and life stages who are entwined in webs of relationships. This session will describe how to create life-enhancing connections and an authentic community in the most unnatural place: a residential community for older and disabled adults. Various models and approaches to intergenerational programming and ways to involve all generations in the life of any community will be discussed.

Kathryn Anderson, Director of Clinical Services, Providence Mount St. Vincent
Marie Hoover, Director, Intergenerational Learning Center, Providence Mount St. Vincent

Investing in the Frontline: Developing Leadership Opportunities for Resident Assistants
We know that Resident Assistants (RAs) are the heart and soul of resident-centered care. They have a critically important role in partnering with the resident and family and ensuring that the resident's well-being is at the center of the care team. In recognizing this, a program was developed whose immediate goal was to develop the leadership skills of RAs, with the overarching goal of improving resident engagement and ultimately resident-directed care. We will discuss the process for developing and sustaining our program, and a panel of RAs will share both the challenges and successes encountered on this ongoing journey.

Tammy Retalic, Chief Nursing Officer, Hebrew Senior Life
Doris Bertram-Morin, Director of Professional Development, Hebrew Senior Life

The Sunny Hill Story of Change
Sunny Hill Nursing Home of Will County, a county owned nursing home in Joliet, Illinois, has been on their Culture Change journey for the past 12 years. Tools and examples will be presented to help attendees put into practice some of the changes that have been successful for Sunny Hill in their journey. Learn how Sunny Hill transformed their dining program, eliminated alarms, gained the community's involvement, empowered the elders by starting a resident interview committee for hiring staff and other practices that have helped the home maintain their person- centered approach to daily living. 

Becky Haldorson, Assistant Administrator, Sunny Hill Nursing Home of Will County

Starting the Revolution in a Circle!
Learning Circles are a powerful yet under utilized tool that communities and individuals can use to start and/or further grow as they seek to change the culture of aging. We will begin by sharing the history of learning circles as they support communication in cultures throughout the ages. Then, through discussion and doing, together we will learn the process for conducting learning circles, and experience first-hand how they can provide the "fuel" needed to change the culture - organizationally and personally. Participants will leave with the knowledge of how to develop a learning circle challenge in their organization. 

Joan Devine, Board President, Missouri Coalition Celebrating Care Continuum Change (MC5)
Paula Lee, Person Centered Care Liaison, The Sarah Community

The Good, the Bad, and the Ugly: Getting the Whole Story
The Human Being evolves his/her story beginning at birth. Culture change begins here, in the individual's first words and steps, the gaining of knowledge and skills, and ultimately forming a purpose in life. For the caregiver of someone living with dementia, recording life history is imperative in providing a quality of life for that person and adopting a person-centered philosophy. Learn how to be thorough in capturing the good, the bad and the ugly in the person with dementia – the REAL person—to make the best possible plan of care at home or in transitioning to other settings.

Dana Territo, Director of Services, Alzheimer's Services of the Capital Area
Katherine Schillings, Program Coordinator/Social Worker, Alzheimer's Services of the Capital Area

The Role of the Physician & Other Members of the Team 
When Planning Person-centered Care
In this world of person-centered care and individualized choices, learn what the roles of the physician and other members of the team are when care planning. How do we "safely" honor risky choices, while lessening litigation and citation risks for health professionals? Don't miss this presentation that blends a 'real life' case study with a skit to demonstrate the process of planning for person-directed care. A discussion follows of approaches and steps that can be taken by physicians and other care professionals to successfully work in the new culture of aging.

Diane Hall, Owner, Balanced Senior Nutrition
Christopher Mulrooney, Assistant Dean/Chief Operating Officer, Florida State University College of Medicine

When Practice and Policy Meet: Applying the CMS HCBS Settings Rule to the Goal of Promoting Community Integration in LTSS
The Home and Community-Based Services regulations issued by the Centers for Medicare and Medicaid Services (CMS) in March 2014 set forth new requirements for several Medicaid authorities under which states may provide home and community-based services. This session will discuss innovative strategies and promising practices that states and providers of long-term supports and services may consider as they continue to flesh out how best to implement the HCBS settings rule by March 2019. Services to individuals living with dementia will be a significant focus of the dialogue. Technical resources will also be shared with participants for consideration and feedback.

Becky Kurtz, Director, Long-term Care Ombudsman Program, Administration for Community Living, U.S. Department of Health and Human Services

How Do Elders Living with Advancing Dementia Voice Their Choices?
This session guides the care partner to recognize the variety of modes of communication from elders living with advancing dementia as they indicate their needs and choices throughout the day. Is the message being heard? Utilizing video case studies, care partners will evaluate elder communication to honor choices which foster self-worth, meaning and purpose for the elder living with dementia. 

Linda Riccio, Vice President of Clinical Operations, Vertis Therapy

Disrupt Infections by Creating Community Immunity
The top three causes of hospitalizations for elders in nursing homes are infections, causing not only personal distress but costly hospital stays and use of resources. These infections and many others in all settings across the continuum of care can be prevented. This session will overview disrupting infections by creating "Community Immunity", which is an approach to elevating awareness about spread of germs leading to infection, and includes practical action steps to stem the spread of germs, including changing daily care practices and involving staff and family's commitment to disrupting infection. 

Lynda Crandall, RN, GNP, Pioneer Network

Concurrent Session C
Tuesday, August 2, 3:30pm - 5:00pm

Innovative Workplace Solutions: Nurse Leadership Make-over
Health care providers continue to look for innovative workplace solutions that lead to a stable workforce. This session will describe in detail the innovative practices that have led to the successful transformation of a nurse leadership team from a dictatorial medical model to a staff empowered decentralized style of management.

Jalane White, Administrator, Pleasant View Home
Marilyn Stufflebean, Director of Nursing, Pleasant View Home

Experiencing Life with Dementia: It's Never Too Late

How much do we really know and understand about living with dementia, and how can we better design environments for residents living with dementia? Our team of senior living experts tackled this issue "head on" by living as memory care residents in communities across the country, using equipment to simulate the challenges experienced by and behavioral responses of a person with mid-stage dementia. A gerontologist followed three Architects and a CEO of a Pennsylvania provider through 24 hour stays in a variety of care settings. The speakers will share their first-hand experiences of "walking in the resident's shoes" with the audience.

Melissa Pritchard, Senior Vice President, SFCS Architects
Amy Carpenter, Senior Associate, SFCS Architects

Kendal at Hanover's Inner Light Program
This session will introduce attendees to Kendal at Hanover's Inner Light Program, our successful person-centered program of care. Our focus is to show how residents and staff benefit from maximizing choice, autonomy and comfort, allowing us to foster nurturing relationships in an environment that promotes wellness of mind, body and spirit. Participants will learn how to establish their own resident-centered care programs, and ways to inspire staff engagement.

Hailey Wetherbee, Assisted Living Administrator, Kendal at Hanover
Laurie Flynn, Director of Nursing, Kendal at Hanover

Engage, Inspire and Uplift People with Dementia through a Dance/ Expressive Movement Program
This workshop will present a model for a dance/expressive movement program which is fun, engaging and esteem-building for older adults and people with dementia. The structure is designed to incorporate the movements and offerings of all participants, regardless of physical or cognitive abilities. Recent studies have found that dance has many benefits which range from a greater feeling of vitality, improved mood and reduced agitation to more coherent speech, increased neuronal pathways and possible protection against dementia. Caregivers/staff who enjoy dancing and moving will leave with the resources to implement such a program.

Donna Newman-Bluestein, Dance/Movement Therapist, Dance for Connection

Getting Household Dining Right, The First Time!
Implementing full-service dining in a household model of care can be the most challenging aspect in the culture change planning process. Delicious and nourishing meals need to be the centerpiece of daily care. The household kitchen must be the heart of the home. Don't take this huge step forward without some background and knowledge of the essentials for successful design, implementation, and training.

Jeffrey Goldone, President, J. Goldone Consulting and Training, LLC.

Coming Together is a Beginning, Keeping Together is Progress and Working Together is Success: Creating Synergy to Promote Culture Change
How do you create an environment where care partners feel valued and an integral part of the team? Imagine an Assisted Living community where departments join together to create synergy while establishing person-centered services. In this session, leaders of nursing, support services and recreation will present examples of how to successfully mentor and engage staff while empowering them to embrace the culture change revolution and remain compliant while maintaining 100% resident, employee and overall family satisfaction.

Marcia Ortez, Administrator, Francis Parker Memorial Home

Our Journey to Culture Change
Join us as we share our journey in changing from institutional to elder-centered care. We will discuss our rough start, challenges with implementation of these ideas, lessons we have learned, successes and what we would do differently if we had to do it all over again. Please join us as we share our stories and "Put yourself in their shoes."

Becky Lawson, DNS/AA/LNHA, Providence Seward Mountain Haven

Video Introductions - An Excellent Tool for Transitions 
Elders and persons with different abilities experience transitions of location as well as care partners. Video introductions illustrate their specific needs to new care partners in order to provide continuity in care and stability for the individual. Session participants will work individually and within a group to plan the implementation of Video Introductions in their community.

Michelle Daniel, VP for Philanthropy & Strategic Implementation, Methodist Senior Services
James Tucker, Audio Visual Coordinator, South Mississippi Regional Center

A Dialogue on Improving Patient/Resident Experience Throughout the Continuum of Care
From clinics and practices, to the acute setting, to long-term care, an unwavering focus on the experience of patients/residents and families remains a critical part of ensuring the best outcomes for those we serve. Through examination of the The Beryl Institute's biennial 'State of Patient Experience' benchmarking study and findings from interviews with leading long term care experts, participants will gain a broader understanding of the challenges and opportunities in creating excellent experiences across the care continuum. In addition, eight guiding principles for experience excellence and suggested application and key considerations for each will be discussed.

Stacy Palmer, Vice President, Strategy & Member Experience, The Beryl Institute

Your Culture Change Journey Can Be Greatly Enhanced by Regularly Checking the Condition of Your Spirit and Your Soul
Contrary to popular belief, we all take our soul and spirit to work with us each day. It affects how we work and the attitude in which we approach daily responsibilities. This session will be about bringing your soul to work and how it can increase your effectiveness and bring more feelings, imagination, and heart to what it is that we are called to do as healthcare professionals.

Pastor Gary Gibson, Chaplain & Director of Pastoral Care, Presbyterian Senior Care

Decreasing Pain, Anxiety and Depression in Residents by Using Selected Interventions Applied by Student Interns
Holistic interventions, carefully selected from a range of options to fit specific individuals, were found to reduce pain, anxiety and depression in residents including those with different types of dementia. This intern-supported program at six Metron Nursing Homes showed that student interns could be readily trained to apply a variety of holistic tools. This session will describe the Metron program and suggest how it might be adapted for use in other settings. Cost and medication reduction benefits, intervention selection methods, intern training protocols, and the metrics applied to assess resident improvement will be examined.

Jamie Garcia, Director of Well-Being Services, Metron Integrated Health Systems
Joy Langereis, student intern, Western Michigan University

Put the Drugs Down and Turn the Music Up!: How Today's Technology is Transforming Aging 

The more things change, the more they stay the same—at least for those providers who continue to deliver the same activity and engagement experiences they have delivered for years to their residents living with dementia. Yet the growth of person-centered technology in activity and therapy programming can't be denied. Why the disconnect? Learn from Presbyterian SeniorCare how the organization has successfully implemented person-based technologies to lessen isolation, increase a sense empowerment and well-being, and, in many cases, to alleviate behavioral expressions, resulting in the reduction of psychotropic drugs given to their residents living with dementia.

Jack York, President / Co-Founder, It's Never 2 Late
Carrie Chiusano, Executive Director, Dementia Care Center of Excellence, Presbyterian SeniorCare

Driving Successful Change Through Facilitative Techniques
Creating an organizational culture that welcomes the ideas and perspectives of all stakeholders, builds trust and inspires team members to develop a powerful sense of ownership is becoming a well known path. Teams develop the ability and flexibility to tackle complex challenges with creativity and confidence. Facilitative practices can respectfully and effectively address concerns, while removing barriers to success. As organizations engage in change efforts, it's the transitions involved that often give rise to the most arduous challenges. Session participants will explore how facilitative approaches can be applied to theses different phases of transition: awareness, letting go, chaos, and the new reality.

Laura Beck, Learning and Development Guide, The Eden Alternative
Denise Hyde, Community Builder, The Eden Alternative Conversation
Reflections on Aging from an Elder Sage

Jeff Jerebker, a national leader with over 40 years of experience in Long Term Care Management leads this Sage Conversation.  Jeff was one of the original voices to champion the psycho social model with a career dedicated to leading care communities through transformation to person-centered care.  Join him as he shares stories of the journey of aging from his wizened perspective.

Jeff Jerebker

Concurrent Session D

Wednesday, August 3, 8:00am - 9:30am

Person-Centered Leadership 
The current environment requires its leaders to be more than ever before: strategist, financial wizard, visionary, coach, motivator and much more. This session will look at qualities exemplified by good leaders and help you to see how you measure up. We will explore leadership styles to determine yours. We will discuss techniques for improving your style and you will learn how you can better motivate your caregivers in a Person-Centered Culture. Participants will start to develop their own plan to develop into the leader they want to be. Leadership is learned – let's continue to grow!

Mary Tellis-Nayak, VP Quality Initiatives, MyInnerView

Positive Work Environments for Nursing: Correlations to a Culture of Change
Studies show that environments with certain characteristics help improve nursing satisfaction and retention. Pathway standards help organizations develop those characteristics. They represent traits that nurses and researchers agree are critical to an ideal practice environment. Recognition of these positive characteristics demonstrates to consumers, health care providers, third-party agencies, and potential accountable care organization partners that processes are in place to support a culture of safety, well-being, excellence, interprofessional collaboration, and innovation. The session will include case studies and testimonials of how a more satisfied and motivated nursing workforce led to better results for long-term care organizations around the country.

Leigh Hume, Appraiser Manager, American Nurses Credentialing Center-Pathway to Excellence
Christine Pabico, Director, American Nurses Credentialing Center-Pathway to Excellence

Utilizing Appreciative Inquiry to Create a New Narrative about Older Adults 
This session will help participants discover how to use strength-based and high-engagement approaches, along with the personal stories of elders, to inspire support and create programmatic improvements within home and community-based services and take advantage of the wisdom and talent that surrounds us as the population ages. A description of the Appreciative Inquiry process we utilized to "change the narrative about aging and older adults" and develop new program strategies that promote seniors' dignity, independence and quality of life will be described.

Jane Bavineau, Vice President, Neighborhood Centers, Inc.

Using Person Centered Discovery Techniques To Reflect Balance in Planning
This session will consist of a brief overview of five essential person-centered questions correlated to the CMS HCBS Settings Final Rule. Participants will be introduced to person- centered discovery skills that will assist them in exploring the boundaries of choice in the context of determining what is important to people. One page, person-centered profiles will be shared and a variety of issues for people using an array of long-term services and supports will be discussed.

Tanya Richmond, Senior Associate, Support Development Associates, LLC

Staff Engagement...Feel The Difference
This session will describe the key roles in a household model and discuss strategies that create a culture that promotes team empowerment and staff engagement. The challenges and opportunities of implementing and sustaining the household model and the benefits for both residents and staff will be described. Hear testimonials that share both trials and triumphs experienced during the journey from a traditional "facility" to a culture change home.

Rebecca Gauthier, Director of Nurses, Commcare Corporation
Vanessa Houck, Administrator, Riviere de Soleil

Transforming Your Physical Environment to Reflect Culture Change
This session will explore the important questions and range of responses that senior living providers face as they try to address culture change needs when upgrading their physical plant. The primary teaching tool will be a Case Study comparing and contrasting two approaches that will draw on the experiences and perspectives of both Owner and Architect. Participants will acquire tools to clarify their organization's goals as they evaluate their current environments and will take away ideas of what to look for to make the most of what they have when budget constraints govern or their physical plant presents significant limitations.

Thomas Grden , Project Director, Stantec Architecture
Steven Tack, President and CEO, Quality Life Services

Exploring the Small Setting and the Home Plus Model
Organizations are on the lookout for the newest trends in bricks and mortar. Whether it is called a household, a small house or a home plus, the small setting is making a big difference in the lives of elders and staff. Four individuals who all bring their perspective to the presentation will describe in detail the blessings and bumps in the road as it relates to the small setting. The session will demonstrate how universal workers, a home atmosphere, and choices for the elders adds up to a very positive experience for all. 

Jalane White, Administrator, Pleasant View Home
Marilyn Stufflebean, Director of Nursing, Pleasant View Home

Advocating for Choice: How Long-Term Care Community Social Workers Can Become Advocates for Resident Rights
Long-term care communities employ social workers to provide multiple functions for residents, especially those with high levels of dependence. These include assessments of cognition and developing care plans, managing difficult resident reactions and identifying useful resources outside of care. However, social workers often lack training and preparedness for the important role as an advocate. This session will demonstrate the importance of this role and provide participants with a better understanding of tools available to long-term care social workers to become advocates for their residents, and how they can be leaders in creating a person-centered environment.

Christine Flynn, Regional Ombudsman Coordinator, VOYCE

Vive la Revolution! Living Culture Change Through Engagement:
Embracing customer service and technology to truly know each individual
What does "culture change" mean to the individual living in a community? How do they feel cared about instead of cared for? We found that in our memory care communities it required a paradigm shift where everybody is a customer service agent. We focus on serving others and building relationships and the results are true engagement. To do this, we leverage technology that enhances living and purpose. As a provider, we'll share our experiences, best practices and tips for integrating a customer service model and technology into existing programming, training and care services to have an impact on real culture change. 

Melany Sattler, MSW, Vice President of Clinical Services, SimpleC, LLC
Wayne Cash, Executive Director, LNHA, MACM, Oxford Senior Living

A Statewide Conference: Organization and Implementation
During this session, members of the Pennsylvania Culture Change Coalition (PCCC) will explain how to organize and implement a successful statewide conference. In recent years the PCCC has held several statewide events featuring nationally known speakers and averaging over two hundred attendees at each one. 

Iain Crichton, VP PA Culture Change Coalition, PA Culture Change Coalition 
Kathy Ardekani, Board Member, PA Culture Change Coalition

Honor, Dignity, and High Quality Living through Palliative Care for Persons with Dementia
Because of the lengthy course of diseases with cognitive loss, people living with dementia stand to benefit from palliative care over a longer period of time than people with other terminal illnesses, yet very few palliative care programs for this population exist. Kendal Outreach developed a program that utilizes evidence based interventions, life history books, individualized music, pain management, person centered care plans, and end of life comfort to increase quality of life for persons living with cognitive losses. Participants will engage in an interactive education session, learning specific proven approaches that maintain dignity and improve quality of life for residents with cognitive losses.

Linda Hnatow, Regional Director and nurse educator, Kendal Outreach LLC
Janet Davis, Regional Director, Kendal Outreach LLC

Breathing Life into Inspired Care, Implementing Action Pact's Household Model Across 77 Residential Communities in Australia. 
Uniting of NSW Australia, is the largest not for profit provider of community and residential aging services in Australia. Led by visionary Steve Teulan who first heard about Action Pact's Household Model in 2007, they have embarked on a deep organizational shift. This intriguing journey has included starts and stops, stalls and fits AND successes and impressive outcomes! Join us to understand the structures, and systems of the change model and hear the stories and results that can help any organization large or small. 

Linda Justin, Director, Continuous Service Improvement, Uniting
Megan Hannan, Executive Leader, Action Pact 

Honoring Everyday Preferences of Nursing Home Residents:
Facilitating Choice and Satisfaction
Person-centered care and evidenced based practices are both highly valued in the culture change movement. Successful implementation of both requires soliciting resident preferences and offering choices. Increasing choices offered to residents is associated with better satisfaction as it values elders' right to self-determination. This hands-on session will offer evidenced-based information for nursing home staff to use in the facilitation of choices for residents.

Liza Behrens, Administrator/Project Coordinator, The Pennsylvania State College of Nursing
Laura Roy, Executive Director, Lutheran SeniorLife Passvant Community

Home Sweet Home: Lessons of the Maturing Green House Model
The Green House Project continues to evolve with each new implementation of this revolutionary model. Now, over a decade since the first homes opened, the collective experience of adopters, along with research released in 2016, has provided new information to further shed the institutional lens. Significant advancements have been made related to the normalization of homes through careful design and selection of Fixtures, Furniture, and Equipment (FF&E). This session will explore the feedback, analysis, and practical advice gained from thirteen years of implementation to reflect on the most critical and valuable decisions in the creation of real Home.

Rob Simonetti, Senior Associate, SWBR Architect
Debbie Wiegand, Project Guide, The Green House® Project

The Java Mentorship Study: Residents helping Residents
Loneliness and depression continue to be serious mental health concerns in residential care communities. In this interactive session, attendees will examine and experience the Java Mentorship Program, where residents, families and volunteers meet weekly for discussion and education, then pair up to seek out and support lonely/isolated residents. The program was implemented in 10 continuing care communities in the fall of 2015. The Schlegel-UW Research Institute for Aging and the University of British Columbia collaborated in a mixed methods trial to evaluate the program and its impact on loneliness and depression. Research results and lessons learned will be shared.

Kristine Theurer , Founder, President, Java Group Programs, Inc.
Susan Brown, Research Coordinator, Schlegel-University of Waterloo Research Institute for Aging

Ageism: Recognizing and Destroying the Weed Sabotaging your Culture Change Journey
It's disguised in jokes, movies, music, and advertising. From years of internalizing these messages, it gets buried deep within us. Ageism, the last socially accepted form of prejudice and a global multi-billion dollar industry. Society views aging in terms of loss, decline and worthlessness. By shifting that focus toward the gifts Elders have to give and their well-being, we empower all care partners to create healthier lives for themselves and those for whom they care. This session will explore how ageism's underlying effects can damage a culture change journey and how to pluck this invasive weed by its root.

Mel Coppola, Owner, Hearts In Care, LLC

Chair Chi: Seated Tai Chi for the Movement Challenged Population 
Chair Chi is a gentle exercise program developed by Pat Griffith to help people receive the benefits of traditional Tai Chi Chuan in the comfort and safety of their chair. This allows people who cannot stand, or do not feel confident with their balance, to participate. Pat is the founder of Chair Chi. He has been teaching at health clubs, senior and wellness centers and senior housing and long-term care since 1997. Chair Chi is currently in 30 states and Canada with approximately 2,400 instructors including Activity Directors, Physical, Occupational, Recreational and Massage Therapists, Doctors, Nurses, Personal Trainers and Managers of Senior Living residences.

Patrick Griffith, Founder, Chair Chi

Coaching P.I.L.L.A.R.S. of Excellence: 
Power Tools to Strengthen Leaders, Health Care Professionals, and their Teams
Are you feeling stuck? Do you feel derailed by competing priorities or resistance to improve? This session is designed to demonstrate through lecture and participation that the 
P.I.L.L.A.R.S. of Excellence can be utilized to enhance teamwork among departments in care settings to elevate employees, engage them more deeply, and change the work culture from one of detachment, to one of inspiration, engagement, and growth. Taken from years of leadership work in aging settings, coaching, and social work, The P.I.L.L.A.R.S. of Excellence are both teachable and enormously powerful. 

Sylvia Nissenboim, Counselor, Coach, Trainer, Lifework Transitions, LLC
Angela Keeven, LMSW, LNHA, Own Living, LLC

Charles House Daytime Eldercare and Eldercare Homes:
A Model for Community Eldercare
Charles House Association, a 25 year old nonprofit, has established an innovative daytime eldercare program and pioneered neighborhood eldercare homes using the household model. This session will describe both programmatic approaches to serving elders within the community.

Paul Klever, Executive Director, Charles House Association

Join the Revolution: How Montessori for Aging and Dementia Can Change Long-Term Care Culture
Montessori for Aging and Dementia is an innovative approach that supports people by enabling them to make choices and to live as independently as possible. Roles and activities are developed for each individual which are meaningful to that person. Montessori principles result in increased safety, reduced agitation and "wandering", and promote self-esteem and independence. The Association Montessori International has newly established standards and training requirements for Montessori programs for elders. This program will share the international guidelines, provide concrete examples of the innovative work being done all around the world, and discuss how care communities can implement this person-centered approach.

Jennifer Brush, President, Brush Development Company Conversation
Tapping the Root Wisdom: 
Five Pillars of a Culture Change Champion

There is a root wisdom that underlies all culture change practices and strategies, It grounds our actions in the highest possible good we can bring to fruit at any moment.  For each of us committed to championing a person centered community culture, this ancient-contemporary wisdom increasingly permeates our actions. It liberates our capacity to spread love, empowerment, equality and hope.  Reflecting on these Five Pillars of a Culture Change Champion we will increase our capacity to embody Pioneer wisdom.  These five pillars are Authenticity; Love; Vision; Compassion; Persistence.

Barry Barkan

Concurrent Session E

Wednesday, August 3, 10:00am - 11:30am

Safely Honoring a Resident's Risky Preferences (SHARP):
An approach for cognitively intact, and mildly or moderately cognitively impaired residents.
A core value of Pioneer Network is: "Risk taking is a normal part of life." Residents with intact cognition or mild to moderately impaired cognition may have decision-making capacity to choose a preference that is potentially risky to themselves and others. Safety Handling a Resident's Risky Preferences (SHARP) is an approach that balances risk-taking and safety; it has potential to empower residents and staff. SHARP will be described. Participants will be asked to provide feedback on the approach and related documentation. Registered nurses, nursing staff, administrators, and interdisciplinary team members are invited to participate in the session.

Mary Dellefield, Research Nurse Scientist, VA San Diego Health Care System
Diane Carter, CEO, AANAC

To Be Somebody's Someone
Anyone working in aging services has probably heard, "It takes a special person to do what you do." The implication is that only individuals with special qualifications, training, or personalities can serve individuals in care communities. Perhaps the answer isn't in what we know, but in who we are in order to best serve the person who is non-verbal, who is actively dying, or who lives with a physical or cognitive challenge seemingly beyond our capability to address. 

Kareen King, a Registered Drama Therapist, offers encouragement through specific narratives in connecting with those we would most like to avoid. 

Kareen King, Registered Drama Therapist, The Golden Experience

Person-Centered Environmental Lighting: Technology's "Pill" to Reduce Sleep Disorders in Older Adults and Caregiver Stress
Research over the last decade has greatly enhanced our understanding of how light synchronizes 24-hour human body rhythms, with sleep and activity being the most observable. We know that environmental light must mimic the natural light/dark cycle of daylight in both the color of light and intensity to maintain healthy circadian rhythms, especially for those living in residential care settings. This session will summarize the prevalence and consequences of sleep disorders among older adults; describe the circadian system (body clock) and how it works; and discuss how environmental lighting is being used to improve sleeping at night and alertness during the day.

Robert Dupuy , Lighting Designer, Robert Dupuy Consulting, L.L.C.
Eunice Noell-Waggoner, Lighting Designer, Center of Design for an Aging Society

Quality Care through Quality Jobs: Employee-Centric Strategies for a Person-Centered Workplace
Direct Care Worker jobs are among the fastest growing positions in America. Now more than ever, providers must stand out as an employer of choice through workplace practices that attract and retain mission driven employees. This session will explore the current demographic trends of our workforce and offer evidence based tools to create a person-centered workplace where employees feel valued, respected, and proud to work.

Susan Misiorski, Director of Coaching and Consulting, PHI

iGen Saskatoon: Bringing an Intergenerational Classroom to Life at Sherbrooke Community Centre
Elders laughing, kids shouting, energy abounding...this is what iGen looks like at Sherbrooke Community Centre in Saskatoon, Saskatchewan. iGen is an intergenerational classroom which shares the home of Elders at Sherbrooke. Grade Six students apply to enter the iGen program and spend their full school year working, learning, and building relationships with Elders and staff. Find out how the first years of the iGen program brought new meaning to the lives of Elders, students, families, caregivers and an entire community.

Keri Albert, Teacher, Sherbrooke Community Centre

NextAge Mississippi: Connecting Older Adults to Resources for Successful Aging
NextAge Mississippi is designed to create a single point of access to empower older Mississippians to successfully age in place. Our definition of age in place is giving NextAgers the opportunity for personal growth and a meaningful life. It offers the right support with the right relationships, at the right time, in the right place. 

Michelle Daniel , VP of Philanthropy & Strategic Implementation, Methodist Senior Services
Steve McAlilly, CEO, Methodist Senior Services

Measuring Culture Change: Relationship to Survey Deficiencies
During this session, participants will discover key components to measuring culture change and learn which components have significant relationships to survey deficiencies. There has been limited research in Louisiana on the impact of Culture Change implementation and the number and scope and severity of deficiencies. This presentation will review the highlights of research conducted in Louisiana which outlines the relationship. Future areas of research to advance the study of new models of care delivery in the long term care setting will be discussed.

Jolie Harris, VP Nursing, CommCare Corporation

"'Ramblin' Man,' Positive Interventions and Deep Understanding for Those Walking with Cognitive Loss"
There are no behaviors without a reason; they are simply unmet needs in action. The mission for care partners is to find the rationale behind that behavior and a person directed way to meet the need of the Elder. Participants will learn how to use Maslow's Hierarchy of Need to identify where the roots of "aimless" and "intentional" walking fall into the Hierarchy and share and discuss ideas about how to meet the need of the Elder. The team will learn how to apply holism and person-directed care sharing to uplift Elders and meet the need that inspires their desire to walk about.

Sandra Place, Administrator, Jackson County Medical Care Facility

Building a Comprehensive Evidence-Based Therapy and Wellness Fall Prevention Program
The purpose of this session is to increase understanding of fall risk in community dwelling elders and how to implement a comprehensive evidence-based fall prevention program though skilled Physical Therapy and Wellness to reduce the risk, keep residents healthier, and help improve community marketability.

Melissa Ward, Director of Clinical Services & Elite Living, Functional Pathways

A Toolkit to Fix Your Culture Change Challenges 
Having 23 communities in eight states makes it very challenging to initiate and sustain culture change. Creation of a Toolkit, which incorporates the components of our culture change journey, the ACTS Signature Experience (ASE), has enabled our communities to meet this challenge. Our ASE Toolkit addresses person-centered living, hospitality, customer service, wellness, language and Quality Assurance Performance Improvement (QAPI). To complement the information within our Toolkit, we have added valuable resource materials and the "how tos" for success. It is a user friendly guide for all stakeholders and will not only introduce you to culture change, but will also assist you in maintaining the momentum and sustaining the journey.

Peggy Brenner, Regional Director of Nursing, ACTS Retirement-Life Communities, Inc.

Revolutionizing the Culture by Overcoming Barriers 

Are you contemplating changing the culture of your organization, but have met resistance or obstacles? Learn about common areas of resistance and how to overcome them. Hear from three homes that are at various stages of organizational change and learn how they have overcome resistance and obstacles to seeing change happen.

Laci Cornelison, Project Coordinator, Kansas State University

More than Meds: It's About Meaning and Purpose
More Than Meds is a project funded by CMS and the New Jersey Department of Health to reduce the use of anti-psychotics through person-centered care. But it really isn't just about anti-psychotics! It is thinking differently about how we can support nursing home residents (and all members of the team) to have meaning and purpose and how we have to change the way we do things to make this happen. In this session, members of the project team will share their experiences, successes, and lessons learned in changing their communities to become better places to work and live.

Sonya Barsness, Owner, Sonya Barsness Consulting LLC
Michele Ochsner, Instructor/Co-Director, Occupational Training and Education Consortium
School of Management and Labor Relations Rutgers University

Banishing the Stigma: Bridging Relationships Between Residents of Varying Cognition Using Art!
There are many stigmas concerning Alzheimer's and Dementia. These stigmas are shared among a large number of the residents currently residing in assisted living and nursing homes. Many residents are uncomfortable with the idea of interacting with others who have memory loss and believe these people are no longer able to create or participate in meaningful activities. Art programming has been used as a bridge in my organization to develop rapport and relationships between residents of varying cognition. Learn how our home's Art Program is banishing resident stigmas and encouraging collaboration. Take this program back to your community and watch the stigmas slowly dissolve!

Colleen Keegan, Director of Activities/Membership Chair, Attic Angel Community/ NAAP

Cognitive Aging: Maximizing Capacity and Changing Culture
Physical aging is widely accepted, and as a result, adaptive devices, tools and supports are implemented to compensate for physical challenges. Cognitive aging, on the other hand, tends to be stigmatized, with less awareness, understanding and acceptance. As a result, techniques and strategies to address both normal and abnormal cognitive aging are underutilized. The BayBridge Senior Living approach to supporting cognitive changes has a conceptual framework that applies to all residents, whether they live in Independent living, Assisted Living or Residential Care. This session will focus on the culture change that surrounded implementing these approaches.

Heather Palmer, Regional Director of Memory Care, BayBridge Senior Living Tank Talk 
How Do You Change a Culture?

Many people agree with the tenets, goals, and desired outcomes of culture change and have spent decades trying to change culture in various settings, with mixed success. How does culture change occur? What are the necessary steps? How do people really change their own behavior? What are the barriers and how can they be overcome. This session addresses these fundamental issues in order to inspire meaningful change now and in the future.

Jonathan Evans, MD