The Pioneer Network is a remarkable coalition of individuals and organizations who are actively engaged in what has been come to be known as "Culture Change" in long-term care. The vision of this organization and its members is value-laden, based on values of honor and respect for the individual and belief in the potential for continued growth and development in every stage of life.
This coalition has a short (perhaps five minutes) video at the following URL. You may want to view it. I have transcribed some of the dialog here that reflects such basic, wholesome, positive views on aging and conditions in the present dysfunctional system of long-term care that beg to be "fixed."
http://www.pioneernetwork.net/getinvolved/
ADVOCATES FOR THE NEW OLD AGE
We are all aging from birth. Boomers are living longer, healthier lives. But like previous generations we shrink in fear of our own aging and the thought of being cared for by others.
Joanne Rader, RN, MSN author, "Bathing Without a Battle"
"Dependency and loss of control are the biggest fears that we have. Many have observed their parents experiencing lack of choice, dignity, and privacy in care settings. Fifty percent of those over 65 will, at some point, need assistance. And for many the nursing home is the only available choice right now. But the present does not have to be our future if Baby Boomers take action now. Seeing what our parents experience is a powerful catalyst for change because we know we are next."
Transforming how we grow old.
Imogene Higbie, age 89. Independent 89-year old living alone in her own home not far from her daughters. Four years ago she became ill and had to move to a nursing home and to assisted living. Her experiences encouraged her to fight not only for improving conditions there, but for transforming how we grow old in America.
"I went in as a person. I expected to become a patient, but I didn't expect to lose myself – which is what happened to me. And I realized that the system I was in was dysfunctional and needed fixing."
Jennifer Macial, daughter
"The experience was intense on every level and even though she was safe and sound physically, it didn't seem to be the place to heal, to grow, to evolve, to move forward and to contribute."
Pioneer Network is taking on the culture of aging in America.
Beth Baker: author of "Old Age in a New Age"
"There are 4,000 more nursing homes in America than McDonalds, not to mention thousands of assisted living centers. So change will take time. But I found (in researching for her book) a lot to be hopeful about. I found places that look and feel like home. I interviewed dozens of workers who are excited to come to work every day. And best of all I found that a lot of these places were solving costly problems and were affordable to everyone.
"This movement is grounded in values of honoring individuals and creating strong communities. If you can bring those values and that vision to all settings, wherever elders live that will be a very exciting future for all of us, for our loved ones and for ourselves as we grow old."
Since its inception in 1997, the Pioneer Network is showing change can happen. Wherever we choose to live our older years, the fullness of life is possible. Pioneer Network is working to replace the traditional nursing home with settings that are really home in both environments and relationships
Pioneer Network is also promoting new alternatives to live at home and in the community where generations can thrive together.
Imogene Higbie elder, activist, consumer
"I realized that old people, if they are informed and want to change things have a lot of power. I found that in my old age that my activism has been effective because I'm old and informed. And I think that is what happening. I hope people realize that when they get old they can speak up, share their experiences and make things better for their children who happen to be our Baby Boomer generation."
Steve Shields, President/CEO of Meadowlark Hills Retirement Community, Manhattan, KS
"As boomers we can dispel the notion that aging is just a time of loss. Aging is a time of self actualization and growth and hope."
--- And to ponder ----
Do I see my own aging as a time of self actualizaion, growth and hope? If not, why not?
How would life in a nursing home you may know and visit look in the programs of daily life, policies, relationships, organizational structure, rate of staff turnover, quality of life and well-being of those who live and work there, if every person who has power to impact an elder's life, starting with the administrator and the board of directors believed in the concept of aging as a time of self actualization, growth and hope and that s/he will one day be old and perhaps dependent?
Monday, August 18, 2008
Sunday, August 10, 2008
Lee Chung Hi
"In screaming, Lee Chung Hi had used her only tool for hanging on to herself…"
This blog entry is longer than most of mine. The sacredness, poignancy and deep symbolism of the story that I excerpt here, however, merits its telling. It's a story of a woman with courage, reaching out in the only way left to her, and of an exceptional leader who trusted his gut instincts about his nursing home which kept telling him: 'It can be better. We must make it better.'
The author of the events recounted in the story that follows is Steve Shields, CEO of Meadowlark Hills, a nursing home, in Manhattan, Kansas that Steve guided from "traditional" nursing home to "home", an ongoing journey. I know Steve. He is an effective, professional executive, a leader with qualities stretching across the four types of leadership: intellectual, reformist, revolutionary and charismatic. (For more information about these types of leadership, see Sister Joan Chittister's address at the 2007 LCWR Assembly when she was presented with the Outstanding Leadership award.) Steve's actions flow from a profound faith and contemplative spirit.
I direct you to the book, quoted here, (co-written with LaVrene Norton another faith-based driven advocate for our frail elders). In Pursuit Of The Sunbeam: A Practical Guide To Transformation From Institution To Household. Published by Action Pact Press, 2006.
FROM CHAPTER ONE: 'The Way It Is."
"She screamed for years but nobody ever really heard it until she stopped. It was a shrill, penetrating, constant and unsettling shriek; a noise not readily identified as human. Words were not part of it. She could not form them. Instead, it was the cry of a trapped and desperate animal hoping someone could hear and understand. The howl haunted the nursing home corridors like a shackled ghost intent on settling its business, belying that the source of the sound was less than five feet tall, not even 90 pounds and unable to walk.
Her Asian skin was healthy and beautiful. The Meadowlark Hill staff moistened it with lotion, turned her at night and positioned her at specified intervals. Lee Chung Hi lived year after year, perched in a reclining Geri-chair. It kept her safe and in place. Her graying black hair was brushed and shining. Vital signs were monitored with regularity and her care-plan was carefully executed. She was bathed on schedule at three 'clock on Tuesday and Friday afternoons. By all valued and applied measures in long-term care, she was well cared for. In the nursing notes, and in the minds of all who cared for her, the never-ending screams were the result of dementia . . . an illness of the mind, which surely must have caused her initial placement. But then nobody remembered for sure.
The other residents were routinely lined up outside the dining room to wait for lunch. Lee Chung Hi ate alone in her chair, parked in the corridor farthest from where people gathered. Nobody – residents, staff or visitor – wanted to be near her. Caregivers attended to her dutifully, yet her noise repelled them. She ate alone, sat alone and slept alone.
She became her noise in the eyes of everyone. But nobody could hear her screaming for what it truly was. It never occurred to us that we might be the cause of it – we, who carry out the biddings of a system lethal to the human spirit.
Years passed before we finally understood it. And not until we transformed Meadowlark Hills into a vibrant household community and witnessed Lee Chun Hi's parallel transformation did we realize how profoundly appropriate her screaming had been in response to the dehumanizing conditions in which she lived."
FROM CHAPTER SIX: "The Essential Elements of the Household Model"
"I rang the doorbell and Susan, a household employee, answered the door and welcomed me in. I saw a warmly furnished living room and an adjacent kitchen and dining room; all appointed like any other home in America. The residents, an average of sixteen per household, had moved in less than two weeks before.
The signs of home were already visible amid what previously had been public corridors, cramped bedrooms and large public gathering rooms. The institutional odor was gone. My stomach growled in response to the smells of breakfast floating from the household kitchen. The previous set of monotonous unit style chairs, tables and other office-like trappings had gone to the auction block to make way for more cozy furnishings.
People were visiting with one another and, in stark contrast to the dismal scene of slumping, slumbering elders once parked at the now-dismantled nurses' station, a more inspiring dance of life unfolded. My heart warmed with hope.
But all the blossoming signs of home faded into the background when my eyes found Lee Chung Hi, the lady who screams. She had abandoned her Geri-chair and was sitting comfortably at the dining table, just as my wife had sat at our kitchen table when I left home for work that morning.
It was the first time I had seen Lee Chung Hi when she wasn't screaming.
She was smiling. Her eyes locked with mine, conveying a warmth of well-being that sent me into a suspended sense of time and place. All I could see was her warm smile and radiating eyes of peace, and I felt myself walking toward her as if in slow motion.
I stopped near her table. With her hands at her side, she bowed her head slowly forward and then back up, all the while continuing her smile. This gesture of greeting and respect, practiced in her culture yet universally understood, enveloped my whole being. I found myself returning the gesture in full communion. I was able to return eye contact and nod in mutual affirmation before emotion overtook me.
Her years of screaming, contrasted with the moment we had just shared, represented to me everything we must leave behind and everything we must achieve. The glaring reality was that she hadn't screamed for years because she was sick, but because we were.
In screaming, Lee Chung Hi had used her only tool for hanging on to herself rather than giving in to vacant slumping. She was a fighter -- a screaming indictment of the traditional nursing home system and proof in the pudding that we can overcome; that we have a moral imperative to do so."
This blog entry is longer than most of mine. The sacredness, poignancy and deep symbolism of the story that I excerpt here, however, merits its telling. It's a story of a woman with courage, reaching out in the only way left to her, and of an exceptional leader who trusted his gut instincts about his nursing home which kept telling him: 'It can be better. We must make it better.'
The author of the events recounted in the story that follows is Steve Shields, CEO of Meadowlark Hills, a nursing home, in Manhattan, Kansas that Steve guided from "traditional" nursing home to "home", an ongoing journey. I know Steve. He is an effective, professional executive, a leader with qualities stretching across the four types of leadership: intellectual, reformist, revolutionary and charismatic. (For more information about these types of leadership, see Sister Joan Chittister's address at the 2007 LCWR Assembly when she was presented with the Outstanding Leadership award.) Steve's actions flow from a profound faith and contemplative spirit.
I direct you to the book, quoted here, (co-written with LaVrene Norton another faith-based driven advocate for our frail elders). In Pursuit Of The Sunbeam: A Practical Guide To Transformation From Institution To Household. Published by Action Pact Press, 2006.
FROM CHAPTER ONE: 'The Way It Is."
"She screamed for years but nobody ever really heard it until she stopped. It was a shrill, penetrating, constant and unsettling shriek; a noise not readily identified as human. Words were not part of it. She could not form them. Instead, it was the cry of a trapped and desperate animal hoping someone could hear and understand. The howl haunted the nursing home corridors like a shackled ghost intent on settling its business, belying that the source of the sound was less than five feet tall, not even 90 pounds and unable to walk.
Her Asian skin was healthy and beautiful. The Meadowlark Hill staff moistened it with lotion, turned her at night and positioned her at specified intervals. Lee Chung Hi lived year after year, perched in a reclining Geri-chair. It kept her safe and in place. Her graying black hair was brushed and shining. Vital signs were monitored with regularity and her care-plan was carefully executed. She was bathed on schedule at three 'clock on Tuesday and Friday afternoons. By all valued and applied measures in long-term care, she was well cared for. In the nursing notes, and in the minds of all who cared for her, the never-ending screams were the result of dementia . . . an illness of the mind, which surely must have caused her initial placement. But then nobody remembered for sure.
The other residents were routinely lined up outside the dining room to wait for lunch. Lee Chung Hi ate alone in her chair, parked in the corridor farthest from where people gathered. Nobody – residents, staff or visitor – wanted to be near her. Caregivers attended to her dutifully, yet her noise repelled them. She ate alone, sat alone and slept alone.
She became her noise in the eyes of everyone. But nobody could hear her screaming for what it truly was. It never occurred to us that we might be the cause of it – we, who carry out the biddings of a system lethal to the human spirit.
Years passed before we finally understood it. And not until we transformed Meadowlark Hills into a vibrant household community and witnessed Lee Chun Hi's parallel transformation did we realize how profoundly appropriate her screaming had been in response to the dehumanizing conditions in which she lived."
FROM CHAPTER SIX: "The Essential Elements of the Household Model"
"I rang the doorbell and Susan, a household employee, answered the door and welcomed me in. I saw a warmly furnished living room and an adjacent kitchen and dining room; all appointed like any other home in America. The residents, an average of sixteen per household, had moved in less than two weeks before.
The signs of home were already visible amid what previously had been public corridors, cramped bedrooms and large public gathering rooms. The institutional odor was gone. My stomach growled in response to the smells of breakfast floating from the household kitchen. The previous set of monotonous unit style chairs, tables and other office-like trappings had gone to the auction block to make way for more cozy furnishings.
People were visiting with one another and, in stark contrast to the dismal scene of slumping, slumbering elders once parked at the now-dismantled nurses' station, a more inspiring dance of life unfolded. My heart warmed with hope.
But all the blossoming signs of home faded into the background when my eyes found Lee Chung Hi, the lady who screams. She had abandoned her Geri-chair and was sitting comfortably at the dining table, just as my wife had sat at our kitchen table when I left home for work that morning.
It was the first time I had seen Lee Chung Hi when she wasn't screaming.
She was smiling. Her eyes locked with mine, conveying a warmth of well-being that sent me into a suspended sense of time and place. All I could see was her warm smile and radiating eyes of peace, and I felt myself walking toward her as if in slow motion.
I stopped near her table. With her hands at her side, she bowed her head slowly forward and then back up, all the while continuing her smile. This gesture of greeting and respect, practiced in her culture yet universally understood, enveloped my whole being. I found myself returning the gesture in full communion. I was able to return eye contact and nod in mutual affirmation before emotion overtook me.
Her years of screaming, contrasted with the moment we had just shared, represented to me everything we must leave behind and everything we must achieve. The glaring reality was that she hadn't screamed for years because she was sick, but because we were.
In screaming, Lee Chung Hi had used her only tool for hanging on to herself rather than giving in to vacant slumping. She was a fighter -- a screaming indictment of the traditional nursing home system and proof in the pudding that we can overcome; that we have a moral imperative to do so."
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